Post TRT - Libido is DEAD :(

[Vince]

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.



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



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.




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.



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.



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.



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.

Research indicates that the body composition benefits of testosterone follow a dose-dependent curve, but the most significant differences occur when moving from deficient levels to physiological levels, not when increasing within normal physiological ranges.

 

[Guided_by_Voices]

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.

Yes, agreed. I think the other factor, and one that I've dealt with for both Clomid-only and TRT, is that it's generally easier to assess the impact of an increase in dose than a decrease, especially if longer esters are involved. If I add 20mg, I can be quite confident that over the next few weeks I will be at higher average levels. However if I drop 20 mg, the combination of longer esters still releasing, the signaling affects of T, and possibly other unknown factors will likely mean it takes a bit longer to reach a new true steady state (which may affect things not measurable by blood levels.) Also, if I know I'm a little on the low side, I don't have to decide whether to raise or lower. So whatever a decent stating point is, my experience is that it's better to approach it from the lower side and with shorter esters. I started TRT with Test Prop for this reason. I eventually found T Cyp to work better for my priorities, but I still think shorter-acting forms are the thing to start with to calibrate dose.

 

[Phil Goodman]

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.

There’s a study literally 2 posts above yours here that shows the benefits of various doses. But due to your cognitive dissonance you just move the goalposts as usual/ignore findings because you don’t agree with the outcome. The “imaginary scenario” as you call it is actually a study comparing the starting dose you support and the starting dose I support. Meanwhile, again, you have shared ZERO studies that illustrate 50-75 mg provide the same benefits as 100-125 mg on that front. Perhaps they exist, but I assume if they did you would have already provided them.No need to waste more time here until you give even the slightest indication you’re interested in having a meaningful, productive conversation.

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.

See above with regard to improvements across various metrics. And lmao at suggesting that improvements in body composition are not a net benefit to health because some side effects might emerge in some patients. Again, safety and benefits have been established…. But you say that myself, my personal experience, multiple health agencies, the experience of millions of other patients, and countless doctors is just wrong.

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

S

Thread 'Most common total weekly dose for cypionate/enanthate'

Mar 11, 2018

I wanted to get some feedback from members on what dosage range is the most widely used.
60-80mg
80-100mg
100-120mg
120mg and up
Not concerned with the frequency, just the total 7 day amount.

• sh1973
• Replies: 38
• Forum: Testosterone Basics & Questions

I agree 100% with feelinglost. I am surprise on how well i am feeling on 110mg/week of testosterone cypionate.

It is always best to start low and go slow.

100 mg/week is a common starting dose albeit low for some.

most people are close to 100 mg per week, thats a good starting point. its really down to blood tests though, the problem is someone injecting 80 mg per week could have the same levels as the next guy injecting 200 mg per week. Not usually the case, but it can happen.

80 to 120 is most common. I think 80 to 100 is best, but everyone is a bit different.

Currently at 152mg total per week

F

Thread 'Looking for a poll and feedback from folks who are “dialed in”'

Aug 21, 2019

Looking to hear some success stories and feedback from guys who are feeling great and achieving all their goals, how long it took them to find that sweet spot, and how long they’ve been there.

To me dialed in would be doing well in these categories:

Energy
Mental clarity
Strength/gym gains
Libido
Quality erections
And anything else I may have missed

• FLguy123
• testoserone testosterone basics
• Replies: 32
• Forum: Testosterone Basics & Questions

Maybe it's early in the game but I started over 2 years ago and have felt dialed in for almost all of that time. I started on 150mg a week split m/w/f. I also started with hcg. But have since stopped taking it.

Overall I have really had a good experience with testosterone. I'm 41 years old and maybe I'm an anomoly but for me it's been amazing. I take 44mg testosterone EOD. No AI or HCG.

I would say I feel really dialed in right now. It took several years of messing with dosing, but I am injecting test cyp 3X per week at 30mg each for the last year or so.

i finally feel more stable. switched to 100 mg enanthate once weekly in castor oil (important because its very thick and matches the half life so releases very slow)
+ small daily hcg dosage.

Well, what I'm supposed to be doing is 7ml each of 200mg enanthate and 200mg nandrolone, but I'll be honest and admit I've been doing 8 simply because my eyes play tricks on me when I try to do odd numbers on my insulin syringes. That's a daily dose.

