Testosterone replacement therapy: compelling use cases, side effects, and optimal dosing schedules
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- Опубліковано 22 чер 2024
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This clip is from episode 274 - Performance-enhancing drugs and hormones-risks, rewards, & broader implications for the public. Derek is the entrepreneur behind @MorePlatesMoreDates and an expert in molecules commonly used and misused by bodybuilders and athletes.
In this clip, we discuss:
- Total testosterone versus free testosterone
- What do we know about the amount of total testosterone over time in a man's life?
- Optimizing the dosing schedule for testosterone
- And more
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About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 90 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
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Spent my entire 40s feeling like I was under water despite forcing myself to work out, eat right, etc. Tried treatments for depression and ADHD since my symptoms mimicked those issues, but only got side effects. Finally, got TRT and it is life changing. Was always an athlete who thought it was an illegal drug, wish I woulda started ten years ago wouldn’t have lost a decade to misery. I don’t think you can judge people without knowing their story. I’ve literally gone from hating life and barely surviving to thriving and driving. And my biceps look pretty good too.
No matter where you are on the spectrum before TRT makes you feel amazing
Fookin awesome. Good your health&wealth is back✌️
Interesting experience. The effect on your psychology/attitude sounds surprisingly strong. Thx for this.
Went through this same exact thing in my 20s and early 30s. Been on TRT for 3 years and it’s amazing how good I feel on a consistent basis now.
I was 33 when I got tested and my levels where the same as a 83 year old man. I couldn't play sports or get it up. I was fat. Now I do 1cc a week for last 3 years and I play 5 hockey games a week and gym 4 days a week, dropped 50 pounds, and play with girls 3 days a week. I feel unreal. Thx trt
Should have just started with the will power....thanks weakness and the drive through mentality of health...
@@jackkollman9683 Proper hormonal function is as important to mental and physical well being as insulin is to controlling blood sugar. What you are saying is equivalent to saying "just power through your diabetes, no need to take insulin." Take a few weeks and get some basic education in how hormones work before posting such things.
@@floorpizza8074100 my friend. That was an extremely ignorant comment of jack
Two things stand out. Derek is super knowledgeable for someone who’s not an MD, and Peter is super humble for being a practicing MD with what appears to be a true quest for knowledge from someone who has useful info to share.
I am sure the kid knows a lot of s*** but both of these guys are reinforcing their grift.
Peter most definitely has an air of doctor arrogance around him.
Despite public perception MDs are particularly knowledgeable about their specialty, not everything health related or will often talk like the know something like TRT when they may have just looked up the guidelines before you talked to them in their office
*a non practicing MD who dropped out of his residency
@@kennethwickey3661 He is a practicing MD. Look it up
🎯 Key points for quick navigation:
00:12 *📊 Data on normal free testosterone levels stratified by age is limited compared to total testosterone data.*
01:07 *🧪 Free testosterone is typically estimated, not directly measured, introducing potential for error.*
02:15 *📉 Men experience about 1% drop in total testosterone and 2-3% drop in free testosterone annually after age 30-35.*
04:18 *💉 Primary hypogonadism (high LH/FSH, low testosterone) is the most justified use case for testosterone replacement therapy (TRT).*
06:52 *💊 A typical starting dose for TRT is 100-120mg per week, adjusted based on individual response and factors like SHBG levels.*
09:38 *⏱️ Injecting testosterone twice weekly is considered minimum for optimal hormone stability, with more frequent injections potentially beneficial.*
11:26 *📈 Less frequent injections can cause hormone spikes, leading to increased side effects and conversion to estradiol and DHT.*
14:43 *🔄 More frequent dosing better mimics natural hormone rhythms, potentially reducing side effects like gynecomastia.*
17:35 *💉 Testosterone cypionate has a longer half-life than enanthate, but injection frequency is more important than ester type for stability.*
19:41 *💪 Subcutaneous injections may provide a more sustained release compared to intramuscular, but the difference becomes less significant with frequent dosing.*
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Excellent!
Thanks mate
I've been on HRT since 2018 for PGF started at 1 ml per week switched to twice a week at half dose. My first year I switched to subq from IM and the twice a week schedule with life changing results. Age 45- 6 years in - I've switched back to once a week injections and found no adverse effects. I did think that it would help me be more muscular but primarily the differences I'm experiencing are lower fatigue, lower joint pain, better function, improved mood. I cant imagine going back to the way I felt at 39.
Are you saying you felt better with once a week or twice a week injections (IM Or Subq), kind of confused reading this.
39 seems extremely young to start TRT. Are you in the States?
I started at 28, there is no minimum age to need testosterone...
@sandeephunjan some people have other issues leading to hypogonadism. At 29yr old my total testosterone was 42. Trt changed and possibly saved my life.
@coachjsu I felt better my first few years with 2 shots per week. 6 months ago I switched to weekly shots and feel no difference. I still feel great. My doc said that with longer term HRT that my body would more efficiently use the T
I've been on TRT for about 8mon now and I can say at least for me it's changed my life. So many physical and emotional issues that this has changed. I want to say it's helped. Plus changing my whole life style. Diet and exercise. I was 285. Now I'm 235. I feel amazing. Get blood work and see what you can get started
I started TRT at 51 doing weekly injections of Cypionate through a local clinic. Great results. Within the last year I switched to pellets. A bit more expensive but extremely convenient, especially as a frequent traveler. Plus no highs and lows. Overall I think it’s worth the extra expense.
I think you have it backwards. You can control your levels much better with injections.
