How Long Does it Take for Testosterone to Work?
The age old question of, “how long does it take for testosterone to work?” It’s something we hear all of the time. Testosterone Replacement Therapy can be used when a patient is suffering from low testosterone or hypogonadism. Men suffer from symptoms such as fatigue, concentration problems, mood swings, poor libido, weight gain or a hard time losing weight, and more. But the question still stands, how long do I wait to see if TRT works? Stick around, learn more about how long you should be waiting to experience results and even maybe why you aren’t getting the results you want.
Testosterone Replacement Therapy, when does it work?
Testosterone Replacement Therapy is a medical treatment performed by trained medical staff in the endocrine industry. It treats people suffering from low testosterone, also known as ‘low t’ or hypogonadism.
Hypogonadism refers to the condition that simply means that your sex hormones are no longer being produced at normal levels for the age or activity level.
The problem is, most men will not visit a doctor when experiencing the symptoms of low testosterone, the truth is, that 1 in 4 men live with low testosterone, and those over 40 are even more at risk of having low testosterone. Each year after that passes after 40, men on average lose 1% per year, you do the math…
Most people are informed on the loss of hormones in women, so the education process for men is generally quite a bit longer. The loss of testosterone in men is known as andropause, which causes an onslaught of symptoms known as low testosterone or low t. The reduction in estrogen and progesterone in women is known as menopause.
Symptoms of Low Testosterone
While not all men can experience all of the symptoms that low testosterone can bring, there’s a few more common symptoms that almost all men experience including: lower libido, erectile dysfunction, fatigue, reduced muscle mass and strength, changes in mood, poor concentration, lack of sleep or a hard time sleeping, and weight gain.
Because of these symptoms, testosterone replacement therapy has become a movement across the world in both male and females, but sometimes, people don’t experience all of the benefits that TRT has to offer.
Does that mean that it doesn’t work in some people? The simple answer is, everyone has a different expectation of what testosterone will do for them, therefore, it “feels” like it may not be working. But there are a few common reasons that testosterone isn’t working in the body.
Reasons why Testosterone may not be working in your body
The body is the immaculate route to any medical treatments, whenever we decide that we want to perform any sort of medical procedure, we should mimic how the body processes everything, including hormones.
Here’s an example:
Men and women both produce testosterone, their levels differ within the body, therefore dosing should be dependent on a mixture of factors. A man should always have blood work done before performing any sort of treatment for hormones. This allows the provider to determine if it is in fact, low testosterone. If you begin to treat a person for low testosterone who doesn’t need it, not only will they not feel the positive effects of the treatment because they did not need it, it can actually bring on more problems. There is no “one-size fits all” testosterone treatment for men.
Every man has different levels, and even two with the same levels metabolize medication differently. Some men can metabolize medication and nutrients quickly which means that their liver is able to metabolize medication and hormones quicker than other men. This means that men should understand that their next-door neighbor shouldn’t have the same prescription dose as they do, unless they are the identical person.
But this also means that not only will their dosing be different, but how the treatment is performed can also differ.
The number one cause of men not understanding testosterone replacement therapy and why it isn’t working in their body is because their provider is dosing incorrectly. Simply put, you may not be taking enough testosterone for your personal needs.
This is where testosterone replacement therapy becomes difficult, because there is no one way to treat men suffering from low testosterone. This means each person will be dosed differently depending on how their lab work reads. There are two basic rules with TRT, never start treatment without having blood work and results first, and always be upfront about your symptoms and side-effects.
Knowing what we know, providers have to start somewhere to learn the person’s metabolism and optimal dose for testosterone. It does not always happen on the first try. Which means that there is a period in which blood work should be pulled consistently to see how the current dose is working in their body.
You should never have to personally re-evaluate your testosterone dose on your own, this should always be done by a medical provider and consulted with your current provider. But there is one thing you should always consider, there are two portions of testosterone, your free testosterone and your total testosterone. Make sure your dose is optimized with your physician for both free and total testosterone.
How Testosterone is Administered
While dosing is the number one priority for testosterone replacement therapy, how testosterone is administered is another priority when understanding why testosterone may not be working for you.
There are four routes for administering testosterone:
1. Gels & Creams:
This route of testosterone therapy is performed by rubbing a gel or compounded cream into the skin which then is absorbed into the bloodstream for your body to utilize. This was one of the first methods available for testosterone replacement therapy, which means there were problems that came about as we learned more and more about the endocrine system.
Because everyone has a different metabolism, this brings us to the reason why gels and creams sometimes do not work. Absorbing through the skin means that people absorb at different rates, sometimes men are getting as little as 25% of the medication they’re actually rubbing on their skin. Because their body isn’t absorbs the medication at different rates, they’re not getting the amount of medication they need.
Additionally, testosterone is a fat soluble hormone, and absorbed through the skin, certain carriers are required to make the transition, some of these carriers can cause reactions to people, both on their skin and internally. While testosterone gels & creams can provide easy treatment, there are also outside risks for friends, family, and loved ones.
Because the gels and creams require a carrier to absorb into the skin, they are an oily substance which poses the risk of rubbing off onto another person. Even if hidden by a shirt sleeve or on the inner thigh, your clothing can absorb the medication and rub off on furniture and other places.
2. Pellet Medication
A pellet is medication that administers testosterone into the bloodstream to be absorbed by the body, it’s done so directly through the muscle. The pellets are bb-like beads that dissolve in the body, they’re placed by making a small incision in the upper glute muscle and it’s placed within the muscle. While sometimes considered painful, the bigger issue is that there is no way to fully know how much is dissolved by the body throughout the 3-6 month pellet life. This means people can be in testosterone excess, meaning symptoms of high estrogen such as mood swings, rage fits, holding on to excess water, and more, can be apparent.
3. Oral Testosterone
Oral testosterone is a medication used to treat testosterone replacement therapy. It dissolves under the tongue and is metabolized into the bloodstream. The issue is that with oral testosterone, they’re metabolized through the liver which can be harsh on the liver causing issues down the road with liver damage.
4. Testosterone Injections
Known as the safest and most effective way to perform testosterone replacement therapy. Testosterone injections are are compounded testosterone medication in an FDA approved pharmacy. This treatment bypasses transdermal (skin) absorption and is delivered into the muscle tissue. There are multiple types of testosterone, some with short half-lives and cypionate which has an 8-day half-life. Because of this, you’re able to administer testosterone one time weekly and while it may seem like a larger quantity at once, your body, because it is delivered into the muscle, is able to utilize this over a week time span. While there are multiple options, ensure that your provider is taking consistent blood work and producing acceptable results.
As with any medical treatment, there are multiple medications available for most medical issues. Be sure that you give each of them time to pan out and see how your levels fall.
How long you perform TRT
As stated above, with any medical treatment, things can take time to adjust. Understanding that testosterone replacement therapy is the same. Understanding that no two treatments are the same is what helps develop the idea that there is a titration period, things take time.
To understand what treatment looks like, you must first have an overall perspective in their health. A full lab panel include their Comprehensive Metabolic Panel (CMP), Complete Blood Count (CBC), testosterone, and free testosterone, will show that dosing takes quite a bit of time. They also require different doses for each individual person.
Some people may wait just a few weeks to notice effects of testosterone, but it can take up ot 15 weeks for dose titration. Understanding that this is a marathon and not a sprint is what makes this medical treatment so effective.
The reason testosterone replacement therapy takes time is because we are avoiding negative side-effects by titrating your dose slowly and understanding how your body works.