Dosage Calculation for Testosterone Injection
Based on a 100 mg/mL concentration, alternating weekly doses of 0.2 mL and 0.3 mL will deliver 20 mg one week and 30 mg the next week, averaging 25 mg per week.
Calculation Breakdown
- With a concentration of 100 mg/mL, each 0.1 mL contains 10 mg of testosterone 1
- 0.2 mL (0.2 units) = 20 mg of testosterone 1
- 0.3 mL (0.3 units) = 30 mg of testosterone 1
- Average weekly dose = 25 mg per week when alternating between these two doses 1
Critical Dosing Concerns
This proposed dosing regimen is substantially below FDA-approved guidelines and clinical practice standards. The FDA-approved dosing for testosterone cypionate for hypogonadism is 50-400 mg every 2-4 weeks, not weekly micro-dosing 1. Standard practice typically uses 100-200 mg every 2 weeks or 50-100 mg weekly 2.
Why This Dosing Is Problematic
- Your proposed 20-30 mg weekly doses are 50-70% below the minimum effective dose of 50 mg weekly used in clinical practice 2, 1
- Testosterone cypionate peaks at days 2-5 after injection and returns to baseline by days 10-14, which is why standard dosing intervals are every 2-4 weeks, not weekly 2
- Weekly injections of such low doses will likely fail to achieve therapeutic testosterone levels in the mid-normal range (500-600 ng/dL) 2
Evidence-Based Dosing Recommendations
- For intramuscular testosterone cypionate, the standard starting dose is 100-200 mg every 2 weeks or 50-100 mg weekly 2, 1
- The American College of Physicians recommends intramuscular formulations over transdermal due to significantly lower cost with similar effectiveness 3, 2
- Testosterone levels should be measured midway between injections (days 5-7 for weekly dosing), targeting mid-normal values of 500-600 ng/dL 2
Monitoring Requirements
- Measure testosterone levels 2-3 months after treatment initiation and after any dose change 2
- Monitor hematocrit periodically and withhold treatment if >54% 2
- For men over 40 years, monitor PSA levels before and during therapy 2
- Reevaluate symptoms at 12 months and discontinue if no improvement in sexual function 3, 2
Common Pitfall to Avoid
Do not use symptom questionnaires or non-specific symptoms alone to justify testosterone therapy without confirmed biochemical hypogonadism (two morning testosterone levels <300 ng/dL) 2. Approximately 20-30% of men receiving testosterone in the United States do not have documented low testosterone levels before treatment initiation, which violates evidence-based guidelines 2.