TRT in the UK and EU | Contact: +44 (0) 203 9003 209 | Login
TRT in the UK and EU | Contact: +44 (0) 203 9003 209 | Login
Medically Reviewed by Dr. George Touliatos
Testosterone replacement therapy (TRT) replaces normal endogenous tesosterone levels with exogenous sources. These different types of TRT doses aim at mimicking the normal levels of testosterone and it’s metabolites. It is a recognised principal in treatment of low testosterone that the physiological state should be mimicked as close as possible.
The best dose is the treatment that will improve your symptoms with the least amount of side effects.
Traditionally doses were prescribed according to the licence for the product as determined by the manufacturer and medicines regulator. They were dreadful recommendations often leaving a patient to be supraphysiological and in a steroid abuser state during the first few days. After which they would decline to hypogonadal states or even lower than before they started TRT. This yo-yo treatment was cruel and unfair but unfortunately many men are still suffering with a sub-optimal TRT dosage from the NHS and not so experienced private consultants.
Fortunately Balance My Hormones are able to offer modern testosterone optimisation techniques that will provide optimal male hormone levels using international or ‘American Style’ TRT with British sensibilities to our patients across the UK and EU.
This testosterone is a blend of short, medium, and longer chain fatty acids.
It theoretically should lead to long lasting and sustained levels over 3 weeks. In practice it falls far short and usually needs to be injected weekly or twice per week.
The dosage is key, as a smaller more frequent dose can maintain stable levels in the blood and stable moods. Sustanon can be misunderstood by some who without looking at the blood test data will say that it may be unstable due to all the different esters, but blood tests have demonstrated time and again very predictable and optimised testosterone blood test levels on that TRT dose.
Our doctor’s have seen levels normally around 30-35nmol/L on the trough day, or the day of the next injection. This has been shown consistently time and again despite several esters being in the mix. When this testosterone preparation is prescribed at the optimal dose then optimal levels and minimal side effects have been seen.
This is a single medium length fatty acid testosterone ester.
It can be dosed every 3-7 days depending on the initial dose used. It traditionally was dosed at 200mg every 2 weeks which was unfortunate as large supraphysiological levels were followed by low hypogonadal levels for several days to a week before the next injection. Testosterone Cypionate is available in North America and parts of Europe. Balance My Hormones has been able to procure Testosterone Cypionate for import to our pharmacy in the UK. This is a good option when Sustanon cannot be tolerated by some due to allergies, or post injection pain which may occur in a small percentage of patients.
The best TRT dosing on Cypionate is one that is specific to you and your physiology, lifestyle, SHGB, and ability to inject more frequently. Many people do well with 80-100mg every 4-6 days, and others with 100mg every 4-7. It really depends on many factors including adherence to the doctor’s treatment plan.
Enantate is easily interchangeable with Cypionate. In the UK it is very costly, and limited in supply. In Europe it’s more reasonably priced and available.
The pharmacokinetics are similar to Testosterone Cypionate and can be dosed in a similar fashion to described above. The constraints with testosterone enanthate is the single use ampoule and cost as frequent smaller doses can increase the cost.
This is a short length fatty acid testosterone ester.
It needs to be dosed every day or every other day. The official recommendation is 50mg 2- 3 times per week. The testosterone propionate is available exclusive to BALANCE MY HORMONES patients is 25mg of Testosterone Propionate in a single use ampoule. Blood levels with 20mg daily injections have been 40nmo/L on the trough day or the next morning before the next injection. For those who do not wish to apply cream daily or twice daily, or for those who prefer daily or alternate day injections, testosterone propionate may be a good alternative. It come in a single ampoule and enough ampoules are supplied as an economical way to do more frequent injections. It provides stable levels so long as you inject frequently.
Lower trough levels could be achieved with 25mg every other day and would more closely result in levels near 20-25 nmol/L on trough days or right before the next injection.
If injecting is not for you and you’ve heard stories about gels not working then you may want to consider bespoke specialist manufactured cream. In the USA they call this testo-cream, or testosterone cream or compounded testosterone cream.
The cream has various absorption enhancers and is able to hold a large concentration of testosterone. The skin or dermis layer can act as a reservoir and slowly release the bio-identical non esterified testosterone into the capillaries.
Through normal skin you can expect around 10% absorption but through scrotal skin absorption could be close to 50% in some men. The cream also produces more of the metabolite DHT or dihydrotestosterone which may be responsible for restoring libido in men who have been refractive to injectable testosterone therapy.
