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I did preliminary homework on the risks and benefits. I did not do homework on dosages and frequencies, because I assumed like other medications my doctor would be qualified to dose correctly and give proper instructions. It seems TRT is the only medication I’ve run into where there are 101 opinions on how to dose and take it, and everybody seems to think docs get it wrong.

Definitely my fault for not doing homework, but I’m not sure it’s entirely fair since every other medicine I’ve ever taken has been “take X milligrams every X days” and I’ve not blinked an eye at following those instructions.
You're welcome. Have a great evening and best wishes on your journey.
 
Defy Medical TRT clinic doctor
200 mg weekly is really too high a dose to start.
These sort of dosage were prescribed years ago and are the result of bad and lack of information that most doctors even today are not aware of.
Research on forums like this will soon point you in the right direction or alternatively find a reputable Hormone therapy centre such as the site sponsor here for modern protocols.
Always remember it's your health we are talking about not your Doctors and you need know by doing due diligence what's best and safest for you, there really is a lot of bad protocols dispensed by GP's who don't know any better.
 
Why does this need to be about him? Where is your ownership into what and how much medication is needed for you?

I guess I’m on Mt Stupid then? Yes, I assumed a doctor could dose correctly. I’ve always assumed that with medication I’ve been prescribed. I’m sure I should push back on every medication I’ve been given, but frankly I assume I’m not an expert in medicine and default to believing a doctor.
 
200 mg weekly is really too high a dose to start.
These sort of dosage were prescribed years ago and are the result of bad and lack of information that most doctors even today are not aware of.
Research on forums like this will soon point you in the right direction or alternatively find a reputable Hormone therapy centre such as the site sponsor here for modern protocols.
Always remember it's your health we are talking about not your Doctors and you need know by doing due diligence what's best and safest for you, there really is a lot of bad protocols dispensed by GP's who don't know any better.

I guess this just boggles my mind. I’m sure I’m naive to think a doctor would know how to dose medication properly. So far literally everybody says 200mg is too much. I…. Just don’t get it. I really don’t. Why would he do this? Is there nothing out there at all that says 200mg is an OK dose? Did he just pull it out of his butt?
 
So far literally everybody says 200mg is too much. I…. Just don’t get it. I really don’t. Why would he do this?
The dosing recommendations for TRT varies wildly, 200-400 mg once a month, every 200 mg every 2 weeks, 75-100 mg weekly.

TRT is a new field of medicine for which is not taught in traditional medical schools. There is no specialty doctor for TRT, some GPs do it, some endo's and some urologists.

Let's say a doctor goes to the appropriate medical school to learn about hormones, prescribing it is a whole other world and most doctors prescribe based on what the manufacturer of the drug is suggesting, only with TRT some of the suggestions are out there.

Is there nothing out there at all that says 200mg is an OK dose?
The Endocrine Society guidelines suggest 75-100 mg weekly.
 
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on Mt Stupid then?
Slope to enlightenment?

You may end up at the 2.5 percentile on graph I first shared. I do not know. That graph shows why starting a guy on 200 mg/week TC for TRT just ain't a good practice unless he wants a dose per week that was common as beginner bodybuilding dose of test years ago. Of course with inflation and the internet now that is 500 mg/wk for the poor noob.

You have to understand something about the human body's dose response to injectable TC/TE. Glad you are surveying the landscape.

If you want more than TRT, great. However, my takeaway from above is you wanted to start with physiologically relevant TRT protocol.

Read the What is TRT thread if you want more knowledge. Many hours of my valuable time to you for free (not really, nothing is free but you get the idea).
 
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Is there nothing out there at all that says 200mg is an OK dose? Did he just pull it out of his butt?
Head over to YouTube and look up Danny Bossa and his Hormone Optimization buddies. Or see my discussion with him in the TRT thread at TNation. Over there in ********/Youtube land it is like Lake Wobegon...every man is a 8 to 16 sigma man with even the least manly dudes sporting >=30 ng/dl Free T levels at trough. In their wonderful world 70 mg/week will castrate a poor chap. There is also Worldlink Medical Friends that teach jacking up dudes on T and calling it TRT. How much do you really want to know?
 
Overreaction.

