HELP - Doubts about TRT

[BSS91]

No “hack”, but you should generally try for the lowest effective dose, same with pretty much everything else. Only HCG protocols I’ve had are 500 ius twice/week, 300 ius three times/week, and 250 ius three times/week. 250 three times/week is the best one I’ve found and I plan to stay there now(and have been for over a year). Another concern with HCG is desensitization by overloading receptors so that it is no longer effective at any dose. That’s a hard phenomenon to study though and reports mostly come from anecdotal stories. But either way it’s still a good idea to go with lowest effective dose, and I think the cookie cutter approach of 500 ius twice/week or nothing is what makes quite a few people think they don’t tolerate it. For some reason people are willing to go all over the place with regard to frequency and dose when it comes to trt, but assume HCG should work at that one recommended protocol or else it won’t work. Imagine if people did that with testosterone. If the only option for testosterone was 200 mg/week a lot of people would say it doesn’t work for them, when in reality they just need a better protocol that is suited for them.


It also depends on if you’re doing HCG mono or using it to supplement trt. I’ve only ever done the latter, and I would think the doses required for monotherapy(or see least the doses I see mentioned for it) would be more likely to lead to issues. But then again some people love it, though I’m not sure I’ve ever seen someone do it longterm without just adding trt to the mix. That kind of seems to indicate it isn’t a longterm solution.

Okay, this shows me I was going to the right direction then.

After reading more I was thinking of doing 200 ius three times per week and 30 mg test 3 times per week, each on the same day as I prefer not pinning 6 times per week.

At least start from there and see how it goes and maybe go off the hcg a few times just to reduce chances of desensitization.

Again, I know it is not exact science but I feel we can, from research, go in the right direction.

 

[Mastodont]

Just to add, the desensitization part is not well established, i would not worry too much as in a popular study 500iu every other day resulted in +25% intratesticular testosterone, if you were planning to run fertility protocols infinitely that would be another deal.

 

[BSS91]

Here is some reading, you can find more, the dosing schedules on hcg vary greatly just like with testosterone, you have to be the judge, but it is well established that testosterone peaks at around 72hrs post injection.

Effect of TRT vs hCG/FSH on upstream hormone pathways.

The role of gonadotropins in testicular and adrenal androgen biosynthesis pathways -insights from males with congenital hypogonadotropic hypogonadism on hCG/rFSH and on testosterone replacement SUMMARY Objective: To delineate the role of gonadotropins in male androgen biosynthesis pathways...

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Single and multi‐dose pharmacology of recombinant and urinary hCG in men

1 | INTRODUCTION Gonadotrophin treatment to induce puberty, spermatogenesis, and fertility in men with congenital or acquired gonadotropin deficiency is based on treatment with human chorionic gonadotrophin (hCG), aplacental heterodimeric glycoprotein hormone and natural, long‐acting analog of...

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Gonadotropin therapy in male infants and adolescents with HH

This video discusses the use of gonadotropin therapy in male infants and adolescents with hypogonadism. Dr. Sasha Howard from Queen Mary University of London explains the evidence and best practices for this treatment. She emphasizes the importance of early diagnosis and treatment to improve...

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Management Outcomes in Males With Hypogonadotropic Hypogonadism Treated With Gonadotropins

Management Outcomes in Males With Hypogonadotropic Hypogonadism Treated With Gonadotropins (2023) Bahaa O. Sahib, Ibrahim H. Hussein, Nassar T. Alibrahim, Abbas A. Mansour Abstract Background Hypogonadotropic hypogonadism is an important cause of male infertility and loss of secondary...

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From what I am reading here, it seems that TRT is creating more problems than it is solving or am I missing something?

 

[madman]

Yes, when I say ``healthy young male at his epitome`` means ``top end young male``.

Don`t know what is false there, I didn`t say that the average young male has 70 mg per week, I am aware that I am talking about the ``epitome``.

I thought maybe I got the meaning of epitome wrong but this is what google confirms:

``a person or thing that is a perfect example of a particular quality or type.``

So for me this means, an almost perfect version of a young male.

Again the average secretion rate of T in the majority of healthy young males is 5-7 mg/day.

