Blood panel, how's mine look?

[Cataceous]

...
No one around here believes the more the better. I'd never heard anyone say that or write that.

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 testosterone.

 

[Vince]

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 testosterone.

I disagree 100% with your theory. Lower testosterone levels equal better health. There's so much you're missing.

 

[Cataceous]

I disagree 100% with your theory. Lower testosterone levels equal better health. There's so much you're missing.

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

 

[Vince]

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

Yes. there are members like you who need lower levels. My understanding is anxiety can be terrible and if someone needs lower level to combat anxiety, I'm all for it.

This one size fits off doesn't work for me.

 

[Cataceous]

Yes. there are members like you who need lower levels. My understanding is anxiety can be terrible and if someone needs lower level to combat anxiety, I'm all for it.

This one size fits off doesn't work for me.

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 yourself that you need supraphysiological amounts of testosterone. Obviously in the absence of objective data I can't disprove that. But from a statistical standpoint, the fraction of men who actually need these higher doses for optimal health is going to be minuscule.

By the way, I personally find higher doses to be in some respects sedating and demotivating. Great for athleticism, but terrible for just about everything else.

 

[FunkOdyssey]

My aromatization runs at the higher end. In the last test estradiol was about 29 pg/mL, which would be unremarkable except that testosterone was only about 310 ng/dL.

By the way, I personally find higher doses to be in some respects sedating and demotivating. Great for athleticism, but terrible for just about everything else.

I would suggest the second statement follows from the first. Excessive E2 has anti-dopaminergic effects via at least three distinct mechanisms: disinhibited prolactin release (prolactin reduces DA synthesis and firing), downregulation of D1 and D2 receptors, and a serotonin/GABA crosstalk phenomenon (E2 increases serotonin synthesis, reduces its clearance, and increases expression of 5-HT2C receptors, while activation of 5-HT2C receptors on GABA neurons increases GABA release, which then reduces firing of DA neurons). There's even a possible fourth mechanism whereby high E2 increases progesterone and allopregnanolone synthesis in the brain that I'm still trying to wrap my head around (more GABA-A potentiation from these).

As an aside, there are fascinating differences in male vs. female neurobiology which explain why high levels of E2 do not have these anti-dopaminergic effects in women (just the opposite, in fact). Doesn't bode well for MtF trans people.

But when I started out with 100 mg testosterone cypionate per week delivered EOD it put TT at about 1,250 ng/dL.

I am very curious what your E2 was at this 1250 ng/dL T level, if it was 29 pg/mL at only 310 ng/dL T. I've been at ~1250 ng/dL total T with an E2 of 87 pg/mL, which felt like apathetic brain-fogged garbage, and am more recently at ~1250 ng/dL T with an E2 of 30 pg/mL, which feels great. Critically, the lower E2 needs to be achieved naturally and not via aromatase inhibition.

I think it would be a fun project to transform you from a high aromatizer into a low aromatizer, with lower % BF, lower insulin, and longer needles delivering T deeper into the muscles. Would your disparaging attitude towards higher doses survive the experience of walking around with 1200 total T and 30 pg/mL E2? I, for one, would love to find out.

 

[Vince]

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 yourself that you need supraphysiological amounts of testosterone. Obviously in the absence of objective data I can't disprove that. But from a statistical standpoint, the fraction of men who actually need these higher doses for optimal health is going to be minuscule.

By the way, I personally find higher doses to be in some respects sedating and demotivating. Great for athleticism, but terrible for just about everything else.

I'm so sorry you feel that way. I will never believe like you do that one size fits all. Not every member gets anxiety I've never had but I do know people that do. They're not even on TRT.

I was waiting for you to speak up when Nelson said he's taking 600 mg of Co q10. I'm sure his levels are out of range.

Post in thread 'Treatment of Chronic Fatigue Syndrome and Fibromyalgia with D-Ribose'

Apr 20, 2016

I love how much better I feel with Coenzyme Q-10 high dose of 600 mg per day and L-Carnitine 2000 mg/day

• Nelson Vergel

 

[Cataceous]

... I will never believe like you do that one size fits all. Not every member gets anxiety I've never had but I do know people that do. They're not even on TRT.

I was waiting for you to speak up when Nelson said he's taking 600 mg of Co q10. I'm sure his levels are out of range.
...

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?

