There are many years of posts that contain what guys have been doing and I have read more and worked more of those than anyone else here. I have no recommendations beyond what is in the ‘advice for new guys’ sticky and 'protocol for injections.
And I need to point out that TRT is only one aspect of male health. Second seems to thyroid function status. Then there are various levels of mood/depression problems and many of those can be characterized by symptoms typical of low dopamine levels. Add the issues of general health conditions and age related problems and the game gets messy. Some are growth hormone deficient [low IGF-1] and then many cannot get or afford GH to address that. We also have adrenal/cortisol levels, with adrenal fatigue and rT3 to deal with.
What works for some will not achieve the same quality of life benefits in others. Fixing T and E2 levels is typically easy, necessary but not always sufficient. As you can see from posts here, many ‘cases’ are quite complex. There are common threads, but sometimes the threads are tangled. And then add various levels of doctor ignorance, contempt, mal-practice and outright stupidity. Some cannot afford labs or meds.
In order of importance or frequency:
TT and FT - inject | transdermals [if thyroid function OK]
E2 management with aromatase inhibitors [AI], anastrozole or in some cases aromasin
hCG to preserve testes, sometimes a SERM. - doctors can deny or overdose or wrongly combine!
- monitor TT, FT, E2, HTC, PSA and perform annual DRE’s in older men
- T tunnel vision stops here, many cases more involved
thyroid function issues and iodine deficiency - doctors are spectacularly useless with these things
cortisol, adrenal fatigue, rT3, stress, impact of chronic infections/inflammation etc.
general health problems which fans out in every direction
We have a lot of guys show up with low T levels who assume that they can fix T levels and life will be perfect [ T tunnel vision]. It often is not that simple. Many docs have the same tunnel vision. And the drug reps who ‘detail’ the expensive alternatives to injected T certainly are not interested in telling doctors about the many complexities/complications. I don’t see that doctors are going to generally evolve. But there are a few who care to specialize in these issues. Some are really dedicated. However there is a gold rush of doctors who are only in this for the money.