J

Thread 'EOD injection dosing'

Jan 29, 2019

Hello all,

I am about to move to EOD (every other day) injections and have a question about how to properly split up the amount of testosterone for each injection. I currently take 120mg of cypionate per week. I am on test only (no hcg, ai, etc). Is anyone else currently running a true EOD protocol? If so how do you calculate your injections? Thanks for any help that you have!

• J71
• eod injections
• Replies: 13
• Forum: Testosterone Basics & Questions

I injected 60mg on an every 3.5 day basis, and when I switched to daily injections four years ago my doctor and I decided 16mg every day made sense (accounting for ester weight it was close to the testosterone output a healthy man would produce every day). That worked out to 112mg a week.


The subjective results are amazing.

High energy, enhanced mental focus, remarkable libido and erectile function. I just celebrated my 61st birthday and feel decades younger. Four years of tests show rock-solid levels, high total and free testosterone values, no hematocrit or hemoglobin challenges, and a sensitive estradiol that sits at either 31 or 33 time after time with no AI.

If this worked for everyone, well, everyone would adopt it. It works for many, no question, but certainly not all. It's a strong illustration of less testosterone more often pays off.

i take 25mg EOD and this keeps my levels close to 800. I have no issues with E2 nor do i have any issues with an elevated hemoglobin/hematocrit and i feel that is because i am using a small dose frequently. I do not use HCG and i feel absolutely amazing.

And from lots of other threads that I don’t feel like posting links to but you can easily find just by searching for the text from the quotes

I've been on 20mg a day for a while now. No HCG.

90mg of test e a week

14mg /daily Test Cyp here. Been on that dose forever and doing great. I’m typically in the high 800’s - to low900s on that dose and feel great.

Indy: What is your SHBG level? I'm doing twice a week at 50mg each, but thinking on going to 3 times a week. My SHBG is always around 20. HCT a little high in the low 50s. Tx

My SHBG is 30. 8 on my last bloodwork. HCT is holding steady a between 47 and 48 at 14mg per day.
Indy

Or just go to Reddit and find threads like this:

https://www.reddit.com/r/Testosterone/comments/1mp0v85/at_what_dose_did_you_feel_good

Where the vast majority of users are at or over 100 mg/week. There are dozens if not hundreds of similar threads.

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.

Good to hear and glad you’re blessed to be in a position where you can do that. Can’t even imagine being able to do that but not gonna lie I’m kinda jealous lol.

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.

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.



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.

Lots of cognitive dissonance rambling, as again I have shared studies that showed the levels and benefits from the dosages I support are superior to your proposed dose of 50 mg/week. I’ve also shown that many studies have determined the levels seen from various doses as well as the fact that multiple health agencies(and agencies that are very conservative with regard to dosing) support 100 mg/week as a traditional starting dose.

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.

Your inability to review the evidence /= lack of it being shared. Again, anyone can go read the things I’ve shared and points I’ve made.


On the other hand, let’s review the “evidence” you’ve shared.

- a link from a healthcare agency that lists 100 mg/week as a traditional starting dose

- a link from another agency that lists 100 mg/week as a traditional starting dose

- multiple links that suggest hitting levels(at trough) that would require more than your recommended doses

- referencing a famous urologists who recommended low and slow… while ignoring that he recommend HCG for all his patients to max out physiological testosterone then putting exogenous testosterone on top of it

- a few anecdotal reports from a handful of guys who suffered from 100 mg or higher (which I fully agree happens sometimes)




And Im not even saying I know you’re wrong, I’m saying you aren’t doing a good job at all of making your case. And since you’re an intelligent person I assume if your case was stronger you would be able to make it much more easily.


But like I said at the start of this post, you seem to have zero desire to have a meaningful productive conversation on this topic. If you change your mind about having a meaningful discussion, find new evidence you’d like to share, or can think of better ways to present your argument feel free follow up. Otherwise I guess we can just continue this discussion when you once again decide to move one of my posts into this thread for telling a poster that 100 mg/week is a reasonable starting dose.

 

[Mastodont]

Yeah it's kind of weak to say that examples of 50mg per week not working are not easy to find here or in the world outside...almost hard to miss these anecdotes, with few outliers i'd say if that dose works it has to be on a daily protocol..and only very few are willing to go there. Personally i have tried once weekly 50mg and can tell you it was one of the worst experiments, meanwhile the same amount daily worked for a while...but eventually crashed. Low doses may work when stuff is added on top, to somewhat mimic natural mechanisms, but it's almost fair to generalize that 100mg once weekly is a lot more common dose that delivers benefits than 50 is. Btw i'm, happy this thread is still alive and in good will.

