question from a user
I’ve been on the cream 4.5mg dose daily for exactly 3 weeks now, but don’t feel any different. Should I keep going for a total of 6 to 8 weeks before I consider upping the dose or switching to injections? Would you recommend your monthly subscription to someone outside the US? My urologist is willing to work with me and listen to a 2nd opinion so he would most likely be able to prescribe whatever you recommend.
AlphaMD's Answer
If it's okay, I am going to share our TRT timeline expectations that we send to folks, because it seems appropriate here:
- The Start, Weeks 1-4 - Many notice effects from the first few injections. During this time, more benefits will become apparent as the half-lives of previous doses build up in your system over time. It is important to give your body time to adjust to your initial dose.
- A Pause, Weeks 5-6 - During this time, many patients will experience a lull in benefits for a few days to a week. This is your body throwing a last "protest" about the new Testosterone before completely accepting it. This is normal, it will pass, and it does not mean you need to increase your dose.
- Evaluating, Weeks 7-8 - This is when your body has completely accepted your new Testosterone levels and is a good time to evaluate your treatment plan. Is all feeling well? Better than expected? Worse? We will send you a check-in survey around this time to touch base. If any changes need to be made, this is when it is fair to evaluate. So, specifically in your case, the absorption rate for creams is usually ~10% for applications to thighs/ shoulders/ chest. The absorption rate can be as good as ~40% when applied to the testicles (thinner skin, better blood flow).If you are applying 4.5mg/day (31.5mg/wk), then even if you are getting 40% absorption, your total weekly dose is approximately 13mg, and is 1.8mg day. Average natural testosterone production is 7mg/day.
Long story short, you are severely underdosed.We do have a newer program where we just meet with people for paid consultations to give opinions/dosing advice if we're unable to service them as our own patients due to location. For that, you could just sign up like normal under "I am already on TRT" & we would just charge $49 for the first visit & you would email/message from your patient portal any time you wanted a another visit at that cost. We'd be happy to help you out. You may need to select a USA state during registration if you don't see your location there, but we're working on that for this very reason. You can always let us know if you have any issues through the "Contact Us" at the top. It sounds like that may be appropriate here.
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