Starting TRT Soon

You keep repeating the same thing over and over again, but provide no documentation why is above average hormone levels are bad.
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Not above average, above range. This means more than two standard deviations above average. In general there are all kinds of negative associations when hormones are out of range, not least of which is reduced longevity. Although long-term research is lacking, specific to testosterone there are negative effects on lipids and blood viscosity. The burden of proof is on you. If symptoms of low testosterone can be eliminated with average levels then there's no justification for going much higher, except for those who put gains in body composition ahead of overall health.

... The majority of men feel better above average levels.
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For which you have zero credible evidence. Don't even bother citing an informal poll of a population you already acknowledge to be unusual. It's also likely that most of this population has actually only tried levels ranging from above average to way above average.

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Maybe we should have people stop taking vitamin D supplements for having above average vitamin D levels, even though it’s optimal to have levels at the higher end of the ranges. We should target average levels, even though people are spending the majority of their day indoors.
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You're probably unaware that maximum endogenous testosterone production correlates with vitamin D levels in the 30s ng/mL. And that negative health correlations appear at levels greater than 50 ng/mL. This is another case where misguided more-is-better thinking is creeping in.

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You’re right, we should set the bar based off a declining, ever increasing unhealthy population with a 50% reduction in fertility and declining testosterone.

The average total testosterone 30 years ago was 720 and now it’s half that. What’s average today won’t be average tomorrow.

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The usual pathetic straw man argument. Do you realize that even Labcorp's current IA test for total testosterone shows an average of almost 600 ng/dL? For the Quest LC/MS test it is 675 ng/mL. Thirty years ago healthy young men also had total testosterone around 600-700 ng/dL.
 
I'm 69 and started out very conservatively at 70mg/wk. I had OK results, but impatience drove me to boost myself to 84mg/wk (where . . . "yes, I felt better"). After 3 months of that, my TT was 29.5 nmol/L (8.4 to 28.8) and my FT was 744 pmol/L (179-475) - both much too high. Clearly I'm a very good responder to exogenous T . . . who knew? I started to cut back a bit, but shortly afterwards I had a TIA which came as a result of night-time Atrial Fibrillation. I've never had anything like that before. Was it caused by the excessive T levels? Impossible to say, but the probability is quite high.

I believe that until you know how you're going to respond to T, everyone should play it safe and start with a very low dose. I'm currently taking 63mg/wk and may still reduce further depending on upcoming bloods.
 
I'm 69 and started out very conservatively at 70mg/wk. I had OK results, but impatience drove me to boost myself to 84mg/wk (where . . . "yes, I felt better"). After 3 months of that, my TT was 29.5 nmol/L (8.4 to 28.8) and my FT was 744 pmol/L (179-475) - both much too high. Clearly I'm a very good responder to exogenous T . . . who knew? I started to cut back a bit, but shortly afterwards I had a TIA which came as a result of night-time Atrial Fibrillation. I've never had anything like that before. Was it caused by the excessive T levels? Impossible to say, but the probability is quite high.

I believe that until you know how you're going to respond to T, everyone should play it safe and start with a very low dose. I'm currently taking 63mg/wk and may still reduce further depending on upcoming bloods.
Has your A-fib gone away since reducing dose?

Early on in my TRT journey, I experienced a bounding heart for several days while I was at high end TT on trough day. It spooked me so I reduced dose and sure enough the problem went away thankfully.

Not the same as A-fib, but just another example of how high-end dose can really bother some guys.
 
I think the A-Fib has gone away since reducing the dose, but as always things are hard to say.

After the TIA, I was required to wear a holter heart monitor 24 hours a day for two weeks (what a hassle . . .). During that time, they later told me that I had 2 episodes of A-Fib; one lasted 30 minutes, the other one lasted 5 hours. I was in the process of reducing my TE, but this entire episode caused me to reduce quicker. The only way to tell if I still have AFib is to wear the monitor again, which I'll do soon. In the meantime I'm told that I should be on a blood thinner for the rest of my life (Apixaban) to counter any blood clots that might be created by the AFib.

Did I ever feel the AFib? Maybe. I sleep alone, and sometimes, when I was lying in a half asleep - half awake state, I felt as if the floor beside me was shaking and vibrating . . . as if a heavy person were jumping up and down on it. It was bad enough that it would wake me and I would sit up to see what was going on, very strange. Since reducing the T, I haven't felt any of those things . . . maybe it was AFib and the heart violently shaking in the chest?

It convinced me of one thing; T is a powerful drug/hormone and you better be very careful with it. Start slow . . .
 
Bump

Took my third shot on Friday. After a quick libido boost, it went dead and has been the last couple of days yesterday and today I’m much more irritable and moody, energy is pretty decent. I know it’s early but I’m already wondering if 120 a week is too much of a starting test and I should bump it down to 100.

As I stated previously the standard starting dose is 100 mg T/week which is a sensible starting dose for most!

Could name off numerous uros considered top of the field in this game where it is a common starting dose.

It's far from an ABSURD dose!

Can some men start on <100 mg T/week.....sure but it is not common practice!

Morgentaler and Khera to name a few have treated 1000s of men over decades..... VAST F**KING CLINICAL EXPERIENCE REIGNS SUPREME HERE!


















When it comes to where you may need your T levels on therapy!



He is not talking PEAK F**KING levels here!

*Some men feel great at T 400 others notice no benefits until T>700




Therapeutic target levels


*Inadequately studied

*Enormous variation is response from person to person


*Some men feel great at T 400 others notice no benefits until T>700

*Most important question is how are you doing with treatment?



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Again he is not talking PEAK F**KING levels here!

*Optimal results often require T values in upper range of normal (T 600-900)





*Goal for most patients is symptomatic improvement

*Optimal results often require T values in upper range of normal (T 600-900)

* Therefore: Suboptimal response with T <600 merits increased dose



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Where does Abe stand when treating men for low testosterone.....restoration of ROBUST YOUTHFUL LEVELS!

Key point here being ROBUST!


*Some groups target T levels 1200-1800 ng/dL

*This is a different philosophy of treatment


*Supraphysiological/pharmacological rather than restoration of robust youthful levels


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