@harveylonsdale_'s TRT dosing advice fact-checked
Quick answer
Testosterone replacement therapy for hypogonadism is typically dosed at 75 to 200mg weekly of testosterone cypionate or enanthate, with the goal of achieving serum testosterone in the mid-to-upper reference range (approximately 400 to 700 ng/dL per Endocrine Society guidelines). Individual response varies significantly based on SHBG levels, age, body composition, and injection frequency, making a standardized starting dose for all patients a clinically imprecise approach. Monitoring hematocrit, PSA, and cardiovascular markers at 3 and 6 months post-initiation is standard of care.
Our take · Written by FormBlends editorial team · Reviewed by FormBlends Medical Team· This is not a transcript. It is our independent review of the video above.
What did @harveylonsdale_ actually say?
The core argument here is straightforward: TRT doses typically run 80 to 150mg weekly, the goal is to sit at the top end of the reference range (not supraphysiological), and the best strategy is to start at 150mg then adjust downward based on bloods. He explicitly said "it's very hard to find a true milligram dose based off your natural blood work" before starting TRT.
He also made a practical case for starting higher: if you overshoot, a small reduction brings you back in range. If you start low and come back suboptimal, he argued it's "much harder to gauge the push up." That's the central clinical claim worth examining. To his credit, he was clear this is about health and longevity, not sitting at supraphysiological levels, which separates this from straight-up performance enhancement content.
Does the science back this up?
Partially. The 80 to 150mg weekly range is consistent with mainstream clinical practice, but the "start high and work down" philosophy is not standard medical guidance, and there are real reasons to be cautious about it.
The Endocrine Society's 2018 clinical practice guidelines recommend titrating testosterone doses to achieve mid-to-upper normal range serum levels, typically targeting 400 to 700 ng/dL in most men, with individual variation. Starting at the higher end of a dose range without knowing how a patient metabolizes testosterone introduces unnecessary risk of erythrocytosis, elevated hematocrit, and cardiovascular strain before you even have a baseline on that patient's response.
A 2020 review by Bhasin et al. in the New England Journal of Medicine noted that interindividual variability in testosterone pharmacokinetics is significant. Two men on identical doses can land in completely different serum ranges. Starting everyone at 150mg as a default does not account for this. The claim that adjusting downward is easier than adjusting upward lacks published support and reads more as a clinical preference than an evidence-based protocol.
What did they get wrong (or right)?
He got the dose range right. 80 to 150mg weekly aligns with what most clinics use and what clinical literature describes for hypogonadal men on testosterone cypionate or enanthate. The acknowledgment that "past 150 milligrams puts you beyond the reference range" for most men is also broadly accurate.
Where this gets shakier is the blanket starting-dose approach. Saying "we start all lads on 150mg" without factoring in age, baseline hematocrit, cardiovascular risk, or SHBG levels is a real gap. SHBG levels alone can dramatically affect free testosterone response to a given dose (Vermeulen et al., 1999, Journal of Clinical Endocrinology and Metabolism). A man with low SHBG will free up far more testosterone per milligram than someone with high SHBG.
He also said it's harder to adjust upward than downward if you undershoot. In practice, both adjustments take weeks to months to stabilize. There is no strong clinical rationale that makes downward titration meaningfully simpler.
What should you actually know?
TRT is not a one-size-fits-all protocol, and starting everyone at the same dose regardless of individual factors is not how the best-practice guidelines read. The goal of sitting in the upper end of the reference range is reasonable for many men, but what that requires in milligrams varies considerably between individuals.
If you are considering TRT, the conversation with a prescribing clinician should include full bloodwork: total testosterone, free testosterone, SHBG, LH, FSH, hematocrit, PSA, and a metabolic panel. These numbers matter for determining a starting dose that is appropriate for you, not just a population average. Bhasin et al. (2010, Journal of Clinical Endocrinology and Metabolism) emphasized individualized dose titration as the standard, with monitoring at 3 and 6 months after initiation.
