Why is testosterone replacement therapy (TRT) so much higher than natural production?

[Clamp]

Why is TRT so much higher than natural production?

I've heard from different people that the testosterone replacement therapy (TRT) dose that brings them up to normal levels is anywhere from 150-200 mgs per week. The average joe is said to only produce 70 mgs of testosterone per week, and 150 and 200 mgs are 2 to 3 times that dosage. If 70 mgs of testosterone is 70 mgs of testosterone then it should only take 70 mgs of testosterone per week to bring those people back within range. Does anyone know why exogenous testosterone is different than endogenous testosterone? I figure that 100 mgs of test is 100 mgs of test whether it comes from a bottle or from your nuts. Where is the extra test is going?

Bro science is not welcome here. Come with some empirical or anecdotal evidence or

 

[theblitzkrieg]

Ester weight? Also, it's a very individual thing. My doc wanted to treat me with 250mg sustanon every three weeks, but I told him it makes me feel like poo and got my dose upped to 250mg every two weeks. After my current blast I'll probably be on 250 E10D.

 

[Clamp]

That's a pretty good explanation. According to Testosterone Esters there is only about 110 mgs of active testosterone for a 200 mg testosterone enanthate shot. I had no idea that the ester was that heavy

And thank you Stonecold for moving this into the right forum. I was just about to ask for it to be moved.

 

[IMT staff]

Well first of all with cypionate the ester weight is about 31%. So for each 100mg you inject, there is only 69mg of testosterone.

Next we are talking about the "average" person produces 70-90 mg a week. Where did they come up with that average? Did one person have 50 mg and the other 130 mg so they called it an "average" of 90mg?

Then once you take all that in you come to realize that trying to compare injections to endogenous testosterone is pointless, its like comparing apples to oranges.

To understand how a T injection works think of it as a "depot" or in laymen "storage unit".

So when I inject that 200 mg of cypionate and create a depot, over 7 days time half ( or 69mg) is released into the blood stream. Then over 7 more days half is released into the blood stream. Then another 7 days, half.

So thats 126mg of pure testosterone released into the blood stream over a 3 week period. So now you see that it takes multiple depots releasing testosterone into the blood at the same time in order to accumulate the TT levels you are trying to achieve.

Keep in mind once testosterone actually enters the blood stream, it only has a life of 10-60 minutes.

I know there is no empirical evidence here, but I think it will suffice

 

[Clamp]

Well first of all with cypionate the ester weight is about 31%. So for each 100mg you inject, there is only 69mg of testosterone.

Next we are talking about the "average" person produces 70-90 mg a week. Where did they come up with that average? Did one person have 50 mg and the other 130 mg so they called it an "average" of 90mg?

Then once you take all that in you come to realize that trying to compare injections to endogenous testosterone is pointless, its like comparing apples to oranges.

To understand how a T injection works think of it as a "depot" or in laymen "storage unit".

So when I inject that 200 mg of cypionate and create a depot, over 7 days time half ( or 69mg) is released into the blood stream. Then over 7 more days half is released into the blood stream. Then another 7 days, half.

So thats 126mg of pure testosterone released into the blood stream over a 3 week period. So now you see that it takes multiple depots releasing testosterone into the blood at the same time in order to accumulate the TT levels you are trying to achieve.

Keep in mind once testosterone actually enters the blood stream, it only has a life of 10-60 minutes.

I know there is no empirical evidence here, but I think it will suffice

Thanks for the explanation. It's always good to hear from someone with a great deal of experience and knowledge behind them

 

[Cosmoen]

Also keep in mind that the body produces a mini surge of testosterone once a day peaking every morning, which slowly falls throughout the day and repeats itself the next morning. Compare this with testosterone replacement therapy (TRT) injections where a large amount is "produced" at once and the body relies on the breakdown of this amount over several weeks.

 

[IMT staff]

^^^ yes this is the true difference. You are comparing a daily curve to a weekly one.

 

[Cosmoen]

You also cannot try to replicate the body's daily curve with daily test injections. That is because the test cypionate takes a relatively long time to break down into useable form while the body's own production is good to go. In fact, injecting too frequently can create a new set of problems

 

[Clamp]

You also cannot try to replicate the body's daily curve with daily test injections. That is because the test cypionate takes a relatively long time to break down into useable form while the body's own production is good to go. In fact, injecting too frequently can create a new set of problems

Problems such as? Scar tissue? I know some people obsess about having steady blood levels and inject long esters as frequently as eod. This seems pretty pointless based off of the charts I've seen of testosterone enanthate levels after an injection. The chart I saw showed that blood levels are pretty steady for about the first 4 or 5 days.

