1500mg per Week Testosterone – What Happened After 6 Months? Clinical Case Analysis
Timeline
Video Summary
A thirty four year old man reports using very high weekly testosterone for months. The dosing pattern is described as repeated large injections several times each week. New concerns include fatigue, anxiety, and erectile dysfunction that worsened over time. A review of history notes common problems such as asthma, reflux, and mild depression. Lifestyle details include occasional cannabis gummies and social alcohol use without dependence. The presentation highlights how symptoms can appear after an early period of feeling great. A goal of staying big and strong is described as the motivation for continued escalation.
Vital signs show significant hypertension and a fast resting heart rate at evaluation. Physical findings include facial puffiness and visible redness suggestive of volume and pressure strain. A coronary calcium scan is discussed with a very high score concentrated in a major artery. Cardiac testing is described as showing left ventricular hypertrophy on electrocardiogram and echocardiography. Laboratory review describes severely low HDL cholesterol and an elevated LDL cholesterol level. Kidney markers are described as borderline on creatinine with uncertainty from high muscle mass. The case emphasizes that multiple systems can be stressed simultaneously during extreme androgen exposure.
Blood testing shows markedly elevated hemoglobin and hematocrit consistent with androgen driven erythrocytosis. Iron studies are described as elevated, raising concern for iron overload and deposition risk. Hormone testing is noted as above assay limits for total testosterone with high estradiol measurements. An aromatase inhibitor schedule is described, but the plan shifts away from that approach. The management plan includes stopping the extreme dose and transitioning to a supervised lower regimen. Cardiology and lipid management are emphasized, including blood pressure control and aggressive LDL reduction. Follow up guidance stresses gradual stabilization, monitoring symptoms, and coordinated specialist care.
Drug Callouts
Condition Callouts
Key Takeaways
- Extremely high weekly testosterone dosing was linked with fatigue and erectile dysfunction.
- Hypertension and tachycardia were documented and treated as urgent risk signals.
- A very high coronary calcium score prompted aggressive cardiology evaluation.
- Hemoglobin, hematocrit, and iron saturation were elevated, raising deposition concerns.
- Transitioning to supervised lower dosing plus lipid therapy was emphasized for safety.