Thanks for the well thought out response.
I am having a really difficult time trying to reconcile what I read online vs. what my doctor is doing. Part of me feels like maybe my doc is not great, although I have trusted him in the past, and he is on TRT as well (and has been for 2 years doing great).
Between here and Reddit, 99% of people say “OMG 200MG YOU ARE LITERALLY TAKING A MASSIVE BODY BUILDER DOSE THAT WILL COMPLETELY WRECK YOU”. But why in the world would a 35 year old doc in a well known medical group, with excellent credentials, who is ALSO on TRT prescribe it? And tell me to wait 12 weeks for blood work?
I just can’t wrap my head around this. And it’s terrifying. Is my doc not good? Am
I doing damage? Am I about to grow boobs and shrink my balls into oblivion? Because that’s literally what everybody makes it sound like.
I’m about to completely stop and deal with whatever the consequences are. This is massively stressful and immeasurably frustrating to say the least. All I wanted to do was stop being tired, grumpy, and stop struggling in the gym. This was supposed to help. Instead I’m stuck wondering if I’m ruining my body trying to get any answer that makes sense.
F**king hogwash!
“OMG 200MG YOU ARE LITERALLY TAKING A MASSIVE BODYBUILDER DOSE THAT WILL COMPLETELY WRECK YOU”.
Relax!
You are already 10 weeks in and it would be ridiculous to drop your dose right away as you stated that you are not struggling as of yet let alone you are due for blood work in 2 weeks.
At least you can see where the high-end dosed trt protocol has your trough TT, FT, and estradiol levels let alone other important blood markers such as RBCs, hemoglobin, and hematocrit.
No point in throwing that out the window.
You can then decide on your next move.
Anyone
starting someone on 200 mg T/week is an idiot!
Again would have been much more sensible to start low and go slow.
Always much easier to increase the dose slightly if need be than coming down from jacked-up levels.
As I stated previously most men on trt are using 100-200mg T/week and the majority could easily hit a healthy let alone high trough FT on 100-150mg T/week.
Far from common that anyone would need the higher-end dose.
Are there outliers?
Sure but far and few.
To be honest I see no issue with one running higher-end levels if blood markers are healthy and you feel well overall.
The downfall is that many can end up struggling with sides sooner or later when running too high a trough FT level.
Pretty much a given that you will end up needing to donate blood frequently to control hematocrit and it is a given that you will eventually crash your iron/ferritin which can open up another can of worms.
Running too high an FT level can easily have a negative effect on mood/well-being, energy, libido, and erectile function.
Again make sure when you have blood work done that you are using the most accurate assays TT/estradiol (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration).
Testing TT, FT, estradiol, SHBG, CBC, and PSA are a given!
Post your results when you get them.
My reply from a previous thread:
As we say the best piece of advice is to start low and slow on a T-only protocol as we want to see how your body reacts let alone give the protocol enough time before claiming it was a success or failure.
Invest enough time (12 weeks) to see how your body reacts to T let alone how you truly feel overall regarding relief/improvement of low-T symptoms before jacking up your dose.
Lab work is critical.
Always keep peak--->trough levels in mind.
Use accurate assays so you know where your trough TT, FT, and estradiol truly sit.
Although symptom relief is what truly matters lab work is critical as not only do we want to see where said protocol (dose T/injection frequency) has ones trough TT/FT level let alone other hormones but also to keep an eye on the impact it has on overall blood markers as we are not only trying to relieve/improve symptoms of low-t but also to minimize/avoid any potential negative effects on overall health especially long-term.
Regarding reference ranges, they are not set in stone and should be used as a guideline to give us an idea of where hormones/blood markers sit as levels could very well be too high or low resulting in negative effects.
There is nothing wrong with one running TT/FT level above range as long as you feel well overall and your blood markers are healthy.
No one is saying you have to keep your levels in a set range as the goal is to achieve the beneficial effects of having healthy FT levels while making sure overall health is maintained long-term.
Do what you feel is best for you!
*The goal of trt is to replace physiological levels of testosterone through the use of exogenous testosterone in order to achieve a healthy TT/FT level which will result in the relief/improvement of low symptoms while at the same time minimizing/avoiding any potential side effects (cosmetic/overall health) while keeping blood markers healthy long-term
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