By now unless you’ve been living in outer space you’re familiar with the BALCO scandal. The BALCO scandal as you know revolved around performance enhancing drugs, most notably anabolic steroids and quite infamously a steroid cream known as “The Clear.” This steroid cream in many ways was very similar to your basic testosterone gel received by many from their local physician in the treatment of low testosterone but it had a unique characteristic a typical steroid cream does not. “The Clear” was comprised of two key components, testosterone and epitestosterone; with the addition of the epitestosterone the individual could apply and administer this steroid cream and do so in a completely undetectable manner. Most athletic drug test take into consideration two key factors, testosterone levels and epitestosterone levels and by the guidelines of the IOC, anyone with a ratio 6:1 test:epi-test is considered to have failed the drug test. “The Clear” eliminated this problem allowing its users to raise their testosterone levels but to simultaneously raise their epitestosterone levels as well; love it or hate it no one can deny this is nothing short of pure genius.
• Evaluate formulation-specific adverse effects at each visit:
- Intramuscular injections of testosterone enanthate and cypionate: Ask about fluctuations in mood or libido.
- Testosterone patches: Look for skin reaction at the application site.
- Testosterone gels: Advise patients to cover the application sites with a shirt and to wash the skin with soap and water before having skin-to-skin contact because testosterone gel leaves a residue on the skin that can be transferred to a woman or child who comes in close contact. Serum testosterone levels are maintained when the site is washed 6 hours after applying the gel.