Keywords: Testosterone Cypionate, Testosterone Enanthate, Testosterone Dose, Testosterone Injection Amount, Testosterone and Athletic Performance. TRT, Low T.
When providing testosterone replacement therapy (TRT) to men, a clinician should consider the following :
1) Patient expectations of Testosterone Replacement Therapy
2) Desire for fertility
3) Patient’s body mass index
4) Lifestyle and Nutritional habits
5) Exercise Routine
6) Plan duration of TRT
8) Estrogen Mangement
9) Comfortability with sterile injection technique
10) Patient reliability to follow for scheduled labs and open communication.
When deciding on the right testosterone dosage for a patient, the majority of guidelines recommend to supply a testosterone dosage necessary to keep serum testosterone levels within the range of 400-600 ng/dL. Most physicians would consider an optimal testosterone dosage of 1cc of testosterone cypionate or testosterone enanthate, 200 milligrams per ml, every 14 days. More experienced clinicians are comfortable with treating patients with 200mg/cc of Testosterone Cypionate weekly or twice weekly. The half of testosterone cypionate is eight days. It is our opinion that testosterone should be provided every 7 days to maintain elevated and sustained therapeutic serum testosterone levels. For patients who are comfortable with injecting testosterone, increasing the frequency of testosterone injections to twice weekly can 1) maintain steady state testosterone levels 2) reduce side effects 3) prevent large surges in hemoglobin and hematocrit values to men who are undergoing monthly phlebotomy and 5) reduce large fluctuating (peaks and throughs) serum testosterone levels.
Larger men, men who are more obese, often require a larger dosage of testosterone replacement to obtain therapeutic serum testosterone levels. Larger men, have a larger volume of circulating blood in the body, and exogenous testosterone can be diluted in such a large volume of blood. Men of larger body weight or muscle mass ( ie: strength athletes and bodybuilders) often require a higher testosterone dosage adjustment. Furthermore, heavier men have more adipose tissue resulting in more aromatase activity unlike athletes who have lower adipose content. Testosterone is converted into estradiol ( primary form of estrogen in men) by aromatase. The aromatase enzyme is present in adipose tissue ( fat cells). Heavier men often have higher aromatase activity and higher estradiol levels, imparting a low testosterone environment. Consideration for the in addition of an aromatase inhibitor, such as Anastrozole, is needed in obese males to combat the obesity-Low Testosterone cycle. For more one Estrogen management in males click here.
Bodybuilding athletes have been reported to use 400mg -1000mg of Testosterone Cypionate per week and sometimes higher dosages accompanied by other anabolic steroids during cycling periods. In a study of athletic performance published in the New England Journal of Medicine, a dose of 600mg of testosterone enanthate in sesame oil injected intramuscular for 10 weeks combined with strength training has been shown to increase fat free mass and muscle hypertrophy. Studies have also provided evidence that Testosterone replacement can reduce waist circumference by 10% and may be a viable addition treatment for the treatment of obesity.
Long term and super physiologic doses of testosterone can have several deleterious effects to the body including but not limited to 1) Emotional lability 2) Testicular atrophy 3) Fluid Retention 4) Gynecomastia 5) Fatigue 6) Anger 7) Depression 8) Cholesterol abnormalities and 9) Cardiovascular abnormalities.
Newer methods of administering testosterone via the subcutaneous injection route have become more popular. Research has elicited similar pharmacokinetics of subcutaneous delivered testosterone when compared to intramuscular testosterone injections. Subcutaneous testosterone injections are injections given in the abdominal fat pad near the umbilicus (belly button). The injections are given with a very fine and short insulin tip needle. The benefits of subcutaneous testosterone injections include, among others: 1) less discomfort at the injection site 2) smaller needle size for the needle phobic patient 3) better visibility of the injection site compared to the buttock region.
For more information on testosterone replacement therapy please visit www.RegenxHealth.com