 

[Cataceous]

There’s a study literally 2 posts above yours here that shows the benefits of various doses. But due to your cognitive dissonance you just move the goalposts as usual/ignore findings because you don’t agree with the outcome. The “imaginary scenario” as you call it is actually a study comparing the starting dose you support and the starting dose I support. Meanwhile, again, you have shared ZERO studies that illustrate 50-75 mg provide the same benefits as 100-125 mg on that front.

This repetition is extremely tedious. For the nth time, 50 mg TC in one weekly dose yields hypogonadism, which is an invalid point of comparison and lame straw man. I have continuously rejected this protocol. The burden of finding a comparison to healthy natural levels is clearly on you, because you're advocating starting virtually all men on more testosterone than they could ever make naturally, which is against standard medical practice.

See above with regard to improvements across various metrics.

When you have nothing else, keeping knocking down that straw man.

You said you'd find examples of harm at physiological doses. Instead you cite polls of guys like yourself who have never even tried them.

And Im not even saying I know you’re wrong, I’m saying you aren’t doing a good job at all of making your case.

Maybe you forgot already:

• Medical societies advocating for initial titration to mid-normal range
* Standard practice for virtually all hormones—not starting with > physical production
* U-shaped mortality curves related to testosterone levels
• Afib risk also U-shaped with levels
• Side effects from high estradiol, high prolactin
• Increased blood viscosity with HCT increasing long-term MI risk
• Dozens of anecdotes with men suffering from higher doses
• No documented harm in starting with mid-physiological levels
• No documented benefit to overall health with > physiological levels
• Excess dosing tied only to TC injections due original Depo-Testosterone protocol

... Otherwise I guess we can just continue this discussion when you once again decide to move one of my posts into this thread for telling a poster that 100 mg/week is a reasonable starting dose.

As you wish.

Yeah it's kind of weak to say that examples of 50mg per week not working are not easy to find here or in the world outside...almost hard to miss these anecdotes, with few outliers i'd say if that dose works it has to be on a daily protocol..and only very few are willing to go there. Personally i have tried once weekly 50mg and can tell you it was one of the worst experiments, meanwhile the same amount daily worked for a while...but eventually crashed. ...

I specifically reject protocols that result in new or continued hypogonadism. If a guy is insistent on no more than one injection a week of testosterone cypionate then he should start at 75 mg, or better yet, use Xyosted, with its longer half-life. Better still for the guy who wants to minimize injections: titrate the dose with small cypionate injections as often as he can stand, and once titrated to a good level switch to the equivalent in testosterone undecanoate, which can be injected once every 10-14+ days.

 

[FunkOdyssey]

Brand new study to argue about:

Real-World Outcomes and Safety of Testosterone Therapy: A Longitudinal, Retrospective Cohort Study of Over 9,000 Men

Clift AK, et al. World J Mens Health. 2026 Apr;44(2):438-450. https://doi.org/10.5534/wjmh.250245

wjmh.org

 

[Phil Goodman]

Brand new study to argue about:

Real-World Outcomes and Safety of Testosterone Therapy: A Longitudinal, Retrospective Cohort Study of Over 9,000 Men

Clift AK, et al. World J Mens Health. 2026 Apr;44(2):438-450. https://doi.org/10.5534/wjmh.250245

wjmh.org

Good find and another interesting study to add to the compilation of various articles for people to consider when deciding where to start. No use in arguing with @Cataceous about it though… he’ll just continue to move goalposts.


At baseline, the median score across all 8 quality-of-life (QoL) domains was 2/5 on the modified qADAM Likert scale (1 = most severe symptoms/burden, 5 = none/minimal), indicating significant symptoms in the cohort. By 12 months, model-estimated mean scores reached 3 (“typical/average”) or higher in every domain. All improvements were statistically significant (p < 0.001 for each domain) based on mixed-effects models adjusted for age, BMI, smoking status, and concurrent treatments.


The study provides detailed model-estimated values (with 95% CIs) as an example for one domain in the text:


• Libido: Baseline mean 1.94 (95% CI: 1.92–1.96) → 12-month mean 3.20 (95% CI: 3.02–3.37); +1.26 points (95% CI: 1.01–1.43, p < 0.001).