 

[Sedg1]

You also cannot try to replicate the body's daily curve with daily test injections. That is because the test cypionate takes a relatively long time to break down into useable form while the body's own production is good to go. In fact, injecting too frequently can create a new set of problems

Good point and illuminates the fact the testosterone replacement therapy (TRT) is "replacement" not supplementation therapy. It is something I seriously pondered before having my first injection 10 days ago. The body is efficient. It does not make what it does not need. And if testosterone is introduced from without, the endogenous production is suppressed, and perhaps ceases altogether. The cypionate sticky confirms that the body's production is quickly affected as soon as testosterone replacement therapy (TRT) is initiated. Never having cycled or dabbled in testosterone before it became a medical necessity, this withdrawal is not an experience I have ever had. Though now ten days after my first shot I sure as hell do not feel like I did eight days ago. My next injection of 200mg is Thursday and I am looking forward to it. If I did not have it, and if my endogenous production is already suppressed, that is a lose-lose situation. Recognizing that my boys will no longer be in business, I realize, as we all do in this situation, how important it is to find that testosterone level sweet spot. It I can not get there with injections, I probably will consider Testopel, which my doc recommended from the outset. But before committing to that, I wanted to see if this protocol was right for me and at what level. Seems only common sense that you tweak the cyp dose until it is right and then translate that into a Testopel dose.

 

[Megatron28]

Good point and illuminates the fact the testosterone replacement therapy (TRT) is "replacement" not supplementation therapy. It is something I seriously pondered before having my first injection 10 days ago. The body is efficient. It does not make what it does not need. And if testosterone is introduced from without, the endogenous production is suppressed, and perhaps ceases altogether. The cypionate sticky confirms that the body's production is quickly affected as soon as testosterone replacement therapy (TRT) is initiated. Never having cycled or dabbled in testosterone before it became a medical necessity, this withdrawal is not an experience I have ever had. Though now ten days after my first shot I sure as hell do not feel like I did eight days ago. My next injection of 200mg is Thursday and I am looking forward to it. If I did not have it, and if my endogenous production is already suppressed, that is a lose-lose situation. Recognizing that my boys will no longer be in business, I realize, as we all do in this situation, how important it is to find that testosterone level sweet spot. It I can not get there with injections, I probably will consider Testopel, which my doc recommended from the outset. But before committing to that, I wanted to see if this protocol was right for me and at what level. Seems only common sense that you tweak the cyp dose until it is right and then translate that into a Testopel dose.

You are going to be on a big roller coaster injecting once every two weeks. Try to inject at least once a week. Just split your dose in half from where it is now.

 

[Megatron28]

Problems such as? Scar tissue? I know some people obsess about having steady blood levels and inject long esters as frequently as eod. This seems pretty pointless based off of the charts I've seen of testosterone enanthate levels after an injection. The chart I saw showed that blood levels are pretty steady for about the first 4 or 5 days.

I can tell you that in my case I noticed a huge difference between injecting once a week and twice a week at half the dose. Here is what my lab work told me:

100mg of test cyp once per week gave me a Total T between 332 and 1,068 (trough and peak respectively). Normal range is 348-1197. I got lab work done so I could see how high and how low I was getting. At that peak dose, I had an E2 of 115 (8-43 normal range). I was not taking any AI.

Splitting the dose to 50mg and injecting every 3.5 days resulted in Total T of 650 at the mid-point between injections and E2 of 27. Again, not taking any AI.

Everyone is different, so glean what you want from that. But remember that estrogen is part of the equation. At the very least, get lab work done frequently to see how you are responding to your protocol.

 

[Clamp]

I can tell you that in my case I noticed a huge difference between injecting once a week and twice a week at half the dose. Here is what my lab work told me:

100mg of test cyp once per week gave me a Total T between 332 and 1,068 (trough and peak respectively). Normal range is 348-1197. I got lab work done so I could see how high and how low I was getting. At that peak dose, I had an E2 of 115 (8-43 normal range). I was not taking any AI.

Splitting the dose to 50mg and injecting every 3.5 days resulted in Total T of 650 at the mid-point between injections and E2 of 27. Again, not taking any AI.

Everyone is different, so glean what you want from that. But remember that estrogen is part of the equation. At the very least, get lab work done frequently to see how you are responding to your protocol.

I was asking what kind of problems are caused by injecting too frequently. Nice informative reply though, still useful information.

 

[Sedg1]

Meg, thanks for your your suggestions. I knew little about the fine details of dosing when I went into this. Read a lot about Low T and believed myself to be a poster child for it. And since my first shot I have been spending hours on this board learning the details, including the need to split the dose, just as you say. Makes perfect sense. My pre-trt total was 304 and a 49 free, with classic symptoms. With one 200mg injection, and a half life of appx 8 days, I am going to be at 100 in just over a week and just about on empty on the 14th day when I get my next injection. And if my own endogenous production is on holiday during this time, I end up in the hole - theoretically with worse levels than when I started down this road. There is something wrong with this picture from a treatment perspective.
And then there is the E2 issue which I understand can be minimized with more but smaller doses. Sounds like you have it nailed. With small but frequent injections, you have been able to establish a very therapeutic level by taking full advantage of the dose lifespan. And fewer E2 issues. Good for you! I assume that you are self-injecting. I raised this with my doc but he seemed quite hesitant to give me a script, saying something about cyp being a Sched III drug. True, but so are narcotics, and you do not go to see the doc three times a day for those. And I already inject B12 and an autoimmune med, so needles are no issue for me. Given that he was so supportive in initiating the therapy, I did not feel it appropriate to have that discussion with him, as we are new to each other. But once we have the dose dialed in, we will. Can not imagine that my insurance co wants me to popping into his office every 4 days.
Have to say that this board, and members like you who have approached this treatment with the maturity it merits, are invaluable. But I am troubled that we to learn this stuff from the web. It is the job of a doc to know something as basic as tailoring the dose to the release curve to maintain a therapeutic balance. Not getting that yet from my doc, and he describes himself as a specialist in men's health. Meg, your experience makes me wonder if most men could actually get by on a smaller amount of test every month if it were more efficiently administered. Maybe that is the Testopel theory.
And Clamp, I apologize for the thread drift but appreciate your post.

