Post TRT - Libido is DEAD :(

[Cataceous]

you're asking what benefits other than literally improving the composition of a patients body?? I mean… I guess everyone has different priorities but I’d say changing the actual COMPOSITION of the body in a positive way is a pretty big benefit. I’d also note that muscle mass and strength, fat mass, and bone mass are all good indicators of both longevity and quality of life. Also, my understanding is that the advantages on those fronts are clearly established as benefits of testosterone. Are you saying the impact of testosterone on muscle building and fat loss is inferred but not proven?

As noted, there's no comparison of healthy controls to those on TRT using the modestly supraphysiological doses you espouse. Differences are inferred through interpolation. In the absence of any rigorous quantification I am free to argue that the differences are trivial and certainly not worth the risks. But as always, I say informed adults should make their own determination. Being informed means trying lower doses too—ideally first.

Is it correct to assume you've never experienced physiological doses yourself? I see you started with 120 mg TC/week.

 

[Phil Goodman]

As noted, there's no comparison of healthy controls to those on TRT using the modestly supraphysiological doses you espouse. Differences are inferred through interpolation. In the absence of any rigorous quantification I am free to argue that the differences are trivial and certainly not worth the risks. But as always, I say informed adults should make their own determination. Being informed means trying lower doses too—ideally first.

Is it correct to assume you've never experienced physiological doses yourself? I see you started with 120 mg TC/week.

No need to go over this again… you are completely fixated on what is “physiological” even though it is achieved in ways that are completely different than what the natural body does to achieve those levels. I’ve already shared studies that compared various doses as well as studies that showed which levels were achieved from different doses. Those are the comparisons I’m using for this conversation because we’re discussing the pros and cons of different protocols.

But sure, you are free to argue that increased muscle mass, decreased fat mass, strength improvements, increased bone density, and other benefits aren’t worth the risk. Actually, no need to argue at all. Just say YOU don’t think they’re worth the risk for you. It’s as simple as that. It could be pointed out that multiple studies found doses from 100-120 as a good dose for seeing benefits with minimal risks, numerous health agencies list 100 mg/week as a traditional starting point, many studies found that dosage put patients at good levels, along with lots of other things that could be considered supportive of that approach… but honestly none of that really matters if it isn’t worth the risks for you(or anyone else that doesn’t want to accept the risks). Everyone has different risk tolerances for different things…. For example your cycling puts you at much higher risk for AFIB than my test dose presents for me, but if that makes you happy and you accept the risk I’m not going to tell you you’re wrong.


Correct. I started at 120 mg/week. When I added HCG around 6 months later I dropped down to about 100. That was with 1000 ius of HCG per week, which has since been reduced to 750 per week. That’s been my protocol for over 3 years now(this year is my 5th year on trt).

 

[MarcoFL]

No need to go over this again… you are completely fixated on what is “physiological” even though it is achieved in ways that are completely different than what the natural body does to achieve those levels. I’ve already shared studies that compared various doses as well as studies that showed which levels were achieved from different doses. Those are the comparisons I’m using for this conversation because we’re discussing the pros and cons of different protocols.

But sure, you are free to argue that increased muscle mass, decreased fat mass, strength improvements, increased bone density, and other benefits aren’t worth the risk. Actually, no need to argue at all. Just say YOU don’t think they’re worth the risk for you. It’s as simple as that. It could be pointed out that multiple studies found doses from 100-120 as a good dose for seeing benefits with minimal risks, numerous health agencies list 100 mg/week as a traditional starting point, many studies found that dosage put patients at good levels, along with lots of other things that could be considered supportive of that approach… but honestly none of that really matters if it isn’t worth the risks for you(or anyone else that doesn’t want to accept the risks). Everyone has different risk tolerances for different things…. For example your cycling puts you at much higher risk for AFIB than my test dose presents for me, but if that makes you happy and you accept the risk I’m not going to tell you you’re wrong.


Correct. I started at 120 mg/week. When I added HCG around 6 months later I dropped down to about 100. That was with 1000 ius of HCG per week, which has since been reduced to 750 per week. That’s been my protocol for over 3 years now(this year is my 5th year on trt).

You guys are good comedy for me. Like I say to my neighbor that his doctor says 6.0 A1c is great but I want mine at 4.5 he has all sorts of health issues. My favorite line we both live on the ocean. I tell him you can own a house 5 miles in and it gives you shelter so why do you live on the ocean. Within reason I push to reasonable upper limits on everything in life. Happy Easter to all. He is RISEN.