10 mg would be those outliers and even then there is not going to be a big difference in how one would feel/function.

Also need to keep in mind that those healthy natty young men running around with those very high T levels have high SHBG and it is not like they are running around with absurdly high FT levels.

Top it off that these TT/FT levels healthy natty young men in their prime are hitting are at peak which is short-lived, their trough/nadir (lowest point)) of the day would be 20-25% lower.

Natural endogenous testosterone secretion is pulsatile and diurnal.

During the natural 24-hour circadian rhythm of a healthy young male T levels will start rising gradually overnight reaching a peak (highest point) in the early AM followed by lower levels in the late afternoon and reaching trough (lowest point) in the evening.

Fluctuations from peak--->trough would be around 20-25%

One daily peak/trough.


This is key:

(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening.



Hourly serum testosterone levels in normal young (n = 17) and older (n = 12) males. The circadian rhythm is lost in older males. Blood samples were obtained using an indwelling peripheral venous cannula, which allowed free movement and normal sleep.

Data from: Bremner WJ, Vitiello MV, Prinz PN. Loss of circadian rhythmicity in blood testosterone levels with aging in normal men. J Clin Endocrinol Metab 1983; 56:1278.







Look over the mean TT and work your way up to those outliers!

Nuff said.

Keep in mind that the majority of men on TTh are using intramuscular/subcutaneous injections using various injection protocols (once weekly, twice weekly, M/W/F, EOD, daily) and in no way are mimicking the natural 24hr circadian rhythm of a healthy young male.

Steady-state, many are running levels well into the supra-physiological range 24/7 let alone the hpta is shutdown.

The closest you could get to mimicking the natural 24hr circadian rhythm would be using the T patch (most closely mimics natty T) or transdermal but again your hpta is still shutdown.

Any form of exogenous T except Natesto will have a significant impact on the shutdown of the hpta.

Top it off with the fact that when using exogenous T we are forcing levels upon ourselves that the body would never produce naturally.

Artificially inflated T levels we say!

Unfortunately many men are overmedicated due to being brainwashed by that more T is better mentality you know everyone and their brother needing to hit that trough TT 1000+ ng/dL with a very high/absurdly high trough FT to boot.

You can blame all those so called men's health forums loaded with those blast n cruizers, bumNation, Facepalm, I just don't Geddit, Gootube, those so called GURUs and those run of the mill dime a dozen T f**king MILLS!

F**king shitshow!

LMFAO!







My reply from an older thread:

Unfortunately most caught up on that more T is better mentality will continue to struggle as they will always be searching for something that will never be there.

Many will refuse to settle for feeling NORMAL and be chasing that so-called OPTIMAL until the cows come home.

Never-ending merry-go-round.

You have people on the forums going on and on about so-called optimal let alone everything being in balance yet these same individuals are trying their damnedest to micro-manage estradiol/DHT/prolactin/DHEA and the laundry list goes on yet when it comes to T are running levels well beyond what their body could ever produce endogenously let alone what level they were genetically at in their PRIME (late teens/the early 20s).

No male in his prime (late teens/early 20s) was producing absurdly high peak or trough TT/FT levels let alone 24/7 (steady-state).

Top it all off that your HPGA is shut down and most are not replacing physiological levels of T they are FORCING levels upon THEMSELVES WELL BEYOND what one could endogenously ever produce.

Unfortunately too many want to be jacked up on T 24/7.

When it comes to building muscle high T levels steady-state is where it's at and there is no denying such.

The sad fact of the matter is many are brainwashed into thinking that more T is better.

For many years we have been stressing the point that many are overmedicated when it comes to testosterone therapy.

Too many caught up on that neanderthal mindset you know that more T is better mentality.

Unfortunately many are jacked up on T from the get-go let alone many are also dick riding that so-called OPTIMAL bulls**t!

Too many get caught up in expecting to feel great 24/7 once on TTh as if testosterone is going to cure all that ails them.

So much misinformation spewed on the numerous forums/gootube.


