This is a question many men ask but the answer isn’t always black and white for every person and can depend on several factors. First patients need to realize testosterone replacement theray is not a magically solution to all your physical or mental health issues. Yes, it does have tremendous health and wellness benefits, but it is not an end all be all to fixing every medical issue someone may be experiencing.
Benefits of testosterone replacement occur in a step wise fashion over 3-12 months, but generally most patients can expect to notice psychological improvements at 3-4 weeks such as better energy, mood and drive. Physical and sexual improvements can start to be noticed at 4-16 weeks and more consistency of well-being at 6-12 months if dialed in correctly. The first 6-8 weeks are critical in symptom and laboratory monitoring to make sure a patient is dialed in appropriately.
This timeline is an average but can vary greatly depending on many factors. An individual’s initial testosterone deficiency, baseline symptoms, previous experiences with hormones or androgen use and estrogen levels. Even the form of testosterone replacement used, such as injection, cream, or gels can have major impact on how fast an individual will start to feel the effects of testosterone replacement and symptom relief. In addition, individual’s dose, rate of absorption, metabolism and excretion and how androgen receptors are responding to the testosterone all can play a role.
It is also important to note that most people think a little bit is good, so more is even better, but this is not always the case for testosterone replacement therapy and can cause more negative side effects than positive. Too much testosterone and high levels can cause the downstream hormones and enzymes to become over saturated. For example, the enzyme alpha five reductase, turns testosterone into dihydrotestosterone (DHT), which has stronger androgenic effects. So high levels of testosterone lead to higher levels of DHT which can lead to irritability and anxiety. Another example is the enzyme aromatase, which makes estrogen or estradiol. The more testosterone in your system the more DHT and estradiol, which can potentially diminish the positive effects of the testosterone or cause side effects such as irritability and anxiety.
Other factors such as cortisol levels, dosing, preexisting health conditions, and activity level can all have some effect on when a patient will start to feel positive benefits of testosterone replacement. It is important that patients receive carefully monitoring of labs and symptoms to dial in correct dose for optimizing hormone levels.
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