What starting doses do labels and guidelines describe?
Here is the range your provider works within, as context rather than instructions. Starting doses are set from your own labs and history, and nobody should start or change testosterone on their own.
| Form | Published starting range | First level check |
|---|---|---|
| Cypionate or enanthate into the muscle | 75 to 100 mg weekly, or 150 to 200 mg every 2 weeks | Mid-interval level at 3 to 6 months |
| Cypionate label range | 50 to 400 mg every 2 to 4 weeks | Adjusted to response and side effects |
| Xyosted, weekly under the skin | 75 mg once a week | Trough after 6 weeks |
| Kyzatrex, oral capsules | 200 mg twice daily with food | 7 days after starting |
The injection regimens come from the dosing table in the Endocrine Society guideline. The wide 50 to 400 mg band is the replacement range on the Depo-Testosterone label, and the guideline narrows it to the regimens above. The Kyzatrex label asks for the level 3 to 5 hours after the morning dose. Our pages on testosterone injections and Kyzatrex oral testosterone cover each form in detail.
Why not start at the top of the range?
Because the target is the middle of normal, not the top. The Endocrine Society aims for mid-normal levels on treatment, and the AUA guideline sets a target in the middle tertile of the normal range, which it describes as 450 to 600 ng/dL.
Overshooting brings problems that a modest start avoids. The AUA notes that injectable testosterone raises hemoglobin and hematocrit more than other forms, and higher levels mean more conversion to estradiol. Stepping up from a sensible start is easier than backing down from side effects.
Why split the weekly dose?
Splitting smooths out the ride. Testosterone cypionate has a half-life of about eight days, so a large dose every two weeks produces a high peak in the first days and a deep trough before the next shot. The Endocrine Society notes that these peaks and valleys may be associated with swings in symptoms.
The guideline already lists a weekly option, and dividing that weekly amount into two smaller injections narrows the swing further while keeping the weekly total the same. The cost is one more injection each week. Our comparison of weekly and twice-weekly injections lays out who tends to benefit.
When are the first labs, and what do they decide?
The first meaningful check comes once levels have settled, which for weekly injections is about six weeks in. The Xyosted label spells out the logic: measure the trough, 7 days after the last dose, after 6 weeks of dosing. A trough between 350 and 650 ng/dL keeps the dose as is, at 650 or above the dose drops by 25 mg, and below 350 it rises by 25 mg.
The AUA guideline makes the same point for other injections, asking that levels be measured after several cycles so they have reached equilibrium. Expect the first adjustment to be a small step, followed by another check. Symptoms need time too: a review of treatment timelines found sexual interest improving after about three weeks, while changes in fat and lean mass took 12 to 16 weeks. Hematocrit is usually part of the same early review; the Endocrine Society recommends checking it 3 to 6 months after starting. For how long a change takes to show, see how long after a TRT dose change.
What else shapes your first dose?
Your numbers and history move the starting point up or down. Your provider weighs:
- How low your baseline testosterone is and what your LH shows.
- Hematocrit before treatment, since injections push it up.
- PSA, prostate history and urinary symptoms.
- Sleep apnea, blood pressure and any history of blood clots.
- Whether you want to protect fertility, which may mean adding HCG.
- Your preference for injections, capsules or pellets.
Our page on the target testosterone level on TRT explains where those first results should land.
How Ultimate Male sets your first dose
At Ultimate Male, the starting dose comes after the TRT pre-screening panel and a one-on-one consultation with a PA-C or MD, never from a template. You leave with clear instructions on how much, how often and when your first trough draw is due.
From there, follow-up visits and labs fine-tune the plan, and changes are made with your provider rather than on your own; our answer on adjusting your own TRT dose explains why. If you are still deciding whether testosterone therapy fits, the free 10-minute call is the place to start.