 

[Vince]

Mindless repetition does nicely enhance the insipidness of your content. 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?

The levels issue are only for testosterone?

Feature Article: January 2019 - In Memoriam: Dr. John Crisler - Age Management Medicine Group (AMMG)

Feature Article: January 2019 - In Memoriam: Dr. John Crisler

agemed.org

 

[Cataceous]

I would suggest the second statement follows from the first. Excessive E2 has anti-dopaminergic effects via at least three distinct mechanisms: disinhibited prolactin release (prolactin reduces DA synthesis and firing), downregulation of D1 and D2 receptors, and a serotonin/GABA crosstalk phenomenon (E2 increases serotonin synthesis, reduces its clearance, and increases expression of 5-HT2C receptors, while activation of 5-HT2C receptors on GABA neurons increases GABA release, which then reduces firing of DA neurons). There's even a possible fourth mechanism whereby high E2 increases progesterone and allopregnanolone synthesis in the brain that I'm still trying to wrap my head around (more GABA-A potentiation from these).

As an aside, there are fascinating differences in male vs. female neurobiology which explain why high levels of E2 do not have these anti-dopaminergic effects in women (just the opposite, in fact). Doesn't bode well for MtF trans people.
...

There's this complexity, and probably even more. I have dabbled with anastrozole when my TRT dose was higher, and I also had a period with very low estradiol for some other reason. I don't recall that these had much effect on motivation. The anastrozole would dampen excessive emotionalism. Very low estradiol totally knocked out libido and made me feel emotionally flat.

I am very curious what your E2 was at this 1250 ng/dL T level, if it was 29 pg/mL at only 310 ng/dL T. I've been at ~1250 ng/dL total T with an E2 of 87 pg/mL, which felt like apathetic brain-fogged garbage, and am more recently at ~1250 ng/dL T with an E2 of 30 pg/mL, which feels great. Critically, the lower E2 needs to be achieved naturally and not via aromatase inhibition.

I think it would be a fun project to transform you from a high aromatizer into a low aromatizer, with lower % BF, lower insulin, and longer needles delivering T deeper into the muscles. Would your disparaging attitude towards higher doses survive the experience of walking around with 1200 total T and 30 pg/mL E2? I, for one, would love to find out.

My E2 was 57 pg/mL when TT was close to 1,250 ng/dL. Interestingly that's one of my lower aromatization rates when not on an AI. I wonder if the saturation effect was starting to kick in? I also see that early on I was using Androgel and measured TT ~600 ng/dL and E2 ~20 pg/mL, an even lower rate of aromatization, perhaps due to the DHT.

I doubt body fat is much of an issue. Not that it can be trusted, but the scale puts BF at 12%. In any case, I would claim to be skinny-muscular, not skinny-fat. Similarly I doubt insulin is much of an issue. Last year the fasting value was 2 uIU/mL, below the reference range. I expect my skepticism would survive the experience of 1,200 ng/dL TT and 30 pg/mL E2. The enhanced athleticism would again be fun. But if the headaches returned then stopping would be a no-brainer, pardon the pun. Similarly, the deteriorating lipids would not be appreciated. With respect to libido and sexual function, I have to mention again that even with that recent excessive E2/T ratio and low TT, these parameters were more consistently good than at any other time on TRT. Admittedly there's added complexity here with my continued use of kisspeptin-10 and gonadorelin. But my expectation is that knocking these out would simply make things worse. I assume your suggested experiment results in full HPTA suppression? I also assume that hCG use would be excluded because that would make it virtually impossible to keep E2 down at 30 pg/mL naturally.

Though Vince doesn't seem to get it, I think I've made it pretty clear that I'm not opposed to informed individuals such as yourself experimenting with TRT doses and ancillaries as you see fit. What bothers me is seeing this parade of guys who are being harmed by high doses given right from the start. As I have said many times before, these situations often get worse when the symptoms of excess are not addressed by lowering the dose. Instead we see bloodletting for high HCT and AIs for high E2. More subtle issues often remain unaddressed. I believe that some fraction of men will have problems from the secondary effects of HPTA shutdown. But at this time there's little official recognition of this, or of the possibility that short-acting testosterone is a solution.

 

[Vince]

There's this complexity, and probably even more. I have dabbled with anastrozole when my TRT dose was higher, and I also had a period with very low estradiol for some other reason. I don't recall that these had much effect on motivation. The anastrozole would dampen excessive emotionalism. Very low estradiol totally knocked out libido and made me feel emotionally flat.