*neanderthal mindset that more T is better

*HIGH T = raging libido/titanium erections

*HIGH T = OPTIMAL as in that fairytale everyone is chasing.....you know the one with raging libido/titanium erections 24/7, unlimited amounts of energy, stellar mood (Mr. Rogers neighborhood), packing on muscle like the hulk with the recovery abilities of wolverine

 

[BSS91]

Again the average secretion rate of T in the majority of healthy young males is 5-7 mg/day.

10 mg would be those outliers and even then there is not going to be a big difference in how one would feel/function.

Also need to keep in mind that those healthy natty young men running around with those very high T levels have high SHBG and it is not like they are running around with absurdly high FT levels.

Top it off that these TT/FT levels healthy natty young men in their prime are hitting are at peak which is short-lived, their trough/nadir (lowest point)) of the day would be 20-25% lower.

Natural endogenous testosterone secretion is pulsatile and diurnal.

During the natural 24-hour circadian rhythm of a healthy young male T levels will start rising gradually overnight reaching a peak (highest point) in the early AM followed by lower levels in the late afternoon and reaching trough (lowest point) in the evening.

Fluctuations from peak--->trough would be around 20-25%

One daily peak/trough.


This is key:

(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening.



Hourly serum testosterone levels in normal young (n = 17) and older (n = 12) males. The circadian rhythm is lost in older males. Blood samples were obtained using an indwelling peripheral venous cannula, which allowed free movement and normal sleep.

View attachment 43304
Data from: Bremner WJ, Vitiello MV, Prinz PN. Loss of circadian rhythmicity in blood testosterone levels with aging in normal men. J Clin Endocrinol Metab 1983; 56:1278.







Look over the mean TT and work your way up to those outliers!

Nuff said.

View attachment 43305




Keep in mind that the majority of men on TTh are using intramuscular/subcutaneous injections using various injection protocols (once weekly, twice weekly, M/W/F, EOD, daily) and in no way are mimicking the natural 24hr circadian rhythm of a healthy young male.

Steady-state, many are running levels well into the supra-physiological range 24/7 let alone the hpta is shutdown.

The closest you could get to mimicking the natural 24hr circadian rhythm would be using the T patch (most closely mimics natty T) or transdermal but again your hpta is still shutdown.

Any form of exogenous T except Natesto will have a significant impact on the shutdown of the hpta.

Top it off with the fact that when using exogenous T we are forcing levels upon ourselves that the body would never produce naturally.

Artificially inflated T levels we say!

Unfortunately many men are overmedicated due to being brainwashed by that more T is better mentality you know everyone and their brother needing to hit that trough TT 1000+ ng/dL with a very high/absurdly high trough FT to boot.

You can blame all those so called men's health forums loaded with those blast n cruizers, bumNation, Facepalm, I just don't Geddit, Gootube, those so called GURUs and those run of the mill dime a dozen T f**king MILLS!

F**king shitshow!

LMFAO!







My reply from an older thread:

Unfortunately most caught up on that more T is better mentality will continue to struggle as they will always be searching for something that will never be there.

Many will refuse to settle for feeling NORMAL and be chasing that so-called OPTIMAL until the cows come home.

Never-ending merry-go-round.

You have people on the forums going on and on about so-called optimal let alone everything being in balance yet these same individuals are trying their damnedest to micro-manage estradiol/DHT/prolactin/DHEA and the laundry list goes on yet when it comes to T are running levels well beyond what their body could ever produce endogenously let alone what level they were genetically at in their PRIME (late teens/the early 20s).

No male in his prime (late teens/early 20s) was producing absurdly high peak or trough TT/FT levels let alone 24/7 (steady-state).

Top it all off that your HPGA is shut down and most are not replacing physiological levels of T they are FORCING levels upon THEMSELVES WELL BEYOND what one could endogenously ever produce.

Unfortunately too many want to be jacked up on T 24/7.

When it comes to building muscle high T levels steady-state is where it's at and there is no denying such.

The sad fact of the matter is many are brainwashed into thinking that more T is better.

For many years we have been stressing the point that many are overmedicated when it comes to testosterone therapy.

Too many caught up on that neanderthal mindset you know that more T is better mentality.

