This post will walk you through the ups and downs of testosterone replacement therapy and give you an idea of how long it takes testosterone to work and what to do if it isn’t. Show
Testosterone replacement therapy can be used to help patients lose weight, improve their mood, and more, but what if you don’t experience those benefits? How long should you wait? Learn more about how long you should be waiting for results and learn about which factors may be limiting your results in this guide… Testosterone Replacement TherapyTestosterone replacement therapy is used to treat patients who may have low circulating levels of testosterone in their bodies. This condition is often referred to as hypogonadism which simply means that your sex hormones are no longer being produced at normal and optimal levels. The unfortunate truth is that this condition will occur over time in both men and women. The reduction in testosterone in men is referred to as andropause, while the reduction in both estrogen and progesterone in women is referred to as menopause. Women also experience low testosterone (just like men) but the difference is that the decline in testosterone may not be noticed as much in women compared to men due to the relative importance of other sex hormones. But just like men, women tend to benefit tremendously from the use of testosterone (1). Because of this testosterone replacement therapy has become widespread in both males and females, but not everyone tends to experience all of the benefits that testosterone replacement therapy has to offer. Does that mean that testosterone simply doesn’t work in some people? Maybe, but there are actually many common reasons that testosterone may not be working in your body and much of it has to do with 3 simple reasons: Reasons why Testosterone May not be Working in your BodyWhenever we use hormones as medications it’s always helpful to consider the body as a template with which we should try to emulate. For instance: We know that men and women have different levels of testosterone circulating in their bodies, therefore, it makes sense that dosing should be different between males and females. We also know that testosterone levels differ among individuals within the same gender, so there really shouldn’t be a “one-size” fits all testosterone dose for ALL males or for ALL females. In addition to these basics, we also know that there is variability in how individuals metabolize hormones, medications, and nutrients. Some people are considered to be “fast metabolizers” which means that their livers can chew through medications and hormones faster than others. This means that the amount of testosterone someone takes will be unique but also HOW they take it, meaning how they put it into their body. With these basics under your belt, you can begin to understand some reasons why standard TRT may not work in certain individuals. #1. DosingThe first and most common reason that testosterone may not be working in your body is simply because of dosing. You may not be taking enough testosterone. Because there is no “standard” dosing this means that each person will need a slightly different amount. Having said that we (doctors) have to start somewhere when we start someone on Testosterone and unfortunately we don’t always get it right on the first try. If you haven’t noticed an improvement in your symptoms then it’s a good idea to re-evaluate your serum testosterone levels (both free and total testosterone) to determine if your dose is adequate. Sometimes it’s really just as simple as altering your dose. #2. Route of AdministrationThe next big important topic has to do with how you are taking your testosterone. There are 3 main ways to do this and each has its limitations:
The moral of the story? If one form of administration is not working for you then it may be worth trying a different route. #3. TimeSometimes it’s just a matter of time and all you need to do is have some patience! When you start digging into patient stories regarding hormonal therapy you will quickly start to understand that no two people are alike. The dosage, amount of time it takes for benefits to kick in, and even which benefits tend to appear, vary wildly from person to person. I’ve found in some of my patients that simply waiting a few weeks is the answer. Always be patient and try not to make any snap decisions regarding your dose because it may lead to negative long-term consequences down the road. Testosterone BenefitsBecause testosterone is a hormone, which acts through genomic changes in each cell, it can take weeks to months for certain beneficial effects to kick in. Genomic changes refer to the ability that testosterone has to literally alter genetic transcription and change which genes are being transcribed into proteins in your cells. Certain benefits which are the result of these changes will, therefore, take some time to experience. On the other hand, testosterone also has non-genomic effects such as its effects on skeletal muscle which result in an almost immediate increase in athletic performance (and sometimes weight loss). So in order to get these benefits, you need to make sure you are: A) Getting the right amount of testosterone (dose) B) Using the right route and getting proper absorption C) Waiting enough time for the effects to kick in if they require changes to cellular transcription Even if all of these factors are taken care of some results appear quicker than others. You can use the list below to help you understand how long it takes for testosterone to work. How long Does it take for…
