Help - Testosterone Cream (Atrevis)

[David2311]

i started TRT in December 2018. My total T was 184 (289-894). I was put on a 50mg compounded cream by choice. I retested 2 months later at 530 and feeling much better. Shortly after I started feeling bad again. Was retested 4 weeks after the 530 test. Now I’m 384. The doctor raised my dose to 80mg and I switched to the Atrevis base. I tested 4 weeks later and came in at 984. I kept taking the 80mg dose for another week after the test before I got the results. I was a raging mad man at my appointment with high anxiety.

I was then told to stick with the 80mg dose and apply 5 days a week. So I skipped one day like I was told and put the gel on the next day. I went into full panic mode for hours. I went to the ER. They suggested Testosterone overdose??? And told me to stop for “a few days”. I stopped 4 for days and went back for a test. Now I’m at 164 and feel like garbage.

I started reapplying the gel 5 days ago after the 164 test. I can’t stay awake, no libido, anxiety, depression.

Do I just need to wait for the gel to build back up? Any insight? Sorry if that didn’t make sense my brain is at 30% right now.

 

[BigBamBoo]

Just my opinion, but I would switch to injections. You should be much more linear/stable vs the cream/gel.

Also, if you can post complete labs, other on here can give you some advise based on your labs.

Hang in there.

 

[fifty]

50mg a little low. 80mg too much. Try 60...or injections.

 

[David2311]

What is the half life of compounded gels? My pharmacists says 10-100 minutes. My doctor says 22 hours. I went from at least 1000 to 164 in 4-5 days.

Does it take longer to build up than it does to go away?

 

[BigBamBoo]

With those kinds of swings in T levels, I do not see you ever feeling good on the gel.

Again, I have never used gels/creams, so maybe those who have will chime in.

 

[TLR]

As I've stated elsewhere I had pre existing anxiety issues before starting TRT, which complicated my journey (understatement). The one time I tried compounded cream it drove my DHT up which my system didn't tolerate at all. Don't know if you had those levels checked but it could explain the anxiety. I don't know your history, but you will not be the first guy that dramatically rose his testosterone level and had anxiety as a response. My doctor is a fairly well respected doctor in this field and he said he sees it in a fair amount of his patients. Injections will allow you to more accurately administer your dosage, and TYPICALLY doesnt generate the DHT response seen in transdermals.

 

[David2311]

Day 6 at 80mg and felt much better this morning. I started going down around 3pm and now at 7:15 I’m feeling pretty low. I get bloodwork tomorrow.

Hopefully this morning is a sign it’s building back up but not enough to get me through the day.

Does anyone know if exogenous testosterone acts the same way as endogenous. Meaning will my T still be the highest in the morning no matter when I put the gel on?

Thanks for all your suggestions and comments.

 

[fifty]

If you feel better who cares what your bloodwork is. Your levels will vary so much through the day idk what value testing is other than to check long lasting markers like hct and psa.

Just go with what feels good. If I could feel ok till 7pm I would be happy. I would just gel up later in the morning if you need to.

 

[TLR]

No. Exogenous testosterone does not act in any way like endogenous testosterone. With transdermals you peak around 2 hours after application typically, so timing your application is highly relevant to how you may feel. Search around on this site. I believe there are some studies with graphs that demonstrate the time / dose relationship.

 

[David2311]

Just woke up on day 7 on 80mg. Nice morning wood without having to pee. No anxiety. No appetite though. I had horrible insomnia last night and anxiety. Fell asleep about 12:30. I go to bed around 10pm.

Going for bloodwork at 10am. I think I just had to let the cream build back up after the crash to 164. So if that’s the case it takes 4 days to return to baseline and 7 days to build back up to a manageable level, I hope.

We will see what my test says in a couple days and see how long I last today before I start feeling bad. I’m riding my jet ski after bloodwork so hopefully I will have a good day.

Thanks again for reading.