Unfortunately many are jacked up on T from the get-go let alone many are also dick riding that so-called OPTIMAL bulls**t!

Too many get caught up in expecting to feel great 24/7 once on trt as if testosterone is going to cure all that ails them.

So much misinformation spewed on the numerous forums/gootube.


*neanderthal mindset that more T is better

*HIGH T = raging libido/titanium erections

*HIGH T = OPTIMAL as in that fairytale everyone is chasing.....you know the one with raging libido/titanium erections 24/7, unlimited amounts of energy, stellar mood (Mr. Rogers neighborhood), packing on muscle like the hulk with the recovery abilities of wolverine

Okay Madman, so now my question is:

What is the solution then? Besides Natesto?

Because from the sound of it, TRT is not a viable option, better stay low T for life (considering everything is done to raise it but the balls just don’t seem to work as they should).

For example, would injecting twice per week a 80-100 mg dose (so 40-50 mg twice per week) would be closest to having at least peaks and downward levels that most closely ressemble natural healthy levels?

In my case I honestly don t care about levels. If i get symptom relief in the 500-600s I ll take it with open arms.

 

[madman]

Andriol sounded a great option but what about the dosage thing, apparently it is severly underdosed like 40 mg a pill, and people saying to have a decent dose that changes something physiologically, you need too many capsules and end up having to buy multiple bottles per month.

Break it down here: Wondering if my TRT prescription schedule makes sense at all

Andriol has been discontinued in Canada and was replaced by the generic Taro-Testosterone.

Even then I would not recommend anyone use it let alone very few doctors would even prescribe it as many men will have a hard time achieving healthy T levels/respond poorly when using the older oral TU (Andriol) formulations due to issues with absorption.

Unfortunately the newer formulations of oral TU (Jatenzo, Tlando and Kyzatrex) are only available in the US.

Luckily things may change soon enough as Verity Pharma is trying to get approval to market Tlando in Canada.

Would be a great option for men interested in the oral route!

Injections is where it's at for most!

License Agreement for TLANDO® Franchise in the U.S. and Canada

https://www.prnewswire.com/news-releases/lipocine-and-verity-pharma-enter-into-license-agreement-for-tlando-franchise-in-the-us-and-canada-302037718.html SALT LAKE CITY, Jan. 18, 2024 /PRNewswire/ -- Lipocine Inc. (NASDAQ: LPCN), a biopharmaceutical company focused on treating Central Nervous...

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post#22 (Natesto)

Hypogonadism 101

https://www.excelmale.com/forum/threads/testopel-%C2%AE-vs-generic-testosterone-pellets.22108/ https://www.excelmale.com/forum/threads/clinical-experiments-with-androgens-1939.22482/...

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Go nuts!

Comparing Rates of Polycythemia in Hypogonadal Men Using Nasal T Gel Versus IM TC

Comparing Rates of Polycythemia in Hypogonadal Men Using Nasal Testosterone Gel Versus Intramuscular Testosterone: Update of a Randomized Clinical Trial (2022) Jesse Ory, Parris Diaz, Marco-Jose Rivero, Raul I. Clavijo, Nannan Thirumavalavan, Ruben Blachman-Braun, Justin Loloi, Ari Bernstein...

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[BSS91]

Considering all of this is theory of course.

I know practically everyone is different.

I see guys having adequate levels at 200 mg per week, others needing only 60 mg so I am talking in theory and in general.

 

[madman]

Okay Madman, so now my question is:

What is the solution then? Besides Natesto?

Because from the sound of it, TRT is not a viable option, better stay low T for life (considering everything is done to raise it but the balls just don’t seem to work as they should).

For example, would injecting twice per week a 80-100 mg dose (so 40-50 mg twice per week) would be closest to having at least peaks and downward levels that most closely ressemble natural healthy levels?

In my case I honestly don t care about levels. If i get symptom relief in the 500-600s I ll take it with open arms.

When it comes to formulations available in Canada you are basically stuck with big pharma transdermal T gels (Androgel, Testim), transdermal compounded T cream, oral TU (Taro-Testosterone), nasal gel (Natesto), or injectable T enanthate (Delatestryl) or T cypionate (Depo-Testosterone/generic).

