TRT Dosage: The Definitive Guide

What is a TRT dose?

A TRT dose is the amount of testosterone a prescriber sets for testosterone replacement therapy (TRT), plus how often it is given. The aim is to bring a man's testosterone back into the normal range, not above it, and the product labels say the dose "is adjusted according to the patient's response and the appearance of adverse reactions". Before treatment starts, US labels say to confirm low testosterone with morning blood tests on at least two separate days. [1], [2], [15]

For the common injections, testosterone cypionate and enanthate, the number that matters is the weekly total. Guideline examples sit at about 75–100 mg a week. The labels are wider, 50–400 mg every 2–4 weeks, and name no blood-test target. [2], [1], [16]

Three things make milligrams confusing:

• The dose is ester weight, not testosterone weight. An ester is a chemical tail that makes testosterone dissolve in oil and release slowly. It adds weight: by molecular weight, 100 mg of cypionate holds about 70 mg of testosterone, and a UK 250 mg enanthate ampoule holds "about 180 mg testosterone". Prescriptions always use the ester amount. [1], [17]
• Milligrams do not transfer between products. The Azmiro label says injectable testosterone products "are not substitutable on a milligram-per-milligram basis", and only about 10% of a testosterone gel dose is absorbed through the skin, so 50 mg of gel and 50 mg of injection are not the same exposure. [18], [19]
• The same dose can be drawn as different volumes, depending on the vial's strength; see mg to mL to units.

TRT dosage: the key numbers

This table shows the injectable testosterone doses in current US, Canadian, UK and Australian labels and in the major clinical guidelines, with the blood level each one uses to adjust the dose. Checked September 2026.

[1], [16], [18], [15], [20], [21], [17], [22], [23], [2], [3], [4], [5], [24], [25], [6]

Most guideline examples land at about 75–100 mg a week of cypionate or enanthate, given weekly or as double that every 2 weeks. The labels are wider, UK and Australian products come as fixed 250 mg ampoules that are adjusted by changing the interval, and the bodies differ on the level they aim for and on whether they judge it midway or at the trough. "Weekly equivalent" is simple arithmetic (dose divided by weeks), shown so the rows can be compared; no source recommends it as a dose. [2], [3], [5], [17]

These are doses for adult men. Testosterone for women uses different products and far smaller doses; see testosterone therapy for women.

Doserly

Label and guideline doses, as a weekly equivalent

Each bar runs from 0 (left) to 200 mg a week (right); the dashed line marks 100 mg a week, above which the VA calls intramuscular cypionate or enanthate a supraphysiologic dose.

Product labels

US labels, cypionate and enanthate

50–400 mg every 2–4 weeks. Weekly equivalent: 12.5–200 mg.

Xyosted, US label

50, 75 or 100 mg weekly. Weekly equivalent: 50–100 mg.

Canada, cypionate label

200 mg every 2 weeks; max 400 mg a month. Weekly equivalent: 100 mg.

Canada, enanthate label

100–400 mg every 4 weeks. Weekly equivalent: 25–100 mg.

UK, Testosterone Enantate

250 mg every 2–6 weeks (start 2–3, maintain 3–6). Weekly equivalent: about 42–125 mg.

UK and Australia, Sustanon 250

250 mg usually every 3 weeks. Weekly equivalent: about 83 mg.

Australia, Primoteston Depot

250 mg every 2–6 weeks. Weekly equivalent: about 42–125 mg.

Clinical guidelines

Endocrine Society, 2018

75–100 mg weekly or 150–200 mg every 2 weeks. Weekly equivalent: 75–100 mg.

AUA, 2018 (confirmed 2024)

100 mg weekly, preferred. Weekly equivalent: 100 mg.

VA, January 2026

50–100 mg weekly or 100–200 mg every 2 weeks. Weekly equivalent: 50–100 mg.

Society for Endocrinology, 2022

50–100 mg weekly or 150–200 mg every 2 weeks. Weekly equivalent: 50–100 mg.

CUA 2021, cypionate

100 mg weekly or 200 mg every 2 weeks. Weekly equivalent: 100 mg.

CUA 2021, enanthate

100–200 mg every 1–4 weeks. Weekly equivalent: 25–200 mg.

EAU, 2026

enanthate 250 mg or cypionate 200 mg every 2–3 weeks. Weekly equivalent: about 67–125 mg.

Weekly equivalents are arithmetic (dose divided by weeks), not doses any source recommends. BSSM gives no mg.

Why do labels and guidelines give different numbers?

Because they answer different questions. The US cypionate and enanthate labels describe what the medicine is approved to do, with broad dosing and no blood-test rule. Guidelines, written with modern testosterone tests, center on about 100 mg a week and adjust it by the level. The AUA itself says "the optimal dosing strategy has not been defined" for these injections. [1], [16], [3]

The guidelines also disagree on the target, from the lower end of normal at the trough (Society for Endocrinology) to the middle of the range midway (AUA), as the last column shows. None of these targets comes from a trial comparing outcomes at different levels. [5], [3]

How do the units work?

