Ask yourself why we even have reference ranges. They are used to diagnose and treat disease/dysfunction. The dysfunction is clearly associated with levels above or below the range. I hope you aren't claiming otherwise.
For all the supporting studies you claim to have, all you can do is return to this one that didn't even look at intermediate doses for once-weekly injections, such as 75-100 mg TC/week. It is not relevant to the discussion here that once-weekly injections of 50 mg TC leads to periods of hypogonadism and poor results. I have never advocated such a protocol. It appears that a single straw man argument is all you have.
Do I need to explain the differences between a nutrient and a hormone? [Edit:
News story today. Too much of anything is bad. What a surprise.]
Not one that compared mid-physiological levels to supraphysiological levels.
There you go. Exactly what I've been saying. You don't begin treatment as if everyone is an outlier who needs high doses of testosterone. You start at average levels and work from there. Case closed.
Now you're inventing stuff again. Where's the study showing that 100-120 mg TC/week is better than 75 mg/week? Just because some TRT doctors cater to the more-is-better mentality doesn't mean that results are actually better. On the contrary, anecdotally we see a lot of suffering from this approach.
Just can't let go of the straw man, can you?
What I would actually claim is that the risks in starting with 50 mg TC/week
in divided doses are less than the risks in starting with 100+ mg/week at any dose pattern.
This exposes a further flaw in your reasoning. Unlike in the study, normal men beginning TRT have endogenous testosterone, to which the exogenous testosterone is added. Given that 100 mg TC/week is already supraphysiological for most men, the exogenous boost initially sends levels well above even marginally high. So you get the honeymoon, followed by an anti-honeymoon crash when endogenous production shuts down. Starting with 50 mg TC/week
in divided doses would do a much better job of keeping patients physiological during the transition period. But then you don't think that being physiological is meaningful, do you?
A single study that only supports a straw man argument. In what world are choices for TRT limited to 50 mg or 125 mg TC once a week?
Same study, endless repetition.
Well at least 80 mg TC/week is an improvement over 100 mg. Grok estimates that about 20% of healthy young men make this much or more testosterone, on average. However, I question your estimation of "countless anecdotal reports". In my estimation, the number of reports of men starting TRT at say 60-80 mg TC/week and switching to 100+ mg for the long haul is quite small, and negligible compared to the number who start at 100+ mg and complain about intractable problems.
Yet you still haven't provided evidence for this. Quote a study that says as much. Not one where the comparison is to hypogonadism, e.g. 50 mg TC once a week. The study should also focus on overall health and quality of life rather than body composition.
Your logic only applies if the physiological range is some meaningless construct.
Only if decades of medical science is to be ignored.