Remember that these are simply guidelines and the exact time frame may vary between individuals. If you are ever concerned that your testosterone may not be working then you should discuss other options such as your dose or route of administration with your prescribing physician. How long does it take for Testosterone Cream to work?Because each route of testosterone delivery is different there are also differences in terms of how quickly these “types” of testosterone tend to work. Testosterone cream often works better in females and studies have shown that daily use of testosterone cream (5 to 10 mg per day) should result in the normalization of total testosterone and free testosterone in the serum (4). What’s interesting is that increasing your dose via the transdermal route won’t necessarily increase your serum testosterone as there seem to be some diminishing returns via this route. The best place to apply this type of testosterone is to the upper arms or forearms. How long does it take for Testosterone Gel to work?Testosterone gel tends to work better in men and most men who use this type of gel will notice normalization of serum testosterone levels by 3 months of daily use (5). The best site for application tends to be the arms or shoulders. How long does it take for Testosterone Pellets to work?Because testosterone pellets are designed to work for several months (up to 6 months) they necessarily need to contain a large amount of testosterone. The delivery device of the pellet also changes how quickly testosterone is released into the body. After insertion of a pellet testosterone levels tend to rise within the first 48 hours which then stabilizes over the next 63 days (6). After the first 60 days, the testosterone tends to drop. Compared to testosterone, estradiol levels tend to peak around day 40-42 which is relevant to both men and women and should be monitored. You will likely notice a rather fast change in your symptoms if you use testosterone pellets assuming that your dose is correct. How long does it take for Testosterone Injections to work?Much like pellets, testosterone shots tend to reach a peak in the serum within 24-48 hours after injection which then begins to decline to by 6-7 days to low-normal levels (7). Testosterone injections, therefore, work fairly rapidly but need to be administered every 6-7 days for optimal results. A better route may be to take testosterone injections in smaller doses twice per week which may allow for more table testosterone levels. In general testosterone injections work better for men. Boosting the Effect of Testosterone with SupplementsWhat if testosterone still isn’t working for you? There are certain supplements that may be able to help you with symptomatic control. While some supplements have been studied and shown to increase testosterone, in general, most testosterone supplements modulate the symptoms of low testosterone without altering free and total testosterone. This may not be a problem, however, if you are interested in benefits such as libido control, weight loss, and increased energy. It’s worth looking at some of these supplements to determine if they have any place in your current regimen. The good news is that they can also be safely added to an existing testosterone replacement therapy program. Supplements that may improve the symptoms of low testosterone include:
You can also learn more about using testosterone boosters in this post. What to do NextTestosterone replacement therapy is a safe and effective way to improve many symptoms associated with low testosterone such as weight gain, fatigue, and decreased libido. Using TRT appropriately means you need to have the right dose as well as the right route of administration for your body. If you are taking testosterone and not noticing any improvement then make sure you discuss other options with your doctor. It’s also a great idea to assess your serum total testosterone, free testosterone, estradiol, and SHBG which all may potentially interfere with testosterone function. And remember: Make sure you are allowing enough time for these benefits to kick in (in some people this may take up to 3 months). How quickly do testosterone levels rise after injection?Testosterone levels peak two to three days after the injection and then slowly drop until the next dose of the hormone is given. There are also testosterone patches that men can use.
Do you feel testosterone shots right away?Men can feel the effects of testosterone replacement therapy (TRT) in as little as 2-4 weeks. In most men effects of TRT are felt within 3 months.
How often should you take testosterone cypionate?Testosterone cypionate (Depo-Testosterone) injections are typically administered every 2 weeks. There are many medications available for GAHT, each with its individual safety risks. Be sure to talk to your provider to make sure the right medication is prescribed for you.
How much testosterone cypionate should I take to build muscle?In general, the dosage is 50–400 mg injected into your muscle every 2–4 weeks. Dosage increases: Your doctor may adjust your dosage based on your testosterone blood levels, response to treatment, and side effects. Maximum dosage: 400 mg injected into your muscle every 2 weeks.
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