Doses are in milligrams (mg) of the ester; volumes are in milliliters (mL); blood levels are in ng/dL in the US and nmol/L in most other countries. To convert total testosterone, divide ng/dL by 28.84 to get nmol/L: 600 ng/dL is about 20.8 nmol/L. The testosterone unit converter does this for you, and the TRT blood work guide explains each test.

How do dose and frequency shape your testosterone levels?

An injection leaves a pool of oil, a depot, that releases testosterone over days. Testosterone itself has a very short half-life in the blood (the US enanthate label gives figures that range from 10 to 100 minutes), so the multi-day half-life quoted for injections describes how slowly the depot empties. [16], [1]

• One large dose makes a big peak and a deep trough. After a single 200 mg cypionate injection in 11 men with low testosterone, levels roughly tripled, peaking on days 2 to 5, many men were above the normal range from days 2 to 7, and levels were back to their starting point by days 13 to 14. Estradiol tripled too. For Azmiro, the label reports a median time to peak of 71.7 hours. [26], [18]
• The same weekly amount, spread out, swings less. In a classic study of 23 men, enanthate at 100 mg weekly, 200 mg every 2 weeks, 300 mg every 3 weeks and 400 mg every 4 weeks (all about 100 mg a week) produced levels that "fluctuated largely within the normal range", but the average level between doses was highest with 100 mg weekly and lowest with 400 mg every 4 weeks. [7]
• Weekly subcutaneous doses give a flatter curve. With weekly subcutaneous enanthate at 100 mg, the average level was 895 ng/dL, with a peak of 1,346 and a trough of 568 ng/dL. On Xyosted's weekly schedule, levels peaked a median of 11.9 hours after the dose, reached a steady state by week 6, and none of the 137 men who completed 12 weeks was above 1,500 ng/dL at week 12. [27], [15], [28]

The half-life figures differ by product and method: the US cypionate label gives about 8 days, the UK enanthate summary 2–3 days, and the EAU guideline table lists 4–5 days for enanthate. Even so, the US labels give cypionate and enanthate the same dose range, 50–400 mg every 2–4 weeks. [1], [17], [25], [16]

Why is about 100 mg a week called a replacement dose?

Because it roughly matches what the body would make and brings levels back into the normal range. Healthy men make about 4 to 9 mg of testosterone a day in isotope studies: 3.7 mg in one study, and 9.11 mg in young White men, 7.22 mg in young Asian men and 3.88 mg in middle-aged White men in another. Esters, absorption and clearance differ, so this is orientation, not a formula for a prescription. [29], [30]

The research on dose shows the same picture. In 61 young men whose own testosterone was switched off, weekly enanthate at 125 mg gave an average lowest level of 542 ng/dL, inside the normal range, while 25 and 50 mg left it at 253 and 306 ng/dL. Research doses several times higher pushed the lowest level to 1,345 and 2,370 ng/dL, far above normal. Lean (fat-free) mass rose with dose, but so did hemoglobin, and HDL ("good") cholesterol fell; sexual function and mood did not change significantly at any dose. These were research doses, not treatment schedules. [31]

Doserly

Same 100 mg a week, three schedules

Simplified model of testosterone cypionate once levels have settled: relative level, not ng/dL. Triangles mark injections; the dashed line is the average level, the same for all three.

200 mg every 2 weeks

Peak about 2.4 × the trough

100 mg weekly

Peak about 1.4 × the trough

50 mg twice weekly

Peak about 1.1 × the trough

The smaller and more often the dose, the smaller the swing around the same average. Illustrative model; individual levels vary; your labs are what count.

The testosterone level visualizer lets you compare schedules with the same simplified model.

What does the research show about dose and frequency?

The strongest evidence on dose comes from dose-finding studies and product trials; the evidence on frequency is mostly pharmacokinetic (how levels move) or observational. We found no randomized trial that compared injection frequencies on health outcomes. [8], [3]

Does splitting the same weekly dose change anything?

Possibly for red blood cells, but it has never been tested directly. Here is what exists:

We found no study in men that kept the weekly total exactly the same and compared once weekly with twice weekly, every other day or daily. The British Society for Sexual Medicine notes that subcutaneous "micro-dosing" has "become fashionable, but long-term studies are not available". A 2026 practice review argues that every-2-week dosing "should not be the automatic default" and treats twice-weekly to daily schedules as "optional tools rather than universal standards"; that is expert opinion from one clinic-affiliated author, not trial evidence. [6], [35]

Is a subcutaneous dose the same as an intramuscular dose?

