Overprescribed?

Hey all,

Glad to be here (my first post)

I began a TRT protocol for the first time with a T Clinic, 3.5 weeks ago.

They've prescribed me 1ML p/day of the follow "Atrevis 10% 100MG/ML"

It's says Atrevis gel on the bottle, but it's a cream.

I was shocked when I asked the doc how much would be absorbed p/day.

His answer:

"You're most likely absorbing 70%, which amounts to 70MG p/day. Therefore you are getting 490MG p/w."

(Applied to inner forearms/wrists)

My concerns:

1) I thought transdermal absorption is around 10%
2) If he's right, doesn't this sound like at least 2-3x a TRT dose?

Thank you in advance for all the feedback you provide!
 
You are correct about transdermal absorption. Normally it is around 10%. Scrotal skin can absorb a lot more efficiency, but even that maxes out at around 50-60%, if I'm remembering correctly. One caveat is that the manufacturer of Atrevis is claiming as much as two to three times better absorption than with other bases. If so then you could be looking at 20-30% absorption.

There's something seriously wrong here if your doctor is planning for you to absorb 490 mg of testosterone per week for normal TRT. That's equivalent to 700 mg of testosterone cypionate. This would be about seven times a high-normal dose.

In any case, it appears that half a milliliter per day would be an appropriate starting dose—giving you a reasonable chance of absorbing a physiological amount of testosterone. You would titrate up or down from there if needed, depending on what lab results show.
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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