TRT as in the use of exogenous T to replace endogenous hypo levels back to levels found in eugonadal male.
That would be reasonable standard of care consistent with four pillars of medical ethics. Normalizing that many are running 30 to 50 ng/dl for symptom relief is not. Informed consent seems in order and looking out for the most vulnerable.
My main problem with Danny is too much passiveness over E2. Ratios sound good in theory but I don’t believe they exist. I myself now am trying new things and ok let’s drop the AI, but then I do absolutely believe I have to reduce dose. He was just too nonchalant about going higher and higher and “letting it work itself out, higher e2 comes with higher T”. At some point it doesn’t matter some level of E2 is a cut off for certain people.
By the way still really really early. I am feeling weird, I feel less wired physically. At the same time I am over come with more emotions I have to juggle, I guess it comes with E2 as it goes back to baseline on 100mg and no AI.
But no way in hell can I inject more and more T without AI like its all good.
[quote=“tareload, post:1, topic:277585”] TLDR (great suggestion by @kazuya_mishima1):
Danny and the TOT folks are mistaken to put it politely with respect to pharmacokinetics and dose response of injectable exogeneous testosterone. They act like it’s some mystery how you will respond to injectable testosterone. It really isn’t and we can put a very confident estimate on it. Many guys running TOT protocols (150+ mg/week) are way above physiologic levels all week long 24 hours a day. Read on if you’d like to understand with an example in excruciating detail. Pay attention to numbers thrown out there. Are they peak or trough? Learn the basics of pharmacokinetics so you can inform yourself about TOT World before you go that route. Then at least you can give informed consent before you embark on their large uncontrolled science experiment that they themselves will admit has an uncertain long term result.
I reached way back for you guys. 1970s-1980s back when we had REAL men.
Where do you think these numbers come from? They represent values measured in a sample of men that can’t be higher than their peak intraday value . So either it’s the max TT or < max TT level these guys are hitting in a day. There’s is almost no one walking the face of the earth “unassisted” with peak ( much less mean ) daily TT levels above 1200 ng/dl.
After you let that sink in then come back to this:
Be careful to clarify where the “1000” is in the context of treatment. Trough or peak?
Corrected for testosterone amount in the ester, of course you can . A human doesn’t eliminate free endogenous testosterone any different than they would eliminate free exogenously introduced testosterone.
Ask yourself, what is being referred to here? Danny gets 1000 ng/dl where on 250 mg/week of test ester? Peak/trough?
The answer would be trough. What would Danny’s peak TT and mean TT be if he is getting a trough of 1000 ng/dl? Assume E7D or E3.5D injection.
I think lab ranges are typically 2 standard deviations on each side of the mean, so if we take the typical 9-25ng/dL Free T range, that gives us a mean of 17ng/dL and SD of 4ng/dL.
Free T at 33ng/dL would be 4 standard deviations above the mean. Very high but not completely insane at around 1 in 1000 men with those levels.
Free T at 80ng/dL however would be almost 16 standard deviations above the mean.
Personally I don’t really care about the semantics of TRT vs TOT vs cruising vs blasting, etc…people can define their own priorities. But at some point you have to use common sense, and if you’re hoping to get away with cruising where 1 in 10000…(58 zeros) men theoretically have their Free T, you’re probably in for a bad surprise
I was thinking about how I’d try to explain to someone how absurd 16 SD’s is. And you can’t really because those numbers are ridiculous, but I think I’d go with…
“Ok, let’s say we have 10 billion people on the planet. Now imagine there’s 10 billion times those 10 billion people. Really think about it; it’s not 10, 100 or even 1000 times those 10 billion people, it’s 10 billion times those 10 billion people. Right? Ok…now take 10 billion times that population, so that you have 10 billion times 10 billion times those 10 billion people. Now do that again and again and again, so that you end up with a population of 10 billion times 10 billion times 10 billion times 10 billion times 10 billion times the current population of 10 billion people we have. Ok? Now out of that population, there is statistically one guy with Free T at 80ng/dL”
I think Danny is doing everyday subq, at least currently.
It is interesting though, i dont know if his receptor resistance theory is all bullshit, as i now guys who get no benefit from a low dose for some reason. It would be pretty odd if the same person could feel good on 70mg or 300mg per week.
I kinda like TOT. It’s more accurate, considering that none of us knows what our healthy Testosterone levels were before we needed exogenous testosterone. So the replacement part of trt, isn’t really accurate.
However, we KNOW quite confidently what the the max ceiling was on our endogenous levels in the absence of clinical disease. It isnt a mystery in the slightest. Hence, taking your peak levels (or mean levels) 1.5-2x above the healthy ceiling is absurd in the context of treating legitimate testosterone deficiency.
It is simply bullshit. Check out PAIS. TOT is taking some guys past PAIS levels to treat a presumed testosterone deficiency. I am still waiting for Nichols and Howell to publish that paper on type III hypogonadism due to androgen receptor resistance in the modern man. Can’t wait to read it. Must be hard being on the bleeding edge of science.
Thanks for this. In the interest of absolute accuracy i went back and tried to look for Danny’s injection frequency back when he threw out the dosage and levels i quoted above. Heres is his first post on TNation:
So he was injecting 200 mg/week of TE (twice weekly injections of 100 mg) and he was getting 1200 ng/dl trough. So i will go back and redo the plot that estimates his PK profile. He isnt the outlier he always claims he is in terms of free T elimination. His mean TT is approx 1.2*1182 = 1418 ~ 1400 ng/dl.
Look that up on my graphs above…he has approx. 50 percentile response.
All those useless graphs and math @cliteastwood. Unfortunately all that useless info points alot of ignorant suffering people being conned by someone who isnt very good at math, science, physiology, etc.
But he means well you say. Ok. And as we know the road to hell paved with the finest of intentions.
Just spitballing here, what if Danny never tried “castrate levels”, what if there is a sweet spot for pretty much everyone, at 50-70mg per week, when you go past it, you have to go way up to get the ratio right for libido etc, as aromatization does not continue to happen in a linear fashion, at the very least you get more dht when you up the dose, to combat the added estradiol? Could there be something here, i have experienced feeling good with around 100 mgs when its time for the next injection, which then takes that good feeling away, on the other hand i have felt good after injecting a full sustanon, for a couple of days, but it’s different, sleeping is pretty hard and you are kind of hyper.
@tareload dude I am having some serious body heat or hot flashes if that’s what they are, and get sweaty at night at times. Not sure if it’s the case of diagnosing everything and anything to TRT regimen.