Roughly, according to the available studies, though none compared the same dose of cypionate or enanthate by both routes in men with low testosterone. The UK Society for Endocrinology says subcutaneous injection of 50–100 mg once a week has "comparable pharmacokinetics, safety and tolerability" to injection into a muscle. A 2022 review suggests starting subcutaneous cypionate or enanthate at 75 mg a week, measuring midway between injections and adjusting to 50 or 100 mg. [5], [36]

• Men with low testosterone. In a pilot of 22 men injecting low weekly doses of subcutaneous enanthate with a 0.5 mL insulin syringe, the average trough was 14.5 nmol/L and the peak 21.7 nmol/L, all within normal. In the Xyosted trial, 135 of 150 men (90%) had an average level in the normal range at week 12. [37], [15]
• Same weekly dose, different route and product. In 234 men on 100 mg a week, trough levels were similar with intramuscular cypionate (536 ng/dL) and a subcutaneous enanthate autoinjector (553 ng/dL), but the autoinjector was linked with lower estradiol and hematocrit. The ester, device and route all differed, so the study cannot isolate the route. [38]
• Trans men. All 63 reached the normal male range on 50–150 mg a week of subcutaneous testosterone (with a median of 75 to 80 mg), and all 22 who had switched from muscle injections preferred subcutaneous ones. In smaller studies, weekly subcutaneous levels stayed fairly steady (average 627 ng/dL), and exposure per mg was similar by either route, with wide variation between people. [39], [40], [41]
• Long-acting undecanoate. In a crossover of 20 long-term users, 1,000 mg given subcutaneously gave peaks similar to injection into a muscle; the authors concluded no dose change was needed, though the injection hurt more the next day. [42]

In practice, labels and guidelines treat a route change like any other change: the level is rechecked and the dose adjusted. Technique is covered in how to inject testosterone.

Does a higher weekly dose do more?

It raises levels in a predictable way, and it raises red blood cells with them. In dose-finding research, hemoglobin and hematocrit rose in a straight line with the weekly dose in both young and older men, and more older men had to leave the study because hematocrit went above 54%. Older men clear testosterone more slowly and had more side effects at the same dose; the researchers judged 125 mg a week the best trade-off in that research setting. [11], [43]

In one US clinic that used 100–200 mg of cypionate or enanthate weekly, hematocrit above 50% occurred in 66.7% of the 57 men on injections, against 12.8% of 47 on gels and 35.1% of 74 on pellets over 3 years of follow-up, although the groups differed in age and were not randomized. Across 29 randomized trials, cypionate or enanthate injections raised hematocrit by about 4 points on average. The hematocrit guide covers what that means. [44], [45]

How often does a starting dose need changing?

Often, which is why guidelines measure rather than guess. In the Xyosted trial, 150 men started at 75 mg a week with one adjustment based on the trough level: at week 12, 104 were still on 75 mg, 25 had moved down to 50 mg and 21 up to 100 mg. About one in three needed a different dose from the starting one. [28]

What do guidelines and labels say about adjusting the dose?

They adjust by blood level, hematocrit and symptoms, one step at a time (titration), and they differ on timing and targets. This section describes what the documents say; it is not a personal plan.

[3], [2], [4], [15]

Where do the sources disagree?

• How often to inject. The US enanthate label says injections more often than every 2 weeks "are rarely indicated", while the AUA prefers 100 mg weekly and the VA, Society for Endocrinology and CUA all list weekly options. [16], [3], [4], [5], [24]
• How low is too low. An older task-force regimen quoted in the Canadian enanthate monograph accepts a pre-injection level of 250–300 ng/dL and calls 100–150 mg every 2 weeks "a reasonable compromise", while calling 300 mg every 3 weeks "generally inadequate". Current guideline targets are set higher, although most are measured midway rather than just before the next injection. [21], [2], [3]
• Where to measure. A midway level estimates average exposure; a trough shows whether levels fall too low before the next dose or build up over time. The same 200 mg dose can read above the normal range on day 2 and be back near the starting level by day 13, so the timing of the draw matters as much as the result. [3], [26]
• Compounded products. The AUA prefers commercially made testosterone over compounded versions when possible. [3]

How are long-acting injections adjusted?

By the interval, not the milligrams. Nebido is 1,000 mg every 10–14 weeks, measured at the end of an interval; the EAU aims for a pre-injection level between 12 and 18 nmol/L. At one Sydney clinic, 297 patients' intervals were adjusted this way to a median of 12.0 weeks, and 70% ended on the approved 12-week interval. In the US, Aveed is a fixed 750 mg at the start, at 4 weeks and then every 10 weeks. See the undecanoate injection guide. [46], [25], [48], [49]

How do you turn a dose into mL and syringe units?

Divide the dose by the vial's strength: mL = mg ÷ mg/mL. At 200 mg/mL, 100 mg is 0.5 mL, which is 50 units on a U-100 insulin syringe. The strength is printed on the vial and carton, and it differs between products and countries. [1], [9]

[1], [50], [18], [16], [15], [49], [20], [21], [17], [22], [46], [23]

How many units is that on an insulin syringe?

