New to TRT, Is This Dose too Low?

Hello everyone. I am a 41 year old male. I work out all of the time and eat healthy. My total testosterone was 352 and my free testosterone was 9. I recently went to a testosterone clinic and im getting 150mg testosterone cypionate along with 250 hcg weekly. They are only giving me a shot once a week and it’s very expensive.

I have felt some good effects such as confidence, energy but my libido is worse than before the first 4 days following the injection the first time comes back. I also have been having mild insomnia. I think it’s a dosage adjustment that needs to be lowered and injections need to be at least twice a week split up.

I saw a urologist today who is prefer to be managed by for trt and he said he wants to start me at 50mg weekly. That seemed extremely low to start at which concerned me. Any suggestions?

Thank you!

The cypionate dosing is good, however the HCG is dose isn’t sufficient as the half-life is 2 days which is why it’s dosed at least twice weekly. Normal HCG dosing at a minimum is 1000 iu weekly (500iu x2).

This is indication of a nervous or inept doctor who doesn’t have a lot of experience managing TRT and hasn’t bothered to read the endocrine guidelines which state 200mg every 2 weeks which is as bad protocol, that’s why the newer guidelines state 75-100mg weekly and even this isn’t enough to optimize your levels in some cases.

To give you an idea what to expect on varying dosages of enanthate, I’ll repeat the study since I can’t upload PDF on this site;

the administration of the graded doses of testosterone enanthate injections resulted in mean nadir (lowest level in the week) testosterone (ng/dL) concentrations of:

253 ng/dL for 25 mg/week
306 ng/dL for 50 mg/week
542 ng/dL for 125 mg/week
1,345 ng/dL for 300 mg/week
and 2,370 ng/dl for 600 mg/week

So, find another doctor asap!

Thanks for your input! This doctor is one of the best rated urologist at Cedar Sinai in Los Angeles, however I feel he deals with mostly prostate issues. I’m thinking I should search for an endocrinologist over a urologist. I just want to avoid a testosterone clinic or ageless clinic.

This is much more in line with optimizing one’s levels and is a good starting point! Now the HCG dosage however isn’t standard at all, 1000 iu weekly minimum.

Please cite your sources on this.

This is a perfect example of a lot of Uros and Endo’s who treat other medical problems and probably never envisioned prescribing TRT. TRT is a new field of medicine and not all doctors focus their attention on it.

The truth is TRT makes up less than 1% of the business a doctor deals with on a daily basis. My endo’s, all of them are not very good choices to managed male hormones (targeting midrange Total T levels) as they stick to dated guidelines regarding protocols, they know are not optimal, but can’t get in trouble following them.

It’s challenging to find one that puts the patient first, profit second. The best I’ve found is Defy Medical and as far as I know, you can’t find a better clinic.

Those places rip you off. Something like $55 a week out of pocket for a $3 shot cost. They also try to upsell you. Find a dr that lets you inject yourself.

1 Like

Yeah the clinic I’m going to is $50 weekly. I can’t afford that and they really are in it for the money. I never met a doctor only nurses.
So that’s why I’m trying to find a real urologist / endocrinologist who can manage this effectively.

The place in dfw I started at had a “Dr”. he spent 2 minutes with you and then went to the next person. The nurse did the shot and drew the blood. So I’m sure they filed the labwork against my insurance.

On the flip side, the dr I go to now only deals in cash. phone consult 2 times a year ($250), and the drug cost is on you. HCG isn’t cheap like Test C.

I’m surprised he would treat you period. Your levels do not fall under “need” by medicinal standards. Clinics I find are the best route but find one that is knowledgeable and fairly priced. Defy Medical is a solid one as @systemlord stated.

As mentioned, 50mg weekly is a waste of your time and money. The 150mg is fine, or at least a good place to start. Regarding the hCG, if you are taking it for preventing atrophy, or maintaining fertility, you’ll probably want more. I know for a fact that 250IU three times a week or 350IU twice a week will work.

Hcg is so expensive! Insurance doesn’t cover it unfortunately.
I’m going to talk to the urologist I met and say I’m not comfortable starting at 50mg a week. I think 100mg is more logical to start at. I do think the 150mg of testosterone might be to high for me because of the insomnia, my libido and sensation is gone for 3-4 days and comes back.

So don’t use it. I hated it personally and my ornaments didn’t atrophy at all. Regarding the Test 100mg/wk is an ‘ok’ starting point but 50mg is simply too low.

100 may be all you need.

On the surface it doesn’t look too low, but there’s really only one way to find out what dose is right for you, and that’s to try it and see

@Jmoney1
i was on TRT for over two years and my testicles shrank a LOT, started HCG, first shot 500iu then 250iu a week and within 4 weeks they had grown in size again. I was trying it just to see if I felt any “upstream benefits”, I used it for 2 months and have now stopped and will use again in a few months for a short period.
I posted about it in this thread

The reason I went with this dose is because of another thread where @lordgains gave some info from a paper (paper link in thread).

FYI, I’m 57 so not interested in having kids etc, or really in how they look. Just tried it for any hormonal benefits it may give.

1 Like

Thanks for bringing these two threads together. For weeks now I’ve wanted to link your thread into mine as the information from your thread is missing in my pure analysis of one study and discussing it.

I think MOST will scoff at a doseage of 50mg as too low.

However, your Dr. knows the rationale why he wants to start low. There is another thread on the Pharma page where the guy takes 50mg test a week and feels great. He has high blood pressure.

So my advice would be to follow doctors recommendation for a few months, then reevaluate how you feel.

There’s no guarantee an endo will be any better, a lot of endos deal in thyroid and diabetes disorders which make up the bulk of their business.

1 Like

This plan of action may very well lead to a long dialing in progress and unnecessary suffering, at 50mg weekly which has shown on average to not be enough (excluding outliers) is not even standard of care if the guidelines have anything to say about it.