For the remaining seven domains (energy levels, strength/endurance, life enjoyment, happiness, erection strength, work performance, and sports ability), the paper states that increases were of similar magnitude, followed the same temporal pattern, and resulted in 12-month average ratings of 3 or higher. Exact baseline/12-month means, differences, and confidence intervals for these domains are presented in Table 3 (and visualized in Figure 2) but are not individually listed in the main text beyond the libido example. The authors emphasize the consistency in trajectory, magnitude, and speed of improvement across all 8 domains rather than highlighting domain-specific differences.


These improvements were rapid: statistically significant gains were observed by month 2 across all domains, with scores generally stabilizing at the improved level by month 4 and remaining consistent through 12 months.


Key Context on Improvements


• Consistency across baseline testosterone groups: QoL improvements occurred regardless of starting testosterone levels (including men with severe deficiency and those with only borderline-low levels who had prominent symptoms). There were no statistically significant differences in average 12-month scores between these baseline groups (all p > 0.05). The trajectory and magnitude of change were also similar across groups.


• By treatment strategies: Among treatment-naïve men, QoL gains were broadly comparable across the most common regimens (e.g., subcutaneous testosterone injections alone, combined with hCG, or with other adjuncts), as shown in supplemental data. Exact point changes were not broken out per subgroup beyond noting similar overall magnitude.


• Relation to testosterone levels: Mean total testosterone increased to 28.05 nmol/L (within the study target range of 15–30 nmol/L) and free testosterone to 0.75 nmol/L by 12 months. QoL improvements occurred alongside these rises but were not further stratified or analyzed by final achieved testosterone levels.


• Clinical meaning: The gains — averaging roughly 1.2–1.3 points on the 1–5 scale for the example domain and described as similar for the others — shifted men from clearly symptomatic/poor function (around 2/5) to average or better function (≥3/5). This covered sexual aspects (libido and erection strength), physical domains (energy, strength/endurance, sports ability), and psychological/performance areas (life enjoyment, happiness, work performance).



This was accomplished by starting patients off on 100 mg/week and adjusting as necessary(and by adjusting… I mean have patients spending plenty of time at what Cat would call a supraphysiological level). But since they didnt suffer(on the contrary, their QOL greatly improved) Cataceous will just go with either a.) it is unnecessarily dangerous… likely pointing to hematocrit or b.) just going “omg it wasn’t long at all so those people will certainly see health problems down the road due to being at supraphysiological levels”.


I tend to think it’s more supporting evidence that 100 mg is a good starting point, or at the very least that there aren’t large percentages of men suffering by starting off at that dose. He will disagree. And everyone else can read the study for themselves and decide what they think about it. As a retrospective cohort study it isn’t the most solidly founded, but at least can continue to point us in the right direction. Also, I really wish they would’ve included the dosage adjustments in results (ie how many went up an how many went down).

And I was surprised such a large percentage were on HCG. We always hear that a very substantial number of men don’t tolerate it at all. But at least in this case about 75% of the patients were on HCG and the patients did really well according to self-reported data. Kind of makes me think that a lot of the guys who didn’t do too good on HCG were probably on too high of a trt dose. The study is pretty much right inline with my protocol and I’d say my metrics for QOL have increased similarly across the board. I think moderate (as in 100-120 mg) test along with 750-1000 ius of HCG per week is the way to go for many men. Sure we’re all different, but to me that seems like a great place to land and at least according to the study that’s true for lots of men.

 

[Cataceous]

Brand new study to argue about:

Real-World Outcomes and Safety of Testosterone Therapy: A Longitudinal, Retrospective Cohort Study of Over 9,000 Men

Clift AK, et al. World J Mens Health. 2026 Apr;44(2):438-450. https://doi.org/10.5534/wjmh.250245

wjmh.org

Basically showing that you don't want to be hypogonadal. Nothing to indicate that the excessive starting dose of 100 mg TC/week is anything other than a historical accident perpetuated by more-is-better thinking.

It's simple to demonstrate that this is outside the norms of TRT in general. Starting with 100 mg TC/week yields an average of 10 mg of testosterone per day. In contrast:

Topical Gels:

Other injections:

Oral testosterone (TU):

Pellets:

 

[Phil Goodman]

Basically showing that you don't want to be hypogonadal. Nothing to indicate that the excessive starting dose of 100 mg TC/week is anything other than a historical accident perpetuated by more-is-better thinking.

It's simple to demonstrate that this is outside the norms of TRT in general. Starting with 100 mg TC/week yields an average of 10 mg of testosterone per day. In contrast:

Topical Gels:
View attachment 56512

Other injections:
View attachment 56513

Oral testosterone (TU):
View attachment 56514

Pellets:
View attachment 56515

Well, I’d say it indicates that you can use 100 mg/week as a starting dose and have lots of success across many aspects with regard to symptom improvements… and not have substantial numbers “needlessly suffer” as some would say. And that’s before even getting into the better results for body composition and other areas.

