question from a user
Would you say most clinicians are wrong for aiming for a total test level rather than regular high free testosterone levels? I had a clinic keep trying to get my total between 900-1300 but I felt awful. Looking at it now, my free test was extremely high and once I got free test in the upper range but not above, I felt good. I do have low shbg and am aware this is causing the higher free testosterone. So, 550 total testosterone gets my free test into the high end of the range, where I feel great. It might sound odd to some people.
AlphaMD's Answer
They're not 100% wrong but they're not right. The main reason some places harp on the numbers is because it's good for marketing. Men love numbers & being able to point at things to see "it's working" when TRT is vastly more about how it feels.
The goal is you should feel good. That can mean going lower in some cases. We have had men go up to 200mg from 160mg because they were convinced by the internet & their friends it was better. They eventually came back to 170mg because the side effects felt worse. It's better to start lower then go higher slowly to know when to stop. It's just so easy to give a blanket high dose & provide additional medication to counteract the side effects ahead of time (with upcharge) than to treat people individually.
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