Injections would be your best bet!

Even when using big pharma gels AndroGel®, Fortesta®, Testim®, or Vogelxo® the strength is only 1-2% so a fair amount of gel needs to be applied.

Keep in mind that absorption using standard transdermal T application whether gel/cream is anywhere from 9-14%.

AndroGel® is available in 1.0% and 1.62% concentrations (packet/pump).

A common starting dose for Androgel 1% was 50mg T/day (5 g of gel/1 packet) which would be roughly 5 mg T/day and in most cases, men would only hit a mid-normal T level at best.

Most men would need the higher-end dose of 100 mg T/day (10 g of gel) which would be roughly 10 mg T/day to achieve a high-end or in some cases very high T level.

Some men are poor responders when using transdermal T as they have issues with absorption.

In some cases switching over to a higher concentration compounded T cream is all that may be needed.

Many end up using compounded transdermal T creams as the strength is much higher 5-20%.

Much less needs to be applied let alone the overall cost of the medication is much cheaper.

Most are using 20% strength (200mg/mL) and unfortunately many end up on that 200 mg T twice daily application protocol which would surely result in absurdly high TT/FT levels.

Many can easily achieve healthy let alone very high T levels on much less especially when applied strictly scrotal.

Although transdermal can be a good starting point when jumping on trt there are men who will continue to be poor responders due to absorption issues or in many cases not using a high enough dose of T seeing as most endos/uros rely on using big pharma transdermal T and the strength/potency is much less than what can be achieved using compounded transdermal T gels/creams.

Most men end up going on injections Depo-Testosterone (TC) or Delatestryl (TE).

Keep in mind that Depo-Testosterone is only available in the 100 mg/mL strength so you would need to inject a larger volume of the oily solution.

Not a big deal unless you plan on injecting strictly sub-q as many tend to avoid injecting more than .5 mL as there may be a higher chance of lumps/pain.

Mind you when I first started TTh (100 mg T/week) I was injecting 1 mL Depo-Testosterone strictly sub-q and never had any issues at the injection site.

 

[madman]

Considering all of this is theory of course.

I know practically everyone is different.

I see guys having adequate levels at 200 mg per week, others needing only 60 mg so I am talking in theory and in general.

Common starting dose is 100 mg T/week or better yet 100 mg T split into twice-weekly injections (50 mg every 3.5 days).

Most men on TTh are injecting 100-200 mg/week whether once weekly, twice-weekly (every 3.5 days), M/W/F, EOD or daily.

Even then the majority of men can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes there are some outliers who may need the higher-end dose 200 mg T/week but again it is far from common as in rare!

Unfortunately too many are overmedicated from the get-go!

When it comes to injection frequency whether once weekly, twice-weekly, M/W/F, EOD or daily no form of exogenous esterified T is going to mimic the 24hr natural circadian rhythm of a healthy young male.

Again the only formulation which would most closely mimic this is the T-patch (Androderm).

Forget worrying about this.

The main difference between injecting once weekly vs more frequently is the peak--->trough and how stable your blood levels remain throughout the week.

Injecting more frequently will clip the peak--->trough and blood levels will be more stable throughout the week.

Keep in mind there is a significant difference between someone hitting a high/very high trough FT injecting once weekly vs EOD or daily!

No one can say what injection frequency let alone trough FT level will suite you best.

Trial and error.

Only time will tell.

Start low and go slow on a T-only protocol.

There will be lots of time to increase your dose if need be or add in an ancillary such as hCG.

Patience is key.

There is no quick fix here.

Have realistic expectations.

As I have stated numerous times over the years the goal of TTh is to replace physiological levels through the use of exogenous T which results in relief/improvement of low-T symptoms and increased overall well-being while at the same time avoiding/minimizing any potential side-effects and keeping blood markers healthy long-term.

Yes some will need to run higher-end trough levels within reason to experience the beneficial effects of having a healthy FT level.

The majority of men would be on a protocol that would result in having healthy TT/FT levels throughout the week by keeping T levels stable and avoiding too low of a trough.

Maintaining stable levels and minimizing the peak---> to trough can have a big impact on the overall effectiveness.