@@keiththomson9628 Gotta respectfully disagree. The pellets last between 5-6 months, depending on activity level. I’ve done labs at various points during each stretch and every time the numbers are spot on. The T leeches out at a constant rate that even a shot per day can’t match. The trick is in the initial dosing. The proper number of pellets need to be inserted. If that’s done correctly you are locked and loaded for the duration. No thoughts or worries for 1/2 a year. I won’t be going back to injections.
@@keiththomson9628he said convenient cause he is on the go and doesn't have to mess with injections.
I get all my medical advice from the liver king
Can't go wrong there...
I’m glad I don’t see him anymore
😂
I use his stack 😂😂
Started TRT at 59, 3 years ago, and it has really helped. I have worked HARD in the gym and take just enough to keep me st normal levels. I still have a way to go but my body and energy level has changed dramatically. I look forward to exercising daily rather than feeling like a tired slug.
A video on trt, let's see the comments of 60 yr olds woth 700+ test levels who say it's all about good sleep and nutrition..
Cope 🤷♂️
U gonna be ok
Legal steriods are a big business, and weak men need an excuse...
A good friend of mine living in Colorado has had a hematocrit over 50 for over 20 years and says its common where they live and pregnant women have to leave from the higher altitudes and even as a child is still growing until they become much older but its zero health problems for adults and many live a healthy long life and take the hematocrit fear over 50 with a grain of salt.
I've been using TRT for a year now. My levels were at 200. I'm over 40 years old and work out almost six times per week. I started working virtually, and by the end of the day, I was done, sore, lethargic, etc. After three months on it, my level shot up to over 2000 using 100 ml per week. I lowered it to 25 ml per week, drew blood again, and it dropped to 900. So, I've been using 25 ml per week. I feel it mostly in my daily lifestyle, work, workout, recovery, etc. I also eat lots of protein, fat, and few carbs. I haven't seen any gains in my strength on any of my lifts, but that's okay-that's not the purpose of this TRT.
I'm really hoping you're mixing up your terminology here. People are generally prescribed .5-1ml of test c/wk in the US. You aren't using anywhere from 50-100 times the common dosing. Maybe you meant to say mg per week. But even then your numbers would be considered absolutely off the charts for those doses.
@@donmerrigan2362 Yes, each bottle is 100 mg, so I'm breaking it into 4 shots. I'm taking 0.25 ml per week; that's what I meant. Apologies for the confusion.
@@TheBigUsualSuspect why lowering it man 2000 is good
@@hanskazan7403 2000 is way too high IMO, its not TRT anymore.
I already had most of the negative side effects from TRT as pre-existing conditions. None of them got worse after I started. In fact, some of them, like sex drive, improved after I started.
Do you think that high estrogen on TRT can cause acne ? Dht is blocked almost completely with dutasteride so its not from Dht , someone knows what can cause it ? I had acne since the beggining on TRT
Great work people, so interesting, keep it coming!!
I'm 48 and was hypogonadal. Now I'm at 586ng/DL. This book goes into real detail and gives insight to things others don't mention. Complete Guide to Testosterone by James Francis.
u on trt?
I'm 41 and I've been on TRT for about 9 months. For the first 6 months I couldn't get above around 500 nanograms per deciliter, they kept cranking up the dose. I started doing a split dose of twice a week and now I'm over 900. Only side effects have been acne which is not terrible on my back, but weirdly I got pretty severe acne between my pecs, and it's very stubborn stuff that won't go away. I've had it for like 3 months now. It is weird being my age and waking up with morning wood every day, but I'm not complaining. I honestly haven't noticed much of a difference in terms of gym performance and muscle growth, but the biggest thing for me is that it works as like an anti-depressant. I am always in a good mood now.
Same here on the acne...I'll get one on the shoulder every once in a while....but mostly chest area
@jaymills1720 this is trt not a full blown steroid cycle goof
All it’s going to do is make you solid and in good shape. You’re not juicing
I get TRT (because of testicular cancer) in a dose and frequency I haven't heard you talk about (also in other episodes): 1000mg of undecanoate. The first prescribed frequency was once every 12 weeks. In my case they brought it down to 8. So a pretty long half-life with a relatively low spike once injected.
I'm from the Netherlands here, so maybe a European thing. But curious about your thoughts, considering that other forms with 2 week half life you guys kind of dismiss (if I understood correctly). What do you think about undecanoate with a half life of 8-12 weeks then?
Undecanoate would be the superior choice for long term administration, maintaining even levels for approximately 4 times longer than other esters. Although mg to mg it is slightly less potent than cypionate or enanthate because a higher portion of the drug is comprised of the ester (at least how it is measured in the U.S.). The problem with your protocol is that 8 weeks is still way too long of an interval even for undecanoate. They push this protocol for marketing reasons (only once every 3 mos? Cool!) and because the long interval makes it possible to go to a doctor for administration ($$$).
An injection of undecanoate every 4 weeks cut in half would be much better. And if I was in your shoes I'd take a 1/4 dose every two weeks.
Here in the U.S. this is not practical because T. undecanoate injections are only available through your doctor (Aveed) and your physician needs their 'special' training as well. Senseless but that is what it is. In the U.S., the most practical protocol is T. cyp twice a week done at home.
Also interested to hear about TRT protocol in Europe, i hear the pinning frequency is much lower, 6-10wks?
TRT protocol in Finland: Either Sustanon (7-12 days typically ), or Nebido (typically 6-10 weeks)
thank you for the comment. I found it very inspiring.
Derek, I have varicocele. I had no idea this could affect my T levels. I've always been a hard gainer. What should I do to get this checked out?
When pinning cypionate subQ daily, what gauge needle do you recommend?
