I do have a few patients who want the 14 day regimen for work-related reasons, but this is uncommon. I try to have my patients on a weekly dose as difference between the highs and lows is reduced. There are clinics that will start their patients off at 200mg IM weekly and adjust from there. I am a bit more conservative and start at a lower dose to prevent symptoms from giving too high of a dose. Another advantage of weekly dosing is that finding the right dose is a process of trying one dose for 5-6 doses, drawing labs to see where we are, and adjusting to a new dose and starting the process over. When taking doses biweekly, it will take longer to find your best dose. You may need your physician to order the syringes and needles.
@@TheLeoBianco1 I really hesitate to put patients on a 14 day regimen as it creates peaks that are potentially supratherapeutic and valleys that may be subtherapeutic. That is a rollercoaster that only those who cannot possibly come weekly should have to ride. That said, each patient needs their own individualized dose to feel the best that they can weather that is on a 14 day, weekly, or daily regimen. For some, it would be 400mg testosterone cypionate, but for most it would be another dose.
As a post RARP & radiation prostate cancer patient, I initiated TRT after 20 months of ADT, 3 months ago. I am currently doing bi-daily IM injections of test-cyp at a rate of 120 mg/2 weeks, using 1/2" 30 gage insulin syringes into ventrogluteal muscles, alternating sides. I achieve steady 22ng/dl Free-T levels with no noticeable "peaks or valleys" and side effects of the ADT are now gone. My PSA remains "undetectable". Microdosing is the right way to do TRT, just as your body used to "micro dose" testosterone naturally.
@@HeliosTelemedicine I have not , muscle injection doesn’t hurt when done correctly. There are good videos on TH-cam on how to . I inject right above my butt and switch sides
@@LK-bz9sk Please let me know how it is working for you,. Please also remember that microdosing can be done with subcutaneous dosing, which might be easier and less painful to do.
I've found Monday morning, Wednesday afternoon and Friday evening or Saturday morning injections per week is my favorite. Keeps my levels steady, no E2 issues, no rollercoaster ride and I feel great every day. When I did weekly and even twice a week I felt like shit the 3rd day and on.
My test levels are at 550 . I’ve had all my hormones checked and there “normal”. I have really low sex drive and feel very tired and weak. I’m only 22 and tips?
What are your estradiol, free testosterone, SHBG, LH, and FSH levels. While 550 ng/dl is in the population-based "normal" range, your body may like it higher. I doubt that any insurance company would pay for TRT unless your free testosterone is low, but, if the LH and FSH are low or even mid normal, you might try clomiphene or enclomiphene by prescription. You may also try herbal supplements like ashwagandha, fenugreek,
That would depend on your estrogen level and symptoms when you reach your steady state testosterone level. Testosterone is converted to estradiol by enzymes In fat cells so we would expect the E2 to rise with the testosterone.
I’m receiving my first dose tomorrow. My doc put me on 200mg biweekly. I’m a bit worried the two weeks is to far apart. The pharmacist did not give me any syringes either, so I can’t administer at home yet. Should I be worried?
I am currently on 100mg injection per week and it works good for me. Albeit I do feel a little tired by injection day but I can’t imagine being a human pin cushion and pinning everyday.
1. You may need just a little more in your weekly dose if you are having symptoms on day 7. Not much, just a bit. 2. If weekly doses work for you, then great, but there are many people who take daily injections such as diabetics and other hormonal issues, those on some treatments for osteoporosis, and those with low testosterone who want the tightest control that they can get. The needles are very thin and rarely cause significant discomfort.
@@jamescaplan7735 I will talk to my doctor after next bloods. I’m actually a little on the high side of the range on my peak day so I don’t think he will be very interested in upping my dose even slightly. I have a hard time pinning even once a week. Kind of scared of needles. My last bloods were 1010 total and on a range from 7.0 to 24 free I was at 22. Thank you for the advice. I’ll run it past him.
One problem I have is even getting it testosterones because the doctor don’t wanna give it to ya I am to 74 and the doctor says oh that’s fine when I tell him no it’s not I would like to get my own stuff and make my own testosterone so I can dose myself it like I need to daily please help.