 

[Megatron28]

Meg, thanks for your your suggestions. I knew little about the fine details of dosing when I went into this. Read a lot about Low T and believed myself to be a poster child for it. And since my first shot I have been spending hours on this board learning the details, including the need to split the dose, just as you say. Makes perfect sense. My pre-trt total was 304 and a 49 free, with classic symptoms. With one 200mg injection, and a half life of appx 8 days, I am going to be at 100 in just over a week and just about on empty on the 14th day when I get my next injection. And if my own endogenous production is on holiday during this time, I end up in the hole - theoretically with worse levels than when I started down this road. There is something wrong with this picture from a treatment perspective.
And then there is the E2 issue which I understand can be minimized with more but smaller doses. Sounds like you have it nailed. With small but frequent injections, you have been able to establish a very therapeutic level by taking full advantage of the dose lifespan. And fewer E2 issues. Good for you! I assume that you are self-injecting. I raised this with my doc but he seemed quite hesitant to give me a script, saying something about cyp being a Sched III drug. True, but so are narcotics, and you do not go to see the doc three times a day for those. And I already inject B12 and an autoimmune med, so needles are no issue for me. Given that he was so supportive in initiating the therapy, I did not feel it appropriate to have that discussion with him, as we are new to each other. But once we have the dose dialed in, we will. Can not imagine that my insurance co wants me to popping into his office every 4 days.
Have to say that this board, and members like you who have approached this treatment with the maturity it merits, are invaluable. But I am troubled that we to learn this stuff from the web. It is the job of a doc to know something as basic as tailoring the dose to the release curve to maintain a therapeutic balance. Not getting that yet from my doc, and he describes himself as a specialist in men's health. Meg, your experience makes me wonder if most men could actually get by on a smaller amount of test every month if it were more efficiently administered. Maybe that is the Testopel theory.
And Clamp, I apologize for the thread drift but appreciate your post.

Thanks Sedg1. One thing to keep in mind is that everyone responds differently. For example, some guys don't have aromatization problems. I do and I found that more frequent dosing helped me. I actually just posted my updated lab trends. Take a look at that and you will see what effects different protocols have had on me. Keep getting lab work done and see how you respond. Do a search on here for Private MD - Buy Lab Tests Online and you will find out how to get cheap lab work done with their Female Hormone Panel (which is for men too). It will cost about $50 using their coupon code. Post here if you need February's code.

Tell your doctor you need to self inject. It is ridiculous -- as you point out -- to not permit that. If he won't allow it find a new doctor. There are good doctors out there if you take time to search. Next time you talk to him make sure you go in there well informed and provide him with knowledge. If he won't listen find one who will.

Good luck!

 

[Sedg1]

Thanks Sedg1. One thing to keep in mind is that everyone responds differently. For example, some guys don't have aromatization problems. I do and I found that more frequent dosing helped me.

Absolutely true. As for E2 issues, I have read that body type or body mass can be a determinant. More body weight = more E2 issues potentially. Me more ecto than endo. I read that abdominal fat can be an indicator of aromitization, particularly as men age and the production of estradiol outpaces endogenous testosterone. From lef.org:

"As men age, the amount of testosterone produced in the testes diminishes greatly. Yet estradiol levels remain persistently high. The reason for this is increasing aromatase activity along with age-associated fat mass, especially in the belly.5 Estradiol levels correlate significantly to body fat mass and more specifically to subcutaneous abdominal fat. The epidemic of abdominal obesity observed in aging men is associated with a constellation of degenerative disorders, including heart disease, diabetes, and cancer.9,35-38"

Going to give this doc some time. If we do not have a meeting of the minds, there is an endo doc I can see.
Nice chatting with you and happy trails.

 

[Clamp]

And Clamp, I apologize for the thread drift but appreciate your post.

No problem. We're all just here to learn and help each other out

 

[juced_porkchop]

yep esters play a big role

 

[Sedg1]

No problem. We're all just here to learn and help each other out

Cool.

 

[methos]

I am curious about the argument that people with higher body fat aromitize testosterone more. I aromotize more than anyone I know and I have always been an ectomorph. Never over 10% BF. Does body fat really have something to do with it? I am also curious about dosage for people with a very high metabolism. These may also mostly be ectomorphic body styles. I don't mean to high jack your thread, but I think I am within the discussion parameters. With Antibiotics, it takes me 300% normal of a dose to achieve blood serums levels of the average person takig 1/3 my dose. Is exogenus testosterone somehow metabolized faster with different metabolic rates? Ectomorphs vs endopmorphs?