T Nation

TRT Reduceing Receptor Sensitivity

I had a appointment with a TRT doctor today who had no problem prescribing Test Cyp for Self injections, HCG and a AI if needed for my low-normal levels. When I told him my goal was to be close to the top of the range I was surprised at the response. He said since I was 43 and could be on treatment for 40+ years that he would recommend starting slow and leaving plenty of room for later. He said that starting at the top of the range would reduce receptor sensitivity over time and we would have no good options later. I have not seen this type of thinking discussed much in the threads to far so I am not sure if it is true why people don’t seem to be considering it more than focusing on getting to the top 20% of the range.

As much as I want to get maximum benefits now for Strength/energy I do not want to limit my receptor sensitivity faster than needed. What he said seems logical - have you guys noticed having to continually bump dosage to get the same effect over time? Do you think being high in the range compounds the problem?

I see the logic. But the issues are complicated by E2 issues that are larger with higher T levels. So now the truth is in two camps, one for E2 management and one not. And then there is the issue of looking at TT or FT levels. SHBG increases with age and for the same T intake/production, T+SHBG goes up, TT goes up, FT and bio-T drop. The who issue is too complex for the generalization that your doc is making. I agree to avoid taking more than 100mg/week, over doing things is not sustainable and many will need more T later to feel the same. Part of that increased need simply aging.

So do not focus on TT, that is immaterial. TT+SHBG is inert. Try to get near top range FT. Good luck getting doc to see this. You will need more TT and T-dose over time to maintain FT. E2 management is mission critical to how you feel. Some anti AI critics will object, stating that not everyone needs AI. That is true. If the E2 labs and approaches that I suggest lead to not needed AI to get to favourable E2 levels, great, that is a possible outcome of E2 management methods.

Doc may have some guys who are pushing for high T doses and he may be reacting to that. Some guys want to get there hands in the cookie jar.