Many doctors will tell you that, at 74, testosterone is not indicated. While I agree that it is unlikely that testosterone replacement therapy will provide enough benefits to extend your life, I believe that the clinical goal of treating patients older than about 65 should be more about quality of life than quantity. If testosterone can improve libido, erectile dysfunction, muscle loss, sleep, and energy levels, then we are doing a lot of good for our patients. If you live in TX, NY, FL, or MO, you can make an appointment to see me at www.heliostelemedicine.com. As long as the clinical goal is understood, then I think that it is worth a 3-6 month trial to see if your quality of life improves. I have never seen a study looking at this, but you may also consider asking about taking enclomiphene 25 or 50 mg three times a week and tapering up as needed. Enclomiphene is not FDA approved, to it is an off-label use and it is not sold by regular pharmacies so it has to be prescribed through compounding pharmacies. It stimulates the whole brain-pituitary-testes axis to increase testosterone production and release. I don't know how much it can achieve at 74 because all the studies on it that I saw arbitrarily limited the age to 65 years or lower, but it is well tolerated with few side effects so I think it may be worth a 6 month trial.
Like all hormone medications the dose has to be tailored to the individual. The starting dose for daily subcutaneous testosterone may start at 10-12 mg but it is likely to change as follow-up laboratory studies and your own symptomatic response are evaluated.
James Caplan I’m injecting 24mg daily and still having e2 issues so not sure if I should lower my dose or add AI: TT 1139 (250-1100) FT 273 (46-224) DHT 105 (12-65) TSH 2.13 (.4-4.5) E2 46 (
According to an article in the Journal of Clinical Endocrinology and Metabolism at academic.oup.com/jcem/article/102/4/1161/2884621, for a 59 year old male the range of normal (which includes 95% of the population) is 267-929 ng/dl and the level at the 50% is 477 ng/dl for the nonobese man. For the man also suffering from obesity, the average is 229-902 ng/dl with the 50% at 446 ng/dl. Remember that your personal normal range is narrower than the population normal range and you may feel normal at higher or lower points in that population range. It all depends on your symptoms. If you don't have them, then you shouldn't just treat the number. Regarding dosage, I can’t answer that. 1. You mentioned 1 ml/wk. Testosterone for injection can come in 20 mg/ml, 50 mg/ml, 100 mg/ml, and 200 mg/ml, and that’s just for testosterone cypionate. There are other forms of injectable testosterone. If you are planning to get this “testosterone” at the gym, then all bets are off. It may not even be real testosterone, but some other anabolic steroid or cocktail of steroids made who knows where, by who knows whom. 2. It depends on the route of administration. One can give smaller doses subcutaneously (in the fat under the skin) with the same effect as doses given intramuscularly (in the muscle.) 3. Everyone has a different symptomatic response to clinically prescribed testosterone. I have guys who feel great with IM doses of 100 mg and would feel hyper if given more. I have others that didn’t feel normal (not like superman) until the dose pushed past 300 mg/week. It’s trial and correction to find each person’s correct dosage. That’s why going to someone who treats low testosterone regularly is important. If you live in my regions (TX, NY, MO, and FL), you can make an appointment to see me at www.heliostelemedicine.com. I hope this helped.
@@HeliosTelemedicine thank you for your reply. My doctor tells me my reading of 17 is average out of a range of between 6 & 27 so I’m not sure what method they use to measure on but clearly it’s not the same as you. @ 59 I have no comorbidities I am at the correct weight none smoke very little alcohol use but I get very tired in the afternoons after a mornings work it’s like a battery going flat & I just want to feel normal again with plenty of energy
@@andrewcunningham1361 They may be using nmole/liter for total testosterone, but I don't know that range of normal. Regardless, if fatigue is your only symptom, then you have a lot of potential causes and testosterone is likely low on that list. You need a complete history and physical exam and a comprehensive set of labs to look at your general health, organ function, and endocrine balances. You shouldn't feel exhausted by mid afternoon, if you are healthy, eat well and have no nutritional deficiencies, and sleep well (preferably 7-8 hours nightly.)
Natesto nasal spray adds to your natural production without shutting down the HPTA, great if using it for fertility. You do have to spray it in your nose 3-4 times per day, not very practical.