I do microdosing daily injectjons wherever the needle will go. Testosterone cypionate 160mg a week. So about .12ml per day. I have minimal side effects estrogen and prolactin stay in check. Zero issues with hematocrit and hemoglobin. Free test around 278. And total test 750ng/dl 24 hours after my injection. Ive tried every protcol known. This works best for me
I tried sub q for 4 weeks to see if I would get those benefits they talked about. I did not, in fact I felt worse. I switched back to IM, felt way better, more focused and energized and motivated.
What is considered Supra physiologic for free and total test?
I have been doing cypionate sub Q once per week for the past four years and I don’t notice any difference in my body throughout that week. So, I have not felt the need to have to split up my dosages.
I started TRT at 37 (45 now)
My total T was in the 200s but I was fat and unhealthy.
I might have jumped the gun yes I admit. Thankfuly I did it after having children.
I have to say that I feel very strong in the gym and I don't lose muscles easily with lower body fat. I actually look better than when I was in my 20s and training.
I take my shots every other day and no side effects ( I have high BP but that's genetic and controlled now).
To me, I have no regrets what so ever.
One serious negative is that libido is very high. It's not always fun when you have to work.
Does any do daily? What needles to use for such small dose?
LH and FSH can also be heavily lowered by concussions.
how do you determine if the low testosterone is a testes problem versus a CNS problem? How do you solve it when its a CNS problem? What is the long term plan if you want to maintain your own level, and only topping up to achieve benefits? Will you always destroy your own testosterone production if you take trt?
You will have to look at age, physical activity, and nutrition then if you are under stress constantly or have other mental problems there goes your CNS, and overtraining can also cause a problem. If you remove much of the stress or at least manage it your T levels should go up. Remember a certain amount of stress is necessary but being the right kind! Hopefully, you're not under constant stress as it will take you down and set you up for health problems and crush your testosterone but jumping on TRT is not the answer right away unless everything else is in check first and if it is and you are not too low you will want a reputable TRT clinic to try other routes first and if only then if you still can't get to point of good levels where you are feeling good then TRT will come into play. Depending on your age going on TRT at a young age you can recover or at least you should back to good levels but not everyone can after going on TRT and ending up on it for life. I no longer believe this will be the case shortly as we have made improvements and in fact, TRT will also fall by the wayside as LH TRT is here and will cheaper and covered by insurance with only needing one injection every 2 years as well as being cardio protective.
Work on maximizing your body’s ability to function efficiently, naturally. I think too many men think that they will go on TRT and it will remedy all the decades of neglecting their body’s own abilities to increase athletic performance. It’s not just about being less stressful but how about a clean diet, daily exercise, proper hydration, proper supplements, sleep hygiene. Improving endurance and evaluation of max watts or increasing your VO2 max and HRV.
Perhaps the path of most resistance that few men will ever take since they can solve their problems with a testosterone replacement therapy the rest of thier lives and will feel amazing doing it that way.
enclomiphene and blood work would be a simple test. if it raises your T level significantly, it's a pituitary issue. If it doesn't affect your T at all, it could be gonads, but could also be that your pituitary won't produce LH even with reduced estrogen activity
See how you respond to clomid or hcg
Exogenous testosterone given in a therapeutically active dose will always shut down your natural production. Which is fine if you are dependent on taking T and will do so for life.
Way too many guys think "Well I'll try it for a while" and dabble with it here and there.
Much better to see where your at, take action to improve your health and try to raise it naturally. If that doesn't work then go ahead and got on T knowing it's for the long haul.
I’ve been dosing daily subq for 12 months no ups and downs, acne or other side effects. My hematocrit prior to the switch from weekly to daily was 53 to 55 which required monthly donation now with daily 50 to 52 still high but steady. Prior to TRT it was in the 47 to 48 very steady. I’m very fortunate that my hospital has a program that tracks all my blood test over the years. Therefore easy to compare trends. I transfer 200mg vial into 10 syringes a pain because it’s so thick and a very small dose but it works.
A little tip, use bigger needle to draw, smaller to inject. And warm up the vial or the syringes under hot water it helps liquify the oil and goes in easier!
@@StelioKontoss Good advice on the needles, 21g for drawing 25g for injecting. I'd skip the water warming for hygiene purposes.
Outstanding I use a larger needle to draw but I will try the warm water method next time
No bumps from subq injections ? How much do you inject every day 0.2 ml? Did you had acne before from once or twice a week shots?
Yes on the daily. Yes on the acne once a week inter muscle. It stopped within one week of subq. A small amount once in a while now. SMALL amount on my nose!
@12:20 you hit it right on the head. It only took me 20 years to figure this out lol.
So would it then make more sense to take daily? Seems likely. Plus some of the orals may flow better with a more natural test rhythm plus I think they are better for red blood testing. Might not get you to super high levels but people who just want standard levels. Is there a good oral vs gel vs injection video?
Great conversation. Thank you.
35 yr old male. 5' 2" inches 146 lbs. 100mg/0.5ml a week. Peak was 926 total, 194 free. Estradiol on a peak was 31.
Trough 6.5 days later,
540 total and 101 free.
I'm super happy with these numbers. Pin every Friday like it's my birthday!! 🎉🎂
Only thing is my ferritin bottomed out, like bottom-bottom, bottomed out. 4 ferritin, 40 iron. Iron binding capacity is slightly over 100% 428/425.
Im on an every other day iron, lactoferrin and copper regimine and to try and get these numbers higher. Just started this. September 9th is my next ferritin and iron check.
As far as the test levels are concerned, they are $$$ at 100 mg a week. Definitely don't need to go higher, but to focus on my iron and ferritin.
Your free T even at peak is kinda low imo. Hell even at trough most guys feel their best if it’s above 200.