 

[Phil Goodman]

You guys are good comedy for me. Like I say to my neighbor that his doctor says 6.0 A1c is great but I want mine at 4.5 he has all sorts of health issues. My favorite line we both live on the ocean. I tell him you can own a house 5 miles in and it gives you shelter so why do you live on the ocean. Within reason I push to reasonable upper limits on everything in life. Happy Easter to all. He is RISEN.

Glad you find it entertaining, as laughter is one of the under-appreciated medicines imho. Also, that’s a great analogy.. there are added risks with living beachfront, but also plenty of awesome benefits obviously.


Happy Easter!

 

[Cataceous]

No need to go over this again… you are completely fixated on what is “physiological” even though it is achieved in ways that are completely different than what the natural body does to achieve those levels.

And your solution is to make it even more different by using more testosterone than your body could ever make? I have been experimenting for over 10 years now, and just about every step I've taken towards better mimicry of natural HPTA function has resulted in incremental improvements in results. A small reduction in athleticism is a trivial price to pay for ending side effects and being healthy.

But sure, you are free to argue that increased muscle mass, decreased fat mass, strength improvements, increased bone density, and other benefits aren’t worth the risk. Actually, no need to argue at all. Just say YOU don’t think they’re worth the risk for you. It’s as simple as that. It could be pointed out that multiple studies found doses from 100-120 as a good dose for seeing benefits with minimal risks, numerous health agencies list 100 mg/week as a traditional starting point, many studies found that dosage put patients at good levels, along with lots of other things that could be considered supportive of that approach…

We obviously disagree on how these studies should be interpreted, and there's not a single one that's comparing those absorbing 4-9 mg T per day on TRT to those getting 10-12 mg. You do not have evidence of worthwhile improvements at the higher doses.

It's still somewhat tangential, because my hard line is for starting with physiological doses—not being locked into them forever. You were denied that opportunity, and apparently felt trapped into defending the practice of higher initial dosing, in spite of the harm it does to many. Unless you're sure you have no room for improvement, you could be one of those harmed—you might also do better overall at lower doses.

 

[Vince]

Thread 'Why Some Men on TRT Experience Anxiety and Brain Fog Despite Optimal Testosterone Levels'

Jan 20, 2026

Understanding the Role of Neurosteroids, Upstream Hormones, and Practical Solutions

Curated By Nelson Vergel | ExcelMale.com​

Introduction: The TRT Paradox​

One of the most frustrating experiences reported by men on testosterone replacement therapy (TRT) is the persistence of anxiety and brain fog despite achieving optimal testosterone levels. As one ExcelMale forum member described:

"I've been on TRT for almost 5 weeks... Most of my social anxiety went away and I started experiencing a calm focus that felt amazing. I even started for the first time in my life to want...

• Nelson Vergel
• testosterone anxiety trt anxiety trt insomnia trt low mood trt side effects
• Replies: 4
• Forum: When TRT Is Not Enough (ED, Libido, & More)

• 

 

[Phil Goodman]

And your solution is to make it even more different by using more testosterone than your body could ever make? I have been experimenting for over 10 years now, and just about every step I've taken towards better mimicry of natural HPTA function has resulted in incremental improvements in results. A small reduction in athleticism is a trivial price to pay for ending side effects and being healthy.

1.) it’s hilarious that you brush off improved body composition and the wide range of health and well-being benefits that go along with it as just “athleticism”. That seems pretty disingenuous on your part because you know how beneficial preserving muscle, preserving bone mass, and maintaining a healthy body fat percentage are for longevity.

2.) it is extra hilarious (and hypocritical) coming from a guy who introduces himself to a much higher risk of AFIB just so he can ride a bicycle for a long distance.

We obviously disagree on how these studies should be interpreted, and there's not a single one that's comparing those absorbing 4-9 mg T per day on TRT to those getting 10-12 mg. You do not have evidence of worthwhile improvements at the higher doses.

You keep saying this despite the fact that I’ve shared numerous studies that showed worthwhile benefits at the higher doses. You keep hiding behind the “yeah but they need to test it by comparing daily injections!!” Or “injecting 25 mg twice per week would fix all of the issues with the 50 mg per week dosage”. This is despite the fact that you have exactly ZERO supporting evidence to show why that’s the case other than “trust me bro, physiology”.

