Your usual retreat to ad hominem statements merely highlights your inability to defend your position. Your bad advice has almost certainly harmed some men. Neither you nor Mr. Goodman can articulate why starting TRT at supraphysiological doses is a good idea. You'd be hard pressed to name other hormones where this is common medical practice.
Numbers pulled out of thin air. Doing great is highly subjective. Personally I've found that even overdosed TRT feels better than being hypogonadal. It was relatively "great", but then side effects came sneaking in over the years.
You haven't provided a single study to this effect. You know there isn't one. The line you are looking for is "We find that in treating hypogonadism, dosing testosterone initially to achieve supraphysiological serum levels of free testosterone is preferable to adopting a low-and-slow approach that begins in the low-to-mid physiological range." Not going to find it. Not now, not ever, because it is flat-out wrong.
There are certain rare conditions that may require higher doses. But that in no way justifies inflicting misery on a much larger population. It's a trivial matter to continue titrating upwards in these rare situations you're hanging your hat on.
Exactly. Yet you and Vince are wanting to dose everyone as an outlier. That defies all logic.
Don't misrepresent me, and don't keep lying about the studies. Although I consider such higher doses to be suspect in most cases, I'm not haranguing the ones claiming to do great. They are adults and can make their own decisions about the potential long-terms risks of high androgen load. The ones I deal with are here sharing their misery over the effects of excessive dosing. They were never given a chance to start with more sensible protocols.
Said approach being based on the published research, which I trust more than a few guys on the Internet saying they do great on higher doses, mostly without even trying lower ones.
Like it or not, levels are a useful source of guidance. You name the hormone, and low or high levels are associated with a variety of problems.
Word is getting out that free testosterone is the better parameter to track. This is more important when SHBG is unusually high or low. Remember, you said "But we don’t base general guidelines on outliers." Thus historical guidance based on total testosterone did not address the SHBG outliers.
We're not only talking about short-term, acute events. The issues include long-term wear-and-tear on the vasculature, cumulative cardiotoxicity, impairment of libido and sexual function via hormonal disruption, etc. You have presented exactly zero evidence in support of starting out TRT at such levels. You're so invested in your position that you can't appreciate the absurdity of skipping physiological dosing at the beginning. Really? Nobody should be given the opportunity to experience something close to their healthy natural levels? That's crazy.
Based on nothing. The stream of guys with side effects say otherwise.
A lot to breakdown here, but I’ll start with these since I find your accusations of me lying to be most offensive.
You said this:
Don't misrepresent me, and don't keep lying about the studies. Although I consider such higher doses to be suspect in most cases, I'm not haranguing the ones claiming to do great. They are adults and can make their own decisions about the potential long-terms risks of high androgen load. The ones I deal with are here sharing their misery over the effects of excessive dosing. They were never given a chance to start with more sensible protocols.
I’m not misrepresenting you. Hell, you said this in this very thread.
I don't recall seeing you document the amount of time you've spent using low/medium physiological doses to firmly establish that they don't work for you. Maybe there are older posts to this effect? For it to count you'd have to spend a few months at these levels, e.g. 50-70 mg TC/week. Or did you just start high and go higher? In some cases going higher ameliorates some imbalances, but that doesn't mean that lower/more natural doses wouldn't provide even better results.
You are encouraging my speculation that you haven't even tried physiological dosing and therefore have no idea what you're talking about.
You’re suggesting his experience and advice doesn’t count because he won’t cut his dose drastically to see what lower levels are like. You’ve done the same to me, as well as others on this forum. So no, you don’t just give the advice to people experiencing issues and I’m not misrepresenting you.
Secondly. I’m not lying about the studies. There are numerous studies which show more benefits at 100 mg/week over 50. And again the safety of these doses ranging from 100-125 is well-established. Meanwhile you even shared a study which found that even when tripling total t levels from 450 to around 1500 the risk profile was the same on all fronts except hematocrit… and again the traverse trials indicate that as long as levels are lower than 54 then risk doesn’t increase meaningfully.
Meanwhile… what other studies have you shared??
1.) a rodent study where they dosed them to 5x natural levels
2.) a couple of articles about doctors sitting around coming up with how to approach treatment.
3.) a meta analysis that found trt to be safe and listed the benefits but did not compare various does.
4.) another study that doesn’t compare doses
5.) a link to appendix C which isn’t a study at all but I’m assuming you shared to go along with the jclinique link. The only dose comparison info I see is this:
A study of 61 eugonadal men given 25, 50, 125, 300, or 600 mg of testosterone enanthate weekly found that sexual function did not change significantly with dose.
∙ A bone study found that men receiving 50 mg/day testosterone gel showed no BMD increase, while those on 100 mg/day did show hip and spine BMD gains.
∙ HDL declined significantly only in the group receiving the highest dose (600 mg testosterone enanthate monthly) in a dose-ranging study testing 25, 50, 125, 300, and 600 mg.
Which actually supports MY case, not yours.
5.) an analysis that doesn’t compare different doses
6.) another one that doesn’t compare different doses
7.) another one that doesn’t compare different doses
THOSE are the studies AI gave you to convince you that you had a better argument?? Most don’t even compare various doses, and of the ones I found that did, they actually support my case instead of yours. But hey, I guess AI did its job by telling you what you want to hear.
Now, I’ll ask again since I’ve already shared studies which support my case for doses between 100-120( and funnily enough SO HAVE YOU just lmao)… can you provide a study that shows 50 mg test per week provides as many or more benefits than 100 mg per week?
And lastly, I created a thread in the past in the hopes of capturing this discussion there to prevent it from spilling into others so feel free to discuss there. Then again, I guess it’ll occasionally re-emerge since you continue to just dismiss all of the evidence and continue to tell people their experiences and insight don’t count because they have never been on a dose of 50 mg/week so they have no idea what they’re talking about. Just lol
academic.oup.com
www.auanet.org
pmc.ncbi.nlm.nih.gov
academic.oup.com
www.frontiersin.org
www.cureus.com