You may feel good now because of how bad you felt with low T but I don’t believe you are fully optimized. Optimized free t would be between 200 and 300 regardless of peak or trough.
@@Kstephens07 I was on 200mg every 10 days before this. Had a total of 1250, free of 255, estradiol of 48 and that I beleive was on a trough lmao. This 100mg a week is working out perfect for me. I dont wanna be in enhanced ranges, just higher than what I was, which clearly I am. I was at a total of 227 with a free of 34 before starting all this. My bodys androgen receptors work very well.
At what age did u start?
@@BiHuSrcu one year ago actually, so my body has most likely stopped making it's own. These levels I obtain on peaks and troughs should be the ones I obtain for life at this dosage. Only thing I need to do is get my iron and ferritin up and my labs will be *chefs kiss*. Not only that but this was 3 days after injection, which could be SLIGHTLY lower than an actual peak. Usual peak via IM test cyp happens after 10 hours up to 2 days so... We can probably assume, but can't prove I'm right at 1000 ng/dc total and slightly above 200 free and im 110% happy with that. Anything above that and I'll be pushing into enhanced ranges and that's not what trt is for. That's called testosterone sports therapy or testosterone enhanced therapy in the realm of going above normal high levels. My energy levels are already through the roof and (SOMEHOW) I'm suppose to feel even more like super man when I get my ferritin and iron up.
Honestly peak 926 sounds optimal to me, i like how they said that injecting twice a week at least might help decrease those super abnormal peaks…what made you get on trt?
Anyone knows if its always needed to donate blood? Like say if you inject more frequently can you avoid having your hematocrit rise to dangerous levels? It seems like a pain in the *ss to have to donate blood every few months and I would like to know if there’s a way around it
I've been on 6 years never had dangerous Hematocrit
@@nateh6441 whats your protocol then?
Plz interview Dr Gil T for TRT. He is awesome!
He is awesome but his expertise is more on the nutritional side of things. If you want to talk T, Derek is at the top of a short list.
Loved this
In Sweden, if (IF) you make it past the narrowsighted doctors that stares blindly at the reference range with complete disregard for symptoms, the only injectable option for trt is 1 gram every 8-12 weeks (6 weeks first injection). NO hcg under any circumstances.
I'm surprised they didn't discuss the new daily oral TRT options (sold under the brand names Kyzatrex, Jatenzo and Tlando). Because it's pill form, it's more convenient than pinning daily and it's only twice/day instead of 3-times/day of Natesto.
Because its new, injections have been studied and done for a long time, they are safe and effective. Pinning > any other method.
Afaik oral testosterone is hard on your liver and often not preferred.
Omg stop
You don't need to pin daily on trt
Twice a week for me with insulin pin on delt. Couldn't be easier
@@HappyWolverine, agreed, but they discuss people who want to pin daily. My only point was that the oral TRT options would (somewhat) mimic that.
Problem you have with any oral version is bioavailbilty and your guts optimisation to break it all down and utilise it efficiently. Pinning is a lot more accurate
Oh thank God it's under an hour. I feel UA-cam vids should be 30 mins max
I use 15 mg T-cyp sub Q q AM as I feel this gets as close as possible to the system designed by nature.
have to disagree - desinged by nature means you have ups and downs. but with daily injections and the half life of 4,5 days, you dont have downs. only with cream you could mimic nature.
Before or after coffe?🤣🤭
Where do you inject? I take it thats a daily dose? Are you not running into issues like scar tissue buildup and lumps?
@@Pieter_LionI got same question
@@Pieter_Lion I stopped subQ for this very reason, lumps. Back on IM
I didn't understand a dang bit of this video. I went to one of those men's clinics and they told me I needed to take t shots. I saw my doctor and he said he didn't recommend it. I think my test level was 190. I don't know what to do or who to see who knows about this.
Same. Did it anyway. Got my life back. You choose your own path. low t will make you not take chances. Consider that influence in your decision.
That should be a very easy decision when your numbers are that low!
190 is way low. General medical practitioners usually have no clue about this stuff.
If I was you, I would run with the T clinic. But your choice, obviously.
Drs are idiots.
It’s mainly about whether you have symptoms of hypothyroidism. Symptoms like low libido, low energy, inability to burn fat and difficulty building muscle, to name a few. 190 is very low for total testosterone. I would be surprised if you aren’t experiencing symptoms.
I received my testosterone bloodtest yesterday ( I am 100% natural) , they are totally normal, but i have some questions.
Results :
- Total Testosterone :
•839 ng/dl
- Free Testosterone :
•16,3 ng/dl
(I did the conversion to ng/dl to make it more understandable, lab result was showing 0,163 ng/ml)
- Bioavalaible testosterone :
•450 ng/dl, which is about
53,7 % of my Total T.
SHBG : 37,7 nmol/l
(Lab reference range : 17 - 77 nmol/l )
My questions are :
1. If i reduce my SHBG levels to the strict healthy minimum , (Let’s say 20 nmol/l ) can my Free Testosterone levels potentially double ?
And reach the optimal range which goes from 18 to 25 ng/dl ?
2. Is my bioavalaible testosterone slightly high ?
(Because in most people Test results i see , bioavalaible testosterone rarely exceed 50% of Total T)
Is it good/bad to have more than 50% of your testosterone bioavalaible ? What are the benefits/side effects ?
3. I did a first testosterone test 2 months ago and my Total Testosterone was 737 ng/dl but my SHBG levels were EXACTLY the SAME (37,7 nmol/l)
Considering the fact that my total testosterone increased from 737 ng/dl to 839 ng/dl in a 2 months scale whitout ANY CHANGE in SHBG levels, can it indicate a good body endocrine function ? Or is it something else ?
