Rankings / Muscle Building

Testosterone (TRT / supraphysiological)

Muscle Building · Endogenous androgen (AR agonist)

Tier B+

anabolicandrogen-therapycontrolled-substanceprescription
7.0 / 10
Tier B+
Ev 8.0 Bn 8.0 Sf 5.0 Ax 5.0

What this is

TRAVERSE 2023 (n=5246, high CV risk hypogonadal men) — TRT non-inferior to placebo for MACE; no prostate cancer increase; small increases in atrial fibrillation, VTE, fractures, acute kidney injury. Reduced progression to diabetes. FDA February 2025 label change: REMOVED boxed warning for major adverse cardiovascular events; ADDED class-wide warning for blood pressure increases (per ambulatory BP monitoring data). Bhasin 1996 NEJM remains definitive demonstration of dose-dependent muscle gain in healthy men. Yeap 2026 J Clin Endocrinol Metab review: nonlinear association of low testosterone with all-cause mortality below ~213 ng/dL.

Mechanism

Prototypical androgen receptor agonist; increases muscle protein synthesis, satellite cell activation, erythropoiesis, bone density; aromatizes to estradiol (necessary for bone, libido, lipids)

Dose & route

TRT: testosterone cypionate/enanthate 100-200 mg/week IM/subQ, or daily gel; supraphysiological cycles 300-1000+ mg/week

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.