Why is 200 mg/wk the "upper limit" for TRT?

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I keep seeing people post that 200 mg/wk of test propionate is the upper range for TRT and that anything more than that constitutes AAS levels, with the implication that if you go higher you are abusing the protocol. Why is that, exactly? I'm a pretty big guy (235, just under 6'), and I feel much better on 300 mg/wk -- which I only discovered after realizing I'd been under-dosing myself for 10 weeks, and had a bonus supply of T. One extra shot last week and my libido shot up, my lifts shot up, and I felt pretty great in general.

Don't get me wrong. I'm happy with my current protocol [200 mg/wk test cyp (1/2 Mon, 1/2 Fri), 1 mg. Anastrozole (.5 Mon/.5 Fri) and 1000 iu. HCG (500 Mon/500 Fri)] and all my numbers are good, but why exactly are higher doses problematic? It doesn't seem like the potential side effects on a slightly higher dose would be that difficult to deal with.

[Edit: I also add a few pumps of Androgel a couple days a week to the protocol, though it doesn't seem to do much -- maybe a little libido boost].
 
#2
Because higher doses will put most guys well above the physiological range that a normal man could possibly attain naturally.

Plus the higher doses will almost always lead to negative health effects in the long term. The most apparent issues include elevated hematocrit and RBCs, hypertension, and an increased risk for stroke and cardiac problems. The goal is to "replace" poor hormone levels with adequate ones. Going too far above and beyond those levels isn't a natural state for the male body.

I have no issues with somebody wanting to go above the range or use steroids, but its not TRT.
 
#3
Your body size has little to do with your dosage. It has a lot to do with your SHBG and your overal metabolism

Typically anything over 200mg will push you well above range. Also unless you space out that amount into frequent injections that large an amount hitting your system will most likely yield a lot converting to E2 which will create an entire additional set of issues

Im a big guy 6'5" 240lbs 13% bf. I also am a hyper excreter and have low SHBG and I still dose way under 200mg weekly More is not always better....
 

Gene Devine

Super Moderator
#4
Because higher doses will put most guys well above the physiological range that a normal man could possibly attain naturally.

Plus the higher doses will almost always lead to negative health effects in the long term. The most apparent issues include elevated hematocrit and RBCs, hypertension, and an increased risk for stroke and cardiac problems. The goal is to "replace" poor hormone levels with adequate ones. Going too far above and beyond those levels isn't a natural state for the male body.

I have no issues with somebody wanting to go above the range or use steroids, but its not TRT.
^^^^What this guy said...and I have nothing else to add as he stated correctly.

If you want to go on a "blast and cruise" protocol you can and I know guys who do that successfully but that's a bit different than TRT...more like a modified TRT/AAS protocol.
 
#7
You know, I was wondering the exact same thing (what OP wrote about). If you can continue staying healthy, and manage healthy levels of hematocrit and HDL cholesterol (and your E levels don't shoot up like crazy), then why should "steroid" dosages not just be considered a more intense form of TRT? It's about health and well-being, isn't it? Everyone's different, and everyone's needs are different. I just wish that doctors would have more flexibility with treatments and dosages...
 
#8
From the gym aspect you shared I'll condur, there's no way, now, that I'd be on a lower dose, currently 97mg 2x week, just because I love that aspect of it. It's 4 or 5th down the line of my pre-TRT symptoms that needed and have been resolved. I was killing myself in the weight room and having little to show for it. Literally. Effort and results were wildly disproportionate.
Do I feel fantastic on almost 200mg a week? Not really. I'm pretty good, taking a low dose of AI (.25mg 2 x week) and cruising right along. I do have the high RBC/Hmatocrit/Hemoglobin and donated a pin 7 weeks ago.

I observe the 200mg limit, but if some one told me I could feel just as good on 100 or 150 would I reduce my dosage? NOPE.
 

Nelson Vergel

Founder, ExcelMale.com
#9
I think all of you guys would enjoy reading this study that found that 125 mg per week (Total blood level of testosterone of 542 ng/dL) is the lowest dose needed to achieve statistically significant decreases in fat mass and increases in lean body mass. Of course, if you use 100 mg per week of TRT plus HCG, this combo MAY equate to 125 mg per week (speculative).

Responses of different doses of testosterone injections on body composition, strength, etc.
 
#11
I agree it not body size. My perscription is 200mg a week 500iu hcg x 2. I always stay under 200mg that amount. and I also reduce my dosage and add a third shot some times becuase I get concerns about E2 and hemocrites getting too high. I'm a smaller framed guy. My weight ranges in the 160's to 170lbs. So far I've had no negative side effects. My gp flipped when my total was over 900 and told me I had to go back to 100mg a week. I explained I felt much better and that I would adjust my dosage down on my own a bit. So I stay compliant and safe. I just had a followup with Dr and thought I could increase by 10 mg 2 times a week.
I definitely feel better at the gym and thought out the day on a higher dosage.
 
