The Science of TRT
The most important hormone for men
- Biomarker testing to determine your levels
- Virtual consultation with your provider
- TRT shipped right to your doorstep
Testosterone production begins in the brain
The hypothalamus releases gonadotropin-releasing hormone (GnRH) to stimulate the pituitary gland. The pituitary gland releases luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH stimulate the Leydig cells in the testes to produce testosterone. Testosterone gets released into the bloodstream where it binds to sex hormone-binding globulin (SHBG) and albumin or remains in its free form to find other targeted cells to bind with.
The system is regulated by the hypothalamic-pituitary-testicular-axis (HPTA) which is sometimes referred to as the hypothalamic-pituitary-gonadal-axis (HPGA)
Testosterone levels decline with age
Primary hypogonadism
Stems from defects in the gonads as observed through elevated levels of LH and FSH; suggesting that the gonads aren't receiving the pituitary's signal to produce testosterone.
Secondary hypogonadism
Stems from defects of the hypothalamus or pituitary gland as observed through reduced or normal levels of LH and FSH; suggesting that the problem of low testosterone stems from the HPTA/HPGA.
Medications used to treat low testosterone
Compounded testosterone
Used to optimize Free and Total Testosterone levels between 450-650 ng/dL. Your practitioner will determine the optimal dosage for you based on symptoms first and corroborated with lab results and medical history.
Gonadorelin HCL
Used to maintain intratesticular testosterone levels, fertility, and your natural production of testosterone while preventing testicular shrinkage.
Anastrozole
If estrogenic side effects arise, an aromatase inhibitor (AI) will be prescribed to counter aromatization.
TRT injections are the most effective delivery method to raise testosterone levels
Bioidentical testosterone is attached to a carrier molecule known as 'ester' which is enzymatically cleaved in the bloodstream. Testosterone still attached to the ester is 'bioactive' and unavailable for your body's use. The longer testosterone is bioactive, the lesser the dosage is absorbed by your body.
Knowing the half-life of the ester allows us to measure how long the ester is bioactive in the body. Metabolizing the ester varies slightly from patient to patient. Clinicians can change injection dosage, frequency, and type to affect bioactivity. Misunderstanding half-lives and bioactivity can seriously affect how patients feel. Sub-optimal protocols lead to irritation at the injection site among other side effects.
Our TRT Protocol
Optimize testosterone levels
Relieve symptoms of low testosterone
Unlimited consultations
Regular lab work
Injections, creams, or pills
Get StartedTypes of injectable testosterone
Testosterone cypionate
Half-life: 5-6 days
Approximate free equivalent from 100mg dose: 70mg
Best use: Bi-weekly or weekly
Testosterone propionate
Half-life: 1.75-2.25 days
Approximate free equivalent from 100mg dose: 83mg
Best use: Daily
Testosterone enanthate
Half-life: 5-6 days
Approximate free equivalent from 100mg dose: 72mg
Best use: Bi-weekly or weekly
Testosterone undecanoate (Nebido)
Half-life: 10-14 weeks
Approximate free equivalent from 100mg dose: 63mg
Best use: 14-week injection protocol
Biweekly testosterone cypionate injections yield the best results
The main difference between enanthate and cypionate is the compounding vehicle. Cypionate requires 20% benzyl benzoate to solubilize. Enanthate melts slightly above room temperature, so benzyl benzoate isn't required.
The metabolization of the testosterone ester creates peaks and valleys.
When measuring blood testosterone levels of testosterone cypionate or enanthate injections, while the half-life is 5-6 days, the peak blood testosterone levels occur 2-3.5 days after injection, while the bottom occurs 4-5 days post-injection.
2x per week injections smooth the peaks and valleys so you consistently feel amazing.
Ways to inject testosterone
Subcutaneous injections
Do not penetrate as far as intramuscular injections as the target fat tissues of the lower stomach or buttocks area are easily accessible.
Research shows that subcutaneous injections produce therapeutic serum concentrations at lower doses than intramuscular injections. Meaning that less medication is needed to achieve optimal health benefits. In some patients, less than half of the dosage of intramuscular injection is needed to produce the same blood levels of testosterone.
Intramuscular injections
Require longer needles, especially if one possesses high levels of body fat, as the needle has to penetrate the epidermis, dermis, sub-Q tissue, and muscle. Intramuscular injections have been trusted for decades.
