3d render of testosterone cypionate vial with syringe over white background. Anabolic steroids concept.

Axiron: Side Effects and Product Failure

Testosterone Cypionate Dosage

There are two things that you can say about testosterone cypionate on the Peak Testosterone Forum:

–It is the most common form of HRT (TRT) by far.

–A wide variety of dosages are used

When the public thinks of HRT, they tend to think of Androgel and topicals.  However, as of this writing, about half of all the men on the forum that were on HRT (TRT) were using testosterone cypionate or enanthate. [1]  Androgel does not have even close to the popularity.  And it is not wonder, because testosterone cypionate gives men tight control over the their testosterone levels and allows a man to boost his testosterone to almost any level he and his physician desire from high to low.

In fact, that is the next question:  should a man use a high or low dosage with his cypionate?

First of all, virtually all doctors want your peak testosterone after the injection to be less than 1200 ng/dl (unless they doing a ridiculous every-two-or-three-week protocol.)  1200 is considered the peak testosterone level of a very healthy young man, and so, in order to stay physiological or natural, they will try to come up with a program that stays below this number.

So how do you stay below this 1200 number?  Simple.  You simply don’t give more than 100-120 mg of cypionate per week.  And you will see on the forum that almost all the guys doing cypionate are doing right around 100 mg/week.  Sure, a few guys will be using something around 150 mg/week, but they are generally going over the 1200 number.  HRT clinics and anti-aging doctors tend to do this, especially at the beginning, because men like it (initially at least) so much.  But, for reasons that we will explain below, most guys end up drifting downward to about 100 mg/week after a certain period of time.

In fact, consider my story:  the HRT clinic that I went to put me on 150 mg/week.  Wow!  That’s all I can say.  That had me amped and it really showed me the power of testosterone.  It cured my venous leakage, got rid of my mild depression and gave me morning erections for the first time in my life.  So I was happy, or at least I thought I was.

However, a few things started to bother me.  Sure, I was feeling good, but these issues lurked in the background:

  • Amped. I was feeling overly hyped. I felt my temper was short on this much testosterone.
  • Gyno. I developed a little bit of ‘man boobs’. It wasn’t anything horrible, but I’m a pretty thin guy and the last thing I needed was a C cup!
  • Arimidex (anastrozole). My estradiol levels from the increased testosterone were high and they had to put me on Arimidex in order to pull me back into a 20 – 30 pg/ml range. So now I was on a pharmaceutical!

(Two times .5 mg per week.)The last straw was a standard physical that I got with my PCP. She pulled my testosterone and it was at 1,354 ng/dl! I just happened to do the blood draw during my PCP s annual physical near my peak. The HRT clinic took my blood draws on the trough day, so my peak testosterone was always estimated. I had no idea I was going so high. I felt good in many ways, but this is when I realized that I needed to tell my clinic that I needed to back down on my dosage. And, basically, I have slowly dropped my dosage down to a level of 100 mg/week over the period of about a year. My current protocol is two divided subQ (subcutaneous) dosages of 50 mg every 3.5 days. In other words, I am now taking about two thirds of my original dosage!

And is my story the norm on the forum?  Well, yes and no.  First of all, if you go high with cypionate, i.e. over about 120 mg/week, my experience is that most guys will develop any number of quite common side effects that can be grouped into the following categories:

a) Estradiol-Related Symptoms.  Bloating, water retention, gyno, moodiness.  These can be hard to control even with Arimidex.  Gyno is particularly problematic as Arimidex just does not always solve the problem .  Arimidex does a nice job of lowering estradiol, but there is more to gyno than just estradiol.

b) DHT-Related Symptoms.  These are not very common, but occasionally a guy will have an enlarged prostate or experience accelerated male pattern baldness.

c) Increased Hematocrit/Hemoglobin.  This is quite common.  Many men do not realize that testosterone controls red blood cell production.  This is the reason that going high with testosterone can push their hematocrit/hemoglobin to the top of the range or even beyond.  The solution is to donate blood, either in your HRT clinic, if they are equipped,  or at a blood bank, if they will allow it.   However, sometimes men will end up too high even after donating.  This is ugly.  In addition, some men actually experience shortness of breath and other nasty symptoms from these high levels.  Another concern is long term stroke and clotting-related risks.