#12
950 Total T

I agree it not body size. My perscription is 200mg a week 500iu hcg x 2. I always stay under 200mg that amount. and I also reduce my dosage and add a third shot some times becuase I get concerns about E2 and hemocrites getting too high. I'm a smaller framed guy. My weight ranges in the 160's to 170lbs. So far I've had no negative side effects. My gp flipped when my total was over 900 and told me I had to go back to 100mg a week. I explained I felt much better and that I would adjust my dosage down on my own a bit. So I stay compliant and safe. I just had a followup with Dr and thought I could increase by 10 mg 2 times a week.
I definitely feel better at the gym and thought out the day on a higher dosage.
I started to notice body composition changes when my total T was around 950. My T was 950 or so with around .75 cc test per week ( about 150mg T I believe), two arimidex at .5mg and two HCG injections. I am sure that for a 24 hour window or so after that dose my T was higher. At that dose, I noticed a decrease in abdominal fat which came somewhat as a surprise as I was not doing anything different then usual. No great strength gains above normal nor better muscle mass gains- just body composition improve with 4 X Weight training a week and no cardio. Blood lipids were high but have always been so, but the ratio of good to bad has always been such as no one has seen medication required. BP was no different then usual - Higher then normal. I believe that any increase in my bp was handled by prescription of one dose 20mg furosemide per day. I probably could have used the furosemide before I started the TRT. One touchy point on the TRT, to keep it recognized as medically appropriate and available treatment it is important to distinguish it from a purely cosmetic drug abuse as is the case in many bodybuilders. I am not a physician, so I am not sure, higher hormones then normal may be medically appropriate in some disease states ( perhaps even obesity), but most physicians will not prescribe nor allow a patient to take T at higher doses to approve muscle mass. Sarcopenia maybe- HIV associated issues...maybe.
 
Thread starter #13
I'm not too concerned about hemocrit levels. I've been donating blood for the last thirty years, and since I started TRT last year I've made a point to donate whole blood every two months or double-red cells every four months, and my hemocrit levels are just fine (range between 47-50). I gave blood last Sunday, and my BP was 108/72, with a resting pulse of 62, so I'm not having BP issues either.

I've noticed a steady body composition change on a protocol of 200 mg/wk test cyp, 1000 iu/wk HCG, 1 mg. anastrozole (split in two Mon/Fri). I'm down about 16 lbs. from late December 2013 (from 251 lbs. to 235 lbs.) and that's mostly a reduction in fat. My strength's gone up a bit, basically back to where it was ten years ago (I'm 50 now), and in some instances I'm stronger. I'm 20 lbs. heavier than I was when I was at 40, and a good bit of that is muscle, so I can't attribute all my strength gains to TRT, but some of it clearly is. And my motivation and recovery speed has definitely improved, and improves further when I up the dose to 300 mg/wk. I'm not saying "more is better" or advocating that people up their dose, but obviously people respond differently to the same dose, and in my case I feel better, stronger, more energetic and more motivated on a higher dose. Plus I get a libido boost, which is a big deal for me. I have terrible sleep patterns, work 60-70 hours a week, and drink 3-4 cups of coffee a day, so it's a giant relief when I wake up feeling strong, rested and have some semblance of an interest in sex.

Can any of the MDs weigh in on this from a clinical standpoint? If all test results come back within range, and I'm not having any unmanageable side effects, I don't know why (medically) there would be a big issue using a slightly higher cruiser/replacement dose. I understand that there are potential political ramifications, of course, including the possibility that the feds start cracking down on doctors prescribing higher doses on the theory that it is for athletic performance rather than TRT, but that's a different conversation. My understanding from bodybuilding sites is that a typical newbie AAS cycle is 500 mg/wk test cyp plus anti-estrogens plus additional testosterone-analogue orals, so 250-300 mg/wk for a non-competing 50-year old wouldn't seem to invite the argument that I'm abusing TRT.

I'll post my new labs after I get back from my meeting with my doctor this Friday.
 

Gene Devine

Super Moderator
#14
It's NOT about the dosage of testosterone as it is what blood work says first and second how the man feels.

Most normal otherwise healthy men who have low serum levels due to age related decline and exhibit symptoms don't need 200 mg a week.

Most men do well on 100 mg a week complimented with HCG in the 500 to 750 iu range per week as it also helps to produce endogenous testosterone.

200 mg is a lot and when you consider that a young healthy male produces somewhere between 6 to 10 mg a day of natural endogenous testosterone one can see why 200 mg a week is a lot...a real lot, with many potential unwanted potential side effects.
 
#15
It's NOT about the dosage of testosterone as it is what blood work says first and second how the man feels.

Most normal otherwise healthy men who have low serum levels due to age related decline and exhibit symptoms don't need 200 mg a week.