An FDA device file puts it simply: "U-100 means there are 100 units of insulin in every mL." So each unit mark on a U-100 syringe is 0.01 mL, whatever the liquid. The units measure volume, not milligrams of testosterone: the milligrams in each unit depend on the vial. [9]

This is arithmetic, shown for doses inside the guideline and label range. The dose itself always comes from the prescription. A result such as 37.5 units falls between whole-unit marks, so ask a pharmacist how to measure it with the syringe you use.

Doserly

From milligrams to millilitres to syringe units

mL = mg ÷ mg/mL. On a U-100 syringe, 100 units = 1 mL, so units measure volume, not testosterone.

The same 100 mg from three vial strengths

100 mg/mL vial

100 mg ÷ 100 mg/mL = 1 mL = 100 units

200 mg/mL vial

100 mg ÷ 200 mg/mL = 0.5 mL = 50 units

250 mg/mL vial

100 mg ÷ 250 mg/mL = 0.4 mL = 40 units

A 100 mg weekly total at 200 mg/mL

Once a week: 100 mg

100 mg ÷ 200 mg/mL = 0.5 mL = 50 units

Twice a week: 50 mg

50 mg ÷ 200 mg/mL = 0.25 mL = 25 units

The same 100 mg can be 1 mL, 0.5 mL or 0.4 mL, so always check the vial strength. The TRT dose calculator does this math for the dose on your prescription.

How does splitting a weekly dose change the math?

Divide the weekly total by the number of injections. At 200 mg/mL, 100 mg a week given twice weekly is 50 mg, or 0.25 mL (25 units), each time. Every other day gives 3 or 4 injections in a calendar week, 3.5 on average, so each dose is the weekly total divided by 3.5. The weekly total is still the number the guidelines describe.

A 10 mL multi-dose vial at 200 mg/mL holds 2,000 mg, or 20 weeks at 100 mg a week, but follow the in-use limit for the vial you actually have, which may end it sooner. For example, the Canadian monograph for a 100 mg/mL cypionate vial says to discard a vial 56 days after first use. [20]

What goes wrong with the math?

Mostly mix-ups between strengths and units. The Institute for Safe Medication Practices has received reports of possible wrong-strength or wrong-volume errors with Depo-Testosterone, which comes as 100 and 200 mg/mL in similar cartons. In a separate warning about compounded semaglutide, not testosterone, the US Food and Drug Administration (FDA) described patients told to draw 5 units who drew 50, and blamed confusion between mL, mg and "units". [10], [51]

Small volumes are also harder to measure: in a bench study of syringes filled with water, errors above 5% became more likely when less than 20% of a syringe's capacity was measured. A syringe close in size to the volume being drawn measures more accurately. [52]

Doserly's TRT dose calculator converts a prescribed dose into mL and syringe units for any strength and schedule. It converts units; it does not suggest doses. Needle and injection technique are covered in how to inject testosterone.

What else do people ask about TRT dosing?

Weekly, twice weekly or every other day?

All three are in use, and the evidence favors smaller, more frequent doses only on pharmacokinetic grounds. Weekly injections are the main guideline option alongside every 2 weeks, and the AUA prefers 100 mg weekly to 200 mg every 2 weeks. Twice-weekly, every-other-day and daily schedules flatten the curve further, but none of the guidelines reviewed here gives a complete schedule for them, and we found no trial showing they improve health outcomes. The choice is the prescriber's, often shaped by symptoms between shots, hematocrit and how many injections a person is willing to do. [3], [2], [7], [6]

Is 150 or 200 mg a week too much?

It is above most guideline examples. The Endocrine Society, VA and Society for Endocrinology give 50–100 mg a week, the AUA 100 mg, and Xyosted tops out at 100 mg; only the top of the CUA's broad enanthate range (100–200 mg every 1–4 weeks) reaches 200 mg a week. The VA goes further: it treats intramuscular cypionate or enanthate above 100 mg weekly as a supraphysiologic (above-normal) dose that should raise suspicion of misuse. [2], [4], [5], [3], [15], [24]

The US labels allow up to 400 mg every 2 weeks, which averages 200 mg a week, but the enanthate label adds that totals above 400 mg a month "are not required", and Canada's cypionate label caps it at 400 mg a month. One US academic clinic used 100–200 mg weekly. Some online testosterone services aim far higher: in a 2022 secret-shopper study, 3 of 6 platforms that offered testosterone stated a goal of 1,000 ng/dL or more, against the AUA's 450–600 ng/dL. What separates replacement from steroid use is covered in TRT vs steroids. [1], [16], [20], [44], [53], [3]

What if you miss or are late with a dose?

The US testosterone injection labels reviewed here give no missed-dose instruction. Canada's cypionate and enanthate monographs say to give a missed dose as soon as possible unless the next one is almost due, and not to double up. UK leaflets tell Sustanon users to contact their doctor or nurse and not to take a double dose, tell Testosterone Enantate users to keep to the injection intervals agreed with their doctor, and warn Nebido users not to miss appointments because levels will not be maintained. Ask the prescriber what to do rather than guessing. [20], [21], [54], [55], [56]

How long after a dose change should you retest?