 

[Cataceous]

Well, I’d say it indicates that you can use 100 mg/week as a starting dose and have lots of success across many aspects with regard to symptom improvements… and not have substantial numbers “needlessly suffer” as some would say. And that’s before even getting into the better results for body composition and other areas.

Lower doses could easily produce results as good or better but with a reduced side effects profile. Many side effects develop over time frames longer than the length of this study. Just admit it: It is poor medical practice to begin TRT with a non-physiological dose.

 

[Vince]

Lower doses could easily produce results as good or better but with a reduced side effects profile. Many side effects develop over time frames longer than the length of this study. Just admit it: It is poor medical practice to begin TRT with a non-physiological dose.

"again"

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].

 

[Phil Goodman]

"again"

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].

It doesn’t matter how many times he sees it, or other studies. He’ll just constantly make claims like this:

“Lower doses could easily produce results as good or better but with a reduced side effects profile.”


While sharing exactly zero evidence.


It’s laughable at this point

 

[Cataceous]

It doesn’t matter how many times he sees it, or other studies. He’ll just constantly make claims like this:

It's almost sad to see you guys clinging to that one dataset that says nothing about physiological dosing. Meanwhile I have delivered overwhelming evidence in support of starting TRT with physiological doses. It speaks volumes that you have made no attempt to contradict that evidence.

 

[Phil Goodman]

It's almost sad to see you guys clinging to that one dataset that says nothing about physiological dosing. Meanwhile I have delivered overwhelming evidence in support of starting TRT with physiological doses. It speaks volumes that you have made no attempt to contradict that evidence.

What is the “overwhelming evidence” for your claim?





Where is the evidence for this claim?

Lower doses could easily produce results as good or better but with a reduced side effects profile.

 

[Cataceous]

What is the “overwhelming evidence” for your claim? ...
Where is the evidence for this claim?

How much repetition do you need?

• Medical societies advocating for initial titration to mid-normal range
* Standard practice for virtually all hormones—not starting with > physiological production
* U-shaped mortality curves related to testosterone levels
• Afib risk also U-shaped with levels
• Dose-related side effects from high estradiol, high prolactin
• Increased blood viscosity with HCT increasing long-term myocardial infarction risk
• Dozens of anecdotes with men suffering from higher doses
• No documented harm in starting with mid-physiological levels
• No documented benefit to overall health with > physiological levels
• Excess dosing tied only to TC injections, not other modalities

 

[Phil Goodman]

How much repetition do you need?

• Medical societies advocating for initial titration to mid-normal range

The societies listed 100 mg/week as a traditional starting dose

* Standard practice for virtually all hormones—not starting with > physiological production

Blanket statement with no supporting evidence for your claim

* U-shaped mortality curves related to testosterone levels

Blanket statement that does nothing to illustrate where the various doses place patients on that curve

• Afib risk also U-shaped with levels

Blanket statement that does nothing to illustrate where the various doses place patients on that curve

• Dose-related side effects from high estradiol, high prolactin

Blanket statement that does nothing to illustrate the frequencies and degree of side effects seen from various doses.

• Increased blood viscosity with HCT increasing long-term myocardial infarction risk

Blanket statement that does nothing to illustrate where the various doses place patients on that curve

• Dozens of anecdotes with men suffering from higher doses

It wasn’t dozens, it was a handful and few if any were on 100 mg/week. You seem to be lumping all “high doses” together… so someone starting at 150 counts as “evidence” for you even though it is much higher than the dose I’m advocating for. Additionally, I’ve already agreed that some will see issues at that dose. And I’ve already shown that way more succeed at those doses, so you don’t construct blanket treatment strategies based on outliers.

• No documented harm in starting with mid-physiological levels

That’s not evidence for your claim.

• No documented benefit to overall health with > physiological levels

Outright false. Also, it has been established that blood should be drawn at trough, which indicates providers are more concerned with avoiding dropping too low at trough rather than avoiding creeping into supraphysiological levels at peak…. Which supports MY claims.

• Excess dosing tied only to TC injections, not other modalities

Using your logic practically all men on cream should take very small doses to avoid hitting supra levels. Also, that statement is not at all evidence for your claim.





There, that took me all of 3 minutes to show you have no evidence.

