T Nation

Starting Dose of Testosterone on TRT

Moving a topic off of another subject. We are discussing why it might be prudent to start someone on either a higher or lower testosterone dosage. @Charlie12 @bmbrady77 @physioLojik

Looking for the good doctors expertise on this one. Where will you start a patient? Will you start on the lower end at say 50mg a week and slowly work up or would you start at 150mg and if you find it too high work your way down?

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To clarify my position, I personally think it would be cruel and unusual punishment to start someone who is already low T on 50mg per week. I think that 100mg is a great starter and could give a dr a good idea as to how each patient would respond to T after 6 weeks and then go from there.

Edit to add… I also think it’s cruel to start a patient on 200mg E2W as well…does anybody respond well to this dosing guideline?

They seem to have their default standards, but then again it is up to us to be more informed about our health decisions. The days of relying blindly on a doctor are what has led to the state of where things are now. The dr should not have to shoulder the responsibility of knowing the exact situational specifics of every individual patient that comes to see them. Every person is unique. That’s why it’s up to the patient to inform himself, so that he and the dr can work together to come up with a proper plan.

They wanted me to start with an AI on hand, and HCG. I simply stated my position on that and he respected that without equivocation.

I agree with this 100% and think that in the internet age people have better access to health information than ever. There are people that feel like forums like this are bad though because they believe that what happens is folks start acting like doctors and giving out medical advice and it really bothers them. I was on another forum for guys dealing with post vasectomy pain and this one guy flipped out about it. He felt like people should trust their doctors 100% and that surgical intervention or even suggesting it as a therapy was wrong etc. etc… He was a mental healthcare “professional” apparently. The guy was a real tool and condescending nurse Ratched type and ended up getting banned for stirring up sh1t.

I think forums like this are extremely helpful and you can use them to really help educate yourself and ultimately that leads to better decisions healthcare wise. After I developed chronic pain post vasectomy I was slapped in the face with the reality that there are some real gray areas in healthcare and science. A combination of pure ignorance and politics/social pressure and just the science not being there. I realized that none of my current providers were worth a damn and could not help me. I found the post vasectomy pain site and read/educated myself for about 1 1/2 years before making a decision that ultimately saved my life.

I have been very impressed on the degree of knowledge on this site.

My doctor at defy was hinting at tweaking my thyroid and wanted to put me on DHEA as well and has also hinted at HGH. I told him I wanted to do one variable at at time. Since my vasectomy debacle I don’t think I will ever put my fate in the hands of any doctor blindly. That’s putting things as politely as I can. It is up to us to be informed and educated. In some areas of medicine where the science is not settled and is evolving (which is many) patients can often be ahead of the curve as doctors like to stick with what is familiar (which I can’t blame them for entirely).

I dropped my dose down to 100mg from 140 btw and have dropped my AI. I am going to discuss this with my Defy doctor when I talk to him here soon as my first labs are being processed now. The lab values will be based on the original protocol with the only change to that being I increased the frequency of my dosage but kept the amounts the same. It would have been foolish to change the amounts prior to my first labs so I stayed at 140mg a week plus AI until then…

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I did for 7 months, best 7 months I had in years actually, then shit went downhill in an astounding fashion.

Same, I feel like every conversation has been a push to tweak thyroid, or put me on HCG, prenenolone, etc. Let me be clear and acknowledge that these people are experts and I’m in their care voluntarily. Maybe I should listen, but I’m being careful after a horrible hormonal experience through another doctor. I’m afraid of starting t3 meds because I’m so sensitive to any kind of stimulant, can’t even have coffee or tea.

Speaking of which, @physioLojik if you don’t mind, do these labs represent someone who’s hypo or hyper in terms of thyroid function?

Reverse t3: 20.7 Range 8-25
T3 free: 3.7 Range 2.3-4.2
T4 free: 1.77 Range .89-1.76 HIGH
TSH: .536 Range .55-4.76. LOW
Thyroid Peroxidase abs: <28.0 Range <60
Thyroglobulin abs: 23.4 Range <60

These labs were in October and TSH has gone up to 1.43 since then, no other labs were drawn regarding thyroid at that time.