The point about natural bloods being hard to use as a dosing predictor is fair. Endogenous testosterone levels fluctuate and do not map cleanly onto exogenous response. But that is an argument for careful titration with monitoring, not for defaulting to the higher end of a dose range without a patient-specific rationale.
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Cardiovascular Safety of Testosterone-Replacement Therapy
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Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline
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Testosterone replacement therapy for hypogonadism is typically dosed at 75 to 200mg weekly of testosterone cypionate or enanthate, with the goal of achieving serum testosterone in the mid-to-upper reference range (approximately 400 to 700 ng/dL per Endocrine Society guidelines).
FormBlends verdict
Testosterone replacement therapy for hypogonadism is typically dosed at 75 to 200mg weekly of testosterone cypionate or enanthate, with the goal of achieving serum testosterone in the mid-to-upper reference range (approximately 400 to 700 ng/dL per Endocrine Society guidelines). Individual response varies significantly based on SHBG levels, age, body composition, and injection frequency, making a standardized starting dose for all patients a clinically imprecise approach. Monitoring hematocrit, PSA, and cardiovascular markers at 3 and 6 months post-initiation is standard of care.
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What it helps with
- Testosterone replacement therapy for hypogonadism is typically dosed at 75 to 200mg weekly of testosterone cypionate or enanthate, with the goal of achieving serum testosterone in the mid-to-upper reference range (approximately 400 to 700 ng/dL per Endocrine Society guidelines). Individual response varies significantly based on SHBG levels, age, body composition, and injection frequency, making a standardized starting dose for all patients a clinically imprecise approach. Monitoring hematocrit, PSA, and cardiovascular markers at 3 and 6 months post-initiation is standard of care.
- The 80 to 150mg weekly dose range for TRT is consistent with Endocrine Society guidelines, but individual response varies enough that a single starting dose for all patients is not best practice.
- SHBG levels significantly affect free testosterone response per milligram of injected testosterone. Two men on 150mg weekly can land in completely different serum ranges (Vermeulen et al., 1999).
What it may miss
- It may not cover eligibility, contraindications, medication interactions, lab history, or dose escalation.
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- Social video captions rarely show the full evidence base behind a claim.
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Start provider reviewWhat You'll Learn
- The 80 to 150mg weekly dose range for TRT is consistent with Endocrine Society guidelines, but individual response varies enough that a single starting dose for all patients is not best practice.
- SHBG levels significantly affect free testosterone response per milligram of injected testosterone. Two men on 150mg weekly can land in completely different serum ranges (Vermeulen et al., 1999).
- Endocrine Society guidelines recommend titrating to mid-to-upper normal serum testosterone (roughly 400 to 700 ng/dL), with monitoring at 3 and 6 months after starting treatment.
- Starting at the higher end of a dose range without assessing hematocrit, cardiovascular risk, or PSA introduces unnecessary risk before you know how a patient responds.
- The claim that downward titration is easier than upward titration lacks published evidence. Both adjustments require weeks to months for serum levels to stabilize.
- Baseline natural testosterone levels are imperfect predictors of exogenous response, but SHBG, hematocrit, and LH/FSH values do inform appropriate starting dose decisions.
- No TRT dose discussed here should be self-administered or treated as a personal prescription. Dose decisions require clinician oversight and regular blood monitoring.
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About the Creator
Modern Man Clinic · TikTok creator
29.1K views on this video
Typical TRT dose can range from 80mg to 150mg per week When finding your TRT dose, we start our lads in the top end & what we think aligns with current lifestyle, habits & body type, get blood work
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Our written guides go deeper with dosing details, comparison tables, and medical-team reviewed protocols.
Not medical advice. This video was made by Modern Man Clinic, not by FormBlends. Our write-up above is an editorial review, not a medical recommendation. Talk to your doctor before making any decisions about medications or treatments.