I do 32,5 mg every 2 days with Testo enanthate 250 mg per ml 1 injection is 0,13 ml = 32,5mg x 3 = 6 days= 97,5 mg + 1 days = 16,25mg = 113,75mg for 1 week 7 days is micro dosing almost and is perfect no down feels great 👍
I've been pointing I'm for months and blast up to 1000ml a week split up eod have not needed an Ai on months we're as before gyno was present so mic dosing work. When I get of a blast and do trt every 5 days is fine. I'm 10% body fat so can use insulin needle and still do I M as it's designed to go into muscle not fat but each to there own
Yes, there are, but it isn't much different from other treatments; like insulin for diabetes, or teriparatide for osteoporosis. I reduces the peaks and valleys of weekly dosage so may make it easier on guys who have very narrow ranges of normal and feel hyper right after the injection and hypo before the next one. It also reduces the peak levels reducing the amount of testosterone available to be converted to estradiol.
I do have a few patients who want the 14 day regimen for work-related reasons, but this is uncommon. I try to have my patients on a weekly dose as difference between the highs and lows is reduced. There are clinics that will start their patients off at 200mg IM weekly and adjust from there. I am a bit more conservative and start at a lower dose to prevent symptoms from giving too high of a dose. Another advantage of weekly dosing is that finding the right dose is a process of trying one dose for 5-6 doses, drawing labs to see where we are, and adjusting to a new dose and starting the process over. When taking doses biweekly, it will take longer to find your best dose. You may need your physician to order the syringes and needles.
What is the typical 14 day regimen? 400mg test cyp?
@@TheLeoBianco1 I really hesitate to put patients on a 14 day regimen as it creates peaks that are potentially supratherapeutic and valleys that may be subtherapeutic. That is a rollercoaster that only those who cannot possibly come weekly should have to ride. That said, each patient needs their own individualized dose to feel the best that they can weather that is on a 14 day, weekly, or daily regimen. For some, it would be 400mg testosterone cypionate, but for most it would be another dose.
Hi doc. I really appreciate your videos. What would you say are the commonest symptoms of significantly elevated total and free testosterone?
As a post RARP & radiation prostate cancer patient, I initiated TRT after 20 months of ADT, 3 months ago. I am currently doing bi-daily IM injections of test-cyp at a rate of 120 mg/2 weeks, using 1/2" 30 gage insulin syringes into ventrogluteal muscles, alternating sides. I achieve steady 22ng/dl Free-T levels with no noticeable "peaks or valleys" and side effects of the ADT are now gone. My PSA remains "undetectable". Microdosing is the right way to do TRT, just as your body used to "micro dose" testosterone naturally.
That’s great. Did you discuss taking the testosterone SQ into the abdominal subcutaneous fat? You can reduce the dose with the same effects.
I’m on 40mg twice a week . It works great for me . I do muscular injections on Sunday and Wednesday
Terrific. Have you talked to your doctor about subcutaneous injections? I think that they are easier, and hurt a lot less.
@@HeliosTelemedicine I have not , muscle injection doesn’t hurt when done correctly. There are good videos on TH-cam on how to . I inject right above my butt and switch sides
@@alexmaceachern3981 If you are happy with it, great. I'm glad you found good care. Good luck.
I am with you. I just started and asked to start x2 / week at 80 and no more and to see how that goes
@@LK-bz9sk Please let me know how it is working for you,. Please also remember that microdosing can be done with subcutaneous dosing, which might be easier and less painful to do.
I've found Monday morning, Wednesday afternoon and Friday evening or Saturday morning injections per week is my favorite. Keeps my levels steady, no E2 issues, no rollercoaster ride and I feel great every day. When I did weekly and even twice a week I felt like shit the 3rd day and on.
That's great. Congrats on finding a regimen that works for you.
I love you man!!!! Keep it up please❤ Greetings from Germany 🇩🇪 ❤
Thank you for your informative advice.
My test levels are at 550 . I’ve had all my hormones checked and there “normal”. I have really low sex drive and feel very tired and weak. I’m only 22 and tips?