Most men do well on 100 mg a week complimented with HCG in the 500 to 750 iu range per week as it also helps to produce endogenous testosterone.

200 mg is a lot and when you consider that a young healthy male produces somewhere between 6 to 10 mg a day of natural endogenous testosterone one can see why 200 mg a week is a lot...a real lot, with many potential unwanted potential side effects.

1) Aren't there men who feel just fine with T levels of 400-500 ng/dl? In cases like that, wouldn't it be better to just let them stay on the low end, if they report no ill effects and are happy and fully functional in all aspects?

2) Don't different doses of exogenous testosterone raise T levels differently in different men? Like I've heard of people that take 120 mg/weekly, and their T levels are like 700 ng/dl. Others take the same dosage, and their levels are 900+. Aren't some men more receptive to testosterone, and others less? Like those with higher/lower SHBG levels, those whose androgen receptors are more "receptive" (is that a thing? lol), etc etc...

3) Doesn't the fact that it is exogenous testosterone change the game a bit? Those men who produce 6-10 mg a day (let's say a max of 70/weekly), that is roughly equal to 100 mg cypionate a week ('cause it's like 60-70 mg of actual testosterone). Yet, in TRT 100 mg cyp a week is considered on the low end, isn't it? So does the body biologically react differently to exogenous testosterone?
 
Thread starter #16
OP update:

Here are the salient results from my labs taken 1/20/15 after 1 year on TRT with a weekly protocol (split Mon/Fri) of 200 mg. test cypionate, 1000 iu HCG, 1 mg. arimidex, plus 1-2 pumps per day of Androgel (the last five months), and the occasional week of 300 mg. test cyp (when I've got surplus from under-injecting at the end of a 10 week cycle).

Total test: 1202 ng/dL [ref range 348-1197]
Free test: 28.5 pg/mL [ref range 7.2-24.0]
PSA: 0.6 ng/mL [ref range 0.0 - 4.0]

Cortisol: 4.0 ug/dL [ref range 2.3-19.4]

DHEA-Sulfate: 302.4 ug/dL [ref range 71.6-375.4]
Vitamin D, 25-hydroxy: 105.0 ng/mL [ref range 30.0-100.0]
IGF-1: 162 ng/mL (last year 174) [ref range 67-205]

Total cholesterol: 199 mg/dL
LDL-P: 1830 nmol/dL (last year 2363)
LDL-C: 126 mg/dL (last year 165)
Small LDL-P: 831 (last year 837)
HDL-C: 44 mg/dL (last year 48)
HDL-S: 30.3 umol/L

Homocysteine: 7.1 umol/L (last year 7.4) [ref range 0.0 - 15.0]
C-Reactive Protein: 0.50 mg/L (same as last year) [ref range 0.00 - 3.00]
Hemoglobin: 17.4 g/dL [ref range 12.6 - 17.7]
Hematocrit: 51.1 [ref range 37.5 - 51.0] [gave blood after lab tests]
Hemoglobin Alc: 5.1 (last year 5.3) [ref range 4.8 - 5.6]

Glucose, serum: 81 mg/dL (last year 98) [ref range 65-99]
Insulin, fasting: 10.3 uIU/mL (last year 19.1) [ref range 2.6- 24.9]

TSH: 0.013 uIU/mL [ref range 0.450-4.5]
T4, free: 1.11 ng/dL [ref range 0.82-1.77]
Triiodthyronine [T3], free, serum: 5.0 pg/mL [ref range 2.0 - 4.4]
 
#17
Haha it's amazing nobody responded to those labs.

Those bloods look perfect man! Lol

Are you still on th same protocol?

After experiencing
Wanting low dose daily and low dose EOD I'm going back to high dose twice a week.

Feels better. Erections no comparison. Strength is up. E2 toughest part of it That's where Arimidex comes in.

Very curious to know how you're doing a year later.

Labs still look magnificent???
 
#18
My cholesterol levels was good at 400 ng/dl of testosterone. When my levels was 1700 ng/dl of testosterone and I also used omega 3 and red yeast rice, my doctor said: "your cholesterol is excellent" :D
 
#19
Simple answer raise the dose, is it the right answer? Running underground gear it always seemed I needed 400mg/week to feel good, this was 2x 200mg injections per week. That dose seemed to overcome my body's physiologic resistance and/or were sufficient to maintain a trough level that was still adequate. Whereas 200mg/week TRT always trying to "dial it in", blood levels looked good, eventually got frustrated and gave up. I may, probably will get back on TRT, but I doubt if >200mg will be an option. Perhaps inject eod to minimize peaks and minimize E conversion.
 
#20
I've been on 200 a week for 5 years and that is my sweet spot as it keeps me at around 900 ng/dl. I have played around with different dosages and do monthly labs. No AI needed. Estrodial is at the high end of normal and I feel better than when it's low with an AI
 
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