What TikTok gets wrong about 'ideal' testosterone levels

What did @coach.neek actually say?

The creator made three distinct claims about TRT optimization. First, that "daily micro-administrations" are "far superior" to once or twice weekly injections. Second, that blood draws for testosterone testing should happen at the midpoint between injections for bolus dosers. Third, that a target of "30 nanomol per liter" is a good optimization goal that will avoid side effects like acne, water retention, and blood pressure issues for most people, unless someone is obese.

These are specific, testable claims. Some hold up reasonably well. Others are presented with more confidence than the evidence warrants. The obese comment in particular is reductive in ways worth unpacking.

Does the science back this up?

On daily dosing: there is real pharmacokinetic logic here. Daily subcutaneous or intramuscular injections do produce more stable serum testosterone levels with smaller peaks and troughs compared to weekly or twice-weekly protocols. That part is supported.

Rastrelli et al. (2019, Journal of Endocrinological Investigation) and data from testosterone undecanoate and cypionate pharmacokinetics studies consistently show that more frequent dosing reduces peak-to-trough variability. Whether that variability matters clinically for all patients is less settled. For some men, twice-weekly injections produce perfectly stable, symptom-free results. "Far superior" is an overstatement of what is genuinely a preference-and-tolerance question for many patients.

On the 30 nmol/L target: this sits in the upper-normal to mildly supraphysiological range depending on the assay. Normal adult male reference ranges in most labs run roughly 10 to 35 nmol/L. Targeting 30 nmol/L is not inherently dangerous but is on the higher end, and framing it as universally benign for non-obese individuals glosses over inter-individual variation in aromatization, hematocrit response, and cardiovascular risk factors.

What did they get wrong (or right)?

The midpoint blood draw advice for bolus dosers is mostly correct and aligns with clinical guidance. Testing at the trough (just before next injection) captures the lowest point and may lead to unnecessary dose increases. Testing at peak captures an artificially high reading. The midpoint gives the most representative steady-state approximation. This is standard advice from endocrinology practice.

Where the creator goes wrong is in the side-effect framing. Saying 30 nmol/L "will give you no issues for acne" or blood pressure for non-obese people is simply too broad. Acne sensitivity is partly androgenic receptor sensitivity, not just total testosterone level. Rahnema et al. (2014, Fertility and Sterility) documented significant dermatological and cardiovascular adverse effects in men using exogenous testosterone across a range of serum levels. Body weight is one factor, not the deciding one.

The suggestion to "lose your weight" as a solution to side effects, while not wrong as general health advice, dismisses legitimate individual variation in testosterone response and could discourage people from reporting side effects to their prescriber.

What should you actually know?

TRT protocols are not one-size-fits-all. Frequency of administration affects hormone stability, but the clinical significance of that stability varies. A 2021 review by Morgentaler et al. in the Journal of Urology noted that patient adherence and quality of life are as relevant to protocol selection as pharmacokinetics alone.

Blood draw timing matters more than most patients realize. If you are on a bolus protocol and your lab comes back low because you tested at trough, or high because you tested at peak, your prescriber may adjust your dose based on a reading that does not reflect your actual steady-state. Know when your last injection was and communicate that to your provider.

The 30 nmol/L target is not a universal optimization goal. Some men feel better at lower levels. Some experience side effects at this level regardless of body composition. Any target should be set in collaboration with a licensed provider who is monitoring your hematocrit, lipids, blood pressure, and symptoms, not just your total testosterone number.