So yes, there is plenty of evidence that shows worthwhile improvements at those doses.

It's still somewhat tangential, because my hard line is for starting with physiological doses—not being locked into them forever. You were denied that opportunity, and apparently felt trapped into defending the practice of higher initial dosing, in spite of the harm it does to many. Unless you're sure you have no room for improvement, you could be one of those harmed—you might also do better overall at lower doses.

I get your point here to an extent but I don’t feel “trapped” into defending it. If you could provide evidence to show why I’m(along with millions of patients, thousands of doctors, numerous health agencies, and many clinical researchers) are wrong in stating that 100 mg per week is a good starting point then I’d like to see it. And just saying “because I said so and because physiology” is not a strong enough counter argument for me.

Also, as I already stated, when I made adjustments to my protocol I did so by going down(both with t and HCG). So I’m not locked into defending my protocol or the more is better approach. You fixate on the harm people see, but for every 1 person you can show me who was harmed at 100 mg/week I can probably point out 10 who saw significant improvements on a dose of 100 mg/week or more. So even on that front your argument is weaker.

But sure, you may be correct when you say I might do better off at a lower dose. It’s possible. However, at this point I’ve seen too many guys make changes chasing “just a little better” who end up spinning their wheels for months or even years trying to get back to a good spot. So for now, I feel good, all of my labs look good, and my overall health appears to be great. This, coupled with the evidence I’ve shared(which you and I disagree with but I feel clearly illustrates that my dose is safe for most men while maximizing benefits) causes me to think I should stay here for now. Not because I feel locked into it, but because it is working great at the moment. It’s likely that it will change at some point, but again it works great for now.

 

[Cataceous]

1.) it’s hilarious that you brush off improved body composition and the wide range of health and well-being benefits that go along with it as just “athleticism”.

You're just making stuff up. There is no evidence that being somewhat supra is better overall than being at healthy levels for young men.

2.) it is extra hilarious (and hypocritical) coming from a guy who introduces himself to a much higher risk of AFIB just so he can ride a bicycle for a long distance.

It would have been good to be warned in advance of those risks as well. In my immediate cohort of fewer than 10 older riders, three experience afib. Of course there wasn't awareness back in the day when we were piling on the miles. But as with TRT, the experience is helpful to the newcomers.

I get your point here to an extent but I don’t feel “trapped” into defending it. If you could provide evidence to show why I’m(along with millions of patients, thousands of doctors, numerous health agencies, and many clinical researchers) are wrong in stating that 100 mg per week is a good starting point then I’d like to see it. And just saying “because I said so and because physiology” is not a strong enough counter argument for me.

The dose-related links to risk factors are undeniable. Standard medical practice with respect to hormones in general is undeniable. As I keep repeating, testosterone is only treated differently because the original Depo-Testosterone dosing of 200 mg TC once every two weeks gave and continues to give cover to misguided more-is-thinking.

Also, as I already stated, when I made adjustments to my protocol I did so by going down(both with t and HCG). So I’m not locked into defending my protocol or the more is better approach. You fixate on the harm people see, but for every 1 person you can show me who was harmed at 100 mg/week I can probably point out 10 who saw significant improvements on a dose of 100 mg/week or more.

There's the problem. I previously asked for anecdotes involving guys who tried physiological dosing for a reasonable period before finding higher doses to be better. So far all I get is people like you and Vince who claim higher is better but have never even experienced normal levels with TRT.

But sure, you may be correct when you say I might do better off at a lower dose. It’s possible. ....

Thus making my case.

 

[Vince]

There's the problem. I previously asked for anecdotes involving guys who tried physiological dosing for a reasonable period before finding higher doses to be better. So far all I get is people like you and Vince who claim higher is better but have never even experienced normal levels with TRT

I guess you never read my postings. For me, higher levels are better. Yes! I know you had or have issues with libido and anxiety and because of them two reasons you cannot run higher levels. And that's fine. I agree you should have low levels. I'm just the opposite. I've never had anxiety or libido issues so I have no problem with higher levels. I enjoy my good sex and have no anxiety issues. And I always tell people if you have anxiety go slow on your dosing because it seems like it will increase your anxiety.

I'm not like you. I don't believe one size fits all.

