I’m a 63-year old male. 6’2", 180lbs. Resistance train 4 days a week. Not obese.
Anyway, my nurse wrote the following Testosterone Cream prescription.( I’ve never done TRT before).
Testosterone Cream 200mg/ml. Apply 1ml twice a day.
My nurse confirmed I would be applying 200mg, scrotal, twice a day for a total of 400mg daily.
I’,m new to this, but this seems like a massive dose to start out on. Am I wrong? Thanks.
You sure it wasn’t like apply one click of cream maybe?
Thanks. The nurse made it clear I would be applying 200mg twice a day. 400mg total. All I want is replacement levels. I’m not taking this dosage.
Well done for thinking on your own. The amount of bad instruction out there is incredible.
Oddly enough, I found this nurse on the World Link Medical website, Dr. Neal Rouzier’s group. The nurse claims to be accredited through WLM for BHRT, and says she’s been through all of Dr. Rouzier’s courses. I sent an email to Dr. Rouzier today to get his thoughts on this prescription. I’ll report back if I get a response.
This is a lot for a 20% cream, but maybe it’s a 10%? Do you know what it is?
I thought 200mg/ml was 20%? No?
I got a reply from Dr. Rouzier. I said I was concerned about the massive dose, considering this was my first prescription for TRT. Here’s his snarky reply-
“Jim: If you are concerned, then don’t use testosterone.”
In case anyone is interested, I asked the nurse about the dosage. Here is her rationale:
"Everyone absorbs the cream differently. A starting dose for someone with a total testosterone of 260 when optimal is 1500 to 2000 with symptoms similar to yours is 200mg/ml applying 1ml twice per day. I have some men doing 3 ml twice a day which is 1200 mg a day. Each person is individual and so is their absorption and how their body uses the testosterone.
If you feel more comfortable starting at a smaller dose, that is not a problem. You can apply 1/2 ml twice a day which is a total of 200 mg a day."
By the way, I measured 260 for Total T at 2:00PM in the afternoon. Still low, I know. But, she had indicated it didn’t matter what time. Weird.
The same applies when being started on injections. Some guys get 200mg/wk, some 160mg/wk, and some are started at 100mg/wk. some guys are not able to deal with high dose so they champion low dose therapy when starting. Others champion high dose, like me. So do what you feel is better or follow doctors orders. Testosterone is not going to kill you just because you started high. Titration is part of the therapy. You either start high to quickly climb to healthy or supra levels and you titrate down for longevity. Or you can work your way up to it, like some men prefer. The beauty is your nurse gave you the freedom to do so. Either way, you’re being managed. I agree with those who applaud your ability to not go through this blindly. So you can stick with the protocol and suddenly find yourself feeling great or not so great. Or you can change the dose and feel great or not so great. Its that simple.
Thanks. That makes total sense.
Do you think it matters what time you draw labs? The nurse didn’t care when I had the blood draw. It just seems that if the prescription is based on numbers, I may have gotten a different prescription had I had an 8:00AM draw, or even at 5:00PM.
Since you’re dosing daily. Mornings before your dose will give a good indication
Are you opposed to injections? I see less guys with issues with injections, than with cream. That is just my observation.
Not really.
Thanks for all the help, especially this graph.
I would ask about them, if you don’t feel as well as you think you should. It just seems like guys struggle more with cream, and although it isn’t giving yourself a shot, it is almost more of a PITA, if you have to do it twice a day.
Yeah, but there’s also plenty of guys who switch to cream for the same reason. I think some providers only use “bioidentical hormones”, so, injectables are out. I have to research bioidentical hormones vs synthetic.
Dr. Rouzier, et al, feel that low T levels should be raised to “youthful/optimal levels”, apparently between 1,500-2,000. They say this range is where the protective benefits lie. Rouzier will break out the studies to prove it. I have no problem with these levels, but just not right out of the gate. My morning total T levels are ~580, but drop to 260 by 2PM. My free T at 2PM measured “3.0”. Amazing I can still function as well as I do. I must have good androgen receptors, I guess.
I think both the cream and the injectable are made from yams (they are synthetic) The injectable has an ester attached (most of the time, unless suspension).
I bet he can’t prove that!
1500-2000ng as optimal? Damn dude, makes a little more sense. That response from Rouzier is … interesting, I guess.
Anyway, I think you’re right to start slow and work up
Rouzier and his Disciples always advocated higher doses as “optimal” in that FB group. No dangers to running high TT, according to them. I thought they had mellowed a bit on that. Guess not
Thanks. I didn’t know injectables could be bioidentical.