Thank you a lot if you respond to those questions, i always reach to professionals like you.
Did blood work and low test doc prescribed me test amd i do half cc a week no side effects at 44yrs if needed i will do half cc my whole life
I’m 27 5’11 175. Looking to get on trt, been feeling the symptoms low energy, fatigue etc. thought it was relating back to depression but don’t wanna get in the medication. Will be getting my blood work next couple weeks.
I wouldn't unless you had no other option. TRT can cause all sorts of health issues if you use drugs and alcohol especially. Even if you live a drug and alcohol free life style you basically need professional scientists to help you do it correctly and that will cost lots of money. You are young. Ideally, only older men over 65 should consider going on TRT. You can raise your levels naturally by running and lifting weights consistently. Just force yourself to do it and it will naturally raise your total and free T levels. My friend is on TRT and is young and he basically ruined his life because he's not doing it right. He's also an alcoholic. It's not worth it though man. At least do your research thoroughly.
@@user-ec9hb3bo7m thanks!!
@@user-ec9hb3bo7mSTOP!. You do not require scientists for this; this has been around for decades.
@@user-ec9hb3bo7m its easy to plan workouts in your head on low T its is depressingly difficult to do it no matter how much will power.
Try shilajit ,nor tongat ,try icing boys o sugar or alch. No cannabis legs heavy day per week you want to be on trt forever ?
I love it! get saucey!
Anyone try enclomephene?
37 with 170 total t. Went on test endosate levels completely went away. Dr switched to test cypinate. 30 ml 2x a week. 800 total t now.
What is your lifestyle ? Weight ? Any medical problems?
@mkinvincible 5'11 200. 33 waist. Had a ultrasound on the boys one is only getting 40% blood flow
@@travissmith-wz5ncdamn! Sorry to hear that. Do you have an arterial malformation that decreases the blood flow to the boys? I am 6 feet and was 205 pounds. I went to low 180's and feel great. I think the 20 pounds more were screwing me up plus high stress levels. Now I am sleeping more.
You should try to cut 25 pounds and optimize your sleep. It should help.
@@mkinvincible old wrestling injury
@@travissmith-wz5ncgot you. It's what it's then. It sounds like you should talk to your primary care doc and he/she should consider the replacement for you. Best of luck.
Caffeine spikes cortisol...is this an issue with T levels?
Why aren’t they discussing the T gel? I’m 58 and been on gel for 18 years daily. Amazing. Now Hemaocrit over 50 for first time. 🤔
I’ve been having a sever side effect at the injection sight for my TRT. 24 hours after the injection I would have extreme pain for 4-5 days afterwards. Unable to walk …. I was told I’m allergic to testosterone. Is there another explanation ??
Could be that you're allergic to either the specific oil and or preservative being used for whatever brand of test you're using. Try another injection site using a much smaller dose and if it still persists then you need to get your doctor to perscribe you a specific brand that uses another oil or even have it compounded with a specific oil and or preservative that you can tolerate.
Thank you
Dumb question but it there a quality difference between companies?
@@billmoskal8463 not that I've noticed tbh. As long as it's coming from a legit pharmacy you should be fine.
@@billmoskal8463 just for reference, the stuff I use is from a compounding pharmacy and is in a grapeseed oil base which is generally seen as one of the more well tolerated oils.
meh....I've been doing 200mg IM q 2 weeks for years now. I have my level checked annually. PIA to do it any more often than that.
You guys didn’t mention the scrotal cream that’s working for a lot of guys that’s strange because I would think that would be something more important to talk about other than that Dom nasal spray
Im 52 my total testosterone is at 894 & my free testosterone is 281.8. On trt 1cc of test cypionate a week
dang those r great levels
I regret ever going on TRT..... I have been on over 10 years under a physician, I have tried bi-weekly, tri-weekly, daily injections, I have tried cyp, prop and cyp/prop combos. My doses have never been ridiculous... they are small to achieve/maintain physiologic levels.. Currently I am on 12mg's of Prop daily... anyway.. since being on TRT my sleep has been non-existant/destroyed (severe apnea developed since starting trt), I do not see any amazing benefits in the gym (most likely due to lack of sleep).......... Although my numbers on paper look great/optimized, I certainly don't feel that way.... seems like I spent half my time on TRT chasing numbers and now spent the other half just trying to feel good and never been able to get dialed in... so with that said, At the end of the summer I am going to go off TRT.... so if anyone has a good protocol for going off trt I would very much appreciate it.
Maybe its no the TRT thats the issue, TRT wont save your entire life if you still have your own stuff to work through.
@@ryanroseevans its the trt....there is a documented relationship between trt and apnea. Never had issues with sleep/apnea until starting trt. I know the apnea /lack of sleep is the cause of all my issues which is directly linked to my trt.
@@btk03z19 That sucks to hear. I have experienced nothing but positives on TRT other than holding water if my diet gets even a little off. I am assuming you use a CPAP? Ive had apnea for 15 years and must use a CPAP to stay alive. I had to start taping my mouth shut after starting TRT.
@@Twelve20Inc. Ive tried cpap (for about 3months) and just couldn't get used to it.. only other option is maybe look into bi-pap.
I’m off TRT and much better!!!
Based on not "blasting" or taking a single shot of 250mg. a week. What are the thought on the Pellets? Wouldn't that logically be the best dosage frequency?
