Many people starting Testosterone Replacement Therapy (TRT) begin with the wrong dosage, and this can significantly impact whether the therapy provides any benefit. Finding the best starting dose is critical and can require adjustments based on various factors like the patient's symptoms, personal health goals, lab values, and dosing schedules. Typically, an initial dose ranges from about 80 to 120 milligrams per week, but this can vary. Adjustments might be needed depending on individual symptoms such as low libido, lack of motivation, low energy, decreased muscle mass, mood swings, and erectile dysfunction.
chapters
00:00 Introduction to TRT Dosage
00:33 Understanding the Best TRT Starting Dose
01:19 Personal Goals and Symptoms
02:17 Health Considerations and Cautions with TRT
03:12 Lab Metrics and Baseline Testing for TRT
03:44 Dosing Schedules and Methods for TRT
04:57 Reasons to Start Low or High on TRT
06:24 Importance of Regular Testing with TRT

Starting with a lower dose is generally recommended for people with chronic health issues, cardiovascular diseases, or high inflammation to avoid potential side effects such as anxiety, exacerbation of sleep apnea, heart palpitations, mood swings, and sleep issues. Lab metrics are essential before starting any dosage and typically include values like total and free testosterone levels, estradiol levels, luteinizing hormone, prolactin, FSH, and red and white blood cell counts, among others.

The scheduling of doses can vary as well, ranging from once a week to multiple times a week, and can include options like gels and creams. More frequent dosing helps in reducing peaks and valleys, which can minimize side effects and provide a more consistent hormone level. Starting low allows the body to gradually adapt to the hormone, and this approach permits adjustments based on subsequent lab results and symptom monitoring.

In cases where an individual's quality of life is significantly impacted by low testosterone levels, a slightly higher initial dose might be considered; however, this still requires close lab monitoring. Regular and comprehensive testing of lab metrics is crucial to ensure that the hormone levels are within the optimal ranges and to detect any adverse side effects. These metrics should be continuously monitored to finetune the dosage.

Testing should ideally be done in the middle of the dosing cycle, typically around days three to five, to obtain accurate readings. This is because testing immediately before or after an injection might not provide a true representation of how the therapy is affecting the body. Consistent adjustments and close monitoring play a crucial role in the successful implementation of testosterone replacement therapy.

It is important to note that starting with a dose that is too high can miss the optimal range or 'sweet spot,' which might make symptoms worse rather than better. This highlights the necessity of a tailored approach to determining the right TRT starting dose. Factors such as personal stress levels and anxiety can influence what the optimal dosage should be. Frequent adjustments and close monitoring are key to the effective management of TRT, ensuring that hormone levels are appropriate and providing the needed benefits while minimizing side effects. Regular lab testing ensures that the dosage remains effective and safe, allowing for necessary adjustments to maximize benefits.