What is the 'average' TRT dose, and does it matter for you?

What did @kmartfit actually say?

The creator, posting on behalf of Harley Meds, told viewers that "most men are getting started on anywhere between about 90 milligrams" up to "150 per week" of testosterone. They also said patients get a follow-up blood test three months in to confirm levels are in an "optimized range." The video ends with a call to switch clinics.

To be clear about what this is: this is a paid promotional video for a telehealth TRT clinic, not independent health education. The creator is actively recruiting patients with a comment-trigger funnel. That context matters when evaluating every claim made here.

Does the science back this up?

Partially. The 90-150mg weekly range is within real-world clinical practice, but framing it as a universal starting point glosses over significant individual variability and established guideline recommendations that often start lower.

The Endocrine Society's 2018 clinical practice guidelines recommend testosterone therapy be initiated at doses that bring serum testosterone into the mid-normal range, typically 400-700 ng/dL, without specifying a single milligram target. A 2020 review by Bhasin et al. in the New England Journal of Medicine noted that standard injectable testosterone cypionate or enanthate dosing typically ranges from 75-100mg weekly or 150-200mg every two weeks, with titration based on trough levels. So 90mg weekly is reasonable. But 150mg weekly as a starting dose is on the higher end and could push some men, particularly those with higher baseline sensitivity, into supraphysiologic ranges before any bloodwork has been reviewed.

The three-month follow-up bloodwork claim is consistent with Endocrine Society guidance, which recommends checking testosterone levels 3-6 months after initiating therapy.

What did they get wrong (or right)?

They got the general dosing ballpark mostly right, but the framing is sloppy in ways that matter clinically. Starting at 150mg weekly without first assessing baseline testosterone, hematocrit, PSA, or cardiovascular risk is not best practice. It is a number chosen for convenience, not precision.

The phrase "optimized range" is also doing a lot of work here without definition. "Optimized" is not a clinical term. The Endocrine Society talks about physiologic replacement, meaning restoring levels to what is normal for a healthy young adult male, not maximizing them. Clinics that use "optimized" language often target the upper-normal or even supraphysiologic range, which carries real risks: erythrocytosis, elevated hematocrit, cardiovascular strain, and suppressed fertility. A 2023 study by Lincoff et al. in NEJM (the TRAVERSE trial) found that testosterone therapy in men with hypogonadism did not increase major cardiovascular events compared to placebo, but that finding applies to physiologic replacement, not aggressive optimization.

The three-month blood test timeline is genuinely correct and worth acknowledging. That is standard, evidence-based follow-up practice.

What should you actually know?

TRT dosing is not one-size-fits-all, and any clinic that tells you otherwise before seeing your bloodwork should raise a flag. Starting dose should be based on your baseline testosterone level, your symptoms, your age, your hematocrit, and your cardiovascular history, not a standard intake protocol.

Injectable testosterone cypionate and enanthate are the most studied forms of TRT. Weekly dosing of 75-100mg is a common and well-supported starting point for most men, with upward titration only after confirming trough levels. Jumping to 150mg weekly from day one is aggressive and not universally appropriate.

The "optimized" framing used by many direct-to-consumer TRT clinics is a marketing term, not a medical one. Ask your provider what specific serum testosterone level they are targeting and why. A provider who cannot answer that question clearly is not practicing evidence-based medicine. If you are considering TRT, work with a provider who reviews your full labs, not just your total testosterone, before writing any prescription.