Quote · Huberman Lab
Essentials: Tools for Hormone Optimization in Males | Dr. Kyle Gillett
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Testosterone Therapy, Dose; Side Effects
At 30:08 · chapter starts 26:48
With the foundation laid on lifestyle and supplementation, the conversation turns to testosterone therapy itself — not replacement in the strict sense, but optimization for men whose levels are technically normal but are experiencing symptoms. Gillett recommends 100–120 mg/week of cypionate or enanthate divided into every-other-day or three-times-weekly injections as the physiologic starting point, noting that even 200 mg/week is far above the reference range. SHBG levels modify the dose calculation — a man with very high SHBG and a free testosterone of 2 ng/dL may need a higher absolute dose to achieve normal free testosterone. The side effect landscape is expansive: acne, hair loss, mental status changes (including manic episodes due to testosterone's dopaminergic properties), cardiovascular microvascular ischemia, rising ferritin and estrogen, lipid abnormalities, and fertility suppression. Huberman underscores the key takeaway: this level of systemic monitoring demands not just a prescribing physician but a true interdisciplinary team with dermatology, cardiology, and lipidology expertise.
A physiologic starting dose is 100–120 mg/week of testosterone cypionate or enanthate, divided into every-other-day or three-times-weekly injections. Warning signs requiring close monitoring include acne, hair loss, mental status changes, lipid shifts, cardiovascular risks, fertility issues, and elevated hematocrit.
A typical physiologic starting dose for testosterone therapy is 100–120 mg/week divided into injections every other day or three times a week.
