Yeah, cause that number doesn’t exist for most of us.
Would be very interesting to see the blood work on those two as natural 19 year olds. My intuition tells me their endogenous T levels were not remarkable, but their genes just do much more with the same levels as Mr Average. Those of us that have been around these type of people in the bodybuilding world know what they looked like and some insight into what they were running. Mostly genetics with a little bit of drugs (80/20 rule as usual).
I KNOW this. With certainty. To explain you would have had to have participated with every single man I’ve worked with in the last few years.
With CERTAINTY.
The ones requiring less than 100 are but a tiny fraction of the whole. They do exist but they are extreme outliers in the grand scheme of things.
You might as well be asking me how I know what I had for breakfast.
I forgot the source of this. Maybe you can determine. But it may help make your point.
According to this the higher the total t and free t mortality increases.
Since I started doing paid consults I’ve been booked solid for the few hours a week that I have put aside for this purpose. I decided to do two calls per day on both Saturdays and Sundays so four calls each weekend. It’s all I can afford to invest, time wise, as I have a family and a home. The slots were immediately filled and I have a two week waiting notice so far. Oftentimes if I can refer a doc who is close to their location I’ll do that instead of consulting with them at all. Most of them want my opinion on things. They are not ‘patients’ as I am not a physician. It is an ‘opinion only’ TRT discussion. I’ve done consults with guys from all over the world with only half of them being in North America.
Hey, thanks for sharing. It comes from this paper in case guys are interested in reading:
https://academic.oup.com/jcem/article/99/1/E9/2836201
As with almost every marker, there appears to be a U-shaped functional relationship (same for Hct, potassium, thyroid levels, etc) with mortality and why the body has very complex control loops to maintain homeostatis. Optimization always involves tradeoffs between competing effects. Each guy will have to navigate these for himself.
My starting dose is 150mg a week. You have to start somewhere and starting at rock bottom means it will take forever to get dialed in. If symptoms are resolved we can always lower dose slightly to figure out what the minimum might be to achieve the same thing. There are guys who cut 100mg a week from their protocols and felt just as good (they were using high doses).
It doesn’t matter how many times I clarify my approach, it continues to be misunderstood and taken out of context.
FWIW, I think starting at about the mean dosage used is a good approach. If adjustments are needed, it should be on average the fastest to the close to optimum dose. IMO, 150 mg/wk is about what starting dose should be for most people. Many will go up, many will go down, but starting out in the middle seems wise.
A couple of other observations / feedback. I’d prefer to deliver these to your anonymous persona but since you have identified yourself on here, I assume it’s no big deal to you.
Your statement above is erroneous. The posts I linked above are germane to the topic at hand. What you should have said is “None of this matters to me.” or something to that effect. I wasn’t posting those for you. I enjoy the pleasure of understanding the mechanisms on how systems operate. Maybe you just like driving the car instead of really understanding its propulsion system? You’d have to ask @bkb333 if it’s important to him to understand why he’s missing some T on his cream protocol, or ask @ncsugrad2002 if it’s valuable to him to understand that guys multiplying their direct RIA free T results by 10 is actually not correct. Or ask @mnben87 if it’s important to him to understand what actually happens with free T/Total T when taking another AAS that signficantly modulates SHBG. Or a myriad of other examples ( @vonko (RIP) and his direct RIA free T, Hct vs viscosity, etc, etc). Guys come on here for all kinds of reasons and have various appetites for various levels of detail. None of this stuff is important to anyone until they want to understand it, then it becomes important.
Since you are now working with guys in a consultative capacity, you’ve got to work on your bedside manner. I wouldn’t recommend ridiculing a guy’s dosage/dosing and mocking him to grow a pair. I’ve never run into a provider (except on here) who did such a thing, and it erodes your image.
Take a course in critical thinking (online resources ?). I shared with you a nice article that gives a high level summary. @eyedentist really gave you thoughtful feedback. I’ve shared with you multiple times that your statement here is incorrect. You openly admitted this yet still keep repeating it. Learn from this feedback and then stop repeating the same things over and over again once they’ve been proven false. This will help with credibility. It’s ok to admit you are wrong. This isn’t a competition as guys’ health is on the line. I realize it’s easy to get sucked into some of these bad practices. With practice, you can start a new habit.
Good luck and best wishes with your new venture.
I appreciate you here as you take deep dives and actually get to truth and the why behind it. It is tedious, but having firm knowledge is valuable to me.
We also seem to share a passion for epistemology. I don’t get as deep into the weeds as you do, but I am fairly good at spotting bad arguments, and understanding that I can’t conclude the person making them is correct (also can’t conclude they are incorrect).
FWIW, the two urologists I went to previously both wanted to start me on 150mg/wk stating that’s where they start with all patients… not a TRT clinic, legit uros.
Uros or endocrinologists?
Just reading the posts on this forum 100 mg I see puts most at least mid range free t and total t.
But guys tell them go higher to resolve symptoms. What if the person has other medical issues?
I don’t know what the answer is. But it makes sense as with many medications you start low. Or else you can’t determine least amount of medicine…
This isn’t something I typically say. What do you do with a man with 26 free T and has all the symptoms, you’ve ruled everything else out, do a trial of T, bring him to 40, and every single one of his symptoms resolve. What do you DO in this case? How relevant were his labs when he looked perfect on paper and had all the symptoms, and upon raising levels he got better.
I don’t know how else to explain it. The numbers, at the end of the day, for me, lose all meaning. They give hints and clues but are not really demonstrative of anything, as in the example I just provided. This is stuff I see all day long. So when someone can provide me with a better means of resolving symptoms of low testosterone, without raising testosterone, I’ll be all ears. Until such time, seems like a logical solution to me which coincidentally has the funny effect of working almost every single time.
Urologists! My bad dude. Not sure where I got endocrinologist from, i don’t even know what that is 
.
This makes more sense, thank you for clarifying. I am convinced the number of in-network Endos that would start a guy on 150 mg/week of testosterone ester can be counted on one hand (while the hand is engaged in a farmer’s carry).
Well I got 2 counted so far. How many you got? Maybe we can get to two hands.
Hmm, I thought you clarified these were Uros, not Endos.
Right again. Maybe I should get back to work. You abbreviated Endo and my mind saw uro
I’m with you. I’ve completely passed the value-added activity point. You guys take it easy.
My lack of knowledge on the terms the doctors call themselves led me to google them. One of the mentioned places is urology centers of Alabama… which made me think he was a urologist. Maybe he’s something else though?
Genetic analysis can diagnose AIS/PAIS/MAIS. The condition is quite rare.
Statistically speaking it helps far more than 1% of those out there. 100-125 mg/wk however is far more sufficient for most.
My doc states the same, around 100mg test E or equivalent per week works for most. Said doctor has seen an absurd amount of patients. Some require more, some require less
Dependent upon individualistic metabolic rates, absorption etc
