Just had a really interesting good chat with my pharmacist (much more helpful than my doctor). I'll share:
She tells me that with the lozenge you absorb about 50-60% buccal and the rest via oral. If you place under tongue, more will go down oral route. Happy for me to try that if I'm still getting side affects. However, oral brings metabolised changes, which I've read lots about.
She said lozenges can be taken vaginally to try that route, but would need to have the sweetener removed to avoid irritation. An easy possibility.
Best of all she said if I'm still finding it difficult she can speak to my doc and get my route of administration changed... Woo hoo. No clinic fee 😁.
She was so helpful. Some people feel bad on low doses (like I did) but also on high doses (like many). It's finding that sweet spot.
The cream obviously avoids the GI tract. Personally I think the cream absorption wasn't strong enough for me, resulting in too low a dose. I am OK on the lozenge but still getting woozy and shaky after taking... And very vague/spacey. Not very sharp

Other option would be slow release pill.
She says only give it 2 weeks before changing route if need be. Suppose its not changing med, just route of administration.