Long enough for levels to settle. Xyosted's label sets 6 weeks after any change, and its levels reached a steady state by week 6. For cypionate and enanthate vials we found no label that gives a time; the AUA's advice for starting (after 3–4 injections, or about 4 weeks) is the closest guide. Draw the retest at the same point in the injection cycle as the last one, or the two results are not comparable. [15], [3]

Does the dose depend on age or body weight?

None of the guidelines reviewed here sets a dose by weight or age; the dose follows the blood level. Age still matters: older men clear testosterone more slowly and had larger hemoglobin rises and more side effects at the same research dose. Weight can matter too: the VA says significant weight gain or loss may prompt an earlier level check, and in one clinic's records the interval for long-acting undecanoate varied with age and body size. [43], [11], [4], [48]

What is the "dose" for gels, capsules, nasal gel and pellets?

Each form has its own labeled dose, and the milligrams cannot be compared with injections:

• Gel. AndroGel 1.62%: 40.5 mg each morning, adjusted between 20.25 and 81 mg by the pre-dose level. About 10% of a gel dose is absorbed. See testosterone gel. [47], [19]
• Oral capsules. Jatenzo: 237 mg twice daily with food, adjusted between 158 and 396 mg twice daily. See oral testosterone. [57]
• Nasal gel. Natesto: 11 mg (one spray per nostril) three times a day, 33 mg a day. See Natesto. [58]
• Pellets. Testopel: 150–450 mg (two to six 75 mg pellets) every 3 to 6 months. See testosterone pellets. [59]

Is TRT dosing safe, and what are the risks?

At labeled and guideline doses, with monitoring, testosterone has a well-described set of risks; higher doses and bigger peaks make some of them more likely. The main dose-related risk is a rise in hematocrit. Labels also warn about blood pressure, fluid retention, sleep apnea, prostate effects, reduced sperm production and misuse, and their dose-adjustment text starts from response and side effects. [1], [60], [15]

Is a higher dose riskier?

For red blood cells, yes: hematocrit rises in a straight line with dose, more in older men. In a large records study, men whose hematocrit reached 52% or more on testosterone had more heart attacks, strokes or blood clots in their first year: 301 of 5,842 (5.15%) against 226 of 5,842 matched men whose hematocrit stayed lower (3.87%), although a records study cannot prove cause. The US labels also warn that taking more than treatment doses can bring withdrawal symptoms such as depressed mood, fatigue and low libido when stopped. [11], [61], [1]

What did TRAVERSE show about heart safety?

TRAVERSE, the largest heart-safety trial of testosterone, randomly assigned about 5,200 men aged 45 to 80 with low testosterone and heart disease or high heart risk to daily testosterone gel or placebo gel, with the dose adjusted to keep levels at 350–750 ng/dL. Among the 2,596 men who used testosterone gel and the 2,602 who used placebo gel, heart attack, stroke or cardiovascular death occurred in 182 (7.0%) and 190 (7.3%) (hazard ratio 0.96), which met the trial's safety goal. Some problems were more common on testosterone: atrial fibrillation 3.5% vs 2.4%, acute kidney injury 2.3% vs 1.5%, and pulmonary embolism 0.9% vs 0.5%. [62], [63]

Its limits matter for dosing: it tested only a daily gel, not injections; men used it for an average of 21.7 months; about 61% stopped their study gel early; and everyone was already at high heart risk. The TRT and heart health guide covers it in full. [62], [63]

Who should be especially cautious?

• Older men, who get larger hematocrit rises and more side effects at the same dose. [43], [11]
• Men who already start near the hematocrit line or have sleep apnea. See the hematocrit guide. [4]
• Men with heart, kidney or liver disease, because testosterone can cause fluid retention: the Depo-Testosterone label rules it out in serious heart, liver or kidney disease, and the enanthate and Xyosted labels warn that swelling can be a serious complication in these men. Men with high blood pressure should also take care, because testosterone can raise it; the labels say it is not recommended with uncontrolled hypertension. [15], [1], [16]
• Men with known or suspected prostate or breast cancer, for whom the current US labels rule testosterone out. In June 2026 FDA requested narrowing the prostate wording to metastatic prostate cancer; that change is requested, not yet in the labels (checked September 2026). [1], [64]
• Men who want children soon. Testosterone switches off sperm production, and the labels say reduced fertility may be irreversible for some men. See TRT and fertility. [15]
• Drug-tested athletes. Testosterone is banned in sport at all times. [14]
• Under-18s. Testosterone for teenagers belongs only in specialist care.
• Women. This guide is for men; testosterone for women uses different products and doses.

Which medicines interact with testosterone?

