History is also full of drs treating numbers and seriously fucking people Up in all aspects of medicine. Look at what they do with statins for a guy with cholesterol of 201. Or the dht blocking meds for bph. Come on man your smarter then that.
Oh, I agree with you 100%. We definitely need more information on what is healthy period. This whole TRT business is still in its infancy. I think some of the new genetic studies on how individuals respond to doses of a given medication answer a lot. There are people who get great results on very low doses (me) and those who need many times more to get the same response. Treating by averages and closing your eyes to how individuals respond is closing your eyes to the truth. I believe in one of the videos Dr. Lipshultz produced he talked about individual responses and mentioned the terms hyper-responders and hypo-responders. It is very possible that some guys need 200mg to be asymptomatic and some like myself need very little. I mentioned once before that while I was in my late 40's and still competing, I set 14 world records in powerlifting using only 250mg of test enanthate a week. Some guys I knew were using 1g+ with all sorts of other stuff. I respond to anabolic steroids much better than most people do. All other medication seems to be the same. If we learning more about the genetic responses to medication we could avoid anyone having side effects from taking too much. We also could be much more accurate in prescribing that 1st dose of TRT. When I was prescribed the "average dose" it took me months to recover from the unwanted side effects. On the flip side, why should a guy who is desperate enough to seek medical help for low T have to spend a year or more adjusting doses to ever feel good? We are in the 21st century and we are managing low T like it was the 19th century. Very little research going on because most can't get over the stigma of anabolic steroids being deadly.
Amen @Charliebizz! If doctors were able to get this TRT treatment down correctly, forums like this would not exist and we would have a whole lot of satisfied men posting here. It is discouraging to see so many men complaining about how they fill and wanting advice. Yet 99% of us are going to doctors where this advice should be coming from. Like I said earlier, TRT is in its infancy. There is very little research and we are just starting to admit using anabolic steroids is not going to kill you. I have a colleague name Dr. Jose Antonio. He published a research study quite a few years back where he said, there have been over 50 million people who used anabolic steroids and to date, not one death has ever been show to be caused by anabolic steroids. He said if they were as deadly we we believed the streets would be littered with dead steroid users. So what does our government do but criminalize steroid users. Had medical science continues with research on these drugs and not stopped in 1989, we might have a lot more informed doctors. Many are still afraid to even prescribe testosterone for fear of reprisal from the DEA. Instead we have 50-60 years worth the athletes who have been using anabolic steroids and have a much greater knowledge of their use than most of our doctors. Point in case, SWALL (Dr, Crisler) hung out on bodybuilder forums for years to learn what they knew.
Of course if nothing changes then it may suggest that the underlying problem is not hypogonadism. If it is hypogonadism then a more likely scenario with TRT is that some symptoms improve, some don't, and new ones may develop. This shouldn't be a surprise when the treatment itself can affect more than 20 other hormones. Talk on the Internet is cheap, but the controlled studies point to a relatively low threshold for serum testosterone needed to resolve low T-induced issues with libido and ED; higher levels gave no additional benefit in these areas.
But then if you don't feel good, what success are you really having?
I am not seeing the magic in Xyosted either. All it is is testosterone enanthhate with no BA or BB. It comes in pre-loaded doses which make it terribly over priced. However, I do prefer enenthate over cypionate.
I agree, and was certainly a skeptic of Xyosted from the start. However, I think we have benefited from the research involved, which demonstrated conclusively that subcutaneous injections are safe and effective. In addition, I think there are those who don't want to inject more often than weekly, yet who have problems because of the oscillations. If testosterone undecanoate is not available then Xyosted is a possible solution. There are also a number of guys who have a phobia about injections, yet seem to do fine with an auto-injector. So while Xyosted is not a product you or I need, it does have a place in the TRT market.
@Cataceous I have a huge amount of respect for you as well. You can debate and give your opinion without making any personal attacks.
iobim.org
Hikma does a very good Xyosted impression for a fraction of the price in a 5 ml vial. Same ester, same sesame oil, tiny bit of chlorobutanol at 0.5% as preservative, safe for people that react poorly to BB/BA like myself, equally non-irritating as Xyosted for SC injection. Liquid gold in my book.