A large percentage of men are using intramuscular/subcutaneous injections using various injection protocols (once weekly, twice weekly, M/W/F, EOD, daily) and feel great.

Yes, there are many men who do well injecting once weekly and fair better with the larger swing in the peak--->troughs.

Unfortunately, many others will struggle with energy, mood, libido, erectile function, and recovery due to the rollercoaster effect.

Key here is to find a protocol (dose/injection frequency) that works best for you and not overshooting when it comes to your trough FT!

 

[BSS91]

Common starting dose is 100 mg T/week or better yet 100 mg T split into twice-weekly injections (50 mg every 3.5 days).

Most men on TTh are injecting 100-200 mg/week whether once weekly, twice-weekly (every 3.5 days), M/W/F, EOD or daily.

Even then the majority of men can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes there are some outliers who may need the higher-end dose 200 mg T/week but again it is far from common as in rare!

Unfortunately too many are overmedicated from the get-go!

When it comes to injection frequency whether once weekly, twice-weekly, M/W/F, EOD or daily no form of exogenous esterified T is going to mimic the 24hr natural circadian rhythm of a healthy young male.

Again the only formulation which would most closely mimic this is the T-patch (Androderm).

Forget worrying about this.

The main difference between injecting once weekly vs more frequently is the peak--->trough and how stable your blood levels remain throughout the week.

Injecting more frequently will clip the peak--->trough and blood levels will be more stable throughout the week.

Keep in mind there is a significant difference between someone hitting a high/very high trough FT injecting once weekly vs EOD or daily!

No one can say what injection frequency let alone trough FT level will suite you best.

Trial and error.

Only time will tell.

Start low and go slow on a T-only protocol.

There will be lots of time to increase your dose if need be or add in an ancillary such as hCG.

Patience is key.

There is no quick fix here.

Have realistic expectations.

As I have stated numerous times over the years the goal of TTh is to replace physiological levels through the use of exogenous T which results in relief/improvement of low-T symptoms and increased overall well-being while at the same time avoiding/minimizing any potential side-effects and keeping blood markers healthy long-term.

Yes some will need to run higher-end trough levels within reason to experience the beneficial effects of having a healthy FT level.

The majority of men would be on a protocol that would result in having healthy TT/FT levels throughout the week by keeping T levels stable and avoiding too low of a trough.

Maintaining stable levels and minimizing the peak---> to trough can have a big impact on the overall effectiveness.

A large percentage of men are using intramuscular/subcutaneous injections using various injection protocols (once weekly, twice weekly, M/W/F, EOD, daily) and feel great.

Yes, there are many men who do well injecting once weekly and fair better with the larger swing in the peak--->troughs.

Unfortunately, many others will struggle with energy, mood, libido, erectile function, and recovery due to the rollercoaster effect.

Key here is to find a protocol (dose/injection frequency) that works best for you and not overshooting when it comes to your trough FT!

Perfect thanks Madman.

About DHEA and Pregnenolone, I was wondering since they are not available otc in canada, if clinic prescribe if there is a need.

This is another thing I was thinking about, it would be nice to have it available on the canadian market if it becomes a need.

 

[Gibbon]

Just my two cents. Start around 50 mg/wk. Keep that for 12 weeks and then evaluate again. I started around 80 to 90 and have moved down to 53 mg/wk. It's done wonders for my anxiety. For me, too high and too low feel very similiar. Some differences but in many ways very similiar

 

[BSS91]

Just my two cents. Start around 50 mg/wk. Keep that for 12 weeks and then evaluate again. I started around 80 to 90 and have moved down to 53 mg/wk. It's done wonders for my anxiety. For me, too high and too low feel very similiar. Some differences but in many ways very similiar

what levels do you sit? Cause I know many that crash on 80 mg because it is bringing them even lower than their natural test (300s)

 

[Gibbon]