• Warfarin and other blood thinners. Androgens can change their effect; the labels recommend more frequent INR checks, especially when testosterone starts or stops. [15], [1]
• Insulin and other diabetes medicines. Testosterone can lower blood sugar and may mean a lower diabetes-medicine dose. [15], [1]
• Corticosteroids. Together with testosterone they may increase fluid retention. [15]

Bring a complete list of what you take, including supplements, to a pharmacist or prescriber. Checked September 2026.

Is testosterone legal, and is it allowed in sport?

Checked September 2026. Rules differ by country and change often.

• United States. Testosterone and its esters are Schedule III controlled substances, prescription only. [12]
• United Kingdom. Testosterone is a Class C controlled drug, in Schedule 4 Part II of the Misuse of Drugs Regulations. [13]
• Canada. Testosterone is a Schedule IV controlled substance. [65]
• Australia. Testosterone is a Schedule 4 prescription-only medicine. [66]
• Sport. The World Anti-Doping Agency (WADA) prohibits testosterone at all times, and its 2027 list, published in September 2026, keeps the ban. [14], [67]

What do people on TRT report about their dose?

Public forums are full of men comparing weekly doses, and of men puzzled by blood results that do not match their dose. The threads below are recent public Reddit discussions, read with their replies. They show what people experience, not how often it happens, and the doses in them are what people reported, not protocols.

Why do similar doses give such different numbers?

Draw timing explains many of them. One man on 200 mg of cypionate a week, with no dose change, measured total testosterone of 750 ng/dL 4 days after a shot, 850 at 2 days, 1,600 when a scheduling conflict put the draw 1 day after a shot, and 1,300 at 2.5 days. [68] Another, on 100 mg weekly, read 1,400 the day after an injection and 805 four days after. [69]

Real differences between people show up too. A man in his 30s on 50 mg a week measured a trough of 1,046 ng/dL, while another on 100 mg a week measured 353 ng/dL midway after six months and still felt unwell. [70], [71] A man in his 60s lowered his dose in steps from 150 to 110 mg a week over two years, but his lab only ever reported "above 13.5 ng/mL" (1,350 ng/dL), its upper limit, so none of the changes showed. [72] At-home tests add another layer: one reading of 2,450 ng/dL, taken about a day after an injection, drew replies asking for a lab test drawn midway between injections. [73]

What happens when people split the same weekly dose?

Results are mixed. A man prescribed 200 mg once a week felt great for four to six weeks, then had low-energy days, weak erections and sore nipples. Splitting it into two 100 mg injections seemed to fix the energy and erections, but a test drawn the day after a 70 mg injection read 1,750 with high estradiol, and his doctor cut the weekly dose to 100 mg. [74]

Others saw little change. One man moved from 100 mg every 5 days to 110 mg a week split every 3.5 days; his trough fell from 1,010 to 750 ng/dL, but estradiol barely moved (57 to 55 pg/mL) and his irritability and anxiety hardly improved. [75] Another switched from twice weekly to every other day at the same 110 mg a week and found his libido and erections got worse. [76] Splitting did not settle hematocrit in the accounts we read: one man reached 56% on 100 mg a week split twice weekly despite giving blood every three months. [77], [78]

What happens after raising or lowering the dose?

Raising the dose raised levels, but not always symptoms. One man went from 125 to 150 mg a week and saw total testosterone rise from 762 to 1,099 ng/dL with no change in his fatigue, poor sleep or weak erections; replies pointed to sleep apnea. [79] Another reached only 437 ng/dL after a clinic raised him from 140 to 160 mg once a week, and felt little difference. [80]

Lowering the dose helped some men and not others. A man who felt terrible at 140 mg a week (low mood, bloating, poor sleep) felt much better for three months at 108 mg split three times weekly. [81] Another cut from 110 to 90 mg a week: he slept better but lost drive and libido, while his trough fell from 808 to 591 ng/dL and estradiol stayed about the same. [82] A Sustanon user whose clinician cut the dose from 125 to 75 mg a week, because of high free testosterone and a hematocrit of 0.52, described fatigue and erection problems four weeks later; replies thought the step was large. [83]

Starting high is a recurring theme. One man started on 200 mg a week and three weeks later reported severe fatigue, anxiety and insomnia, with total testosterone of 1,130 ng/dL. [84] Another, prescribed 210 mg a week by an online clinic, felt great but tested at 1,500 ng/dL or more and chose to reduce. [85] At the other end, a man in his 50s who deliberately started at 60 mg a week, split twice weekly, reported a midway level of 799 ng/dL (from 340) and better energy at his first follow-up, while also taking a weight-loss medicine. [86]

What goes wrong with the math?