If I could handle sustained 425-450 ng/dL on daily injections, this would be optimal for me. The only thing is, sustained levels suppresses my hepcidin and crushes my ferritin fast! On Jatenzo, I require higher peaks to maintain an average or midpoint of 425-489 ng/dL and similar response to therapy.
What sucks for me is I have absolutely no writing and grammar skills. I wasn’t much a “school” guy. Always been into working with my hands. I do have common sense and street smarts. And although the human body is very complex I look at it similar as I look at the machines I work with for a living. Or cars that I used to work on.
But again to many variables even with the controlled studies. You really don’t know how bad any of these men felt before treatment. And what one man considers a success is another man’s failure.
The rebuttal you're going to get to this is something like "of course you feel good when testosterone is at 'supraphysiological' levels", and "if you need to go that high you're masking symptoms of something else."
Exactly my friend. I spent thousands I mean thousands of dollars seeing every dr under sun to get to bottom of my issues. Tried every supplement. Every “restart” protocol from clomid to Triptorelin. Tried thyroid replacement in every form. Cortisol replacement you name it. I tried the lowest doses possible and was chasing my tail. Till I finally went on the cream and keep my numbers up at the top of range. I no longer have the cold intolerance that plagued me for years. I have great sex drive, libido I don’t feel like I’m gonna die the day after a workout. The list goes on. It’s not a panacea. But I feel like what I assume a normal 41 year old male would feel like. I’m not a reckless person at all. This has been a 17 year process and it was simple as running a little higer dose then most and using a “outside the box” place to apply a different delivery method then most. People used to shit on the cream and called guys crazy for putting it on the nuts. And “your dht is too high”. But why do I feel good with absolutely no side effects, great labs and great vitals ?
Glad you mentioned this example. I would bet money that raising fT3 over the long haul reduces life expectancy. Maybe it's worth it, but don't you think informed consent is essential? I don't see enough of this latter, which applies to high testosterone too. The doctors promoting excess blithely claim no risk when they actually do not know.
How do you know life expectancy is not reduced? Without a careful accounting who is going to notice a few years reduction in average longevity of the cohort? Nobody, which leads to empty assertions that there is none. That's what studies are about. It's hardly an obsession to demand rigorous scientific support for such hypotheses. You seem to be calling studies flawed without even reading them. Why not get specific and identify the studies and flaws so we can discuss them?
There are some TRT-related hypotheses for the "something else" that are mentioned above: unnatural variation in serum testosterone or disruption of other hormones. In any case, yours is a typical misrepresentation of my position. The vehemence is directed against starting new patients at high levels and then mishandling the symptoms of excess that often result.
You betting money isnt very scientific is it ? Drs aren’t telling men when they put them on statins and Finasteride to name a few that it’s going to severely diminish quality of life. We can name hundreds of drugs drs prescribe like candy that they do not warn patients of issues they can cause. I’ve been prescribed ssri like candy without ever being warned of a side effect. You are just so stuck on this “do no harm” thing with testosterone but you’re willing to give all this other bullshit modern medicine pushes a pass ? Not to call you out and get in an argument with you but look at all the shit you have experimented with in your health journey. Have you ever given higher t levels a shot. With out all the ancillary drugs you’ve tried ? Maybe that’s all you would need to feel well. Or maybe you shouldn’t be on trt at all if you’re so worried about having to take all these other things to try and keep your Hpta somewhat intact.
You are so stuck on “natural production” when we take trt it’s far from natural. Serious question. Do you believe that endogenous levels vs exogenous levels are identical and metabolized exactly the same ? Do you think that the Hpta being shut down can lead to people need more t to feel better to overcome said shutdown vs natural?
While I wasn't referring to you in particular, I don't really see much of an argument for starting people off at high levels either, and I certainly never said that.
I won't strictly define it with a percentage based on natural production, because this makes many assumptions, and strict definitions are part of the issue of this mindset in the first place. But as a rough range for discussion's sake, on certain forums, anything above 100-120mg per week of enanthate/cypionate up to 200mg is considered a moderate/high TRT dose before it starts getting more into the performance enhancement side (this range again is arguable based on many factors).
I've had this same thought as well. There is no such thing as mimicking natural production while using any form of exogenous testosterone unless the dose is so low and/or so many ancillary drugs are added on that there is still production of GNRH - in which case, you probably don't need the testosterone to get to roughly the same serum level in the first place. Cream/test suspension isn't natural either.