On 80 mg/wk I was sitting at around 180 free (240 max) and 650 total (900 max) and that is at trough. Those are pretty accurate but I will be getting new tests in a month or so. It's feeling and then figuring out what to do, go up or down. Insomina, anger/agitation, anxiety, rising estrodial, and some other side effects tell me it was too high. I became an asshole, and I didn't like it. The biggest issue is people changing every few weeks because they don't feel good. You have to give it time (8 to 12 weeks) and I had to go down after about a year because of my SHBG lowering and free shot up. Hey, all power to people that can run higher levels but when you look at how much a normal male produces in a day and I was at 7.8 mg after taking into account the ester. When I started TRT I was at half the lowest number on the scale for both free and total. My anxiety is almost non existent right now and TRT totally changed how I feel in that regards. I have secondary hypo as my pituitary puts out very low LH. I could have gone without my boys shrinking and maybe some day I will work on that but right now I am physically and mentally in a very good spot

 

[Cataceous]

... Cause I know many that crash on 80 mg because it is bringing them even lower than their natural test (300s)

This is misleading at best. Is it fair to assume that these individuals are injecting once a week at most and are measuring trough serum levels? Your statement then neglects that peak testosterone is usually going to be 2-3 times the trough level. In such cases a trough total testosterone of 300 ng/dL can easily signify that average testosterone is about 500 ng/dL, which is about the same as a healthy young guy who measures 600-700 ng/dL at his morning peak. The simple solution for the guy on TRT is to split his doses into more frequent injections.

A further confounding factor is that 80 mg TC/week is providing more testosterone than over half of all men would ever make naturally. Therefore it's common to see some suppression of SHBG, which in turn artificially reduces total testosterone, while not affecting free levels.

 

[Phil Goodman]

I keep seeing people repeat “healthy young men produce this much….” but where is that number coming from? Also, in an unhealthy population…being average is much more likely to mean being unhealthy. For example based on height and weight, my daughter has always been underweight if you go by percentiles. But in reality, she is a healthy weight and we just have an exploding obesity problem in children and adults. At this rate, having blood sugar levels that indicate prediabetes will soon make you an average young person. That doesn’t mean anyone should aim for those blood sugar levels. Not the best analogy, but it gets the point across.

Also, different people respond very differently to different doses of testosterone. Some people can take 100 mg/week and have total levels getting up close to 1,000 while someone else may take 100 mg/week and barely get into the 500s. So I don’t think people should be locked into “the healthy young person produces this per day so anything over that is supraphysiological”. I do agree with starting out lower rather than higher, but at the same time I don’t think people should be locked into thinking anything much higher than 100/week will be unhealthy.

 

[Cataceous]

I keep seeing people repeat “healthy young men produce this much….” but where is that number coming from? Also, in an unhealthy population…being average is much more likely to mean being unhealthy. For example based on height and weight, my daughter has always been underweight if you go by percentiles. But in reality, she is a healthy weight and we just have an exploding obesity problem in children and adults. At this rate, having blood sugar levels that indicate prediabetes will soon make you an average young person. That doesn’t mean anyone should aim for those blood sugar levels. Not the best analogy, but it gets the point across.
...

A multitude of studies yield the testosterone production figures for healthy young men, as well as serum levels for healthy populations. Obese individuals are excluded from these populations. It's true that there is a skewing of averages in the overall population over time due to factors such as increasing overweight and obesity. If this is creeping into laboratory reference ranges then it's reasonable to rely on earlier research. I frequently refer to this study, which finds a normal range for Vermeulen calculated FT in healthy young men of 7.06-22.6 ng/dL.

... Also, different people respond very differently to different doses of testosterone. Some people can take 100 mg/week and have total levels getting up close to 1,000 while someone else may take 100 mg/week and barely get into the 500s. So I don’t think people should be locked into “the healthy young person produces this per day so anything over that is supraphysiological”. I do agree with starting out lower rather than higher, but at the same time I don’t think people should be locked into thinking anything much higher than 100/week will be unhealthy.

The differences in total testosterone in response to injected dose are exaggerated by differences in SHBG, as well as differences in protocols and sampling times. The spread should be considerably less dramatic when free testosterone is examined under controlled conditions.

