#21

I take the gel in a small but sensible dose that has a number of benefits, although it is not a panacea. Nor has it stopped a recent decline in my RBC and HGB, which can be an indication of anemia. However, it is not a collapse. I still have a lot of energy.

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#22

Started on 150 a week and was having to go get a phlebotomy every 3 months, switched to 50mg Monday and Thursday and everything has been fantastic ever since. Think the super highs stimulate erythropoietin. Wouldn’t quit just smaller dose more often.

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#23

There is no need to have phlebotomies. This will lead to major iron deficiency and your hematocrit will come right back up to baseline weeks after doing it.

https://ashpublications.org/blood/article/128/22/5032/99465/Blood-Donation-May-Not-Reduce-Risk-of-Testosterone

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#24

I too had a doctor prescribe 75 mg injections once a week when my T dropped to zero after a TBI ( interestingly my SBHG spiked after the TBI and my normally 900 T levels dropped to nonexistent after the accident - weight gain was rapid- thankfully Doc ordered labs as part of post concussive treatment)

Originally I was prescribed 75mg IM once a week. It was great but soon started having prostrate aches and can only assume to this day it was related. My urologist was not a T fan ( for a reason- he is a 50 yo with prostrate cancer)

I monitored carefully and read all I could on T. I eventually settled on 25 mg subq once a week for 3 with one week off. I have been doing this for 5 years now and maintain a 900-1000 blood T level

I do not get the ups and downs of with Subq for some reason and quite frankly at the recommended levels of injections was getting prostrate issues.

Hematocrit levels need to be watched but giving blood once took care of that.

My doctor and my friends who are Doctors say they’ve never heard of Subq T. Seems like a no brainer to me and there are studies to report. Much easier than IM

T users will likely lose head hair and gain body hair. Must watch PSA and hematocrit religiously

I’m not a doctor but do my own labs and interpret them as well with AI assistance. My doctor missed low iron that AI caught.

62 yo. 190lbs 5’11”

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#25

My RBC and hematocrit levels are generally on the lower end (and lately even lower, due to all the blood tests I had to take at the hospital, where they sucked out vial after vial after vial of blood); but I’ll probably wait a while before trying to see if I qualify for T again – or even if it would improve my health. The last time I tried was a couple years ago (about 4 I think) at a clinic, and they measured my natural levels at ~700 ng/dL, and then refused to give me any, saying I already had enough. I’m not sure why I thought I might need it (I was already in good shape and had a lot of muscle, but one always thinks one needs more, I guess).

It might be lower now, but I have seen people online talk about how they raised theirs by purely natural means. The guy named “Richard” that does the Modern Healthspan videos I think got his up naturally without injections.

I also read somewhere that hyperbaric oxygen therapy can naturally raise T levels. I’ve been meaning to give HBOT a try to see what health-promoting effects it might have…

Addendum: One more thing I’d like to add is that, as I get older, I worry more about the possibility of prostate cancer. So far, my PSA levels are relatively low; but I worry that taking T might increase my risk. So, I am a little more hesitant than in the past to raise T.

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#26

for me, 182mg per week would be massive dose.

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#27

Yes same. Even just 100mg per week took my total T from 300 to around 1200. I’ve settled on 80-90mg per week for now

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#29

Remember, the timing of your labs after taking your last shot makes a severe impact on what the result will be. For example, if you are taking one weekly shot on Sunday, your level will be much higher Tuesday/Wednesday than Saturday. Possibly double the amount.

Also, having slightly elevated T levels on TRT isn’t a bad thing. The lab range was created for unhealthy people who aren’t taking TRT.

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#30

Testosterone works much better in smaller doses per week. Same total dose just don’t get peaks that stimulate EPO.

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#31

Agreed. I dose 20mg daily

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#32

Physiologic adaptations that occur from high altitude blunt or eliminate the increased risk of thrombosis from altitude-induced increases in hematocrit. These beneficial adaptations do not occur from testosterone-induced elevations in hematocrit because the mechanisms are different.

I have previously posted published evidence showing increased risk of thrombosis from testosterone-induced elevations in hematocrit. Lowering the dose or changing to a transdermal formulation if Hct reaches 52 or 54 seems perfectly reasonable to me. No need to panic and cut the patient off completely. Can also add in low dose aspirin and focus on controlling other thrombosis risk factors (obesity, smoking, diabetes, lack of exercise, sleep apnea, etc).

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#33

If I were to start TRT, I would definitely start low-dose finasteride/dutasteride along with it. Hair preservation is very important to me.

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#34

Subcutaneous or intramuscular?

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#35

Intramuscular. I even get away with a 5/16 inch insulin needle and get the same T levels as I would with a 1/2 inch insulin needle.

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#36

If there’s such a thing as blood aging (where Rapa slows it down by inhibiting mTor in blood stem cells and lowering RDW, increasing Lymp/Neutr ratio, lowering WBC etc), I suspect excess testosterone is a causal agent of it. High hematocrit is a symptom of it, alongside the most-likely increase in Levine phenotypic age. Do you not like TRT? I think clomid studies are legitimately promising. Testosterone Replacement Therapy (TRT)

#37

You’re very well informed on this topic and know the following, but I think many others don’t know that the cypionate and enanthate ester weights account for roughly 30% of the total, so 100mg is really about 70 mg of testosterone.