My E2 was 57 pg/mL when TT was close to 1,250 ng/dL. Interestingly that's one of my lower aromatization rates when not on an AI. I wonder if the saturation effect was starting to kick in? I also see that early on I was using Androgel and measured TT ~600 ng/dL and E2 ~20 pg/mL, an even lower rate of aromatization, perhaps due to the DHT.

I doubt body fat is much of an issue. Not that it can be trusted, but the scale puts BF at 12%. In any case, I would claim to be skinny-muscular, not skinny-fat. Similarly I doubt insulin is much of an issue. Last year the fasting value was 2 uIU/mL, below the reference range. I expect my skepticism would survive the experience of 1,200 ng/dL TT and 30 pg/mL E2. The enhanced athleticism would again be fun. But if the headaches returned then stopping would be a no-brainer, pardon the pun. Similarly, the deteriorating lipids would not be appreciated. With respect to libido and sexual function, I have to mention again that even with that recent excessive E2/T ratio and low TT, these parameters were more consistently good than at any other time on TRT. Admittedly there's added complexity here with my continued use of kisspeptin-10 and gonadorelin. But my expectation is that knocking these out would simply make things worse. I assume your suggested experiment results in full HPTA suppression? I also assume that hCG use would be excluded because that would make it virtually impossible to keep E2 down at 30 pg/mL naturally.

Though Vince doesn't seem to get it, I think I've made it pretty clear that I'm not opposed to informed individuals such as yourself experimenting with TRT doses and ancillaries as you see fit. What bothers me is seeing this parade of guys who are being harmed by high doses given right from the start. As I have said many times before, these situations often get worse when the symptoms of excess are not addressed by lowering the dose. Instead we see bloodletting for high HCT and AIs for high E2. More subtle issues often remain unaddressed. I believe that some fraction of men will have problems from the secondary effects of HPTA shutdown. But at this time there's little official recognition of this, or of the possibility that short-acting testosterone is a solution.

Still you can't group everyone as the same. I started with 70 mg of T twice a week along with 500 IU twice a week. All my brain fog was gone. It was amazing. For whatever reason I was in great shape before TRT. What really helps me is creatine. As you may have read in my threads, it healed my tendonitis in my achilles tendon. But still not everyone does good on creatine again. One size does not fit all. I know that goes against your theories

 

[Systemlord]

I disagree 100% with your theory. Lower testosterone levels equal better health. There's so much you're missing.

That’s what it is, a theory. No data saying above normal testosterone is unhealthy. Some people are just more conservative but that doesn’t mean they’re the authority on the matter.

 

[Vince]

That’s what it is, a theory. No data saying above normal testosterone is unhealthy. Some people are just more conservative but that doesn’t mean they’re the authority on the matter.

I do agree with the anxiety issue. Some men with anxiety, trt can help others it can really hurt.

If someone has anxiety issues like Cataceous, you need to start very low. Let their hormones adjust slowly.

Thankfully I do not fit in that box and have zero issues at least up to this point in my life with anxiety.

 

[Cataceous]

Still you can't group everyone as the same. I started with 70 mg of T twice a week along with 500 IU twice a week. All my brain fog was gone. It was amazing. For whatever reason I was in great shape before TRT. What really helps me is creatine. As you may have read in my threads, it healed my tendonitis in my achilles tendon. But still not everyone does good on creatine again. One size does not fit all. I know that goes against your theories

A one-size-fits-all approach is a doctor who gives all his patients 140 mg TC per week right from the start. And from there his plan is bloodletting to control cases of high hematocrit and AIs to address symptoms of high estradiol. This results in unnecessary suffering by many of his patients. The better approach is to start with 60-80 mg TC/week and titrate as needed. The creators of Xyosted understand this. But others still yield to more-is-better thinking. You are defending the indefensible.

...
If someone has anxiety issues like Cataceous, you need to start very low. Let their hormones adjust slowly.
...

Ok, this is amusing. I haven't had anxiety since around when I started TRT—perhaps one of the biggest benefits of all this hormonal tinkering.