What are your estradiol, free testosterone, SHBG, LH, and FSH levels. While 550 ng/dl is in the population-based "normal" range, your body may like it higher. I doubt that any insurance company would pay for TRT unless your free testosterone is low, but, if the LH and FSH are low or even mid normal, you might try clomiphene or enclomiphene by prescription. You may also try herbal supplements like ashwagandha, fenugreek,
Would you still need anti estrogen if you were microdosing every day or every other day??
That would depend on your estrogen level and symptoms when you reach your steady state testosterone level. Testosterone is converted to estradiol by enzymes In fat cells so we would expect the E2 to rise with the testosterone.
I’m receiving my first dose tomorrow. My doc put me on 200mg biweekly. I’m a bit worried the two weeks is to far apart. The pharmacist did not give me any syringes either, so I can’t administer at home yet. Should I be worried?
yeah that sucks bad. Optimal administration is twice a week.... (if your not microdosing)
Biweekly is awful. How's it going? Assuming you figured it out?
I am currently on 100mg injection per week and it works good for me. Albeit I do feel a little tired by injection day but I can’t imagine being a human pin cushion and pinning everyday.
1. You may need just a little more in your weekly dose if you are having symptoms on day 7. Not much, just a bit. 2. If weekly doses work for you, then great, but there are many people who take daily injections such as diabetics and other hormonal issues, those on some treatments for osteoporosis, and those with low testosterone who want the tightest control that they can get. The needles are very thin and rarely cause significant discomfort.
@@jamescaplan7735 I will talk to my doctor after next bloods. I’m actually a little on the high side of the range on my peak day so I don’t think he will be very interested in upping my dose even slightly. I have a hard time pinning even once a week. Kind of scared of needles. My last bloods were 1010 total and on a range from 7.0 to 24 free I was at 22.
Thank you for the advice. I’ll run it past him.
Interesting!
One problem I have is even getting it testosterones because the doctor don’t wanna give it to ya I am to 74 and the doctor says oh that’s fine when I tell him no it’s not I would like to get my own stuff and make my own testosterone so I can dose myself it like I need to daily please help.
Many doctors will tell you that, at 74, testosterone is not indicated. While I agree that it is unlikely that testosterone replacement therapy will provide enough benefits to extend your life, I believe that the clinical goal of treating patients older than about 65 should be more about quality of life than quantity. If testosterone can improve libido, erectile dysfunction, muscle loss, sleep, and energy levels, then we are doing a lot of good for our patients. If you live in TX, NY, FL, or MO, you can make an appointment to see me at www.heliostelemedicine.com. As long as the clinical goal is understood, then I think that it is worth a 3-6 month trial to see if your quality of life improves.
I have never seen a study looking at this, but you may also consider asking about taking enclomiphene 25 or 50 mg three times a week and tapering up as needed. Enclomiphene is not FDA approved, to it is an off-label use and it is not sold by regular pharmacies so it has to be prescribed through compounding pharmacies. It stimulates the whole brain-pituitary-testes axis to increase testosterone production and release. I don't know how much it can achieve at 74 because all the studies on it that I saw arbitrarily limited the age to 65 years or lower, but it is well tolerated with few side effects so I think it may be worth a 6 month trial.
Yea but how much daily ?
Like all hormone medications the dose has to be tailored to the individual. The starting dose for daily subcutaneous testosterone may start at 10-12 mg but it is likely to change as follow-up laboratory studies and your own symptomatic response are evaluated.
James Caplan I’m injecting 24mg daily and still having e2 issues so not sure if I should lower my dose or add AI:
TT 1139 (250-1100)
FT 273 (46-224)
DHT 105 (12-65)
TSH 2.13 (.4-4.5)
E2 46 (
@@qsdailydose8970 That depends on your testosterone and estradiol levels and your symptoms. Talk to your doctor about your options.
@@qsdailydose8970 DIM works and it's not terrible like AI's. If you end up taking an AI, take tiny doses.
Sam Clark I literally take .03125mg AI (1/32) on 36mg daily once a week. And even then sometimes I crash!
What is an average testosterone level for a 59 year old man ? What should it be and what would 1mil per week do injected ?
