Less than 50 mg of T per week

Cataceous said:

That's basically argument from authority. They may simply be responding to the demands of their customers, who by and large have more-is-better thinking. I see that @Willyt has already mentioned Xyosted. Its success dispels the notion that supra-physiological doses are needed to ameliorate symptoms of hypogonadism. The main thing I object to is starting new patients on 100+ mg TC/week when many will be harmed by this practice.

There is an evolution-based argument in favor of targeting average serum levels for healthy young men, which can be the 600-700 ng/dL figure of earlier decades, predating the recent decline. The reasoning is that nature had selected those levels as optimal for reproductive success. Reproductive success is then suggested to be a decent proxy for overall success in life; you have the resources and skills to attract a mate and ensure the survival of the resulting offspring. So in the end this gets you back to those physiological doses of testosterone, around 3-9 mg/day.

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Melody68 said:

I'm one of these layperson guys that does well on a smaller dose, probably around 70mg/week. That puts me in the Cataceous camp of thinking. One concern I've always had is that, acknowledging the ideal of 4-8 mg/day that young men produce and use, it seems likely to me that our pathway of T delivery via injecting into the muscle or subcutaneous fat is no where near as efficient as what nature provides. Perhaps, when we inject IM we have to inject more T into the muscle to finally net out to the same 4-8mg that naturally arrives at the necessary sites for use by the young man. If that were true then higher daily allotments of 10, 12, 14 or more mg/day might be necessary . . .

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Melody68 said:

I'm one of these layperson guys that does well on a smaller dose, probably around 70mg/week. That puts me in the Cataceous camp of thinking. One concern I've always had is that, acknowledging the ideal of 4-8 mg/day that young men produce and use, it seems likely to me that our pathway of T delivery via injecting into the muscle or subcutaneous fat is no where near as efficient as what nature provides. Perhaps, when we inject IM we have to inject more T into the muscle to finally net out to the same 4-8mg that naturally arrives at the necessary sites for use by the young man. If that were true then higher daily allotments of 10, 12, 14 or more mg/day might be necessary . . .

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Cataceous said:

Absorption via injection is almost 100%. And once the testosterone gets into circulation your body can't tell if it was injected or manufactured in the testicles. At that point the only differentiation is in the pharmacokinetics—basically the serum concentration and how it changes over time. If your TRT method provides a reasonably natural diurnal variation then you'd have to look at other factors if you're casting about for some reason to justify unnaturally high doses. One such factor is HPTA disruption. However, even if there's something to it, it's akin to fixing a nearly-flat tire by letting air out of the others to match. You restore some balance but degrade the performance of the entire system.

For example, there's a school of thought that says that symptoms of high estradiol should be addressed by increasing the dose of testosterone until the issue resolves. It's somewhat plausible because at higher doses androgenic activity is increasing faster than estrogenic activity. So maybe you do regain relative balance between the two, but you're left with unnaturally high levels of both, which can easily disrupt other systems. The irony is that the original symptoms of high estradiol frequently come about because the starting dose of testosterone was too high.

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Vince said:

Interested. Who said to increase testosterone to lower the effect of estrogen? I've never heard that one before.

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Cataceous said:

Dr. Nichols and presumably some others in the TOT crowd. ChatGPT says "Some of his discussions of TRT, while emphasizing a holistic approach, have included mentions that, in specific cases, higher T doses may be needed to optimize the ratio of T to E."

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Vince said:

@Cataceous You mean this doctor?

Keith Nichols, M.D. - Tier 1 Health & Wellness

One of American's top doctors in bio-idential hormone replacement therapy, J. Keith Nichols, M.D. is the Medical Director and CEO of Tier 1 Health and Wellness, a preventive medicine clinic headquartered the Chatanooga, TN.

tier1hw.com

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Cataceous said:

Yes. You should know him. He has posted here as "RobRoy" and previously as "J. Keith Nichols MD". He has quite an ego, and a temper that flares whenever he is questioned.

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"Needing" 300mg a week

I have been following this guy for a while because he seems to chant constantly experiment on himself and I do find it interesting He does come across as someone who knows less than he thinks but now he seems to think he needs trt at 300mg to feel best for him and that it's not a a cycle Is this...

www.excelmale.com

Cataceous said:

Yes. You should know him. He has posted here as "RobRoy" and previously as "J. Keith Nichols MD". He has quite an ego, and a temper that flares whenever he is questioned.

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Belekas said:

I've seen how he replies to serious questions and to be fair he is a clown as he can't handle any discussion politely and seems can't handle his ego as well. Nobody in their right set of mind would talk to other people like that esp when one is a doctor. Probably needs to lower his androgens and get a proper "treatment" instead talking like a little guy who has no idea what time it is. Just another keyboard warrior who happens to be a doctor. Not sure who can go to him after reading his menstruation posts. Smh

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