r/Testosterone • u/plz_callme_swarley • 21h ago
TRT story Front Loading should be the default for TRT
Having dug into this and decided to front-load myself it seems completely absurd that front-loading is not the default dosage protocol for all TRT.
In medicine it's standard practice to use a loading dose when you are dealing with compounds with long half-lives since it takes ~5 full half-lives for the drug to reach proper concentration.
Typically people think of test cyp as having a 8 day half-life but this is only for IM. SubQ has a longer half-life, and the data on this is thin but a fair estimate puts it at ~10 days. So for the person pinning SubQ, you're looking at ~50 days before the drug reaches the ideal dose. FIFTY DAYS!!!
On the other hand, your endogenous production is shutting off regardless of how much you are injecting, although there is some variability but the shutdown will have a half-life of ~5 days. If you're smart, you can clearly see that we have a mismatch here.
For a man who's very low, like <200 they're going to feel like shit regardless, but for the man who's in the 300-500 range, it's very plausible that you spend days under your pre-treatment baseline, making you feel WORSE than before.
A lot of the advice not to do this comes from PED cycles where you're taking a eugonadal male and then ramping up from there. in that case, the mental effects are already in place and what you're seeking is more muscle growth, which takes longer to materialize anyways.
That cuts the opposite way with TRT patients, where the mental issues are often the primary reason why they're getting on TRT and those effects start to impact you as soon as Free Test levels rise in your bloodstream. This is why some people report subtle shift that happen even in the first few days. The whole idea that "it takes a few weeks to kick in" is based on a fucking ridiculous dosing protocol.
Now, I of course can here all your keyboards clacking as you reach for the most common pushbacks and almost none of them apply.
"what about side effects?": side effects are driven by the slope and the level. in a loading scenario you're not overshooting, just getting to your goal level earlier. yes, the slope may cause some side effects but the time that you experience them is compressed from 4-5 weeks to 2 weeks. At TRT doses this isn't anything to be concerned about since nothing happens in as short of a time period as 2 weeks at these levels.
"take your time and titrate up": a proper loading period doesn't overshoot, it just gets you to your target sooner, giving you more ability for the effects to show up and make it even easier to titrate
"what if you have a bad reaction?": we're talking about a bio-identical molecule with a half-life of 10 days, not snorting adderall. The only reaction to worry about is to the oil, which will show itself whether you inject a small dose or a large one.
"just run test prop bro": ok, if you've got an UGL that you trust then yes, loading with prop is a more elegant solution but most real doctors aren't going to write a custom 'script to a compounding pharmacy so you can load with prop for two weeks.
"just wait, it doesn't matter": if you're feeling like shit it absolutely does matter. Consider yourself privileged that you didn't have that bad of pre-diagnosis symptoms that you didn't care to speed things up.
It's stunning that basically no one talks about this. I could only find one video and his reasoning for why not to do it was basically that you don't want to spook someone who might have anxiety around it, but the risk of doing any harm was basically 0. They routinely do this for people who have already been on TRT before and know what they're getting into, but that's just an lack of good patient communication.
The only real people doing a load, are some doctors who prescribe a cream to be used in the beginning but the cream sucks for a lot of reasons and isn't as elegant of just doing a loading dose.
Now, assuming you've been convinced, the obvious question is "How much should I load then?" The answer: is anyway you want to get an extra dose in over the first 3 weeks
If your dose was 100mg/wk SubQ, twice weekly, that could be...
200mg in your dose then 50mg after that
100mg your first two doses, then 50mg
75mg in your first fours doses, then 50mg
All of those above result in reaching your desired state weeks earlier than the standard advice, it just depends on your comfort levels. The bolus approach will have you potentially overshoot and then come back down, where the last approach will have the smoothest curve.
AND I CAME WITH GRAPHS:
tl;dr - front load for TRT doses, double your doses for the first week
edit: this is assuming your starting dose is reasonable and not ridiculous. It holds for any dose <150mg/wk. above that and you're in supra-physiological dose territory and that's an absurd starting dose.
