Starting TRT Soon

[Cataceous]

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.

 

[Melody68]

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.

 

[Willyt]

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.

 

[Melody68]

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 . . .

 

[madman]

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!

Post in thread 'Testosterone Therapy (TTh) - How To Treat - Abraham Morgentaler'

Nov 28, 2023

Had been treating men for DECADES!

Pay close attention @6:34-7:02

This sums it up

*So we start at 0.5 and if that's not good enough we go to 0.6 (120 mg) and 0.7 (140 mg) and occasionally but NOT VERY OFTEN we go above that

What is that Abe?

Those so-called gurus (hint hint) claim that's BABY DOSES of T and would have everyone and their brother that they treat believing that they need 200 mg T/week to achieve HEALTHY let alone HIGH trough FT levels to experience relief/improvement of low-T symptoms due to testosterone resistance let alone being cursed with that...

• madman

Post in thread 'The Science of Optimizing Your Testosterone'

Mar 4, 2025

Throw this in there too for that dime a dozen club stinking up all those so called men's HRT/health forums!

Truth hurts!

This is coming from the man who would be considered the father of testosterone who has made huge contributions in the field of testosterone therapy and men's health let alone has treated 1000s of men over decades!

Would be considered one of the top heavyweights when it comes to (research/clinical experience) in the field of hormone replacement therapy!


* what's important to understand though is that the concept of testosterone therapy in theory is designed to...

• madman

* what's important to understand though is that the concept of testosterone therapy in theory is designed to replicate youthful levels of testosterone to help people who are deficient in this hormone, the goal isn't to make them into supermen and the real question is why do people want to go above normal if at all, much of the concept of treating up lets say a 1000 let's say our normal upper limit, in the anti-aging community or age management community there are some people who believe the there's an optimal level of testosterone that may be 1200 or 1500 or even I've heard 1800 and the basis for that is WEAK!








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

Post in thread 'High Testosterone on only 80mg/week'

Jun 22, 2024

Based on the comments you made here about a hematocrit of below 54 being safe are you willing to stand liable for giving out this false information if the OP has a stroke or heart attack?

Also please enlighten us on where you attended medical school and where you got your degree in endocrinology?

If you are having to give blood to reduce the hematocrit, you are not on "TRT" you are taking a small steroid cycle and calling it TRT.

As for my advice to the poster, I know personally of two people I have given similar advice to, both had strokes under the age of fifty. One with a...

• madman

• 

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?

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

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

Post in thread 'From Guidelines to Practice—Navigating the TRT Treatment Spectrum'

Yesterday at 11:43 AM

Pay attention!

Start low and go slow we have always stressed here!

As I have been preaching for years on here the majority of men can easily achieve a high-end/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Some men can hit stellar levels injecting <100 mg T/week.

Yes there will always be some outliers who need the higher-end dose 200 mg T/week but it is FAR from COMMON as in RARE!

Such dose would have the MAJORITY OF MEN OVERF**KING MEDICATED!

As I have stated numerous times before the standard starting dose across the board used by...

• madman

Where to begin in terms of the dose?

14:37-16:24

* for some patients its straight forward you can start them on .5CC (100 mg T) or .3CC (60 mg T) per week




16:25-18:20

* the rule of thumb that I tell other docs is you know START LOW because you can always GO UP and its A LOT EASIER TO INCREASE THE DOSE than to be CHASING DOWN SIDE-EFFECTS




18:21-20:39

* for MOST patients I START ONCE A WEEK alright and I'm COMMONLY looking at you know about .5 CC (100 mg T) as being my BASELINE for the MAJORITY OF PATIENTS and then I can consider kind of moving that down or moving that up from there, if I have an older patient with less muscle mass okay that is someone where they probably dont need .5CC (100 mg) they could probably do FINE on .3CC (60 mg) or .4CC (80 mg) so lets go ahead and lets try it, now if Ive got a well muscled guy in his early 40s then I am going to start miving him up a bit

 

[Forty2]

Update:

I am two shots into my protocol (40 ml Monday and Wednesday Morning), I decided to go down to 120mg to start vs. the 150 Defy suggested. My provider agreed that it was ok to start lower. I know it's beyond early, but I had a few things I wanted to run by you vets to get feedback on. The last two nights, I have woken up almost exactly after 4 hours of good sleep completly wired. It's not anxiety, but like I drank 6 Red Bulls. I know this is common early on, but my sleep has been garbage for a long time. Anything besides Melatonin used by you guys early on to fight this?

Second I feel some soreness in my breast area starting last night. It,s not throbing, but more of a dull acheI know this is usually a sign of elevated E2, but can it really show up after two shots, or is it more likely some fluid retention. My waist or face isn't showing any fluid retention, in fact since I started back on my 16:8 fast and low carb regiment this week, my pants are much looser. felt extremely reved up for about 6 hours after my injection, and it subsided around noon. My mood and temperment have been really good this week. I was suprised how quicky that was impacted. My wife commented my disposition and communication have been the best she has seen in years.

Lastly, I have bruised the first two times I have sub q injected into my stomach. I h used the method Defy models, but still bruising. I am more than 2 inches away from the bellybutton. I am thinking of trying the outside fatty layer of the thigh for sub q tomorrow. Anyone inject there and have advice.

I know my body will be adjusting a lot over the next several weeks, I just was hoping for some feedback form you guys that have experienced some of these same things when you first started. Thanks for any feedback and advice you can offer.

Why are you fasting and eating low carb?
That may well have been responsible for lowering your testosterone. So many guys end up on TRT after following that bs diet.
A high carb low fat and low-moderate protein diet may have saved you from TRT.

 

[Systemlord]

A high carb low fat and low-moderate protein diet may have saved you from TRT.

A diet with lower inflammatory in mind would be the carnivore diet which can reverse chronic disease.

 

[Forty2]

A diet with lower inflammatory in mind would be the carnivore diet which can reverse chronic disease.

A high sugar diet in the presence of very low fat and low-moderate protein is very anti inflammatory. It's only when you combine lots of carbs with lots of fat which puts you in a caloric surplus, that it becomes inflammatory.
There are so many guys who have screwed up their thyroid and lowered their testosterone by following the advice of people like "Professor" Bart 'The Fart' Kay, Ken "Dad bod" Berry, "Shaun "Vegan Hater" Baker, Anthony "Plants are trying to kill you" Chafee and Paul "Fat Chasin' Mason.

 

[Systemlord]

I’m not buying what you’re selling. Not when the carnivore diet has been shown to have reverse 98% of disease in participants.

The positive stories keep coming in, personal hand accounts. The Harvard study.