 

[Cataceous]

The societies listed 100 mg/week as a traditional starting dose

Bloodletting was a "traditional" treatment for a lot of maladies. That doesn't make it preferable to better-informed modern alternatives.

* Standard practice for virtually all hormones—not starting with > physiological production

Blanket statement with no supporting evidence for your claim

Do you actually dispute this? If so then ask your favorite AI about it and don't waste my time on it.

* U-shaped mortality curves related to testosterone levels
• Afib risk also U-shaped with levels

Blanket statement that does nothing to illustrate where the various doses place patients on that curve

Even you should know off the top of your head that when optimum outcomes correlate with TT around 400-500 (which by the way is a peak AM measurement), then taking 10 mg T per day is going to put the average guy at around twice these levels. Do you deny this or are you intentionally wasting bandwidth?

• Dose-related side effects from high estradiol, high prolactin

Blanket statement that does nothing to illustrate the frequencies and degree of side effects seen from various doses.

Not claiming particular frequencies, but these are commonly reported side effects seen even with upper-physiological dosing. Hard to dispute that they are dose related. At one time averaging 6.5 mg T/day put my E2 levels in the lower 50s pg/mL, a full standard deviation above the top of the normal range. You can be sure I felt this. Unsurprisingly the symptoms go away at lower levels. Search for high E2 symptoms in the forum if you like. There is research showing that E2 is a driver of prolactin, so they can rise and fall together.

• Increased blood viscosity with HCT increasing long-term myocardial infarction risk

Blanket statement that does nothing to illustrate where the various doses place patients on that curve

You act as if you didn't review the study I linked to above. It is concerning, given that it tracked men who were young and healthy at the start and found a linear correlation of MI risk with HCT. These guys would have had HCT in range, yet it's routinely advised here that it's fine to have HCT sit in the low 50s (%). I think this signal is eventually going to show up in long-term TRT users.

I assume you're not denying that elevated HCT is a common dose-dependent side effect of TRT. This study suggests that any increase in HCT is heightening your risk. Many on TRT do not see this rise, but many do, which is why a low-and-slow approach to TRT is more rational than what you advocate.

It wasn’t dozens, it was a handful and few if any were on 100 mg/week. You seem to be lumping all “high doses” together… so someone starting at 150 counts as “evidence” for you even though it is much higher than the dose I’m advocating for. Additionally, I’ve already agreed that some will see issues at that dose. And I’ve already shown that way more succeed at those doses, so you don’t construct blanket treatment strategies based on outliers.

I listed 20, which are just some of the ones since I started looking. That's more than a handful, and infinitely more than the zero you've offered to demonstrate that physiological dosing causes harm. You'll note that most of them ended up well below 100 mg TC/week, even after trying a range of doses.

The best that can be said about your approach is that many men can tolerate it, but there's no proof of better results compared to what's physiological, and the risk of side effects is undeniably greater.

Another fun side effect of mildly supra levels:
"I experienced this 'dead wood' penis insensitivity on and off for a long time while on dosages around 100 mgs per week of T. When I lowered the dose down to 60-70 mgs, sexual sensitivity improved considerably. Erectile function is also more responsive and reliable.
...Too much testosterone is not a good thing, especially for your penis."

• No documented harm in starting with mid-physiological levels

That’s not evidence for your claim.

But it is when you were the one claiming harm in starting physiological. Nice to see that you're abandoning the position.

• No documented benefit to overall health with > physiological levels

Outright false.

Ok, cite one study citing the superiority of supraphysiological testosterone levels for overall health. It doesn't exist, so your denial is pathetic.

Also, it has been established that blood should be drawn at trough, which indicates providers are more concerned with avoiding dropping too low at trough rather than avoiding creeping into supraphysiological levels at peak…. Which supports MY claims.

This is a false dichotomy. Guys do not have to accept hypergonadism to avoid hypogonadism. If you can only support your claims with fallacious arguments then it's game over.

• Excess dosing tied only to TC injections, not other modalities

Using your logic practically all men on cream should take very small doses to avoid hitting supra levels. ...

Apparently you never looked at a dose-response chart for topicals.

There, that took me all of 3 minutes to show you have no evidence.

My evidence stands firm against your empty denials. Meanwhile you continue to offer nothing to support the superiority of supraphysiological starting doses.

 

[Vince]

Bloodletting was a "traditional" treatment for a lot of maladies. That doesn't make it preferable to better-informed modern alternatives.