According to an article in the Journal of Clinical Endocrinology and Metabolism at academic.oup.com/jcem/article/102/4/1161/2884621, for a 59 year old male the range of normal (which includes 95% of the population) is 267-929 ng/dl and the level at the 50% is 477 ng/dl for the nonobese man. For the man also suffering from obesity, the average is 229-902 ng/dl with the 50% at 446 ng/dl. Remember that your personal normal range is narrower than the population normal range and you may feel normal at higher or lower points in that population range. It all depends on your symptoms. If you don't have them, then you shouldn't just treat the number.
Regarding dosage, I can’t answer that.
1. You mentioned 1 ml/wk. Testosterone for injection can come in 20 mg/ml, 50 mg/ml, 100 mg/ml, and 200 mg/ml, and that’s just for testosterone cypionate. There are other forms of injectable testosterone. If you are planning to get this “testosterone” at the gym, then all bets are off. It may not even be real testosterone, but some other anabolic steroid or cocktail of steroids made who knows where, by who knows whom.
2. It depends on the route of administration. One can give smaller doses subcutaneously (in the fat under the skin) with the same effect as doses given intramuscularly (in the muscle.)
3. Everyone has a different symptomatic response to clinically prescribed testosterone. I have guys who feel great with IM doses of 100 mg and would feel hyper if given more. I have others that didn’t feel normal (not like superman) until the dose pushed past 300 mg/week. It’s trial and correction to find each person’s correct dosage. That’s why going to someone who treats low testosterone regularly is important. If you live in my regions (TX, NY, MO, and FL), you can make an appointment to see me at www.heliostelemedicine.com.
I hope this helped.
@@HeliosTelemedicine thank you for your reply. My doctor tells me my reading of 17 is average out of a range of between 6 & 27 so I’m not sure what method they use to measure on but clearly it’s not the same as you. @ 59 I have no comorbidities I am at the correct weight none smoke very little alcohol use but I get very tired in the afternoons after a mornings work it’s like a battery going flat & I just want to feel normal again with plenty of energy
@@andrewcunningham1361 They may be using nmole/liter for total testosterone, but I don't know that range of normal. Regardless, if fatigue is your only symptom, then you have a lot of potential causes and testosterone is likely low on that list. You need a complete history and physical exam and a comprehensive set of labs to look at your general health, organ function, and endocrine balances. You shouldn't feel exhausted by mid afternoon, if you are healthy, eat well and have no nutritional deficiencies, and sleep well (preferably 7-8 hours nightly.)
I take testo every day. Slin pin for the win. No AI needed and levels mega super stable
That’s microdosing for you. Glad you’re doing well.
Does microdosing still end up in shutdown?
Yes. You are still raisiny the test levels higher than the hypothalamus thinks is normal so the whole axis will be suppressed.
Natesto nasal spray adds to your natural production without shutting down the HPTA, great if using it for fertility. You do have to spray it in your nose 3-4 times per day, not very practical.
@@Systemlord30 That and it is more expensive.
I do 32,5 mg every 2 days with Testo enanthate 250 mg per ml 1 injection is 0,13 ml = 32,5mg x 3 = 6 days= 97,5 mg + 1 days = 16,25mg = 113,75mg for 1 week 7 days is micro dosing almost and is perfect no down feels great 👍
I'm very happy for you. Keep your doctor.
@@jamescaplan7735 thanks really and I take hcg 300 ui every 2 days 1 day Testo 1 day hcg ans works fine
I've been pointing I'm for months and blast up to 1000ml a week split up eod have not needed an Ai on months we're as before gyno was present so mic dosing work. When I get of a blast and do trt every 5 days is fine. I'm 10% body fat so can use insulin needle and still do I M as it's designed to go into muscle not fat but each to there own
Hope you're making money as a bodybuilder or plifter bro bro lol
This doesn’t sound like TRT to me. It’s more like anabolic steroid abuse.
That are lot’s of needles 💉
Yes, there are, but it isn't much different from other treatments; like insulin for diabetes, or teriparatide for osteoporosis. I reduces the peaks and valleys of weekly dosage so may make it easier on guys who have very narrow ranges of normal and feel hyper right after the injection and hypo before the next one. It also reduces the peak levels reducing the amount of testosterone available to be converted to estradiol.
20ml. a day Sub Q for me and it seems to be fine.
Glad to hear you found your dose. How’s your estradiol? Blood counts?
Which Ester are you using?