I did pellets for 2 years, would not recommend. It's advertised as a slow steady release, but as a man they have to put so many pellets into your butt cheek everytime I would be sitting down they would get smushed and be releasing test.. so very front loaded in the test release.. they were supposed to last 6 months but I'd feel a drop-off after 3 months and basically done by 4-4.5 months. Injections are the way from everything I've learned and experienced
Vegan for 26 years (mostly whole foods), BMI 20 to 21, moderately active: at 37 years my testosterone level is higher than 99,7 % of the male population in my age bracket. Try lifestyle first, take care of your health
TRT gave me crazy anxiety and panic attacks. However, I am predisposed for anxiety. Both injection and Natesto. Androgel didn’t absorb so nothing good or bad from that. Wish I could figure out how to avoid that. I know onion in a small subset of guys that have that reaction.
Seems psychosomatic to me. Definitely not a typical reaction. Having an appropriate T level usually makes you smoother and more relaxed and more emotionally stable.
I had the same reaction when I first started TRT. So I cut my dose in half for a month and eventually I was able to titrate up without any anxiety or panic attacks.
Trt had NOTHING to do with your anxiety, as long as you were in normal range
It's like saying breathingbair gave you anxiety lol
Testosterone is endogenous bro
@@HappyWolverine With all due respect, you don't know what you're talking about. Testosterone can stimulate the sympathetic nervous system.
What was your dose? How frequently did you inject?
Anyone above 30 should get levels checked. Literally as important as blood pressure. Low T causes a ton of health issues.
absolutely! especially with all the processed food that have invaded our food supply!
Is there cancer risk associated to TRT treatment?
They suspect prostate, but no definitive data to prove it, however it does increase cardiovascular problems…
I’m 40, loved TRT, have genuine low test, never touched PEDS. Had to stop, was killing my hair, even on finasteride. I’m too vein lol I’ll feel sluggish and skinny and keep my thick head of hair
I would rather lose the hair than feel terrible. I believe low test also has a cascade effect in other areas of metabolic health.
I second that.
Gonna lose your hair no matter what 🤷
Get on fin and min and spread dose more frequently to prevent DHT spikes
f the hair
How likely it is to get hypogonadism in one testicled man?
Obviously TRT/HRT is becoming more popular but I’m curious about how many men that prescribed to this therapy are risking other problems.
there is certainly unavoidable consequences. but there are serious consequences to living with chronically low testosterone. Low T increases the excess mortality risk for men. it's a risk equation different for everyone.
It's riskier to have low T than T in the proper therapeutic range. The only exception to this is if a man has had low T for many decades and then suddenly boosts it. There is an increased chance of stroke in those individuals for one year after which risk goes back to baseline. In other words addressing the problem earlier than later is safer.
@@Lucas_Jeffrey there are serious consequences to have a low GFR or having HTN or Diabetes from years of abuse and neglect of consistent exercise, just saying.
Id rather live to 65 optimal and thriving that 90 like a pile of dog crap.
I seriously don’t think these practices that promote “Men’s Health” actually address the collateral damage of possibly renal failure possible stroke and other serious complications from stressing a broken done cardiovascular system with weak organs.
How did this cvnt become regarded as an expert???
I’m 33 an been on methadone for 10 years it’s ruin my metabolic health I’m hypogonadle my test levels were below 100. I know once I get off methadone my levels will go back to normal but until then I’ve decided to start trt 250 mg a week. Sucks but I was tired of feeling like shit all the time. Hopefully once I get off methadone my body will return back to normal opioids synthetic an illicit will ruin ur metabolic health
Injecting SQ has been shown to hit steady state in 6 hours and then begin a slow taper but will be still be in therapeutic range. Study used 100mg and it showed wide variance testosteronw levels: ranged from 600 to 1100.
I have my patients take q5-7 depending on patient preference and have them check test level in 3 days.
Danger in females is that the pharmacist prescribes the 1mL vial per week and some patients don't want to waste it so they inject the full 200 mg. Have had some patients with free test of 30.
Never prescribe IM.
I don't really care what is natural per say. Is it safe to do trt at a reasonable level, continuously? At 175mg a week pinned twice weekly, I had never felt so good...... i don't think we live 'natural' lives these days.
As a tradesman I am physically on the tools and running a company so I have physical and mental stress at least 10 hours a day. I love my job, just want the energy I need to do it effectively
Where is the best spot to inject. To benefit the most if there is.
If possible, why not just take a SERM? Clomiphene works well.
gold.
I live in a shitty country where i can't get trt. I'm 45 and i feel my testosterone is low. I can get below the counter testosterone, but i'm afraid to take it as trt..
TRT is life
Yall against the 1.62% gel? 4 pumps gets me between 450-650. Not great but no needles and $20 month on insurance.
Not good if you have children around.
boy i ll put that needle in me singing for a better effect
Propionate daily for me.
Estrogen response is much less compared to injecting 1-2x of Cypionate.
Propionate is a very irritating ester to inject (kind of feels like you got stung). You could use cyp daily and get the same effect.
i get crazy post injection pain with propionate even with the best carrier oils.
@@BB2001. I did right away. I am only pinning 3/10th cc a day. I use an insulin syringe. 30 units.
Twice a week with insulin pin in delt. Couldn't be easier
Thank me later
Do you think high estrogen on TRT can cause acne?
Im 50 yrs old. 185 lbs. I bench and squat twice my body weight.. 5’8” with a 32” waist… im on 150 mills a week of Test Cyp amd life couldn’t be better.. i make it threw the work day now, my wife is happier, im happier and more confident.
I was a thin hardgainer with low test at 200 nanos per deciliter.. 165 pounds weak no energy… pecker didnt work that well and life was just a struggle daily..
My wife and I work out together. Eat one ingredient foods, pound the water, sleep well and the rest works its self out.