Volume mistakes come up again and again. One man meant to inject 0.13 mL three times a week but was drawing 0.33 mL, about two and a half times the planned amount, and found out only after a trough of 65.6 nmol/L and feeling worse. [87] A new patient noticed his instructions read "Inject 0.3 mL, 100 mg" twice a week from a 200 mg/mL vial, figures that do not match: 0.3 mL of that vial is 60 mg. [88] Another wrote "20 mg three times a week" and "140–160 mg a week" for the same schedule, then worked out that 20 units every other day at 200 mg/mL is 40 mg a shot, or about 140 mg a week. [89]

Products bought outside a normal prescription add a different risk: one man's level fell from 1,208 to 340 ng/dL on the same dose of an underground product, and a new vial of the same brand tested the same. [90]

What advice do replies give?

Replies disagree with each other and often with guidelines. A commenter who said he was a physician told one man he would like to see him at 900 ng/dL or more at the trough. [91] Many threads end with the same practical points: draw blood at a consistent point in the cycle, change one thing at a time, and wait several weeks before retesting. [92], [82] In a 2022 study, half of the online testosterone services that offered treatment stated a goal of 1,000 ng/dL or more, well above every guideline target in the key numbers. [53]

How can you judge a dose story?

Ask: What was the dose in mg, and what vial strength and volume produced it? How many hours or days after an injection was the blood drawn, and was it a lab test or a home test? Was it a prescribed product? What else changed at the same time, such as weight, sleep, hCG, an aromatase inhibitor or a weight-loss medicine? And what did the next test, drawn the same way, show?

These selected discussions show what people experience and the questions research has not answered. They are not a survey of all men on TRT, a success rate or a substitute for the studies above.

What should you track when your dose changes?

The dose, the date and time of each injection, and blood tests drawn at a known point in the cycle. Use this summary to prepare questions for your prescriber; it is not a personal testing plan. [2], [3], [4]

[2], [3], [15], [4], [60]

A single result is one point on a line. Because draw timing moves the number so much, results drawn at the same point in the cycle, under similar conditions, say more than any one value. The TRT blood work guide covers each test.

Common questions about TRT dosage

How much testosterone should I take a week?

The amount your prescriber sets, based on your blood levels and symptoms; there is no single right number. For cypionate or enanthate injections, guideline examples are about 75–100 mg a week, and the AUA's example starting dose is 100 mg weekly. Labels allow a wider range, and about a third of men in the Xyosted trial needed a dose other than the starting one. [2], [3], [28] See the key numbers.

How many mL is 100 mg of testosterone, and how many units?

It depends on the vial. At 200 mg/mL, 100 mg is 0.5 mL, or 50 units on a U-100 insulin syringe; at 100 mg/mL it is 1 mL (100 units); at 250 mg/mL it is 0.4 mL (40 units). Check the strength on the vial every time, because US Depo-Testosterone comes in both 100 and 200 mg/mL. [1], [9] See mg to mL to units.

Is it better to inject once or twice a week?

Twice weekly gives smaller peaks and troughs for the same weekly total, but we found no trial showing better health outcomes from it. The evidence that more frequent doses help is pharmacokinetic, plus one clinic's records linking 100 mg weekly with fewer high hematocrit results than 200 mg every 2 weeks. [7], [8] See weekly, twice weekly or every other day.

Can a 200 mg every-2-weeks prescription be given as 100 mg weekly?

Only if the prescriber changes the prescription. The weekly average is the same, and the AUA prefers 100 mg weekly, but the timing of blood tests changes with the schedule, so the prescriber needs to know which schedule the results reflect. [3] See adjusting the dose.

Why are my levels high on a low dose, or low on a high dose?

Usually because of when the blood was drawn, and sometimes because people simply respond differently. After a single 200 mg injection, levels roughly triple within days and fall back by day 14, so a level drawn soon after a shot can look far higher than one drawn just before the next. Doses that put trans men in the normal range ranged from 50 to 150 mg a week, and measuring errors or product problems can also play a part. [26], [39] See what people report.

How long does it take for a dose change to show up in blood tests?

Among injections, Xyosted is the only product with a stated rule: its levels settled by week 6, and its label rechecks 6 weeks after any change. For other injections, the AUA's first check comes after 3–4 injections. Gels and capsules have their own label timings. [15], [3] See how long to wait.

Glossary

Plain explanations of the dosing, lab and research terms used in this guide. Underlined terms in the text link here.

Aromatase inhibitor

A medicine, such as anastrozole, that blocks the enzyme that turns testosterone into estradiol. The VA does not recommend them for men on testosterone.

Clinical guideline

Recommendations written by a medical society or health system, based on its review of the evidence and expert judgment. Different guidelines can reach different conclusions.

Concentration (strength)

How much medicine is in each milliliter of a vial, written in mg/mL. The same dose needs half the volume from a 200 mg/mL vial as from a 100 mg/mL vial.

Controlled substance

A medicine whose prescribing and possession are restricted by law because it can be misused. Testosterone is Schedule III in the US, Schedule IV in Canada and Class C in the UK.

Controlled trial

A study that compares people who receive a treatment with a similar group who do not, often receiving a placebo instead. Randomly assigning people to each group makes the comparison fairer.