 

[FunkOdyssey]

LOL. I now think Vince must be trolling Cataceous with the anxiety talk.

 

[Phil Goodman]

You're just making stuff up. There is no evidence that being somewhat supra is better overall than being at healthy levels for young men.

Ok, I’ll try to make this as simple as possible. I’m going to lay out a scenario and then ask a single question.

There are two patients; Patient A and Patient B. They have both started a new treatment. Below are some comparisons of benefits.

Patient A acquired substantially more muscle mass than Patient B, who acquired minimal to no extra muscle mass.

Patient A lost substantially more body fat than Patient B, who either didn’t lose any body fat or possibly gained it.

Patient A saw more increase in bone mass than Patient B.

Both patients had improvements in metabolic health metrics, and Patient A’s improvements were as good or better than Patient B’s.


Which patient saw more benefits on those fronts? It’s a pretty simple question, so if you can’t even answer that (or even worse, just keep saying I’m lying and/or making stuff up) then I have to assume you actually have no intention of having a meaningful conversation.

It would have been good to be warned in advance of those risks as well. In my immediate cohort of fewer than 10 older riders, three experience afib. Of course there wasn't awareness back in the day when we were piling on the miles. But as with TRT, the experience is helpful to the newcomers.

Do you still ride?

Do you now tell people that you don’t think the risks are worth it and that they should strongly consider not doing it?

The dose-related links to risk factors are undeniable. Standard medical practice with respect to hormones in general is undeniable. As I keep repeating, testosterone is only treated differently because the original Depo-Testosterone dosing of 200 mg TC once every two weeks gave and continues to give cover to misguided more-is-thinking.

Yes, there are dose-related risks with testosterone just like with everything else. Tons of studies and research has been done, and it appears that the dose of 100-120 mg is well-tolerated by most patients and provides many benefits without over-exposure to risks. And again, it isn’t just me saying that. You can try to brush it off as outdated thinking and again… you might even be right. But you are not providing any evidence to support your case other than “physiology and trust me”. When you bring more meaningful counter-arguments to the table I will consider them. And actually, throughout this thread you have actually done more to support my position(anyone reading this post is free to go back and read the entire thread then decide for themselves).

There's the problem. I previously asked for anecdotes involving guys who tried physiological dosing for a reasonable period before finding higher doses to be better. So far all I get is people like you and Vince who claim higher is better but have never even experienced normal levels with TRT.

So now your argument is relegated to “yeah you’re doing great, feeling great, and have great health… but you MIGHT have done better if you went with my approach instead of the approach suggested by all the people with decades of experience and tons of research supporting it”.

And besides that, you’re just bobbing and weaving again. That wasn’t in response to your request for anecdotes, that was a response to your claim about men being harmed. I simply said “for every man you can point to being harmed I can point to more who are doing great at those doses”. I’m saying I can point out more who were NOT harmed at those doses and who were helped. But all you have is “they MIGHT have been harmed or they MIGHT be harmed later”… yeah, and mites grow on a chicken’s ass.

Also, if you haven’t watched the video on cognitive dissonance yet, that sign is discussed as well… the unspecific doom forecast. At this point I think you’ve covered just about all the signs in this thread.

Thus making my case.

Lmao… what?! Saying something is possible does not equal making a case for it. It’s possible I might win the lottery tonight. By stating that I’m not making a case for it. It’s possible you would do better on 200 mg/week. Does that mean I’m making a case for it to be true?

 

[Guided_by_Voices]

I've long since lost track of what you guys are arguing about but I'll make one observation...

The psychological factors are probably at least 50% percent of the equation for both risks and benefits, and are likely almost impossible to say anything meaningful about at a population level. What is the effect on confidence, mood and energy? What does someone's wife or girlfriend prefer? Is the person single or in a relationship? What injury history does the person have? What sports activities bring the person joy? What is the person's natural body style? All these things and many more likely play a role and it's worth remembering that one of (possibly the most) powerful driver of health is positive social engagement, so measuring the impact of that would be essential. Total mg could also be a combination of T and other anabolics depending on the person's goals/issues.

I always advocate for starting at the lowest dose that we've seen someone be successful at (which I think is around 60mg per week) and adjusting upward if necessary, but I think trying to say what's higher and lower risk/reward at the population level for a certain dose is likely unknowable and will unfairly under-weight individual differences.

Ok, carry, on.