Not directed at @LukeMV :
It’s also clear from forum anecdotes that there’s something different about the way exogenous testosterone feels… I don’t think the reason is understood, but to get symptom relief (and this is not simply a matter of SHBG and free-T), many men need higher doses than would be expected. Perhaps this has something to do with LH and FSH getting shut down. It’s also worth noting that the rate at which one metabolizes testosterone esters varies widely, and this can even vary considerably in the same man depending on the context (food, exercise, sleep). I’ve seen wildly different responses to the same batch of testosterone over periods of weeks. There are outliers that require 300mg a week to get into the upper range! So don’t automatically dismiss 150-200mg as an extreme dose. It may not be for that person.

For me, I suspect that needing higher doses is related to needing higher levels of estradiol (well above range) and DHT. DHT in particular, converts into neurosteroids that act as modulators for GABA A, producing that nice, calm, stoic feeling from the anxiolytic effects. You also get the 3-beta-androstanediol pathway that modulates oxytocin for better emotional tone. Block those things with finasteride/dutasteride and you increase the risk of neuroticism and depression. DHT high → confident, calm, happy, masculine, and maybe bald.

As for the article, when I see things like this, I remember: (1) these are written to get attention, not to provide information, (2) they are deliberately contrarian and tend to represent extreme outliers - fear sells, (3) there’s a strong anti-male bias in the Western press, and this is part of it. Masculine, healthy men are a threat to the powers that be, which is why they hate TRT. Fat, sluggish, sleepy, depressed men are much easier to manage.

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#38

Well said and thanks for backing me up. Treating the symptoms should be the goal, rather than the lab ranges. If Total T, Free T, estradiol, and DHT are a little elevated but you feel much better, then there shouldn’t be a problem.

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#39

I have been on TRT for 7 years now, my only regret is not starting earlier… I started when I was 60 or 61… can’t remember exactly… I mean, you have to be smart with it, like anything else you do… it’s easy to over do… more of a good thing is not always better…

Testosterone (and any other hormone therapy) is highly individual… you have to monitor yourself closely… and it can also change in time… In my case, I became more sensitive to Testosterone as my SHBG got lower with time… this required me to lower my dose to keep it in a “reasonable” range… which I have learned to modulate when I need to…

TRT is a tool like many others… you should use it well and take advantage of it fully… it gives you better exercise endurance…which you should exploit as it’s probably the best benefit of TRT overall…

But again, N of 1 cries It nearly killed me… and here we go again… lol That guy has issues that go far beyond testosterone… lol

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#40

Hot off the presses. If you’re diabetic, go on TRT

Testosterone therapy is associated with reduced risk of acute kidney injury, kidney failure with renal replacement therapy, and cardiovascular events in men with diabetes and hypogonadism

Abstract
Background

Testosterone deficiency is common in men with diabetes. Effects of testosterone therapy on kidney failure and cardiovascular outcomes in diabetic men remain poorly understood. Our aim was to assess whether testosterone therapy is associated with reduced risk of acute kidney injury and kidney failure requiring replacement therapy in men with diabetes and hypogonadism compared to matched untreated men with diabetes.

Methods

Participants were recruited from the TriNetX Research Collaborative network. We identified 26,027 diabetic men with hypogonadism treated with testosterone and matched them 1:1 using propensity score matching to 26,027 untreated diabetic men with hypogonadism. Primary outcomes were acute kidney injury and kidney failure requiring replacement therapy (dialysis or transplantation). Secondary outcomes included myocardial infarction, ischemic stroke, atrial fibrillation, and all-cause mortality. Cox proportional hazard models were used over a mean follow-up of 3.3 years.

Results

Men had a mean age of 58 years (SD 12), with 71% being non-Hispanic White. Testosterone-treated men had significantly lower risk of acute kidney injury (HR: 0.93 [95% CI 0.87–0.98], p = 0.01) and kidney failure with replacement therapy (HR: 0.81 [95% CI 0.72–0.92], p = 0.001) compared to untreated men. Testosterone therapy was also associated with reduced risk of myocardial infarction (HR: 0.85 [95% CI 0.78–0.93], p < 0.0001), ischemic stroke (HR: 0.88 [95% CI 0.80–0.97], p = 0.01), atrial fibrillation (HR: 0.91 [95% CI 0.85–0.98], p = 0.01), and all-cause mortality (HR: 0.85 [95% CI 0.79–0.91], p < 0.0001).

Conclusions

In this large real-world cohort study, testosterone therapy in diabetic men with hypogonadism was associated with significant reductions in acute kidney injury, kidney failure requiring replacement therapy, major cardiovascular events, and total mortality. These findings suggest that testosterone therapy could be more readily considered for men with diabetes and hypogonadism as a potential intervention to prevent kidney injury.

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#41

New Carvalho video about natural ways to boost testosterone:

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