The burden of proof clearly is on you with the extraordinary claim that non-physiological levels are better for overall health and should be the default starting point for TRT. As I went through your list of references it became clear that you had not read them and were relying on a faulty AI summary. You're grasping at straws with that one study that did not include physiological levels. I agree that with once-weekly injections of testosterone cypionate you will get better results with 100 mg than 50 mg. But 100 mg is simply the lesser evil. In fact there is a ton of evidence in favor of physiological dosing of testosterone. Ask your AI to tell you more about injections of testosterone undecanoate. You were linking to some of these same studies without realizing that the comparable dose of cypionate is 75 mg/week.
Ok, well then we could’ve saved a lot of time by having you present this ton of evidence that shows dosing at physiological levels is better than higher doses. Surely you will now present all this evidence. If that’s your claim, then the burden of proof is also on you to support your claim, or does it only work one way??
Testosterone increases muscle mass and strength and regulates other physiological processes, but we do not know whether testosterone effects are dose dependent and whether dose requirements for maintaining various androgen-dependent processes are similar. To determine the effects of graded doses...
pubmed.ncbi.nlm.nih.gov
Although testosterone levels and muscle mass decline with age, many older men have serum testosterone level in the normal range, leading to speculation about whether older men are less sensitive to testosterone. We determined the responsiveness of androgen-dependent outcomes to graded...
pubmed.ncbi.nlm.nih.gov
Older men are as responsive as young men to testosterone's anabolic effects; however, older men have lower testosterone clearance rates, higher increments in hemoglobin, and a higher frequency of adverse effects. Although substantial gains in muscle mass and strength can be realized in older men with supraphysiological testosterone doses, these high doses are associated with a high frequency of adverse effects.
The best trade-off was achieved with a testosterone dose (125 mg) that was associated with high normal testosterone levels, low frequency of adverse events, and significant gains in fat-free mass and muscle strength.
Dose-dependent changes in AT(adipose tissue) mass were negatively correlated with TE dose at all sites and were equally distributed between the trunk and appendices.
The lowest dose was associated with gains in sc, intermuscular, and intraabdominal AT, with the greatest percent increase occurring in the sc stores. At the three highest TE doses(which includes 125 mg per week) , thigh intermuscular AT volume was significantly reduced, with a greater percent loss in intermuscular than sc depots, whereas intraabdominal AT stores remained unchanged. In conclusion, changes in testosterone concentrations in young men are associated with dose-dependent and region-specific changes in AT and lean body mass in the appendices and trunk.
Give me a break. All of those papers were based on that one non-physiological dose-response study. The other links were not even relevant and you should be embarrassed for including them.
For one thing, they certainly do not start at these doses. It also does not apply to Type 1 diabetics. "However, because injected insulin is delivered subcutaneously (bypassing the liver's first-pass metabolism, where ~80% of natural insulin is cleared), it can lead to higher peripheral (systemic) insulin levels than what occurs naturally, even if the total dose is not excessive." Only in Type 2 diabetes with insulin resistance might you need to go higher.
Now the number of hypogonadal men with effective "testosterone resistance" is likely minute, so your analogy crashes and burns.
Again, now do all the others. Or better yet let’s just start here since you keep avoiding it: Are the millions of people that take creatine every day being absurd? It’s a simple yes or no question. If you can be honest enough to answer that perhaps we’ll move on to the other hormones.
You're inventing this "top of the U curve" thing. Show me the publications and this time include specific quotes. It's no straw man argument that you are willing to disregard physiological ranges. Taking 100+ mg TC/week puts virtually every man over the physiological range. You are claiming unproven benefits—aside from muscle growth—while downplaying the very real risks that are illustrated regularly by posters here. You also do not know whether the long-term risks of excessive androgen exposure are "significant" or not. Yet you glibly suggest that everyone should be exposed to them.
Again, it isn’t “unproven benefits”… I’ve shared other studies with regard to well-being and mood along with other benefits. Sure some people may have risks from higher levels of testosterone, some have risks from taking it at all. Some people have risks from peanuts. People have risks from all types of things. We don’t base medical approaches on outliers. We base it on data and evidence for what is a good starting point to give someone the best odds of maximizing benefits while minimizing risks. Perhaps your issue is with the minimizing risks part… but there are also studies(that I’ve shared) which show people taking lower doses can actually end up worse off. I’m not saying some people don’t need lower doses. However, you conveniently ignore all of the people doing great at doses of 100-120(of which there are many more than people taking 50). You’re fixated on this aspect because of your personal experience and because you are over-exposed to specific examples that may support your case(though in some cases it’s also quite possible that they don’t and you just perceive it that way due to your bias). The studies and real-world approach by the vast majority of trt doctors show people at 100-120 do better than people at 50-75. That doesn’t mean all, but it means it’s a reasonable starting point.
You know something about making straw man arguments. The one point I have been very rigid on is that there should be a low-and-slow approach to TRT. What exactly is your argument against this? In the end it would amount to catering to a small minority who may need higher-end levels at the expense of the vast majority who do fine with physiological levels.
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2 things… well actually 2.5 things here
1.) you’re just using the tried and true persuasion technique of over-stating the benefit of what you’re supporting and also over-stating the risk of what you’re opposing. You fail to mention the risk of starting at 50 mg/week and ending up worse than when you started(which has been shown in a study). You can claim that it doesn’t apply because levels were artificially dropped before starting the study, but actually the lack of endogenous testosterone would be a very real factor for people taking 50 mg/week. So there are risks to starting at 50 mg/week. Not the least of which is the patient stopping treatment before getting the benefits that could be provided at higher doses. It’s also extremely likely that they would not receive the full extent of benefits at that dose. This is supported by the studies I’ve shared(which for some reason you continue to lie about). And I even shared one in this very post that shows 125 per week is a great sweet spot for maximizing benefits while not introducing significant risks.
2.) you’re just making stuff up and claiming it’s a tiny percentage of guys who need levels above 80 mg/week, and that the vast majority do fine with 80 mg per week or lower. Those claims are not supported by any studies I’ve seen or the real-world data or the countless anecdotal reports of people who need more than 80 mg week to get the most benefits. Unless you are saying “fine” as in “yeah you aren’t maximizing the benefits but at least you don’t feel like shit anymore”. If that’s the case then fine, just say it that way. But don’t lie and say there isn’t tons of evidence that additional benefits come along with higher doses(as in 100-120) without a substantial increase in risks. People making that calculation aren’t being “absurd” as you like to claim.
2.5) you’re being hypocritical by just making stuff up and not providing any evidence for your claims while demanding that the burden of proof is on others any time they make a statement.
Which reminds me… weren’t you supposed to be sharing a “ton of proof” that shows doses of 50-75 mg provides as many or more benefits at 100-120 while being a lot safer??