These gatekeepers in the fitness world need to get over themselves.. just cause you dont fuck with dont mean others shouldn’t.
I have done subQ and went back to mon-thurs and have been fine with it. Some still do the once a week and that doesn't work for me. I have found subQ a bit of a problem after getting too many pokes at least after a year as we are talking about an everyday injection, of course, the needle is tiny leaving less scarce tissue but this is not the case at least for me after a year as that is a heck of a lot of injections so I think its has its limits and may be why guys love it at first and after awhile they are looking for to places to inject and finding it also over time not as effective. We now know even with subQ if someone keeps injections in the same spot after a couple of months they say they find it not as effective, I believe that the small amount of scar tissue has built up enough from so many injections that it's being slowed down in its ability for good absorption. Just my opinion and what I have seen over the years. Works great at first but we have to remember just because it's a tiny needle it still leaves scar tissue over time with so many daily injections and we are constantly looking for new places to inject. I think after a while you will end up hitting a spot that starts to build scar tissue which slows down the absorption of the oil getting trapped in scar tissue. Then back to intermuscular injections. But with LH TRT coming it will put an end to all of these issues.
there's adipose tissue all over your body. with gentle injection technique there is not much scar tissue to speak of. having sustained 700-800 ng/dL every day, eventually you'd get used to it and it won't feel like it used to. I don't think this has anything to do with absorption.
Way less scar tissue into fat than piercing muscle tissue, use an insulin needle size, theres fat everywhere change spot and dont inject too much. IM won't be better at limiting scar tissue, on the contrary
The scar tissue is a reaction to the shitty cottonseed oil they use in many injectable testosterone preparations. If they used grapeseed oil it would be much less irritating on our bodies. Even dealers in Mexico are thoughtful enough to use better oils!
Very annoying because they are only saving a few cents per injection and you get some nasty lumps that last months at least.
The scar tissue has nothing to do with the needle itself.
66yo, get T pellets, T between 700-1000 for 5 months. Don’t care about free T … just care that I feel great and “all systems on high alert”.
Ha hahahah “all systems on high alert” so woody is A-OK. Ive thought of starting at age 64 put concerned with heart issues.
@@bobwilliams9061 I’ve been on statins for years and had a ct angiogram .. calcium:0 “no vessel,disease” .. I would imagine that high T would probably help to keep arteries flexible. I also run 4mi/day and do CrossFit 3d/week .. not that concerned about dying .. but .. do like getting laid without worrying about “lack of interest” all the cialis on the planet won’t fix erectile boredom ..
Well sir you feel great because free T must be OK 😂
Well you should care about free T because that is what is doing all the work to make you feel better. The rest is bound and not active.
@@bearclaw5115 SHBG is fine so nothing can be done about fee T so what’s the point of worrying. The only way to increase free T is by increasing total T and mine is maxed.
When they say 100 to 200 mg … how much is that in a syringe of 3 ml for example ?!
200mg is 1ML
Depends on how much mg/ml.
@@sergeidecoene9822 let’s see for like 100 mg ?!
If your test bottle is for say 200mg per ml, 1ml would be 200mg
@@cshan159 🙏
200 mg of sub queue would be awful
I want to meet a 90 year old who started taking TRT in his 50’s
They die way too young
Wait a couple decades, bunch are in their 70s now, arnold and such…
@@BiHuSrcu Arnold had triple bypass and did not do roids forever
Gentlemen, I am 6 foot one, 185 pounds with abs, and I’ve had visible abs most of my life. I am 41 years old, and testosterone last blood test was 927. I have never taken any steroids. I don’t drink alcohol, I don’t have social media, I don’t watch porn. I live my life outdoors, go to the gym four days a week and lift, hike, play music. It is 1000% all about how you live your life. Stop listening to the snake oil salesman. None of these guys on testosterone look good at all. And it will age you like crazy. Live your life outdoors, doing things, put down the phone, stop watching porn, and have a healthy sex life and have sex every day, do not masturbate. This is my advice.
u r lying about ur levels!!!!
I think i have hormone issues, and I am not even doing junk food once a month, i dont consume junk at all, same with Alcohol, zero Alcohol and working out 3 times a week, medium carb loads 130grams per day, huge protein load 2-3 grams of proteins per kilo body weight, lots of healthy fats and overall 10-15% body fat, free T is 16,15 and without all the herbs eg ashwagandha, msm, tongkat ali, Tribulus and maca, without all these +b1, 2&3 I wouldnt even have energy to work out.
Doctors do nothing to help because I am still within normal range of T..
Im 6’1” 170lbs 68 years old
Been on cyp for 4 years on recommendation from doctor 150 mg week
7% bf Bench 225 DL 310 Squat 350 2r on each
Feel good with good energy no sides
How about dialling down the technicality of these chats so those without a degree in medicine can understand! Its like listening to medical techno bingo. If you are looking to help men with potential or known hormone issues, they need to understand what the hell you’re on about. Chats about sub q vrs im mean zero to most people.
I have already done several hours of more fundamental research, so I already understand those topics. For me this video was perfectly executed. Rehashing beginner stuff in every single video would just make them unnecessarily long. I recommend finding some beginner videos and building up your fundamentals.
You're on the internet, look things up as you watch!
I wish someone would actually consider someone that has testicular cancer and has a testicle removed. No one ever talks about it and compares the pros and cons of it
I have been on TRT for over 10 years and have had prescriptions from different doctors. Some prescribe it every 4 weeks and currently every 2 weeks. None of the primary care physicians I have seen would entertain any information on half-life or information I would try to show them from the Endocrine Society. So, the bigger issue is trying to get Doctors educated. They are supposed to be smart so why do they fuck up so bad and not give a fuck. My current doctor is very adamant that I do not take the testosterone more frequently than every 2 weeks so I have to lie to him. I have lived in small towns for the last 10 years so I do not have the luxury of finding a better doctor.