You would not be so blasé about taking thyroid hormones at triple the healthy normal production rate. Why should testosterone get a free pass? It's only because the side effects aren't quite as severe and the more-is-better perception persists. There are individuals who can take over 100 mg TC per week without apparent negative effects on health. However, let's not pretend that it's TRT when you're taking in more testosterone than the vast majority of the population could make naturally. If you're going to operate outside of physiological ranges then the burden of proof for safety is on you.

 

[BSS91]

This is misleading at best. Is it fair to assume that these individuals are injecting once a week at most and are measuring trough serum levels? Your statement then neglects that peak testosterone is usually going to be 2-3 times the trough level. In such cases a trough total testosterone of 300 ng/dL can easily signify that average testosterone is about 500 ng/dL, which is about the same as a healthy young guy who measures 600-700 ng/dL at his morning peak. The simple solution for the guy on TRT is to split his doses into more frequent injections.

A further confounding factor is that 80 mg TC/week is providing more testosterone than over half of all men would ever make naturally. Therefore it's common to see some suppression of SHBG, which in turn artificially reduces total testosterone, while not affecting free levels.

I ve seen lots of guys having to bump up their test dose to 120 mg to feel benefits and finally see their test levels go to the 700-800s.
For other guys 120 mg doesn`t raise them enough and they need 150 mg.

It depends on each person, regardless of frequency of injections.

And believe me, I prefer to go on your direction because for me, 80 mg divided in 2 or 3 injections was my magic number, that is where I wanted to start but all I see is that even when injecting more than once per week, hypo and hyper responders still exist.

 

[Systemlord]

I keep seeing people repeat “healthy young men produce this much….” but where is that number coming from? Also, in an unhealthy population…being average is much more likely to mean being unhealthy.

There was a study from Harvard that showed three groups of men on TRT, those with testosterone levels on the lower end, testosterone levels midrange and levels above the normal ranges, supraphysiological, and the men with the highest testosterone lost the most fat!

Then all groups were given an aromatase inhibitors and all groups developed significantly more belly fat, proving that estrogen is the main driver of fat loss on TRT!

My point is that higher testosterone, even supraphysiological, in men produces better results in overall health.

I don't know about you, but I don't want to be average! The average person is overweight.

 

[Cataceous]

I ve seen lots of guys having to bump up their test dose to 120 mg to feel benefits and finally see their test levels go to the 700-800s.
For other guys 120 mg doesn`t raise them enough and they need 150 mg.

It depends on each person, regardless of frequency of injections.

And believe me, I prefer to go on your direction because for me, 80 mg divided in 2 or 3 injections was my magic number, that is where I wanted to start but all I see is that even when injecting more than once per week, hypo and hyper responders still exist.

My bet is there are confounding factors, such as low SHBG, which means that you can have robust free testosterone even with total testosterone in the 400s ng/dL. But if we take the statements at face value, then why do these men think they need more testosterone than virtually any man could make naturally? Seeing subjective improvements is also no guarantee of long-term safety. It's not unreasonable to expect that some men will experience toxicity from chronic exposure even at doses not so much above a realistic TRT range.

The frequency of injections is very relevant when you're counting on a single measurement in an injection cycle to determine your response to dose. A guy can easily see a trough TT of 400 ng/dL on weekly injections, then switch to daily injections and see 800 ng/dL. If free testosterone is also neglected then one has little idea about what's going on.

 

[BSS91]

My bet is there are confounding factors, such as low SHBG, which means that you can have robust free testosterone even with total testosterone in the 400s ng/dL. But if we take the statements at face value, then why do these men think they need more testosterone than virtually any man could make naturally? Seeing subjective improvements is also no guarantee of long-term safety. It's not unreasonable to expect that some men will experience toxicity from chronic exposure even at doses not so much above a realistic TRT range.

The frequency of injections is very relevant when you're counting on a single measurement in an injection cycle to determine your response to dose. A guy can easily see a trough TT of 400 ng/dL on weekly injections, then switch to daily injections and see 800 ng/dL. If free testosterone is also neglected then one has little idea about what's going on.

So what do you think of my potential protocol of 90 mg per week divided in 3 injections and 200 iu of hcg in three injections?

You think this will eventually lead to chronic exposure of high test levels if other factors are in place?