TRT for men and women: what fitness influencers get wrong

What did @braedenmillerfit actually say?

The creator laid out a male and female TRT guide covering starting doses, injection frequency, blood work schedules, delivery method preferences, and aromatase inhibitor (AI) use. For males, he suggested 100 to 200 milligrams per week and said daily injections are ideal. For females, he recommended 2 to 5 milligrams per week with twice-weekly injections of a long-ester testosterone. He called creams unreliable because of inconsistent absorption, pushed injectables for both sexes, argued quarterly blood work is the minimum, and made the sweeping claim that AIs are never necessary on TRT, adding that clinics prescribe them purely "to make fucking money."

That last point is where things get complicated. The rest of the guide is a reasonable lay summary of common clinical practice, but some of it blurs the line between general population trends and individual patient needs.

Does the science back this up?

Partially. The preference for injections over transdermal delivery has legitimate support, but the blanket AI dismissal does not hold up under scrutiny for every patient.

On injection frequency, the pharmacokinetic case is real. Shorter injection intervals with testosterone cypionate or enanthate produce smaller peak-to-trough swings, which many patients report feeling better on. A 2020 review in the Journal of Clinical Endocrinology and Metabolism (Ramasamy et al.) confirmed that more frequent dosing reduces supraphysiologic peaks, a genuine clinical concern.

On transdermal absorption variability, the creator is largely correct. Gel absorption varies by skin site, hydration, and individual physiology. Studies including Swerdloff et al. (2000, Journal of Clinical Endocrinology and Metabolism) documented meaningful inter-individual variation in gel absorption, which complicates dose titration.

On AIs, however, blanket dismissal is not defensible. Some men on TRT aromatize testosterone to estradiol at rates that produce symptomatic hyperestrogenism, including gynecomastia and fluid retention. A subset of patients genuinely benefit from low-dose AI use under clinical supervision, per Shoskes et al. (2016, Translational Andrology and Urology).

What did they get wrong (or right)?

He got the injection frequency argument right in spirit. He got the cream criticism mostly right. He got the AI blanket ban wrong, and that is the most clinically consequential error in the video.

The claim that "there is no world where you need an AI when you're running TRT" is too absolute. While over-prescription of AIs is a documented problem in cash-pay hormone clinics, the correct answer is that most patients on physiologic TRT doses do not need an AI, but some do. Hammering that distinction matters because a patient with true symptomatic hyperestrogenism who watches this video may dismiss a legitimate clinical tool.

The female dosing range of 2 to 5 milligrams per week is broadly consistent with published clinical guidance from organizations like the Endocrine Society, though the evidence base for female testosterone therapy remains thinner than for males, and individual titration is important. His female AI dismissal is more defensible since exogenous testosterone at these doses rarely produces estradiol excess requiring pharmacologic intervention in women.

The quarterly blood work recommendation is reasonable as a minimum but conservative clinicians often recommend more frequent monitoring in the first 6 to 12 months of therapy.

What should you actually know?

TRT is not a one-size protocol, and anyone telling you there is a single right answer for all patients is oversimplifying. That said, the creator gets more right than wrong, which puts him ahead of most TikTok hormone content.

If you are considering TRT, a few things are worth knowing. First, baseline labs before starting are non-negotiable, including total testosterone, free testosterone, LH, FSH, estradiol, hematocrit, and PSA for men. Second, whether you need an AI is a question your bloodwork and symptoms should answer, not a blanket policy. Third, delivery method should match your lifestyle and absorption profile, not a content creator's preference. Fourth, female testosterone therapy remains an area where clinical guidance is still evolving, and the evidence base is weaker than many hormone optimization providers acknowledge.

FormBlends connects patients with licensed clinicians who review your labs before any prescribing decision. No protocol is determined by what a TikTok video recommends.