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Is the "one size" my counsel for moderation when starting out? If so you're acting as though the low-and-slow approach to hormone replacement—and often to meds/supplements in general—is some weird idea I came up with at random. Do you remember John Crisler?

It's absurd to characterize a normal range that encompasses at least 95% of the population as "one size". Furthermore, as a long-time resident here you should be well aware that being an outlier is problematic, and is associated with reduced longevity and other problems. You've convinced...

The usual straw-man nonsense. Let me fix that for you: "Physiological testosterone levels equal better health."

Actions speak louder than words. Even Defy Medical seems to routinely start guys with well over 100 mg TC/week. Yet the available evidence does not support this approach when overall good health is the goal. It's easily inferred that this is a result of more-is-better thinking specific to...

I think compared to hypogonadism even dated TRT protocols would provide some relief. But you must be aware that nobody around here is going to recommend taking 200 mg TC once every two weeks. It's not an assumption, but standard medical practice for just about any hormone other than...

That's a bit of a hit-and-run. I'm prepared to defend my hypotheses, particularly the one saying that a starting dose of 100 mg TC/week is excessive. The main caveat is that these high doses came about due to the assumption of infrequent injections—once or twice a month to once a week. Under...

For quite some time I was using 18 mg TE EOD, which resulted in TT of ~800 ng/dL, SHBG ~30 nMol/L. Vermeulen calculated free T was around 20 ng/dL, which puts it in the mid to lower part of the top quartile for healthy younger men. The worst symptom I'd link to this was a persistent headache. It...

By conventional standards I was never on high doses. But when I started out with 100 mg testosterone cypionate per week delivered EOD it put TT at about 1,250 ng/dL. Thanks to the influence of the late Curt Moyer I knew this was higher than I wanted, and titrated down to more like 65 mg/week...

I would guess at least 1,200-1,300 ng/dL for your peak. It is considered standard practice to test at trough, but then you do need to keep in mind that the peak is a lot higher with weekly injections. With twice-weekly injections peaks may be more like 50% over troughs. To some extent testing at...

I don't know the practical limitations on particle size for testosterone suspension. Maybe there's a cost-benefit tradeoff? In addition, the interest in very fast-acting testosterone is more recent and still limited. Bear in mind that testosterone basically does not dissolve in water. However...

Your instincts are good with respect to dose frequency. With once-weekly doses of testosterone cypionate it's common to have peak levels that are two to three times trough levels. This is decidedly unnatural. Assuming your lab work is at trough then you are likely going from very high to mid-low...

Apparently this study did not track free testosterone, which makes the results considerably less useful. Higher BMI is expected to correlate with lower SHBG [R], which leads to lower total testosterone for the same level of free testosterone. Therefore these cohorts with different BMIs could...

The most common cause of thyrotoxicosis in pregnancy is gestational transient thyrotoxicosis (GTT), which occurs from the stimulatory action of human chorionic gonadotropin (HCG) on the TSH receptor. https://pmc.ncbi.nlm.nih.gov/articles/PMC4166486/ Interesting. There's always something new...

I can't say with certainty, but I think it's associated with improved mood and motivation. There are no side effects that I'm aware of.

I do take it orally, on waking with an empty stomach.

Yes, I've been taking 2.5 mg/day consistently.

I've taken the first one, which is to investigate where the missing testosterone went. It appears likely that the filtering action of a small needle is part of the problem, along with wastage via particle deposition on the vials. The empty vial that had contained 1 mL of the TS and 1 mL of...

If you're including testosterone suspension in this then yes, I am using it as a form of TRT. As documented here, I recently tried measuring the response over time. My protocol has involved injecting a nominal 1.5 mg three times a day. But based on lab work I'm beginning to suspect the actual...

This is very much in line with my thinking, particularly the part about a longer HTPA shutdown being more problematic. In my case the addition of hCG was an improvement, but it never led to consistent libido and/or sexual function, and things still went downhill over the years. Dropping the hCG...

Lately I’ve been insinuating that some testosterone suspension products may qualify as fast-acting, and therefore be in the same league as testosterone nasal gels and buccal troches. The “fast-acting” quality is important if the goal is to retain HPTA function in the presence of exogenous...

I do believe that TRT in just about any form is preferable to hypogonadism. However, now that we have an increasing number of choices that are less disruptive of the overall hormonal milieu I would hope these eventually become the new standard of care.

These are all relatively short and with small N, as they acknowledge: "A large number of clinical trials with relatively small numbers of participants, have been conducted to investigate the effects of testosterone, for generally limited durations of intervention, on various cognitive function...

As noted, GnRH may play a role in adult neurogenesis. Also in the post I linked to: ”[1] Furthermore: “Multiple lines of evidence indicate that the expression of extrapituitary GnRH receptor is not limited to reproductive tissues. For instance, it has been demonstrated by RT-PCR and Southern...

Which studies evaluated the rates of dementia? Healthy controls or just untreated hypogonadal subjects? What's needed to answer this question more definitively is a study with large N that has matched eugonadal men as controls. The study needs to last long enough and/or have old enough subjects...

Regardless of whether the testosterone is endogenous or exogenous, the fraction that is aromatized is trivial, and you'd be unable to detect such an increase, subjectively, or even with current lab tests. On the other hand, knocking down a big fraction of estradiol is what can cause significant...

That's good to know and nice work by Maximus. It sounds like I may be able to add it to the list of short-acting testosterone treatments. I still don't like the use of the term "bioidentical" to differentiate it from products that in the end also yield bioidentical testosterone. "Non-esterified"...

DHT is created from free testosterone. The rate of creation is not expected to change with lower estradiol. This means free DHT should not change. But as with testosterone, if SHBG is driven down by the lower estradiol then total DHT may drop. I should add that I'm ignoring the tiny amount of...

In this situation an aromatase inhibitor should not affect your free testosterone. It could indirectly affect total testosterone by reducing estradiol. Lower estradiol can lead to lower SHBG and therefore lower total testosterone as well. Your dose of testosterone has likely suppressed LH and...

As I recall, all of the oral forms of testosterone have considerably longer half-lives than the nasal gels. Something like a few hours versus less than an hour. This makes the difference between significant and possibly complete suppression of the HPTA, versus relatively minor suppression. Over...

It's less common to have low-T symptoms with that level of free testosterone. I would steer you away from the three treatment options you're considering. They all come with some risk of doing more harm than good given that you're not firmly into hypogonadal territory. If you want to explore...

I’ve covered this issue in many posts, but I thought it would be helpful to put more information in one thread and expand on the topic. TL;DR: Under TRT, free testosterone is proportional to the dose rate and inversely proportional to the metabolic clearance rate. The liver accounts for most of...