@officialharleymeds's TRT starting dose claims, fact-checked

What did @officialharleymeds actually say?

The creator shared their personal TRT journey, noting they began at 90mg per week and gradually increased to 180mg over time. They then generalized from their own experience, claiming "most of the guys I see get prescribed" somewhere between 100 and 150 milligrams per week as a starting dose for TRT-naive patients. The video ends with an engagement prompt asking viewers about their own starting doses.

To be clear about what this is: one person sharing anecdotal experience and informal observations from their social circle. There is no clinical context provided, no mention of lab values, no discussion of the underlying diagnosis driving the prescription, and no acknowledgment that dosing in testosterone replacement is supposed to be guided by bloodwork, not round numbers.

Does the science back this up?

Partially, yes. The 100-150mg per week range the creator cites does roughly align with common clinical practice for testosterone cypionate or enanthate, but that alignment is somewhat coincidental. The actual clinical picture is more nuanced than the video suggests.

The Endocrine Society's 2018 clinical practice guidelines (Bhasin et al., 2018, Journal of Clinical Endocrinology and Metabolism) recommend doses titrated to achieve mid-normal range serum testosterone levels, typically 400-700 ng/dL in most guidelines, rather than targeting a fixed weekly milligram number. A 2020 review by Corona et al. in the journal Andrology found substantial individual variability in pharmacokinetics, meaning the same 100mg dose produces meaningfully different serum levels across patients based on body composition, injection frequency, and metabolism. Starting at a fixed dose without follow-up bloodwork at 6-8 weeks is, frankly, how men end up either undertreated or pushing hematocrit into problematic territory.

What did they get wrong (or right)?

They got the ballpark right but missed the reasoning that makes that ballpark meaningful. The 100-150mg range is not a universal starting point. It is a rough clinical convention that exists specifically because it tends to produce therapeutic serum levels in a reasonable proportion of men, with the expectation that dose adjustments follow lab results.

The creator's own trajectory, 90mg escalating to 180mg over repeated three-month intervals, actually illustrates the titration process correctly in practice, even if it is framed as a personal story rather than a clinical protocol. What is missing entirely is any mention of hematocrit monitoring, estradiol management, or the fact that 180mg per week is meaningfully above what most endocrinology guidelines would call standard replacement dosing. A 2019 study by Ramasamy et al. in Translational Andrology and Urology noted that doses above 150mg per week are often associated with higher erythrocytosis risk, which requires monitoring.

• Credit where it is due: acknowledging individual variability is accurate and important.
• The omission of any lab-based titration framework is a significant gap for a video about dosing.
• Framing 180mg as being "fully optimized" without clinical context is imprecise at best.

What should you actually know?

TRT dosing is not a starting number you pick and increment on a schedule. It is a process driven by baseline and follow-up bloodwork, specifically total testosterone, free testosterone, hematocrit, estradiol, and PSA in older men. The Endocrine Society guidelines are explicit that the goal is serum testosterone levels, not a weekly milligram target.

The 100-150mg per week figure circulates widely in online TRT communities and does reflect common prescribing practice, but "common" and "correct for you" are different things. A 2021 analysis by Mulhall et al. in the Journal of Sexual Medicine found that a significant proportion of men on TRT are either over- or under-dosed when dosing decisions are not supported by regular monitoring. If a provider is adjusting your dose on a fixed three-month schedule without lab values driving those decisions, that is worth asking questions about. Bloodwork, not a calendar, should drive titration.