My suggestion is to think of overall TRT dosing in terms of a MONTHLY TOTAL, and definitely not per week the way most people talk about it. There are not an even number of weeks in any month besides February, and that's only 75% of the time. Basing it on a 30-day month leads to consistent results and easy math. A lot of men will achieve an average serum Total T level similar to their total monthly T administration. For example, injecting 2500mg per month puts the average Total T level (tested at the right timing) of around 2500ng/dL, with some variability of course. The greatest impact on blood levels will come from exercise and activity level, since your testosterone administration is stable over time. I think doing injections of testosterone cypionate or enanthate every three days is the best overall strategy because each injection tends to peak on day three and you are therefore injecting on peak day for each dose and have a very even profile without needing to do smaller injections every day or two. Take the monthly total target and divide it by the number of injections you'll do per month. If you inject 70mg every day you get roughly 2100mg per month and will likely have a blood level around 2000-2200 or close to it on any given day. If you inject 140mg every two days you will have about the same experience and blood levels with just a tad more variation. Injecting 210mg every three days also tends to "feel" the same and blood levels are stable enough to check every day. I tried all of those strategies as well as going every 4 days, 5 days, 6 days and weekly at various time. Every 3 day injections seems like to best overall strategy in terms of getting stable results, convenient testing any day you like, and only ten injections per month instead of 15 or 30.

BPC-157 and TB-500 peptides definitely help repair injured soft connective tissues (ligaments, tendons, cartilage) much faster than normal - BUT ONLY when injected directly into the site of injury. These peptides do not appear to have "endocrine" function as "hormones" the way certain peptides do such as HCG, Insulin, Growth Hormone, Glucagon, etc. Most peptides only have local effects, and a select group have systemic endocrine effects like those peptide hormones I mentioned. It is not effective to inject those two hormones subq and expect them to circulate around the body healing injuries everywhere. That's a marketing ploy and a scam in my opinion, but I don't think most people out there promoting these peptides for use in this manner actually know that; they are just repeating what they were told without fact checking. There is a peptide that DOES appear to offer systemic healing promotion though, and that is ARA-290. There is very promising research using that peptide for systemic healing when used IV, IM, or SQ. There is even human research published for this one, with promising results. Based on limited human dosing studies (the one I reviewed was looking at nerve regeneration in patients with sarcoidosis and peripheral neuropathy, but I think would extend to any condition) and current understanding of the mechanisms it seems that taking doses intermittently is most efficient and certainly most economical. That Sarcoid study tried 2mg, 4mg, and 6mg daily dosing I believe and found continued AUC improvement over time with a possible plateau around the 6mg point - but again we don't really know how long the physiological repair effects will continue after each dose and what optimal dose spacing is. ARA-290 comes in 10mg vials (at least that's what we purchased) and it seems that injecting maybe 4-5mg (roughly half of a vial) every 5-7 days could be a good strategy. We need more research to iron that out, but I would start there. My wife is trying to heal her S1 nerve on the right after having severe disk herniation and a complicated prolonged surgery to remove those pieces. She's done just 2-3 doses now at this regimen and we will see if her recovery speeds up.

I am not aware of any meaningful risks from these peptides, but there is nowhere near enough research on BPC and TB to be sure. There has been enough human research that any common adverse effects should have been identified with ARA-290. One study I read said a single patient n the study had experienced some unusual weight loss, but she was already losing weight prior to the study and there was no apparent link.

@Louis Camassa There are a lot of negative side effects people commonly get from statin drugs that involve weakened cell membranes and impaired mitochondrial energy production in highly metabolically active tissues (liver, nervous system, skeletal muscle) due to the lowered cholesterol level and impaired production of ubiquinone (Coemzyme Q10). I recorded a long video on the topic yesterday that will hopefully be ready and posted this week. The pharmaceutical industry chooses to ignore the frequent subjective complaints patients have when taking statins and suggest that only severe reactions reaching the level of tissue damage/destruction count. Those are not very common and they are able to make the statistics look like problems are rare. Considering that statin drugs don't actually offer real meaningful benefits (lowering your blood lipids artificially with drugs doesn't yield any improvement in life span or quality of life), any amount of risk isn't really worth it in my mind. There are estimated to be more than 200 million people taking statin drugs across the developed world and yet the world incidence and prevalence of atherosclerotic disease is going up instead of down. The strategy of lowering lipids and blood pressure artificially with drugs has clearly failed and we need to change our understanding of the problem.

