Healthspan Podcast | Episode 3
TRT Dosing: Minimum Effective Dose vs Maximum Tolerable Dose, with Dr. Andrew Winge
How much testosterone is enough? How much is too little?
And at what point are you no longer doing replacement therapy… ?
In this episode of the Healthspan Podcast, I sit down with Dr. Andrew Winge of Man Medicine to discuss one of the most debated topics in testosterone replacement therapy:
Minimum Effective Dose vs Maximum Tolerable Dose.
We break down what realistic dosing looks like, why free testosterone is more important than total, the significance of SHBG, insulin resistance, the significance of genetic variability, anabolic resistance, aromatization, estrogen myths, body composition as a key metric, metabolic health, and why the “right” TRT dose is highly individual.
We also discuss why many men fail TRT despite “normal” lab values, the limitations of current guidelines, why symptom resolution matters, and the growing divide between conservative TRT philosophy and the increasingly common “TRT+” approach seen online and in some clinics.
If you’re on TRT, considering it, or trying to optimize your protocol, this episode will help you think about dosing in a much more nuanced and individualized way.
⏱️ Timestamps
00:00 Why “Safe” TRT Often Fails Men
00:18 Introduction to Dr. Andrew Winge
01:34 Dr. Winge’s Personal TRT Story
05:40 How Testosterone Changed His Medical Practice
08:46 Why Most Providers Don’t Understand TRT and why you shouldn't expect them to
11:44 The Problem With Modern Primary Care
13:35 Why Muscle Mass Matters for Longevity
18:20 Minimum Effective Dose vs Maximum Tolerable Dose
19:18 Why TRT Guidelines Fail Many Men
21:57 Why Many Men Quit Testosterone Therapy
26:06 Free Testosterone vs Total Testosterone
28:45 Why Some Men Need Higher Testosterone Levels
31:49 Why Out-of-Range Labs Aren’t Automatically Dangerous
35:04 Testosterone Safety and Higher Dose Studies
38:19 Testosterone, Muscle Mass, and Metabolic Health
40:42 When Higher Testosterone Doses Stop Helping
41:23 Why Lifestyle Still Matters on TRT
43:35 Optimal Free Testosterone Ranges
45:20 Why Broader Medical Experience Matters in a TRT provider
46:47 The Big Rocks of Health Still Matter Most
49:03 Estradiol, Aromatization, and Obesity
51:20 Why Estradiol Is Protective in Men
56:31 Why Adiposity Is the Real Problem
57:58 The Problem With Aromatase Inhibitors
59:01 DIM, Estrogen Myths, and Bad TRT Advice
01:02:12 The Business Side of TRT Clinics
01:05:12 Why Estradiol Labs Often Mislead Doctors
01:07:18 Estradiol, Nitric Oxide, and Erectile Function
🎙️ Guest: Dr. Andrew Winge | Man Medicine
Website
https://www.manmedicine.com/
Instagram
https://www.instagram.com/manmedicinemd/
YouTube
https://www.youtube.com/@manmedicine
📌 Need expert HRT guidance?
At Men’s Healthspan, we fix hormones and metabolic health so you can feel better, look better, and live better.
➡️ Book your free consult here:
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🔢 Free TRT Tools
Free Testosterone Calculator
https://menshealthspan.com/free-testosterone-calculator-2/
Testosterone Dosage Calculator
https://menshealthspan.com/testosterone-dosage-calculator-use-insulin-syringes-for-trt/
GLP-1 Dose Calculator
https://menshealthspan.com/semaglutide-and-tirzepatide-dose-calculator/
