Frequently asked questions

Generally adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition like high blood pressure or type 2 diabetes. Your provider makes the final call based on your full health history.

Brand-name medications like Wegovy® and Zepbound® are FDA-approved. Compounded medications are prepared by a licensed pharmacy for individual patients and are not FDA-approved or reviewed by the FDA for safety, effectiveness, or quality. They are not the same products. Your provider can walk you through which fits your situation.

Semaglutide acts on one hormone, GLP-1. Tirzepatide acts on two, GLP-1 and GIP. Your provider can help decide which fits your history and goals.

The weekly injection is the most common form. The orally disintegrating tablet (ODT) dissolves in your mouth each day, so there are no needles. Doses are not interchangeable, and your provider will explain what to expect with each.

Often, yes. Your provider sets a starting tirzepatide dose based on your current semaglutide dose and how you tolerated it.

Nausea, constipation, and reduced appetite are most common, especially early on. Starting at a low dose and increasing slowly helps. Your care team can adjust your plan if side effects get in the way.

That’s up to you and your provider. Appetite often returns after stopping, so many people stay on treatment long term.

Not by itself. It’s nutritional support. MIC-B12 is compounded by a state-licensed pharmacy and is not FDA-approved.

No. A brand-name version is FDA-approved only to reduce excess belly fat in adults with HIV-associated lipodystrophy. Prescribing it for weight loss is off-label, and the version we prescribe is compounded and not FDA-approved.

Surna plans are self-pay; we don’t bill insurance. You can ask for a receipt to submit to your insurer, HSA, or FSA, but reimbursement isn’t guaranteed.

Sometimes. For some treatments, like sermorelin, your provider may ask for recent bloodwork before prescribing. You’ll know after your assessment.

Some patients do. Your provider checks for overlap with your other medications and decides whether a combination makes sense.

Most use a tiny needle just under the skin, and you’ll get step-by-step instructions. If you’d rather skip needles, ask about the nasal spray or lozenge options.

No. HGH replaces growth hormone directly. Sermorelin prompts your body to release its own, which keeps your natural feedback system in place.

Injections are absorbed more predictably. The lozenge avoids needles. Your provider can help you choose based on your goals and preferences.

No. It is compounded by a state-licensed pharmacy. Compounded medications are not FDA-approved or reviewed by the FDA for safety, effectiveness, or quality.

Flushing and stomach discomfort are common, especially at higher doses or when injected quickly. Injecting slowly and starting low usually helps.

No, and we don’t prescribe it for that. The FDA has warned against products marketed for skin lightening.

You take your treatment at home in a minute instead of sitting in a chair for an hour, and a licensed provider reviews your health history before anything is prescribed.

Sometimes. Your provider may order labs to check levels like B12 before recommending treatment.

Usually, but your provider checks for interactions and overlap with anything you already take.

Injections skip the digestive system, which matters if absorption is the problem. Your provider can tell you whether a pill might be enough.

Both raise B12 levels. Cyanocobalamin is the most studied and lowest-cost form. Methylcobalamin is an active form some people prefer. Your provider can help you choose.

Injections deliver a larger dose less often. The spray is needle-free and used daily. Your provider can help you choose.

Some people feel mild stinging at first, which usually eases with regular use. Tell your care team if it doesn’t.

Hormone therapy requires a live visit so your provider can review your labs and history with you directly before prescribing.

We ship a lab kit to your door. Collect your sample, send it back in the prepaid package, and your provider reviews the results before your visit.

Usually before you start, again after a few months, then periodically. Your provider sets the schedule based on your treatment.

It can. Testosterone therapy can lower sperm production. If you’re planning to have children, ask your provider about enclomiphene.

TRT replaces testosterone directly and can lower sperm count. Enclomiphene helps your body make its own and is compounded, not FDA-approved. The better choice depends on the cause of your low testosterone and whether you want to preserve fertility.

Testosterone is Schedule III because it can be misused. That’s why treatment requires labs, a video visit, and ongoing monitoring.

No. It isn’t right for everyone, especially with a history of certain cancers, blood clots, or stroke. Your provider reviews your history before prescribing.

The tablet treats whole-body symptoms like hot flashes and night sweats. Vaginal cream treats vaginal dryness and discomfort, with effects mostly where it’s applied. Your provider will help you choose.

Usually not. It’s mainly prescribed to protect the uterine lining, so women without a uterus often take estrogen alone. Your provider will confirm.

It isn’t safe if you take nitrates for chest pain or certain other heart or blood pressure medications. Your provider reviews your health history and medications before prescribing.

Sildenafil works for a few hours and is taken about an hour ahead. Tadalafil can work for up to 36 hours, and a low daily dose means you don’t have to plan around a pill. Your provider can help you pick based on your routine.

It depends on your routine. As needed works well if sex is occasional. Daily suits you if you’d rather not plan around a dose.

Not on your own. Only combine ED medications if your provider prescribes it.

No. It is compounded by a state-licensed pharmacy. Sildenafil and tadalafil are FDA-approved on their own, but this combination is not.

Yes. Fem Max is a compounded rapid-dissolve tablet for women that combines tadalafil, oxytocin and bremelanotide (PT-141). Compounded medications are not FDA-approved. Your provider reviews your health history and decides whether it is right for you.

No. Orders ship in plain packaging, and your pharmacy label is inside the box.

Hair grows slowly, so any change takes months of daily use, and results vary from person to person. Your provider will tell you when to check in.

Any gains usually reverse within months of stopping.

Most men have none. A small percentage experience lower libido, erection problems, or mood changes. Tell your provider right away if you notice any. Women who are or may become pregnant should not handle crushed or broken tablets.

The spray is applied directly to your scalp, and the pill is simpler to take. The spray is compounded and not FDA-approved. Your provider helps you choose based on your goals and any side effect concerns.

It means a medication is prescribed for a use that isn’t listed on its FDA label. Oral minoxidil is commonly prescribed off-label for hair loss. Your provider will explain the benefits and risks.

It can. Unwanted hair growth on the face or body is the most common side effect, especially in women, and usually goes away after stopping.

Only after a provider reviews your assessment and prescribes. If they don’t, you pay nothing.

You aren’t charged for anything that isn’t prescribed. Your provider may explain why, suggest a different option, or recommend you see a doctor in person.

Quarterly is our standard plan, billed every 3 months at the lowest regular price. Monthly gives you more flexibility and costs more per month.

Your price won’t go up for 12 months from when you start.

Your provider approves each medication separately. If one isn’t prescribed, single-treatment pricing applies to what is.

Brand-name medications are priced by the manufacturer. At Surna you pay one monthly price that includes the medication and your provider care.

Plans are self-pay; we don’t bill insurance.

Yes. Message your care team to change plans, or cancel online in your account any time before your next billing date. Anything you have already paid for still ships.

A state-licensed U.S. pharmacy, and we name it on every label so you always know who made your medication.

We’re available in most U.S. states. Your assessment will confirm availability where you live.

In plain, discreet packaging, with cold packs when your medication needs them.

Anything that has to travel cold is dispensed and sent a month at a time, even on a quarterly plan.

Yes. Refills ship automatically, and you can pause or cancel before your next refill.

Yes. Your health information is protected under HIPAA and shared only with the people needed to treat you and fill your prescription. Orders ship in plain packaging.