* Standard practice for virtually all hormones—not starting with > physiological production


Do you actually dispute this? If so then ask your favorite AI about it and don't waste my time on it.

* U-shaped mortality curves related to testosterone levels
• Afib risk also U-shaped with levels


Even you should know off the top of your head that when optimum outcomes correlate with TT around 400-500 (which by the way is a peak AM measurement), then taking 10 mg T per day is going to put the average guy at around twice these levels. Do you deny this or are you intentionally wasting bandwidth?

• Dose-related side effects from high estradiol, high prolactin


Not claiming particular frequencies, but these are commonly reported side effects seen even with upper-physiological dosing. Hard to dispute that they are dose related. At one time averaging 6.5 mg T/day put my E2 levels in the lower 50s pg/mL, a full standard deviation above the top of the normal range. You can be sure I felt this. Unsurprisingly the symptoms go away at lower levels. Search for high E2 symptoms in the forum if you like. There is research showing that E2 is a driver of prolactin, so they can rise and fall together.

• Increased blood viscosity with HCT increasing long-term myocardial infarction risk


You act as if you didn't review the study I linked to above. It is concerning, given that it tracked men who were young and healthy at the start and found a linear correlation of MI risk with HCT. These guys would have had HCT in range, yet it's routinely advised here that it's fine to have HCT sit in the low 50s (%). I think this signal is eventually going to show up in long-term TRT users.

I assume you're not denying that elevated HCT is a common dose-dependent side effect of TRT. This study suggests that any increase in HCT is heightening your risk. Many on TRT do not see this rise, but many do, which is why a low-and-slow approach to TRT is more rational than what you advocate.



I listed 20, which are just some of the ones since I started looking. That's more than a handful, and infinitely more than the zero you've offered to demonstrate that physiological dosing causes harm. You'll note that most of them ended up well below 100 mg TC/week, even after trying a range of doses.

The best that can be said about your approach is that many men can tolerate it, but there's no proof of better results compared to what's physiological, and the risk of side effects is undeniably greater.

Another fun side effect of mildly supra levels:
"I experienced this 'dead wood' penis insensitivity on and off for a long time while on dosages around 100 mgs per week of T. When I lowered the dose down to 60-70 mgs, sexual sensitivity improved considerably. Erectile function is also more responsive and reliable.
...Too much testosterone is not a good thing, especially for your penis."

• No documented harm in starting with mid-physiological levels


But it is when you were the one claiming harm in starting physiological. Nice to see that you're abandoning the position.

• No documented benefit to overall health with > physiological levels


Ok, cite one study citing the superiority of supraphysiological testosterone levels for overall health. It doesn't exist, so your denial is pathetic.


This is a false dichotomy. Guys do not have to accept hypergonadism to avoid hypogonadism. If you can only support your claims with fallacious arguments then it's game over.

• Excess dosing tied only to TC injections, not other modalities


Apparently you never looked at a dose-response chart for topicals.
View attachment 56525



My evidence stands firm against your empty denials. Meanwhile you continue to offer nothing to support the superiority of supraphysiological starting doses.

Around we go

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]

Bloodletting was a "traditional" treatment for a lot of maladies. That doesn't make it preferable to better-informed modern alternatives.

Just an example of cognitive dissonance causing you to jump to an absurd absolute. Also… it’s funny how those are completely valid sources when you use them, but when I point out the dose they list as a traditional starting dose they suddenly become on par with recommendations of bloodletting. Just lol.

* Standard practice for virtually all hormones—not starting with > physiological production


Do you actually dispute this? If so then ask your favorite AI about it and don't waste my time on it.

* U-shaped mortality curves related to testosterone levels
• Afib risk also U-shaped with levels

I didn't dispute the fact that the U-shaped charts exist… I’m saying you’ve provided no data I’ve seen which compares the various doses and shows where patients fall on that curve. And you still haven’t. Thus, it’s just a blanket statement on your part.

Even you should know off the top of your head that when optimum outcomes correlate with TT around 400-500 (which by the way is a peak AM measurement), then taking 10 mg T per day is going to put the average guy at around twice these levels. Do you deny this or are you intentionally wasting bandwidth?

Where is the data which shows that hitting 400 TT AT PEAK results in optimum outcomes. Do you have it and just refusing to share it to waste bandwidth, or are you just blatantly making things up. My statement stands that standard practice is to measure at trough and achieve levels at the middle to top of the range depending on patient. So my earlier statements were accurate. And in your response you’ve gone beyond just making blanket general statements and ventured into making false statements(or at the very least statements which you’ve provided zero evidence for).

