Testosterone (TRT / supraphysiological)
Muscle & Strength · Endogenous androgen (AR agonist)
Tier B
Bottom line
Read Off Label grades Testosterone (TRT / supraphysiological) as B (6.8/10) based on strong evidence, strong benefit magnitude, and a med-risk safety profile.
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.
Typical use: TRT: testosterone cypionate/enanthate 100-200 mg/week IM/subQ, or daily gel; supraphysiological cycles 300-1000+ mg/week — Rx for hypogonadism (Schedule III US as anabolic steroid); illicit supraphysiological use illegal.
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
Citations
- https://pubmed.ncbi.nlm.nih.gov/37326322/
- https://pubmed.ncbi.nlm.nih.gov/8637535/
- https://doi.org/10.1210/clinem/dgaf622
- https://doi.org/10.33963/v.phj.111620
- https://pubmed.ncbi.nlm.nih.gov/41596342/
Links go to the source. If a link is dead or you want something re-checked, let me know.
Common questions
- Does Testosterone (TRT / supraphysiological) work?
- Read Off Label rates the evidence for Testosterone (TRT / supraphysiological) as Strong and the benefit magnitude as strong, producing an overall grade of B (6.8/10). 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.
- Is Testosterone (TRT / supraphysiological) safe?
- Testosterone (TRT / supraphysiological) has a med risk profile in published human data. Legal status: Rx for hypogonadism (Schedule III US as anabolic steroid); illicit supraphysiological use illegal. This is not medical advice — see the disclaimer.
- What is the typical dose for Testosterone (TRT / supraphysiological)?
- TRT: testosterone cypionate/enanthate 100-200 mg/week IM/subQ, or daily gel; supraphysiological cycles 300-1000+ mg/week
- How does Testosterone (TRT / supraphysiological) work?
- Prototypical androgen receptor agonist; increases muscle protein synthesis, satellite cell activation, erythropoiesis, bone density; aromatizes to estradiol (necessary for bone, libido, lipids)
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.