Let me be blunt. You are well-meaning and trying to be helpful, but your posts tend towards vapidity. Many are along the lines of "Here is my protocol and I do great on it." The problem with this is that because you are a moderator your posts carry more weight with newcomers than they should. They encourage men to bypass the low-and-slow approach. "Well if Vince says it's good then why waste time trying lower doses?" Meanwhile I'm trying as hard as I can to counteract this: "Wait a minute, many guys fare much better with physiological doses. Read some of their stories. With this in mind, why not start low and raise the dose only if needed?"

That’s what it is, a theory. No data saying above normal testosterone is unhealthy. Some people are just more conservative but that doesn’t mean they’re the authority on the matter.

And the cigarette companies used to say "It's only an association. There's no proof they cause cancer."

Is high HCT unhealthy? What about high estradiol? Is it healthy to use AIs to address symptoms of high estradiol? I think it's pretty safe to say that for most men supraphysiological testosterone is less healthy overall than in-range testosterone. The exceptions might include those whose insecurities compel them to maximize musculature; the stress of untreated body dysmorphic disorder could be worse than high testosterone.

 

[Vince]

A one-size-fits-all approach is a doctor who gives all his patients 140 mg TC per week right from the start. And from there his plan is bloodletting to control cases of high hematocrit and AIs to address symptoms of high estradiol. This results in unnecessary suffering by many of his patients. The better approach is to start with 60-80 mg TC/week and titrate as needed. The creators of Xyosted understand this. But others still yield to more-is-better thinking. You are defending the indefensible.



Ok, this is amusing. I haven't had anxiety since around when I started TRT—perhaps one of the biggest benefits of all this hormonal tinkering.

Let me be blunt. You are well-meaning and trying to be helpful, but your posts tend towards vapidity. Many are along the lines of "Here is my protocol and I do great on it." The problem with this is that because you are a moderator your posts carry more weight with newcomers than they should. They encourage men to bypass the low-and-slow approach. "Well if Vince says it's good then why waste time trying lower doses?" Meanwhile I'm trying as hard as I can to counteract this: "Wait a minute, many guys fare much better with physiological doses. Read some of their stories. With this in mind, why not start low and raise the dose only if needed?"



And the cigarette companies used to say "It's only an association. There's no proof they cause cancer."

Is high HCT unhealthy? What about high estradiol? Is it healthy to use AIs to address symptoms of high estradiol? I think it's pretty safe to say that for most men supraphysiological testosterone is less healthy overall than in-range testosterone. The exceptions include those who are so insecure that their mental health requires maximizing muscle mass.

Thankfully I've never smoked haha. What percent of men actually get lung cancer from smoking? 10% maybe 20%? Hopefully we're not comparing TRT to smoking.

I still believe twice a week injection does work on most men.

Some like me who has a very busy lifestyle, many children, many grandkids and a few great grandkids. I really don't have the time to mix my own testosterone and constantly micro dosing. But I'm not you. You have more time than me and that works for you!

I should add, I'm 70 been on TRT for over 10 years. Still working full time. TRT definitely works for me.

I love our chats.

 

[FunkOdyssey]

I also see that early on I was using Androgel and measured TT ~600 ng/dL and E2 ~20 pg/mL, an even lower rate of aromatization, perhaps due to the DHT.

How did this feel? I would think this, with some daily hCG added to bump the numbers up a little and fill in some gaps, ought to be a decent protocol for you.

I doubt body fat is much of an issue. Not that it can be trusted, but the scale puts BF at 12%. In any case, I would claim to be skinny-muscular, not skinny-fat. Similarly I doubt insulin is much of an issue. Last year the fasting value was 2 uIU/mL, below the reference range.

Look at you! Very impressive sir - not much room for improvement here. Still, give the 5/8" needles a shot (hah) if you ever return to injections. These are one of the few significant changes I made between my 87 pg/mL and 30 pg/mL E2 eras.

With respect to libido and sexual function, I have to mention again that even with that recent excessive E2/T ratio and low TT, these parameters were more consistently good than at any other time on TRT. Admittedly there's added complexity here with my continued use of kisspeptin-10 and gonadorelin. But my expectation is that knocking these out would simply make things worse. I assume your suggested experiment results in full HPTA suppression? I also assume that hCG use would be excluded because that would make it virtually impossible to keep E2 down at 30 pg/mL naturally.

I'm starting to divide the TRT world into people who are sensitive to the effects of HPTA shutdown and people who are not. For you, on the maximally sensitive side, I would not advocate an injectable TRT protocol that didn't leave room for hCG (daily, low dose to minimize systemic E2 impact).