• Dose-related side effects from high estradiol, high prolactin

Again, a blanket statement that doesn’t compare the extent and frequency of those effects for patients on 50 mg per week compared to 100

Not claiming particular frequencies, but these are commonly reported side effects seen even with upper-physiological dosing. Hard to dispute that they are dose related. At one time averaging 6.5 mg T/day put my E2 levels in the lower 50s pg/mL, a full standard deviation above the top of the normal range. You can be sure I felt this. Unsurprisingly the symptoms go away at lower levels. Search for high E2 symptoms in the forum if you like. There is research showing that E2 is a driver of prolactin, so they can rise and fall together.

See above

• Increased blood viscosity with HCT increasing long-term myocardial infarction risk

It appears that as long as hematocrit stays under 54% there is no increased risk. And that’s in a study group that went into the experiment with either outright pre-existing heart problems, or risk factors that already put them at increased risk. Either way, you’ve shown nothing that compares 50 to 100 to show how the outcomes differ. Thus, I was correct to call it just a blanket statement with no supporting evidence.

You act as if you didn't review the study I linked to above. It is concerning, given that it tracked men who were young and healthy at the start and found a linear correlation of MI risk with HCT. These guys would have had HCT in range, yet it's routinely advised here that it's fine to have HCT sit in the low 50s (%). I think this signal is eventually going to show up in long-term TRT users.

See above.

If it does “eventually show up” let me know. Otherwise it is, again, just a blanket statement on your part.

I assume you're not denying that elevated HCT is a common dose-dependent side effect of TRT. This study suggests that any increase in HCT is heightening your risk. Many on TRT do not see this rise, but many do, which is why a low-and-slow approach to TRT is more rational than what you advocate.

And not a single study was provided to compare the dose you recommend vs the one I recommended. Yes when you start hitting mid 50’s and above risk goes up. Some people on low doses still go up to those levels. And either way, again, you’ve shared no studies to compare the doses. Thus, it’s just a blanket statement on your part.

I listed 20, which are just some of the ones since I started looking. That's more than a handful, and infinitely more than the zero you've offered to demonstrate that physiological dosing causes harm. You'll note that most of them ended up well below 100 mg TC/week, even after trying a range of doses.

The best that can be said about your approach is that many men can tolerate it, but there's no proof of better results compared to what's physiological, and the risk of side effects is undeniably greater.

More blanket statements from you.

Another fun side effect of mildly supra levels:
"I experienced this 'dead wood' penis insensitivity on and off for a long time while on dosages around 100 mgs per week of T. When I lowered the dose down to 60-70 mgs, sexual sensitivity improved considerably. Erectile function is also more responsive and reliable.
...Too much testosterone is not a good thing, especially for your penis."

Again, I already said I agree some people don’t tolerate doses of 100 mg/week. That doesn’t refute my overall approach and claim.

• No documented harm in starting with mid-physiological levels


But it is when you were the one claiming harm in starting physiological. Nice to see that you're abandoning the position.

Not evidence for your case.

• No documented benefit to overall health with > physiological levels


Ok, cite one study citing the superiority of supraphysiological testosterone levels for overall health. It doesn't exist, so your denial is pathetic.

Lmao… it’s been done ad nauseum and you just dismiss it. No need to keep going around in this circle.

This is a false dichotomy. Guys do not have to accept hypergonadism to avoid hypogonadism. If you can only support your claims with fallacious arguments then it's game over.

• Excess dosing tied only to TC injections, not other modalities


Apparently you never looked at a dose-response chart for topicals.
View attachment 56525

Gel /= cream. Also, the majority of stories you hear of from guys on gel is that they don’t get symptom relief and don’t see the full range of benefits from improved testosterone levels. Thanks for helping support MY case yet again.

My evidence stands firm against your empty denials. Meanwhile you continue to offer nothing to support the superiority of supraphysiological starting doses.

Lmfao… all you keep doing is making blanket statements with no studies to back up your claims. Meanwhile the list of studies supporting my approach is growing frequently, with another posted recently. Which you say indicates nothing other than an outdated approach… just lol.

 

[Phil Goodman]

@Cataceous we could keep going round and round with your blanket statements, or you could share actual evidence(ie data and studies) which compare the two starting doses and show that the group on your dose did much better than the ones starting on my dose, and that it was done much safer. Blanket statements about u curves and side effects tell us nothing for the context of our discussion, and certainly don’t make the case that you think they make.