 

[Abuser200]

Just woke up on day 7 on 80mg. Nice morning wood without having to pee. No anxiety. No appetite though. I had horrible insomnia last night and anxiety. Fell asleep about 12:30. I go to bed around 10pm.

Going for bloodwork at 10am. I think I just had to let the cream build back up after the crash to 164. So if that’s the case it takes 4 days to return to baseline and 7 days to build back up to a manageable level, I hope.

We will see what my test says in a couple days and see how long I last today before I start feeling bad. I’m riding my jet ski after bloodwork so hopefully I will have a good day.

Thanks again for reading.

How many times a day do you apply? And where do you apply the cream?

 

[David2311]

I apply once a day, either on forearms or inner thigh. I’ve tried scrotal application a couple of times, but didn’t notice much difference.

I seem to run out of gas around 4pm today, but I applied later because of bloodwork. I’ve tried splitting the dose at 7am and 1pm but that did not help. I will try splitting the dose again tomorrow to see if it is different this time.

Thanks for the reply.

 

[JimBob]

FWIW, Dr. Nichols prescribes scrotal cream, twice a day, 12 hours apart, for best symptom resolution. No crashes. I'm not his patient, but I've heard him say this enough times.

 

[Tman]

Day 6 at 80mg and felt much better this morning. I started going down around 3pm and now at 7:15 I’m feeling pretty low. I get bloodwork tomorrow.

Hopefully this morning is a sign it’s building back up but not enough to get me through the day.

Does anyone know if exogenous testosterone acts the same way as endogenous. Meaning will my T still be the highest in the morning no matter when I put the gel on?

Thanks for all your suggestions and comments.

When I was on the gels, I was back to my base line 24 hours later and could definitely feel the drop by late afternoon when dosing in the morning. I'm a low shbg guy. That gel doesn't need to build so much as the injections your body will react to that t cream/ gel within an hour after taking it. Most are at Max dosage within 2 hours of application and then you slowly return the baseline overtime depending on a multitude of factors. be careful with the more must be better approach that is definitely not often the case for many of us unless you think more side effects are better. Start low and go slow ...your mental state becomes better well before any physical changes. I think you went way too high too fast based on numbers and you need to test you or peak 2 hours after application. If you wait till that afternoon or the next day then your numbers are low when in fact you were very high at one point. 40mg put me at 1200 two hours later 60mg put in at 1400 with anxiety 2 hours later well again 24 hours later I was back to 200. If you already have issues with anxiety you definitely need to go slow and keep it low.

 

[David2311]

Thanks for that advice Tman and JimBob!

I got my results back from my lab work on 5/7

Total = 236 (284-916)
Free = 9 (6.8-21.5)

I do feel much better when I wake up and through the morning and early afternoon. By 4pm I can feel the sluggishness start. By 8pm the anxiety starts, no appetite and just overall sh*t feeling. The insomnia too! I applied 40mg at 7am today and will apply 40mg at 7pm tonight. It’s 2:25 now and I feel ok, but not “conquer the world” great. I can function and little to no anxiety.

Hopefully it’s all uphill from here. I’m testing weekly through discountlabs from now on instead of every 2 months like my Endo wants so I can keep a closer eye on things.

 

[CoastWatcher]

When are you testing? With topicals you have blood drawn at a different point than those injecting.

 

[David2311]

I usually test between 11am and 12:30pm. I go on my lunch break. I do not apply the gel until after my test. So I go get labs 28-29 hours after my last application.

 

[Tman]

I usually test between 11am and 12:30pm. I go on my lunch break. I do not apply the gel until after my test. So I go get labs 28-29 hours after my last application.

You're supposed to test your peak...your peak for gels should occur 2 hours after dosing that's really what you need to think about. After about 20 hours you're approaching your normal low T levels. what I experienced was good t throughout the day and then my T levels were dropping in the evening faster than my estrogen levels so by late afternoon I had really high blood pressure dizziness and just high e side effects which includes anxiety for many people.

 

[David2311]

Thanks for letting me know that Tman. Good stuff. I will apply the gel 2 hours before I test on Monday. Interested to see what it is.