Drop to 100 mg/week and labs in 6 weeks. Or 4 in your case. Then go from there.
You know of @highpull on t-nation. He has credibility b/c he's a physician on TRT, as well as prescribing. He's been on 200 mg once a week for a few years and doing fine. Many of his patients are taking between 150 and 200 mg, once a week, doing fine. He's a practical, pragmatic, transparent physician. Wish he was on here, too, to share his experience.

For some men 200 mg, regardless of injection frequency is too much but there's no biblical warning, 'Thou shall NEVER prescribe 200 mg'. Flashing red lights and and the piercing sound of a klaxon seem to be go off when someone posts that they were prescribed that dose, particularly if that man is new to TRT. Agree that it's better to start at 100 mg and titrate up if conditions warrant. Everyone is entitled to their opinion but it's an opinion, not a fact.
 
Slope to enlightenment?

You may end up at the 2.5 percentile on graph I first shared. I do not know. That graph shows why starting a guy on 200 mg/week TC for TRT just ain't a good practice unless he wants a dose per week that was common as beginner bodybuilding dose of test years ago. Of course with inflation and the internet now that is 500 mg/wk for the poor noob.

You have to understand something about the human body's dose response to injectable TC/TE. Glad you are surveying the landscape.

If you want more than TRT, great. However, my takeaway from above is you wanted to start with physiologically relevant TRT protocol.

Read the What is TRT thread if you want more knowledge. Many hours of my valuable time to you for free (not really, nothing is free but you get the idea).
Thanks. I did read it and appreciate you putting it together. Not trying to be obtuse or a jerk, I’m just dumbfounded by the fact that all I wanted was some relief from my low-T symptoms, and now I’m on a body builders dose. Not what I wanted. I didn’t want to have to be scared of side effects, growing boobs, etc. Just wanted some aspect of my life back.

Now I’m here stuck trying to figure out if I wait it out for a few more weeks before making a change, or just cut my dose in half on Monday and see what happens. Something I wish I, as a non-medical provider, did not have to choose.
 
Yea as mentioned before make sure you get your facts from credible sources. There’s a ton of shit out there online. Real, credible doctors don’t need a YouTube channel, and they usually don’t post on forums like these.
 
Thou shall NEVER prescribe 200 mg'
PHYSIOLOGICAL replacement ----> TRT: Thou shall not start at 200 mg/week with absolutely no idea the patient's clearance or distribution volume.

Only in cash pay / anti-aging [sic] clinics is this a thing.

Never been to an in network PCP/provider where he/she/they/it says "well shit Bob, let's start you off at 200 mg/week TC and see how you like that." No that would be dumb as hell and state medical board would eventually nail to cross.

Agree with your comment on 100 mg/wk to start. Minimum effective dose, etc.


Enjoy this one as well:



 
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One more for you...


Enjoy!!
 
PHYSIOLOGICAL replacement ----> TRT: Thou shall not start at 200 mg/week with absolutely no idea the patient's clearance or distribution volume.

Only in cash pay / anti-aging [sic] clinics is this a thing.

Never been to an in network PCP/provider where he/she/they/it says "well shit Bob, let's start you off at 200 mg/week TC and see how you like that." No that would be dumb as hell and state medical board would eventually nail to cross.

Agree with your comment on 100 mg/wk to start. Minimum effective dose, etc.


Enjoy this one as well:



@highpull, again. Maybe he doesn't start patients at 200 mg/weekly but he states that many are up at 150 to 200 mg/weekly injection.
 
Again, I refer to 'a real and credible doctor' on t-nation. @readalot and @Systemlord can attest to that.
I referred him to 4 threads where highpull plays a part in the discussion. MY understanding is highpull is an NP providing cash pay testosterone therapy. As shown above, i used his practice data as part of the plots I have made. A discussion on testosterone therapy philosophy between he and I is found in the What is TRT thread.
 
Beyond Testosterone Book by Nelson Vergel
@highpull, again. Maybe he doesn't start patients at 200 mg/weekly but he states that many are up at 150 to 200 mg/weekly injection.
Correct on your second part. I have also done another plot here:


This is large patient pool from cash pay clinic. Guys have lots of options.

Long story short is pay to play and cash let's you run higher and providers keeps the insurance and state medical boards off their backs.

No longer able to post pictures (for weeks now @Nelson Vergel). Perhaps a glitch to fix?


Damn! You got your money's worth @62caster . Thank @Nelson Vergel , a truly unselfish human being.
 
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