Unburied this from another thread in case guys were curious about TRT dosing in the world of hypogonadism.
Google xyosted, a vastly overpriced** testosterone enanthate (TE) sub-Q delivery system designed for mass in-network medical provider use to treat hypogonadism. Then look at the three dosages (50, 75 and 100 mg of TE) available for once weekly auto injection. Then think to yourself, why would Antares spend millions of dollars to develop an fda approved product that would undermedicate the vast majority of men being treated for hypogonadism? Here’s a hint, they did not.
Now look at the PK data I already shared for this product in the other thread. This dosage range (50-100 mg per week equivalent) will bring the vast majority of men within physiologic range. Xyosted gives providers three dosages to choose from. Why? Then look at ALL the major medical society dosage guidelines for IM weekly injections which call for 75-100 mg per week equivalent of test ester.
Then try to compare these data to the claims I’ve wasted time trying to debate on another thread where it was claimed that (1) the vast majority of men find relief (symptoms alleviated) at free T levels of at least 25-30 ng/dL and that (2) weekly dosages of at least 150 mg/ week are routinely needed to accomplish this. Think about the where Total T levels will be if these parameters are satisfied (requires one to look at reference range for SHBG and conceptualize a distribution using statistics and math).
Then wonder about the survivorship bias involved in that claim given the limited subset of hypogonadal patients that internet coaches/“TOT” doctors work with for some type of “TOT” strategy.
From the article:
How can people avoid falling prey to these kinds of biases?
Look at your life and where you get feedback and ask, “Is that feedback selected, or am I getting unvarnished feedback?”
Whatever the claim—it could be “I’m good at blank” or “Wow, we have a high hit rate” or any sort of assessment—then you think about where the data comes from. Maybe it’s your past successes. And this is the key: Think about what the process that generated the data is. What are all the other things that could have happened that might have led me to not measure it? In other words, if I say, “I’m great at interviewing,” you say, “Okay. Well, what data are you basing that on?” “Well, my hires are great.” You can counter with, “Have you considered the people who you have not hired?”
It’s a very simple thing, where you just need to ask the question: What’s the data that’s not present?
The 75 mg per week patients are the “outliers”? Nope.
Again no judgment for TOT guys, but to suggest (give the impression) to guys on here that taking 75-100 mg per week of test ester to address hypogonadism symptoms is a statistical rarity is completely asinine. This practice will also give impressionable folks the idea that their protocol is underdosed; further reinforced with unhelpful comments they may get on forums that their dosage isn’t manly enough (“grow a pair” as I have heard on here a few times). Then these unfortunate gentlemen increase the dose and here comes the ED/Hct/E2 issues, blah blah.
Just some big picture thinking here.
In summary Dear reader: Take whatever works for you, but sweet Jesus, don’t believe this bastardization of all that is scientifically holy that 75-100 mg/week guys are outliers in the universe of hypogonadism treatment. Yes, I am confident they are a statistical rarity in the world of @dbossa and TOT. The TOT population is just a subset of the hypogonadism universe. This I pray sweet Lord. Amen.
Survivorship bias and extrapolating one’s experience to the whole population is not ideal when encountering new men who are candidates for hypogonadism treatment. No, your PCP is not trying to chemically castrate you. In reality, the truth is out there and somewhere in between the extremes of (1) very conservative Endos and (2) T mill clinics for most men. The more T you take, the more risk you take on once you pass the upper limit of human physiology. It’s an optimization.
Good luck and best wishes.
** For the record don’t use this product. Just get yourself a cheap bottle of Test ester and some 27-30 g insulin pins and save yourself big money.