 

[Cataceous]

LOL. I now think Vince must be trolling Cataceous with the anxiety talk.

It's either that or memory/cognitive impairment. Given the oddities in some of his other posts I lean towards the latter.

 

[Cataceous]

...
I always advocate for starting at the lowest dose that we've seen someone be successful at (which I think is around 60mg per week) and adjusting upward if necessary, ...

This is exactly what I'm advocating. Too many men start with higher doses and suffer as a result. I don't put any hard limits on where dosing can end up, but this should be after sufficient experience with doses that are in the range of physiological production. It's crucial to have points of comparison so you can be objective about whether there are actually benefits in dosing higher.

 

[Vince]

It's either that or memory/cognitive impairment. Given the oddities in some of his other posts I lean towards the latter.

As you have said in the past in your postings. That trt has helped your anxiety but not eliminate it. Also it has improved your libido. Even though you still have some libido issues.

C

Post in thread 'Low Testosterone saving a marriage ???'

Mar 31, 2019

The opposite is sometimes argued: declining testosterone makes men anxious and with the feeling they have to prove themselves, sometimes leading to affairs, etc.

Personally, TRT greatly reduced my anxiety, making things better all around. Mismatched libidos is somewhat of an issue, but it could easily be worse. No question that my marriage would be worse off if I weren't on TRT.

• Cataceous

• 

 

[Cataceous]

Which patient saw more benefits on those fronts? It’s a pretty simple question, so if you can’t even answer that (or even worse, just keep saying I’m lying and/or making stuff up) then I have to assume you actually have no intention of having a meaningful conversation.

This is pretty laughable. I don't have to create imaginary scenarios. I can point to guys coming here every week suffering from symptoms of excess. Ask them if the suffering is worth a couple percent of extra lean body mass. Meanwhile some resort to bloodletting to knock down hematocrit, crashing ferritin in the process. Or libido is impaired, or high estradiol has them feeling emasculated, and on and on.

Do you still ride?

Yes, but at modest levels.

Do you now tell people that you don’t think the risks are worth it and that they should strongly consider not doing it?

This exactly parallels the situation with testosterone. It's important to understand the risks going in. If you prioritize your sports performance/body composition above overall health then take those risks—it's your choice. Otherwise dial things back. I can't say with certainty how my younger self would choose to act when given only statistical outcomes. I think most of us are less risk-averse when younger, so we're more likely to take those chances. But if our older and wiser selves had a do-over we'd most likely be more conservative.

Yes, there are dose-related risks with testosterone just like with everything else. Tons of studies and research has been done, and it appears that the dose of 100-120 mg is well-tolerated by most patients and provides many benefits without over-exposure to risks. And again, it isn’t just me saying that.

It's not confidence-inspiring that a treatment is "well-tolerated" and only in the short term of a study. Meanwhile humans have been operating at physiological levels for millennia. It's an obvious choice as to where dosing should start.

Also, if you haven’t watched the video on cognitive dissonance yet, that sign is discussed as well… the unspecific doom forecast. At this point I think you’ve covered just about all the signs in this thread.

I asked AI about your position and it came up with "cognitive dissonance" on its own:

Question: Is there a name for the phenomenon in which someone does something a certain way and then later argues vociferously in favor of that way even in the face of strong opposing evidence?​

​

Answer: Yes, this is most commonly described as a manifestation of cognitive dissonance (specifically, post-decisional or effort-justification aspects of it), often combined with related biases like confirmation bias or choice-supportive bias.​

 

[Phil Goodman]

This is pretty laughable. I don't have to create imaginary scenarios. I can point to guys coming here every week suffering from symptoms of excess. Ask them if the suffering is worth a couple percent of extra lean body mass. Meanwhile some resort to bloodletting to knock down hematocrit, crashing ferritin in the process. Or libido is impaired, or high estradiol has them feeling emasculated, and on and on.

They aren’t “imaginary scenarios”… those are well established, dose-dependent benefits of testosterone. The fact that you absolutely refuse to answer the question tells me all I need to know about your intentions with regard to having a meaningful conversation.

Also, for every 1 person you can point out that is suffering at 100 mg/week I can point to many many more that are doing well on that dose or higher. Likewise I could also point to many people who start at 50 mg who suffer needlessly due to not sufficiently raising levels. I can also point to studies that show that dosage did not provide the same benefits as higher doses.