Though Vince doesn't seem to get it, I think I've made it pretty clear that I'm not opposed to informed individuals such as yourself experimenting with TRT doses and ancillaries as you see fit. What bothers me is seeing this parade of guys who are being harmed by high doses given right from the start. As I have said many times before, these situations often get worse when the symptoms of excess are not addressed by lowering the dose. Instead we see bloodletting for high HCT and AIs for high E2.

That's fair. I am also bothered by the same things, and would love to see a world where we are not donating blood for high HCT and taking AIs for high E2. I have a level of enthusiasm for higher doses that you don't share, but my position is that you need to earn them by establishing a foundation of health first. Dumping high doses into overweight, inflamed, insulin-resistant bodies is a recipe for disaster.

More subtle issues often remain unaddressed. I believe that some fraction of men will have problems from the secondary effects of HPTA shutdown. But at this time there's little official recognition of this, or of the possibility that short-acting testosterone is a solution.

We have a large body of clinical research that has identified benefits of TRT, and has not identified problems associated with HPTA shutdown besides infertility and testicular atrophy. I don't doubt that some men experience subtle or even not-so-subtle issues, but they have yet to show up in research that would cause the world to take it seriously. You would think this would be an angle of research that purveyors of short-acting testosterone would pursue to differentiate their products, but for some reason it is yet to happen.

 

[Cataceous]

Thankfully I've never smoked haha. What percent of men actually get lung cancer from smoking? 10% maybe 20%? Hopefully we're not comparing TRT to smoking.

I still believe twice a week injection does work on most men.

Some like me who has a very busy lifestyle, many children, many grandkids and a few great grandkids. I really don't have the time to mix my own testosterone and constantly micro dosing. But I'm not you. You have more time than me and that works for you!

I should add, I'm 70 been on TRT for over 10 years. Still working full time. TRT definitely works for me.

I love our chats.

That smoking analogy is only meant to highlight that a possible risk factor should not be dismissed just because causality is not yet established.

Testosterone levels are associated with a U-shaped mortality curve in some studies, particularly in men. Research indicates that both low and high serum testosterone levels are linked to increased all-cause mortality, while mid-range levels are associated with lower risk. For example, a 2011 study in the Journal of Clinical Endocrinology & Metabolism found that men with testosterone levels in the lowest and highest quartiles had higher mortality rates compared to those in the middle quartiles, with low testosterone linked to cardiovascular and metabolic issues, and high levels potentially tied to other risks like prostate issues or behavioral factors. [Grok]​

You are fortunate that basic TRT works well for you. Don't lose sight of the fact that many are not so lucky. You can help the ones who are stuggling by encouraging a low-and-slow approach. There's little to lose and much to gain.

I agree that twice-weekly TC injections appears to be a relatively successful protocol. Interestingly, Xyosted probably offers similar variation in serum testosterone with once-weekly injections due to its half-life being about double that of generic TC.

 

[Vince]

That smoking analogy is only meant to highlight that a possible risk factor should not be dismissed just because causality is not yet established.

Testosterone levels are associated with a U-shaped mortality curve in some studies, particularly in men. Research indicates that both low and high serum testosterone levels are linked to increased all-cause mortality, while mid-range levels are associated with lower risk. For example, a 2011 study in the Journal of Clinical Endocrinology & Metabolism found that men with testosterone levels in the lowest and highest quartiles had higher mortality rates compared to those in the middle quartiles, with low testosterone linked to cardiovascular and metabolic issues, and high levels potentially tied to other risks like prostate issues or behavioral factors. [Grok]​

You are fortunate that basic TRT works well for you. Don't lose sight of the fact that many are not so lucky. You can help the ones who are stuggling by encouraging a low-and-slow approach. There's little to lose and much to gain.

I agree that twice-weekly TC injections appears to be a relatively successful protocol. Interestingly, Xyosted probably offers similar variation in serum testosterone with once-weekly injections due to its half-life being about double that of generic TC.

A 2011 meta-analysis published in the Journal of Clinical Endocrinology & Metabolism summarized findings from several studies that looked at the relationship between testosterone levels and mortality in men.