We’ve had reports from patients who have switched to the cream from injections and said it was nothing like what they have tried before and it improved their libido more than injections.
The dose for cream is either one pump once per day or one pump twice per day. Blood tests should be done no more than 24 hours after the last dose and before applying the next dose. The timing window for blood testing is rather small so it’s important to arrange your blood test within 1-2 hours of your next dose either at the 12 hour or 24 hours after last application depending on how the doctor has dosed you.
If you have low or very low SHBG you may tend to excrete testosterone at a higher rate and actually end up with lower levels, so smaller and more frequent dosing may be required. Testosterone cream can be formulated to meet your individual requirements so your testosterone dose will be just right for you.
This testosterone injection dosage chart illustrates the most common testosterone preparations available in the UK.
Not all options are available everywhere and those with a * denote they are mostly exclusive to Balance My Hormones.
| Preparation | Route of Application | Historic TRT Dose | Modern Optimal TRT Dose |
|
Testosterone Enanthate (Enantate) |
Intramuscular injection | 200-250mg every 2-3 weeks | 125mg every 5-7days
250mg every 7-10 days
|
| Testosterone Cypionate* | Intramuscular injection | 200-250mg every 2-3 weeks | 75mg every 3 days
80mg every 3-4 days 100mg every 4-7 days 250mg every 7-10 days |
| Sustanon®
Each 1 mL dose of testosterone Sustanon 250 solution for injection contains 100 mg testosterone decanoate, 60 mg testosterone iso-caproate, 60 mg testosterone phenylpropionate and 30 mg testosterone propionate
|
Intramuscular injection | 250mg every 3 weeks adjusted according to response.
|
100-125mg every 4-5 days
125mg every 5-7 days 250mg every 7 -10 days |
| Testosterone Propionate* | Intramuscular injection | 50 mg 2–3 times a week.
|
20-25mg daily, or 25-50mg alternate days. |
| Testosterone Undecanoate, Nebido® | Intramuscular injection | 1000mg every 8-10 weeks | Not recommended, in rare cases more frequent dosing every 4-6 weeks |
| Specials Manufactured Trans-scrotal Testosterone Cream 100mg-200mg per dose.
Available in 30,50,100ml in various pumps, dispensing volume, and base creams. |
Topical Scrotal application, Rib cage, or forearms | 100mg -200mg per dose applied once or twice per day | 100mg -200mg per dose applied once or twice per day |
| Licenced Transdermal Testosterone Gel 16-50mg per 1-5g of gel
Testim®, Testavan®, Tetogel® |
Topical/Transdermal Application Apply and rub in to the shoulders and/or upper arms.
|
5 grams once daily
Apply 60 mg once daily, subsequent application adjusted according to response; maximum 80 mg per day.
|
Not normally recommended at modern TRT clinics. |
This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.
References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.
Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject.
We value your feedback on our articles, if you have a well-researched paper you would like to share with us please contact us.
If you know your total testosterone reading from a previous blood test input the results to the left above to see if your testosterone levels are normal.
You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.
The Total Testosterone Level You Entered Is Incorrect. Figure Must be in nmol/L you can use our converter here.
Your testosterone levels appear to be in the normal range.
You must be over 38, have had your ovaries removed or have suffered with premature menopause to warrant further hormone tests.
Please contact us to discuss your hormones, we need your total testosterone levels to validate your hormone deficiency. You can order a blood test here.
You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.
You appear to have higher than normal testosterone levels, please contact us for further investigation.
You appear to have normal testosterone levels. Contact us if you have any concerns.
Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
Men lose 50 to 100 hairs every day. Your hair falls out, and new hairs take their place as their growth cycle begins. However, sometimes you start losing more hair than you grow. As a result, thin hair patches appear on your head. Data show more than 85% of men lose hair at some time […]
Male hypogonadism is a condition in which your body fails to produce sufficient male sex hormone, testosterone, which plays many crucial roles in the body. It can affect men of any age; however, it is more prevalent in middle to old aged men. Data shows that 35% of men older than 45 years have primary […]
Testosterone, also referred to as the ‘king of hormones’ for men, plays a crucial role in driving libido, regulating mood, and maintaining bone density. But did you know testosterone’s influence extends far beyond these well-known roles? Recent studies have unveiled an interesting relationship between testosterone levels and the immune system. Keep reading the article to […]
Balance My Hormones helps customers restore their hormones to optimal levels through bespoke TRT and HRT treatment plans. We use modern American treatment methods and have over 25 years of experience in hormonal health which is backed up by our very own GPhC pharmacy.
