Hello Dr. Ty, I really like your TRT framework and the way you think about optimization. After watching your videos, I just went to an online TRT clinic recently and am waiting for my first dose to come in, so I’m excited to get started. At the same time, I want to be cautious and make sure I’m thinking about the science and health markers correctly. I had a few questions: 1. For long-term targets around 1500–2000+ ng/dL, what evidence best supports that range as not just subjectively better, but also healthy/safe long term compared with more conventional TRT ranges? I know you aimed for your patients to be around this range, but I often see so many forum posts often from bodybuilding circles where high dosing T leads to many bad side effects - organ enlargement, generally cardiotoxic and leading to heart disease, etc etc. I know it may be propaganda, but honestly I am a bit scared of jumping straight to 450 mg a week and keeping that indefinitely. On that note - would you ever recommend starting at 250 and titrating up until 2500 ng/dL is reached on days before injection? 2. On hematocrit, you’ve said testosterone-induced high Hct is different from polycythemia vera and is not something to worry about. What studies or data best support that position specifically for testosterone-induced erythrocytosis? Is there any Hct level where you personally would reduce dose or intervene? Is it truly truly safe to have very thick blood (extreme case hypothetical). 3. For cardiovascular risk, what markers do you care most about when deciding if someone is safe to proceed or needs to adjust — blood pressure, ApoB/LDL, Lp(a), urine albumin/protein, hematocrit/hemoglobin, estradiol, DHT, PSA, liver enzymes, kidney markers, etc.? Asking very respectfully. Again, I love your frameworks and will start TRT hopefully this week. Thank you so much.

Hi, I am new here from odessa Texas. I have been on trt for about three years. Been on pellets and injections. My level has been as hi as 2300 ng/dl on pellets my hemoglobin was over 18 and I was tired and sleepy all the time with headaches estradiol was high also. Is this from hemoglobin or should I check something else. I noticed I was was waking up at night with high pulse rate when levels were high.

Hey Dr Ty, I know you mentioned HCG use as mostly for fertility. But I was wondering what you think about using it at all times together with your testosterone (which is what I'm doing). I hadn't had much success with testosterone only - HCG improves libido/erection quality significantly. I'm pretty sure there has to be some mechanism in action here. I'm wondering if having functioning testicles is very important not only for fertility, but for libido/erection quality, and also, one thing I notice my downstairs is way more sensitive to HCG, so in short, on testosterone alone, I lose some sensibility. I'm pretty sure intra-testicular testosterone/estrogen is important to have this system fully working. I also heard in one of the podcaster which was really into medicine and biology, that pretty much TRT only obviously shuts down the testicles, and with enough time, scar tissue builds up inside the testicles, and blood flow down there drops significantly - which then if you want to have a child or even stop the TRT (I know you shouldn't) significantly harder or even impossible. So, would it make sense to add HCG to preserve testicular function? I know I'm not alone with what I experienced, HCG being necessary for optimal libido/erection quality/sensation - plenty of people experienced the same if you visit Reddit, for example.

Hey! Thyroids are a very important topic, and we know that testosterone lowers Thyroid hormones. I was wondering what your take is on this? A lot of specialized clinics already hand out thyroid meds together with testosterone (HRT vs TRT) when needed. In my particular case, I feel a bit sluggish and it looks like my free T4 is on the lower end, which could explain this, although in reference ranges, this is highly personal, just like testosterone ranges. I'm about to try T4/T3 meds, what's your take on this?

Hi Dr. Vincent, Super glad you added this platform! Always looking to learn as much as I can. What is you opinion on Telmisartan? Best, Patrick Brothers