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 my name is Trent. I’m a missionary serving in Mexico. I started TRT with a level of 394 after being on it for 5 weeks i was at 1500. Ive been on it for 9 weeks now. I’m taking 250mg/ml once a week. I feel so much better. I plan on getting tested again before my 11th shot to see where I’m at. Im just getting into this so my question is does it seem like I’m doing this right? Haha

64yo. I have had a high PSA since the first time checked at 40yo between 9 and 35ng/ml. Have had biopsies, recently had MRI and PET/CT F18 PSMA PYLARIFY, no cancer found. No clinc will put me on Trt. I also have BPH prostate 180cc. I have been low testosterone 250ng/dl since I was in my 30’s. Dr at VA put me on 100mg per week at 45yo and it helped some, but the VA changed my dr and took me off due to high PSA. Should I wait to start TRT after surgery or less invasive procedure. Or start now. I’ve raised me testosterone or 500ng/dl through Enclomiphene. Helps some and done see any negative effect or further prostate enlargement. Thank you