The Ultimate Testosterone Replacement Guide

Thanks for putting this together, TC. This is great content, a good baseline knowledge for TRT. Sure, details can be discussed, but this is useful and pretty comprehensive.

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Much appreciated!

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I think of Johnny Lawrence everytime I see your avatar.



Just wanted to say thanks for this guide and your other articles. Your stuff is a “must read” as it always has one takeaway point.

Had my blood work done off the back of this and came back with very low T…like 80 year old levels and I’m in my 30s! Meeting with TRT doctor today, to kick off fixing it.

Be bloody amazing if TRT works and helps speed up fat loss, been dieting for the last 8 months (-106lbs so far…~20lbs or more should get me to outline of abdominals).

Now if they could find a magic pill for autism, I’d be set!


Hey, you’re welcome, and thanks! Regarding T levels, they’re generally reduced with increased waist circumference and obesity, so that may explain yours – might not have rebounded yet, though, despite the awesome weight loss. Congrats on getting your house in order!

I read an article recently which indicated that E2 levels for men on TRT best be a ratio of T to E2 and that the absolute E2 level was not as important. Does this approach make sense? Most men, including me, fear higher E2 levels and have a tendency to crash their E2 levels with AI’s…

No evidence of this unless both fall into physiological ranges. Hence some “ratio” exists if you try to force it with an average E2 and average T.

Testosterone/estradiol ratio, is it useful in the diagnosis of erectile dysfunction and low sexual desire? - PubMed (

The association between testosterone, estradiol and their ratio and mortality among US men - PubMed (

Testosterone to oestradiol ratio reflects systemic and plaque inflammation and predicts future cardiovascular events in men with severe atherosclerosis - PubMed (

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Interesting so that study showed no correlation between estradiol and testosterone ratio for sexual desire and erection issues if I’m reading correctly?

Pay attention to the base levels they all started on and what they ended up with. More or less practically all of them had low T or low both, once fixed they drew up a “ratio”.

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@TC_Luoma what do you think roughly in terms of raising Free T specifically?

Labcorp numbers initially, then with a clomid 1 week trial by Anti-Aging clinic Physicians Assistant (test to see if it could jumpstart levels):

Testosterone Total: 500 raised to to 626 (264 to 916 ref range)
Free T: 9.3 dived down to 6.7 (6.8 to 21.5 ref range)
IGF: 113 dived down to 67 (84-270 ref range)
Estradiol: Was under 5 now 22.5 (7.6 to 42.6 ref range)
LH: Went from 2.8 to 6.7 (1.7-8.6 ref range)
SHBG: 34.7 to 47.5 (16.5 to 55.9 ref range)

Supplements are locked in already/ I take the Res-V, Magnesium, and about 15 other things. Sleep is good. Workouts are fine.

Any tips to really fix the Free T and Estradiol issue (related?) without having to jump into TRT right now?

As always, much appreciated - thanks for all you do.

Sorry, just saw this! What’s your age? And what’s your approximate body fat percentage? Yeah, clomid does elevate the T/E ratio, and this aromatization of estrogen takes place in fatty tissue. Bodyfat percentage MIGHT be a factor. Here’s an article on estrogen that covers some stuff that might be an issue for you (and be lowering E, i.e., putting a crimp in the conversation of T to E, we might raise your free T level: Keep Estrogen Under Control

Very much appreciated, and no problem, we know you’re a busy man around here!

Age is mid-40’s. Body fat not an issue (if anything a little underweight but in shape) - I’m estimating sub 10%?

Already take Boron and Rez-v, heavy Mag/Zinc/Curcumin, wondering if I need to add in Tongkat, DAA/Fenugreek, Shilajit, Saw Palmetto or anything else to help the Free-T issue without going the TRT route right now?

FYI most who are actually this lean have 6 visible abs at all times, at rest or not. If this applies to you, I commend you on that.

Seems to me like your clomid trial didn’t work out that well.

To me, it looks like you’re already taking about everything - but you could give Tongkat Ali a try. IMO you seem like a decent candidate for TRT.

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I agree with Androgen. You’re already taking a bunch of stuff, but you could try Eurycoma (tongkat Ali). And yes, you seem like a good candidate for TRT. Any reason you’re reluctant?

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Big believer in TRT in general, just don’t want to start the lifelong commitment now at mid-40’s. Feel fine overall, workouts/sleep, etc. Libido a little lighter so if some natural supplements would boost that w/ some free T I’d be fine coasting till early 50’s or so before starting.


Also kinda curious how no one seems to mention Fadogia Agrestis besides Huberman - anyone have any experience with it?

Fadogia Agrestis? Ain’t he the Slovakian defenseman for the Calgary Flames? Okay, maybe not. The plant looks interesting, but most of the studies appear to be on rats. That’s not at all disqualifying, but it’d be nice to have at least a few involving human types.

99.9% of all these herbal supplements, bio hacks, and biohackers are complete nonsense with negligible results at best. These guys get so wrapped up in rat studies or studies done under very specific conditions for certain populations and small sample sizes and recommend people take 20+ supplements a day to be “optimal”. Measurable results in a lab don’t always translate to real life results either and can be misleading.

That may be true, which makes looking at the entire body of studies on a particular substance all the more important. Very few things in nutrition, outside the basic biochemistry, are certain, so we do the best we can in extrapolating from studies. Sometimes we’re right, and oftentimes we’re wrong.