Maybe you can find one online? I would strongly suggest a minimum of twice weekly! I think its because Testosterone is still taboo. But there are good endocrinologist out there!
My experience has mirrored your own. You'll likely have better luck with endocrinologists. GP's are nearly universally terribly uneducated on this vital and common issue.
Your doctor is insisting on bigger spikes and longer troughs which is terrible for your body!
I've come to the conclusion that the only place to find good doctors is in major cities and even then you have to be very selective. I don't know what has happened to the medical profession - most of them don't seem to give a fuck about anything - most are poorly informed, don't keep up with medical literature and lack in depth knowledge and understanding. And in terms of being caring, you'd probably get more interest, empathy and care from a block of wood.
@@gdok6088I'm an M.D. & admit I could give a flying f__k about my patients! My first question is do they have insurance & then how can I max out my cost to benefit in terms of the 10 minutes I spend w/ them?! I generally try to make at least $600 per ten minutes consultation & I try to see at least 6 patients per hour over the course of 8-10 hours 6 days per week! I love my job 😁
Damn. I’ve been injecting 200mg every Sunday. 🤦♂️
I get sick of injecting twice a week, but I guess I’ve got no choice.
"a person's total T is 800 ng/dL"
you mean a MAN'S t. as a woman, that level would be scary. don't be scared of attributing sex, please.
Obviously he was talking about men. No need for gender policing.
It should be obvious that he's talking about men.
I’m 56, 6’1” and 230lbs at water tank tested 8% bodyfat. I have a natural testosterone level of almost 800. I also travel 75% for work and head on the family. I train at 4am on the morning to get in my workout before work and family obligations and eat healthy even when traveling (grocery stores instead of restaurants etc.). I don’t care what anyone says it absolutely your lifestyle that affects your testosterone levels so if they are low then change the poor choices you are making. These TRT clinics give it to anyone and it will screw you up.
Same. I stopped exercising and was earing shitt. For years. Got my t tested and it was 180. I was told my testosterone woukd never go much higher naturally. I started eating well and lifting daily. Now I'm at 750 and feel better than when I was 20. 25 years ago. Do the work.
@@whatthefunction9140 Thank you. I have no idea whatmine is but I lift hard but at 64 the results are less than inspiring. I’m tempted but probably wont make the jump.
@bobwilliams9061 yeah sorry didn't mean to sound like it has no place. I want to start around 60 if I can't keep my numbers where they are.
I was absolutely ripped and run a half marathon weekly zone 2, two fast interval runs a week, lift 3x full body heavy per week, macro nutrient compliant with a coach. I dropped a ton of muscle and strength and my vo2 plummeted. I had no idea what was going on, super sick 24/7. A doc finally diagnosed me with systemic mastocytosis and eosinophillic leukemia. I started taking targeted chemotherapy and my blood work for anemia and a lot of other messed up stuff normalized but I still felt like crap and couldn’t get my strength back. My bench had plummeted from working sets at 225 lbs to 135 in 6 months. I had my T tested and total T was 180. I’m at 500 now and am finally symptom free at 50 years old two years later. My work ethic has been far above most I know as I served in special operations until 24 years old and never ever stopped taking care of fitness. Some people DO have real medical issues and your own testimony doesn’t negate others experience. Yes there’s shady clinics out there.
That's genetics, I was foing everything alright and my test was still low at 28, needed trt, before hopping on I tried 2-3 years to fix it , no success, you can't extrapolate your story to others as there are many factors such as genetics. In your case you seem to have good genetics for high t, but your life style led you to low t. In my case I had low T even doing everything allrigjt, sleep training, nutrition, low body fat...
200mg of test cypionate, once a week has worked for me for the past 12 years.
Topical works great for me. No reason to inject.
If your needs are low (mild boost) than topical is fine. But injections are a much more reliable way of raising T levels substantially and is much cheaper and probably easier to live with.
I highly doubt it’s genetics because I guarantee if I observed how you lived your life from about the age of 13 into your 20’s (when your frontal lobe finishes developing) I am sure I could point out several choices you made that contributed to your condition. Guaranteed my generation was more active, had less overeating, less TV, video games, conveniences all together (like we had to walk or ride our non-electric bikes to get places-not saying you did just using “conveniences” as an example.
Yeah, because we don't age, not at all, and we don't have individual genetics. Nah, no way, haha!...
I believe Peter puts his clients on statins right away as well. He said himself, a lifestyle change is way harder than pinning it (take a "medication"). Typical American way out, shortcut city...
I dropped my cholesterol 71pts in a month with nothing more than oatmeal and switching to lower fat cheese. My doctor didn't even want to test after a month stating that it would be likely too soon to see a difference! DR's definitely under-rate the impact of dietary changes.
I didn’t know God ran a TRT clinic. I’m in Tucson this week and we should train together I’ll prove you wrong.
Wtf are you on about
Dr Derek is a much better Canadian doctor than Dr Greg.
Obesity is causing the bulk of the decline in male testosterone over the last few decades. Stay lean and your testosterone will likely be fine.
Been on TRT for about 5 weeks. My feet and ankles are holding water and a bit swollen. Is this a big deal? Upon looking it up it says it's normal,but of course your also dying. Lol. Good ole google.
Derek got all his education from Victor Black…he wont ever say it. Sad
Why does the bloke with hair think he is a celebrity just because he on steroids