Yes, but at modest levels.

What do you consider “modest levels”? How many miles per week do you ride?

This exactly parallels the situation with testosterone. It's important to understand the risks going in. If you prioritize your sports performance/body composition above overall health then take those risks—it's your choice. Otherwise dial things back. I can't say with certainty how my younger self would choose to act when given only statistical outcomes. I think most of us are less risk-averse when younger, so we're more likely to take those chances. But if our older and wiser selves had a do-over we'd most likely be more conservative.

Well rounded response other than your insistence on brushing off body composition like it isn’t a health benefit on its own… and a very large one at that. There are plenty of health benefits that go along with an improved body composition.

It's not confidence-inspiring that a treatment is "well-tolerated" and only in the short term of a study. Meanwhile humans have been operating at physiological levels for millennia. It's an obvious choice as to where dosing should start.

1.) the levels seen today and the levels you’re basing your targets on are lower than they’ve been throughout practically all of human history as far as we know. So it’s quite possible that getting back to higher levels puts us closer to what actual optimal males(not males in a less healthy state due to the various environmental and other factors impacting us) should be at.

2.) again you’re confining an unnatural process to process to natural parameters. And again you’re using parameters from a less than optimal state(ie today’s society) to hinder it further.

3.) there are lots of variables that could/should be factored in regarding where to start. But generally the approach that is taken is to identity the dosage that is safe while providing robust benefits. That dosage has been established after a multitude of studies as well as real-world experiences from millions of men. Again, you say it’s obvious without offering any reasoning to why that is, and why all of the data that went into establishing the current approach is wrong, other than “trust me bro”

I asked AI about your position and it came up with "cognitive dissonance" on its own:

Question: Is there a name for the phenomenon in which someone does something a certain way and then later argues vociferously in favor of that way even in the face of strong opposing evidence?​

​

Answer: Yes, this is most commonly described as a manifestation of cognitive dissonance (specifically, post-decisional or effort-justification aspects of it), often combined with related biases like confirmation bias or choice-supportive bias.​

Yes, I’m very familiar with the definition and concept. The funny thing is that you don’t realize you’re the one doing it in this thread.

 

[Vince]

Serum Testosterone Levels

25 mg/week: Levels dropped well below baseline; insufficient for replacement.

50 mg/week: Some increase, but still suboptimal.

125 mg/week: Returned testosterone to baseline (pre-suppression) levels for these young men.

300–600 mg/week: Produced supraphysiological levels—common in bodybuilding circles[1].

Body Composition

Lean Mass (Fat-Free Mass): Significant increases began at 100–125 mg/week and continued at higher doses. These gains were recorded despite no exercise, confirming testosterone’s powerful anabolic potential.

Fat Mass: Doses of 100–125 mg/week and above led to reductions in fat mass. Lower doses (25–50 mg/week) paradoxically increased fat mass, suggesting underdosing may be counterproductive[1].

Thread 'What is the Optimum TRT Dose for Muscle Growth? : Nelson Vergel Reviews the Data'

Jul 22, 2025

Landmark Study Reveals How Different Testosterone Doses Affect Muscle, Fat, and Health Markers in Young Men

A deep dive into one of the most influential studies on testosterone dosing reveals key takeaways for anyone interested in hormone optimization—a topic of persistent debate in men's health communities and clinics alike.

Background and Study Design

In 2001, a seminal paper was published in the American Journal of Physiology, Endocrinology and Metabolism. Dr. Shalender Bhasin and colleagues—considered among the top experts on androgens—sought to answer a fundamental...

• Nelson Vergel
• best testosterone dose best trt dose for muscle
• Replies: 16
• Forum: Testosterone Basics & Questions

• 

 

[Phil Goodman]

I've long since lost track of what you guys are arguing about but I'll make one observation...

The psychological factors are probably at least 50% percent of the equation for both risks and benefits, and are likely almost impossible to say anything meaningful about at a population level. What is the effect on confidence, mood and energy? What does someone's wife or girlfriend prefer? Is the person single or in a relationship? What injury history does the person have? What sports activities bring the person joy? What is the person's natural body style? All these things and many more likely play a role and it's worth remembering that one of (possibly the most) powerful driver of health is positive social engagement, so measuring the impact of that would be essential. Total mg could also be a combination of T and other anabolics depending on the person's goals/issues.