Depot

A pool of medicine left in the body, such as oil in a muscle, that releases the drug slowly over days or weeks.

Dose (amount each time)

The amount given on one occasion. A protocol lists both the dose and how often it is given.

Ester

A chemical tail joined to testosterone that makes it dissolve in oil and release slowly after injection. The body removes the tail to free testosterone. Cypionate, enanthate and undecanoate are esters, and doses are written as the weight of the ester.

Estradiol

The main form of estrogen. In men it is made mostly from testosterone, so it rises when testosterone rises.

Half-life

The time it takes for the level of a substance in the blood to fall by half. For injected testosterone esters it reflects slow release from the oil depot, about 8 days for cypionate on the US label. It is not the same as how long an effect lasts.

Hazard ratio

A measure comparing how often an event happens over time in two groups. A hazard ratio of 1 means no difference; 0.96 means about 4% lower in the first group.

hCG (human chorionic gonadotropin)

A hormone medicine that acts like the pituitary signal LH and makes the testicles produce their own testosterone. Some clinics give it alongside TRT.

Hematocrit

The share of the blood made up of red blood cells. Testosterone raises it, more at higher doses, and most guidelines act when it reaches about 54%.

Intramuscular (IM)

Injected into a muscle. US cypionate and enanthate vial labels use this route.

Mid-interval level

A blood test taken halfway between two injections, such as day 3 or 4 of a weekly schedule. Several guidelines use it to judge the dose.

Multi-dose vial

A vial meant for several doses, with a preservative. A single-dose vial is used once and any leftover is discarded.

Observational study (records study)

A study that follows a group of people, or looks back at their records, without assigning treatments. It can show links but not prove that one thing caused another.

Peak level

The highest level of a drug in the blood after a dose. After a cypionate injection it comes a few days later; after a weekly subcutaneous dose, within about a day.

Pharmacokinetics

How the body absorbs, moves, breaks down and removes a substance, and so how blood levels rise and fall after a dose.

Placebo

A dummy treatment with no active ingredient, used as a comparison in studies.

Product label (prescribing information)

The official document approved by a medicines regulator for a product, describing its approved uses, doses, warnings and monitoring. In the UK it is called the summary of product characteristics, and in Canada the product monograph.

PSA (prostate-specific antigen)

A blood test for a protein made by the prostate. It rises slightly on testosterone and is used to decide whether prostate checks are needed.

Steady state

The point, after several doses, when blood levels rise and fall in the same pattern from one dose to the next. Blood tests taken before it can mislead.

Subcutaneous (SC)

Injected into the fatty layer just under the skin. Xyosted uses this route, and a UK guideline accepts it for weekly cypionate or enanthate doses.

Supraphysiologic

Above the range the body makes naturally. The VA treats intramuscular cypionate or enanthate above 100 mg a week as a supraphysiologic dose.

Syringe units (U-100)

Markings on an insulin syringe that measure volume. On a U-100 syringe, 100 units equal 1 mL, so 0.5 mL is 50 units; the milligrams in each unit depend on the vial.

Titration

Adjusting a dose in steps, usually based on blood tests and symptoms.

Trough level

The lowest level of a drug in the blood, measured just before the next dose. Some UK guidelines and the Xyosted label judge injections by it.

TRT (testosterone replacement therapy)

Prescribed testosterone, by injection, gel or other forms, for men with low testosterone. It switches off the brain's LH and FSH signals.

WADA

The World Anti-Doping Agency, which publishes the list of substances banned in sport. Testosterone is banned at all times.

Weekly total

All the amounts given in one week, added together. For example, 50 mg twice a week is a 100 mg weekly total, and 200 mg every 2 weeks averages 100 mg a week.

How this guide was researched

This guide is built from a thorough review of the sources cited throughout it: current product labels from the United States, Canada, the United Kingdom and Australia, clinical guidelines from seven medical bodies, published pharmacokinetic and dose-finding studies, device and medication-safety documents, and legal and anti-doping rules. We also reviewed public online forums where men on TRT describe their own doses and blood results.

The guide cites 92 sources, including 18 product labels and monographs, 7 clinical guidelines, 24 studies in people and 25 public community discussions. Each type of source answers a different question. Labels and guidelines show what clinicians are told to do. Studies show what was measured. Personal accounts show what individual people experienced. Every numbered citation links to its entry below, labeled by source type.

How this guide was made

Research and drafting were AI-assisted. Every cited source was checked against the original, and the guide was reviewed and edited by Doserly before publication. It has not had an independent clinical review, and Doserly does not currently have medical reviewers. Doserly makes a medication and health-tracking app and runs Doserly Academy, both of which are promoted in this guide. Read our editorial policy for how guides are researched, updated and corrected.

This guide is for educational purposes. It summarizes what the reviewed sources report so the research is easier to understand; it is not medical advice. For a deeper dive, or to check any point for yourself, go straight to the cited sources.

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