We can’t tell you that; your bloodwork, BP, and overall feelings will guide you. If your lipids, CBC, BP, etc. are all fucked up on the higher dose, then it’s not sustainable long term
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Thanks for your attention to detail and putting a space between characters.
What’s normal in regards to lab values might not be normal for someone else, in regards to symptom resolution. That’s why men seek doctors who actually understand that and don’t use lab values as their guide. None of us are lab values; we’re individuals and we each respond differently.
While that is true, needing 200 mg per week for symptom resolution is highly unlikely, and euphoric feelings of supraphysiological values of T isn’t a sign of resolution. But, at the end of the day, some guy’s dose isn’t my business. I simply asked my question because there is likely no difference in physical function within mid- to high-normal T values. @mip1950
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I hear what you’re saying. On this forum @highpull is the resident expert and as a prescriber, he has the experience to discuss this with more detail.
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No offense to you or @highpull but there are plenty of ‘experts’ on this forum with differing opinions. @highpull is definitely among the best but not the end all be all. @BrickHead is more politically correct than I while I tend to be more straight to the point on my opinions. So here it is… I think the treat symptoms over ranges BS is used too often. If you can’t find symptom relief in normal ranges than you’re likely barking up the wrong tree. TRT is not a cure all and as @BrickHead stated those ‘feel good’ moments from high doses are just masking other problems.
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I am not sure what you are trying to do here. Are you trying to say you won’t listen to @BrickHead because he isn’t a prescriber or you don’t consider him the expert here? If so that isn’t sound reasoning. It’s called an appeal to authority argument (it isn’t a good argument FYI). It is better to listen to the merits of an argument vs who is making the argument.
I think BrickHead made a pretty point in that masking other issues with a lot of T isn’t necessarily a good path. It is better to address those things directly in many cases.
There also has to be a line with treating symptoms. What if 1000 mg/wk makes a guy feel his best? Should a doctor Rx that dose since it addresses all symptoms? How do we come up with that line that separates treatment vs malpractice? It seems to me that the natural ranges is a decent guide. I am not of the opinion that it has to be within the ranges, but it should be at least fairly close.
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Not a dis, and I apologize if it came across that way. We all have our experiences and opinions, which have there validity. A clinician, on the other hand, treats many men, from young(20’s) to men in their 70’s. That person is going to see patients with comorbidities and various responses to different doses and dosing protocols. Aside from T clinics, which seem to use a cookie cutter approach, which might work for some men, an individual practitioner assesses each patient and works towards tailoring a dose and protocol that provides symptom resolution and improved overall health.
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No worries sir, same here.
Agreed.
At the end of the day we all need to advocate for our own health in this emerging industry. Yes TRT has been around a long time and care is improving but their are still a lot bad protocols out there.
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Thank you, I’ll take that as a compliment. To be very clear, there are no experts on this forum. While it my seem some are acting as though they think they are, I hope I am not one of them.
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Very well said. Also, it hasn’t gone well over time with any of the self proclaimed experts. #fakedoc #TRTcoaching
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Humbly disagree with respect to a clinician’s expertise. My father’s internist provides him with a TRT script - 250MG every two weeks. In my opinion, and experience, this is not ideal. But, that doctor also treats many, many other of my father’s many ailments - TRT is not his area of specialty, and I would not him to have the same expertise as someone that specializes in hormone therapy. In fact, I would expect someone with years of experience using TRT (@BrickHead) might have information that should be considered.
Just my .02.
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Again,I apologize to all my fellow members for how I expressed my thoughts. We ALL have experience and knowledge, both self gained and what we learn from our doctors or patients. And our doctors are still learning. My urologist has over 30 years experience in TRT and his learning hasn’t stopped.
This is a forum for the exchange of ideas and respectful debate for the betterment of all…
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Can your father split that into .5ml 1x/wk?
You’d negate a supraphysiological peak and potential subphysiological nadir.
Reduce the chance of developing polycythemia and dyslipidemia.
I am aware of the benefits of splitting dosages as I have been on TRT for several years. My father chooses to follow the infallible MD who insists on IM every 14 days.
I have mixed it up - including 75mg e3.5SubQ - but my father will have none of it. He insists on following his MD, who follows the drug company. It’s risk averse medicine.
He may be fine with it. It is estimated that as many as 3% of men are on TRT. If you figure one third of them are going through their MD that would be roughly 1,000,000. The vast majority of them are doing every other week. I know guys (these are not guys I am treating) on the standard bimonthly schedule and after questioning them they are happy with TRT.
If it does not go well once he starts, he may be more open to more frequent dosing.
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No argument here - just an offer to consider.
I believe TRT will be going more mainstream in the future due to environmental and diet issues, but that might be a lot of errata. I doubt my father is the prototypical TRT patient. He is 85 years old in end stage heart failure, Type II diabetic and morbidly obese. I am sure 200 or 250mg e2w is fine for him.
I do know that protocol did not work for me, that I do better on 140mg e7days, or even 70 mg e3.5 subq. But, big pharm will frown on that - no peer reviewed research to support it.
I think it would be interesting to find out the demographics of your theoretical 1,000,000 men going through their MD, and likely another 300,000 or more self medicating, and see how many are e14d, e7d, e3.5d.
Appreciate your contributions.
The 3% of men are on TRT is not my estimate. The one third of them going through an GP/mainstream medicine is. I suppose an actuary could figure it how many, but that is beyond me.
We have insurance claim data, and we know how insurance companies look at TRT, and pharmaceutical company data. TRT clinics are booming, but that is cash with no claims. Compounding pharmacies might be able to track prescriptions. Then you have the underground sources, which I think are significant but impossible to track. I also think more men then ever are looking at TRT. I am not sure mainstream medicine will get on board.
I’m surprised your father was given testosterone by his PCP. Hope it helps his quality of life.
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To clarify, his PCP is also an Endocrinologist and treats him for diabetes as well, so not your regular PCP.
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