Stay the course unless things take a turn for the worst, then you have something to fall back on.
okay, so you think it would be best to continue on 37.5mg?
What negative symptoms should i be looking out for?
thanks
@systemlord Having read hundreds of case studies and protocols, I think the standard starting dose should be around 150mg per week. Most men do not feel optimized on less and they will only stop their natural production replacing them with suboptimal levels.
That’s why my doctor recommended me 20mg ED, also this was what I considered before starting it. The best doctors I know recommend starting dosage between 20 and 30mg daily for most men. Of course they can never know before trying which is the right dosage for you.
Keep going until you have reason not to. Fluctuations are expected, but high estrogen symptoms will be anxiety/anger on a level you probably never experienced. You would feel slow minded, you might even feel high and easily upset.
The Endocrince Society recommends 75–100 mg per week of T Cyp or Enant.
This is also in agreement with a number of dose finding studies on subq application of T Cyp or Enant.
https://academic.oup.com/jcem/article/103/5/1715/4939465#116523890
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@johann77 Man, no offence but the endocrine society is the last thing I will listen to for anything related to hormones. In my mind there is no more discredited organization in the world than them. These people have no idea how to manage hormones. Their guidelines regarding testosterone, THS, FT3 and FT4 are absurd.
I would listen to the progressive doctors with years of hormone management experience who really know what they are doing.
I am not sure about that.
I browsed a bit through the forum and extracted the data of 26 members; weekly dose, injection frequency and total T. Correcting measured total T, which mainly is trough values, by the established PK profile of T results in the graph below - showing average TT levels.
Average TT levels of the different dosage ranges are:
50 - 80 mg/week 680 ng/dl
85 - 110 mg/week 850 ng/dl
140 - 160 mg/week 990 ng/dl.
Of course the variability between men is high and factors like SHBG need to be considered in the treatment. But to get a mens total T level to on average of 680 ng/dl with a starting dose of 50 - 80 mg/week is perfectly reasonable. If you dont feel fine, increase your dose. Maybe at higher dosages men run into side effects such as high HCT or high E2.
A medical society sets the recommended starting dose by balacing benefits vs risks and that makes absolutely sense. Thats also the reason why a starting dose of 75 mg/week is recommended for XYOSTED which was recently approved by FDA.
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@johann77 Why then the best doctors with real experience in that(not like the theoretical stuff of the endocrine society) start most men on above 140mg per week?
I understand their idea and reason but you must consider it for yourself.
TRT is not a math, neither a statistic. It is first about getting people to feel better, otherwise it is pointless.
Average TT levels of the different dosage ranges are:
50 - 80 mg/week 680 ng/dl
85 - 110 mg/week 850 ng/dl
140 - 160 mg/week 990 ng/dl.
I like that statistic. According to that my dosage may be right or may need to be increased a bit, but I will not hurry with that for sure
Because its big business and the ‘best doctors with real experience’ promise to make you into an alpha male.
Or in other words, its the difference between medical need and ‘optimization’.
@johann77 I personally want to be optimized. I did not have medical need to start TRT but felt miserable.
By the way I know a bunch of patients of dr Nichols and all of them are very happy.
Perfectly fine. I am only expressing my personal opinion.
Also dr Nichols for example puts a lot of emphasis on improving the health of his patients, not only their well-being.
These are hand in hand, care to elaborate?
I made that comment in response to that:
Because its big business and the ‘best doctors with real experience’ promise to make you into an alpha male.
the endocrine society is actually posting data which is useful. It’s not theoretical. And it makes clear sense from all available data to start a TRT patient with around 100mg/week. In no other segment of the medical community would anyone recommend starting on the upper dose range of a hormone or drug and then adjust down if necessary. It’s ludicrous…Unless they have a vested interest in the amount of said hormone or drug being consumed.
Who would make profit from prescribing a little bit more testosterone?
Is this not the same organization that says 300 ng/dL is normal across a large age group of men?
I will listen to Dr. Abraham Morgentaler, he is the expert in testosterone. After all this is the guy leading the field in TRT and prostate cancer as it relates to TRT.
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Well I’m a little conflicted now on whether or not I should drop my dose considering I’m still very early in TRT, I just did this mornings shot of 37.5mg. I have noticed a little bit of water retention already which may be due to elevated E2
Exactly. The endocrine society is a fuckin joke. Almost none of us would get treatment if it is up to them…
The endocrine society position is young men can have low testosterone and not experience any symptoms, then the door must swing both ways and a man with midrange FT levels can also experience symptoms due to biochemically unique individuals.