I always advocate for starting at the lowest dose that we've seen someone be successful at (which I think is around 60mg per week) and adjusting upward if necessary, but I think trying to say what's higher and lower risk/reward at the population level for a certain dose is likely unknowable and will unfairly under-weight individual differences.

Ok, carry, on.

Good points about the psychological aspects that go into it and are harder to pin down (no pun intended). For someone more prone to anxiety they very well may want to start at a lower dose. And there are lots of other factors that could cause a person to want to start lower. At the same time though, confidence and being more open to adventure/new experiences are pretty common effects of testosterone and are generally seen more commonly when levels are closer to the top of the range. Obviously, like everything else, it is a balancing act but I’d say being the top quarter of the range is probably a good spot on that front for most men.

But you are right that there are tons of factors to consider when deciding what will likely be best for a person. And honestly, instead of asking “what is a good starting dose for everyone?”… a better question would be “how can we get better about understanding all of the various factors so we can improve the chances of starting someone closer to their ideal dosage?” THAT is the real way to minimize suffering of guys trying to settle into a good protocol. If we could better identify which guys are more likely to do better at 50 mg/week and which ones are more likely to do better at 150 mg/week while also understanding who is more at risk of various side effects the whole trt world would be a better place. Hopefully with all of the medical breakthroughs, technologies, and more acceptance of trt as a whole we’ll see some good advancements on this front over the next years and/or decades.

 

[Cataceous]

They aren’t “imaginary scenarios”… those are well established, dose-dependent benefits of testosterone.

It is completely imaginary since you cannot point to a single study or even credible real-world examples where men absorbing healthy physiological amounts of testosterone daily acquire "substantially" less muscle mass, retain "substantially" more body fat and have noticeably less bone mass improvement than those absorbing 10-12 mg of testosterone per day.

These are dose-dependent effects, but as madman has discussed many times, you have to go much higher with dosing to really move the needle. You've already pretty much stipulated that minor improvements in body composition are not a net benefit to health, accompanied as they are by a deterioration in other parameters such as HCT, lipids, etc.

Likewise I could also point to many people who start at 50 mg who suffer needlessly due to not sufficiently raising levels.

Please link to these examples, especially the ones on ExcelMale.

What do you consider “modest levels”? How many miles per week do you ride?

Mostly the trainer lately, about 45 minutes at ~200 watts most days. Outside, occasional rides of around 25 miles, with groups sometimes 60-100 miles. Both time and intensity are much reduced from earlier years. Now it's more about staying healthy than being competitive.

1.) the levels seen today and the levels you’re basing your targets on are lower than they’ve been throughout practically all of human history as far as we know.

...And again you’re using parameters from a less than optimal state(ie today’s society) to hinder it further.

False. The numbers are based on the period before the recent lowering of testosterone levels. Otherwise we might be calling 4-5 mg T/day normal for young men rather than 6-7 mg.

2.) again you’re confining an unnatural process to process to natural parameters.

You have offered no evidence that higher dosing is reasonable compensation for unnatural delivery patterns. With respect to injections, when dosing is too infrequent relative to the ester half-life then frequency should be increased—not cumulative dose.

3.) there are lots of variables that could/should be factored in regarding where to start. But generally the approach that is taken is to identity the dosage that is safe while providing robust benefits. That dosage has been established after a multitude of studies as well as real-world experiences from millions of men. Again, you say it’s obvious without offering any reasoning to why that is, and why all of the data that went into establishing the current approach is wrong, other than “trust me bro”

So the point of treatment is to resolve hypogonadism while minimizing the risk of side effects. As with the exhortation: "First, do no harm." This is why standard practice calls for levels to be started in the mid-normal range; it is statistically the safest place to be, while also giving a good chance of resolving symptoms.

You're the one trying exceptionally hard to rationalize your dosing strategy with only a "trust me", even though you haven't tried anything else. You have offered zero evidence in favor of starting beyond what human physiology is capable of. Do not keep relying on the straw man of hypogonadism as your point of comparison. There's no question that many parameters are lousy with this affliction.

Yes, I’m very familiar with the definition and concept. The funny thing is that you don’t realize you’re the one doing it in this thread.

I go where the evidence takes me. In totality it leads to a low-and-slow approach to TRT dosing. With respect to initial dosing in particular, I am emboldened by your inability to offer any cogent argument or tangible evidence opposing this sensible practice.