When I first started in healthcare, I was working in a traditional internal medicine practice.  Testosterone was prescribed the same way for almost everyone: 200mg every two weeks, intramuscular injection.

It didn’t matter what your labs showed. It didn’t matter what your SHBG was.  That was just the protocol.

And the reason is simple—it’s built around how insurance reimburses for visits and medication, not around how hormones actually work.

The Problem With Standardized Testosterone Dosing

After going deeper into the physiology and training around hormone optimization, I realized we were treating testosterone like a billing protocol—not a hormone.  Testosterone cypionate has a half-life of about 7–8 days, but that doesn’t mean stable levels for 7–8 days.  If you inject 200mg once every two weeks, what actually happens is:

• Your levels spike shortly after injection
• Then steadily decline
• And by the end of the two weeks, many men are back near baseline

It creates a hormone roller coaster.

Why This Matters

That fluctuation shows up as:

• Energy swings
• Mood instability (roid rage symptoms)
• Inconsistent libido / erectile dysfunction (ED)
• Decreased mental clarity
• Variable performance in the gym and daily life

It’s the hormonal equivalent of telling someone with high blood pressure to take two weeks’ worth of medication at once and check back in two weeks.  We wouldn’t accept that anywhere else in medicine.

What Actually Determines the Right Dose

Testosterone therapy should be based on: 

• Your lab values 
• Your symptoms
• A thorough analysis of how your body is metabolizing the testosterone
• Your response over time

This is why many men do better on smaller, more frequent dosing (2–3 times per week) rather than large, infrequent injections.

A Better Approach

In my experience, if a provider isn’t tailoring dosing, they’re often not accounting for absorption, metabolism, and symptom response either.  Hormone optimization requires precision and adjustment, not a one-size-fits-all protocol.

What We Do Differently at Chelle

At Chelle, we don’t follow a standard dosing template.  We evaluate a myriad of lab values, but most iimportantly—how you actually feel.  Then we adjust your protocol to create stable, consistent levels—not spikes and crashes.

If You’re Not Feeling Better, There’s a Reason

If you’re on testosterone and still dealing with fatigue, mood swings, low libido, brain fog, or inconsistent results, it’s not something you should just accept.

There’s a better way to do this.