question from a user
I'm 50-years-old, and my doctor recently prescribed TRT to address my symptoms of low testosterone. While I don't suffer from hypogonadism, my doctor recommended a dosage of 200mg every two weeks, in line with Kaiser Permanente's guidelines for treating hypogonadism. Browsing through various discussions, I've noticed that many individuals opt for weekly injections, and some even divide these into multiple shots per week. My primary aim isn't to build muscle mass; instead, I'm looking to improve my mental clarity, motivation, and revive my diminished libido. Two months ago, I embarked on a ketovore diet, which has led to a significant weight loss of 34 pounds. Alongside this, I've incorporated light cardiovascular exercises into my routine, although I haven't started any serious strength training, focusing more on weight loss for the time being. Given my situation, I'm curious if there's a greater benefit in altering my TRT regimen to 100mg injections weekly, rather than the current bi-weekly 200mg. Additionally, I'm considering whether incorporating strength training into my exercise routine would be advantageous. For years, I've neglected my health and fitness due to a sedentary lifestyle. Now, as I try to educate myself, I often find myself overwhelmed and confused by the plethora of information available. I'm seeking guidance and insights on the best course of action to improve my overall health and well-being.
AlphaMD's Answer
First, most providers go by mg per week, so for this we will just say your dose is 100mg per week. That is generally a lower dose, especially for something as long as two weeks between doses. It would depend on your starting levels but we would argue it could be a bit higher.
We know of Kaiser, and like many insurance mandated protocols, they tend to make the most money when they provide the least treatment. So when it comes to treatment guidelines from an insurance entity, take it with a gain of salt.
We would very much suggest discussing switching to weekly or twice weekly injections with your doctor.
What is likely happening now is that you feel quite good the first 5-6 days then a lot lower on energy after that. This is because the half life of testosterone supinate is 7-8 days. This means by day 7 your levels are half of what they were after the injection. Depending on your dose, it is very possible you have lower T than before you started treatment on such an infrequent dosing schedule.
Switching to weekly or better yet twice weekly would help reduce your spike (and any extra Estrogen made from it) and raise the down periods between shots by keeping a more steady supply in you between shots. Your body appreciates when things are more steady you should have better health/fitness outcomes by doing so.
Resistance training is one of the best ways to improve metabolism, it would be very much encouraged. It can also help with bone density/support which becomes more of an issue with age.
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