My take on all of this was that I wanted to get over my gyno and I wanted off of the Arimidex.  In addition, I knew that I would be on HRT for life, so I wanted to be safe. Although my hematocrit has never been high, but I like my levels to be a bit on the lower side.  I think men would generally do well to err on the side of caution when it comes to this, since heart disease is the #1 killer of men here in the West.

And basically I found that 100 mg/week, especially when I went to subQ (subcutaneous) injections, got rid of my gyno.  I also lost about 3-4 more additional pounds – my body fat was probably around 14% – as well, which got my estradiol to 27 pg/ml without Arimidex.  This is ideal in my opinion and I was feeling very good.

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A BRIEF TRY AT 80 mg/week in Divided Doses: However, I noticed one more very strange thing as time went on this 100 mg/week protocol:  my morning erections were always stronger on days 3 and 4.  This was not a pattern, that I remembered anyway, when I was on cypionate initially.  Nevertheless, it seemed to be the case at the time.

Now the theory is that cypionate probably peaks on day one – see my page on “Just When Does Testosterone Cypionate Peak?” as to why I believe this. And, if day one was my peak, then days 3 and 4 were my lowest testosterone days.  And this is how I came to conclusion that I needed to try a lower dosage of testosterone cypionate as my next tweak or fine tuning experiment.

Even though I believe in going as low with testosterone as possible and still feel good, have good morning erections / libido and hit your numbers (for A1C and estradiol), I noticed that the opposite began happening as the weeks went by on 80 mg/week. My libido slowly declined and morning erections grew weaker. So I went back to 100 mg per week and have stayed on that ever since. The only change is that I now inject .14 ml (28 mg) of cypionate every other day, but that still works out to 100 mg/week. Also, you may be interested to know that on 80 mg/week subQ, my total testosterone was measured at 667 ng/dl, whereas on 100 mg/week, my last two total testosterone reads have been 700 and 800 ng/dl.

These are not very high levels and I was surprised that I felt so good at that low of a level.  And this brings up a major theory of mine:  the more you (naturally) boost your nitric oxide and lower inflammation, the less testosterone that you need.  Testosterone activates eNOS, the enzyme that controls your endothelial nitric oxide, which is your primary engine for NO.  So I always felt that men with arterial issues probably subconsciously pushed for higher T levels to compensate.  And I have been working very hard on my arteries and feel this may be part of the reason I have been able to live with lower testosterone levels.

LESS THAN 100 mg – ARE YOU CRAZY?  One of our senior posters brought up the fact he is seeing a trend toward lower dosages of testosterone cypionate and posted some interesting commentary:

“Dr. Mark Gordon is one of the heavyweights in TRT; he’s a good friend of Dr. Crisler, and also the guy who invented the phrase “interventional endocrinology” to replace “antiaging medicine”. Turns out both of these guys are moving against the standard 100 mg per week injections. Gordon said he averages about 60-80 mg per week, usually in divided doses, for his patients to reach good levels, and he doesn’t use an AI for this reason…” [2]

EXCEPTION – LOW SHBG MEN:  Based on what I have seen, men with low SHBG need to do the following to compensate:

a) Lower Dosage.  The reason for this is that low SHBG leads to higher free testosterone levels and, therefore, they need less total testosterone.  I have also seen evidence that they spike their testosterone, i.e. they can get abnormally high levels of testosterone on day 1 of their injection cycle.

b) More Frequent Dosing.  SHBG binds to testosterone and kind of puts it into a “reserve” if you will.  Without enough SHBG, men rapidly clear their testosterone effectively giving their cypionate a shorter half life.  For this reason, low SHBG guys tend to need more frequent injecting schedule, often every other day for example.  (Thanks Sam!)

REFERENCES:

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