Methylprednisolone reportedly has a half-life of 18-36 hours, which is a wide range and suggests many variable affect this. That would imply that it could take several days or more than a week for all molecules of the drug to leave your body. BUT, the clinically relevant effects of the molecule clearly wear off in less than a day when people use it, and each dose shouldn't suppress pituitary ACTH production for more than 2-3 days even at high doses. The important factor is how LONG a person has taken it. If you take a high dose steroid "burst" for just 3 days you probably go back to your own natural adrenal production within 2 days of stopping, your own HTPA axis waking back up gradually as the synthetic steroid level gradually drops below physiologic replacement level. The adrenals are your least forgiving endocrine glad after being temporarily suppressed, and that means your chances of full adrenal function recovery go down the longer you are taking corticosteroids that suppress ACTH production. If someone is on these steroids for longer than 5-7 days they often need to taper off gradually to avoid an abrupt period of adrenal insufficiency. Most people I have seen who took suppressive doses for more than a few months have a very hard time ever recovering their own full adrenal function, and that gets worse the longer a person takes them. This is one of the trickiest hormones to work with because of this.

One thing I think I've said here somewhere but bears repeating about using GLP-1 peptides: I strongly encourage people to use HCG at the same time as these weight loss peptides. It shifts your metabolic fuel to mostly burn fat for energy rather than carbohydrates, helping you lose more fat than protein and preserving lean body mass to a great degree. We've been using that in combination all along and have gotten great results in people who tried GLP-1 peptides by themselves with no results. We also try to get everyone's metabolic hormones dialed in first too and provide dietary advice that improves outcomes if people follow the directions. This really needs to be a comprehensive metabolic approach rather than just using a peptide and some supplements if you want optimal results without losing a lot of muscle.

The vast majority of molecular effects you see discussed in the "bench" science area of medicine (purely laboratory study with very controlled experiments conducted in test tubes rather than living systems) does not extend to showing the expected clinical response in actual human beings. Most of the integrative/functional world worships at the altar of this sort of laboratory chemistry-based science and prescribes all sorts of supplements and prescription molecules to try and manipulate these pathways to no avail or very unimpressive results by and large. Life is very complex and we have redundant counterbalancing systems for everything in our bodies. This is why studying certain biochemical processes in relative isolation fails to predict what is truly going to work. HCG is an internally-produced molecule and is incredibly high during pregnancy. Pregnant women need to feed a lot of calories to their baby and HCG (there are likely to be other hormones produced during pregnancy that help with this, which we haven't even discovered yet) helps them use fat for that purpose while retaining their lean mass - otherwise pregnant women would starve to death much more often and take the baby with them. This is real world evidence of how an endogenous molecule "works" even though I doubt we have even half the cellular mechanisms and biochemical pathways sorted out in terms of bench science. We've have clients who had no response or only mild weight loss on the GLP-1's (even Reta) in the past do great when we combine the same peptide with HCG. That's where my opinion on this comes from, and the bench science doesn't beat actual results in my philosophy. We also try to get each person's metabolic hormones optimized prior to retrying the weight loss peptides, and I'm sure that is part of the improved success as well. I can't be certain how much the HCG itself helps because of that, but the nonconventional weight loss community has used HCG alone for weight loss for decades with good success. They had to restrict their calorie intake with much more willpower and discipline, which is where using the GLP-1 alongside it fits in. These two peptides each achieve impressive weight loss on their own and they fill in each others' deficiencies in terms of mechanism for what seems like a synergistic improvement in clinical outcomes.

I am likely going to update this document soon, mention a cap on how high we should push our T levels at older ages. I think our needs decrease as we age and it can have negative effects to maintain the levels I've mentioned after middle age. I am in the process of lowering my own TRT dosage now, having recently turned 53 and feeling like something is off. There are probably other hormones or anabolic molecules we stop producing as we age and keeping testosterone disproportionately high relative to those other declining factors may be a problem. I should have a better idea about this over the next several months between experimenting with my own TRT regimen and talking with patients over age 45-50.

I"m in the middle of experimenting on myself, so I will wait until I feel like I have found a new optimal TRT regimen and what that looks and feels like before I offer advice. Any advice I give now will likely change after I gain that new knowledge and understanding.