The meta-analysis, which included 12 studies and over 16,000 men, found that low serum testosterone levels were associated with a 35% increased risk for mortality. Studies that focused on older men (mean age > 60 years) or that reported lower mean testosterone levels were more likely to show this association between low testosterone and mortality.
The meta-analysis aimed to clarify previous inconsistent findings in the literature and assess the association between endogenous testosterone levels and all-cause and cardiovascular disease (CVD) mortality.
It found that low endogenous testosterone levels were associated with an increased risk of both all-cause and CVD death in community-based studies of men. However, the analysis also highlighted considerable differences between studies, which were related to various characteristics of the studies and the subjects involved, suggesting that the effects observed might be influenced by differences between the groups studied (e.g., in their underlying health status).

 

[Vince]

That smoking analogy is only meant to highlight that a possible risk factor should not be dismissed just because causality is not yet established.

Testosterone levels are associated with a U-shaped mortality curve in some studies, particularly in men. Research indicates that both low and high serum testosterone levels are linked to increased all-cause mortality, while mid-range levels are associated with lower risk. For example, a 2011 study in the Journal of Clinical Endocrinology & Metabolism found that men with testosterone levels in the lowest and highest quartiles had higher mortality rates compared to those in the middle quartiles, with low testosterone linked to cardiovascular and metabolic issues, and high levels potentially tied to other risks like prostate issues or behavioral factors. [Grok]​

You are fortunate that basic TRT works well for you. Don't lose sight of the fact that many are not so lucky. You can help the ones who are stuggling by encouraging a low-and-slow approach. There's little to lose and much to gain.

I agree that twice-weekly TC injections appears to be a relatively successful protocol. Interestingly, Xyosted probably offers similar variation in serum testosterone with once-weekly injections due to its half-life being about double that of generic TC.

In particular, a previous study positive associations between high levels of free testosterone (not attached to any proteins) and insulin-like growth factor-I (IGF-I) and increased risks of prostate cancer. It is thought that the link between levels of these hormones and prostate cancer may be due to their role in regulating prostate cell growth, function and survival.

To date, the limited number of prostate cancer cases within cohort studies meant it was not possible to assess how IGF-1 and free testosterone affect the risk of different types of prostate cancer, particularly aggressive forms of the disease.

Furthermore, it was not clear whether these hormones directly increase prostate cancer risk, or if they are merely linked to a different factor which is the true cause. It was also possible that these associations were the result of reverse causation, where preclinical cancer symptoms caused the hormone levels to change before the disease was diagnosed.

To clarify these unknowns, CEU researchers led the largest study to date, using data from an international consortium: the Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group.

 

[Vince]

That smoking analogy is only meant to highlight that a possible risk factor should not be dismissed just because causality is not yet established.

Testosterone levels are associated with a U-shaped mortality curve in some studies, particularly in men. Research indicates that both low and high serum testosterone levels are linked to increased all-cause mortality, while mid-range levels are associated with lower risk. For example, a 2011 study in the Journal of Clinical Endocrinology & Metabolism found that men with testosterone levels in the lowest and highest quartiles had higher mortality rates compared to those in the middle quartiles, with low testosterone linked to cardiovascular and metabolic issues, and high levels potentially tied to other risks like prostate issues or behavioral factors. [Grok]​

You are fortunate that basic TRT works well for you. Don't lose sight of the fact that many are not so lucky. You can help the ones who are stuggling by encouraging a low-and-slow approach. There's little to lose and much to gain.

I agree that twice-weekly TC injections appears to be a relatively successful protocol. Interestingly, Xyosted probably offers similar variation in serum testosterone with once-weekly injections due to its half-life being about double that of generic TC.

The cost of Xyosted per month can vary depending on several factors, including whether you have insurance and the pharmacy you use.
With Insurance & Copay Assistance:

• Eligible commercially insured patients can potentially pay as little as $25 per prescription using the Xyosted Co-pay Assistance Program. This program provides a maximum benefit of up to $125 per prescription.
• Some patients have reported paying around $15 per month with insurance and this copay assistance program.

Without Insurance or with Cash Programs:

• Without insurance, the retail price of Xyosted can be around $843.70 for a typical prescription (4 autoinjectors).
• The XYOSTED4YOU Program allows eligible patients (without insurance or whose insurance doesn't cover Xyosted) to purchase it for $199 per month.
• Using free coupons from services like GoodRx, you can find prices as low as $458.56 per month.
• SingleCare coupons can lower the cost to around $573.60 for 4 autoinjectors.