This is not my expertise but I have some opinions.What’s your take on a cruisy level of Cypionate for older guys? In one of the starting strength podcasts, Rippetoe talks about guys in their 50s that work out in his gym that get on say 300mg per week and feel 10 years younger. Helps a lot with energy and recovery.
In theory being more anabolic would be a good thing for muscle development and recovery. There's been a ton of studies on TRT and how it affects performance. I think the normal range is still somewhere between 300-900 give or take. No studies have found a performance difference for men who have been within that range...so for men who want to go from say 400 to 800, they won't see a noticeable or measurable performance benefit.
Men that have symptoms of hypogonadism I think are good candidates for TRT and should seek expert counsel. The problem is your family doctor knows jack sh!t about it and you need to sift through a lot of shady practices to find a good one. Also before going down the road of TRT you need to make sure there isn't something else going to that is preventing you from using what you already have. You can have a low T number, but also have a high free T number...meaning you body isn't using what you already have which could be causing the low production. Things like excess adipose tissue, alcohol abuse, liver disease, low SBHG can all have a negative effect on your bodies ability to use testosterone. Depending on the person, lifestyle adjustments could be all that's necessary.
There's so much out there about TRT and a lot of it is opinion. A very well respected DR doses on how patients feel and pays very little attention to the total testosterone number. It's common for his patients to have a total around 1200. He's worried more about driving up free T and how the patient feels vs finding a total number.
Some prescribers are worried about hematocrit levels spiking while others feel there is an actual benefit to increased hematocrit.
Water retention is a short term issue while your body adapts to new hormone levels. Blood pressure will rise and for some it's temporary while for others it's permanent and will need to be addressed. Do you want to cause something and then add a medication to fix it?
When you drive testosterone up your estrogen will rise. Some prescribers (very bad awful ones) will try and manage this with an aromatase inhibitor, which is poison. Estrogen rising is fine if it's in balance with total T. Estrogen also is an important part of fighting disease like cancer.
Some say there is a connection with TRT and prostate cancer yet every study I'm aware of has called bullshit on this.
There is a ton of placebo effect with TRT.
If I felt OK and my total T was within the normal range I probably would look at TRT as a last resort and begin with lifestyle adjustments. Are you eating right? DO you have more than 1-3 drinks per week? Are you meeting the minimum guidelines for physical activity and do you strength train regularly? I know a lot of people who are on TRT and there is a honeymoon phase where you feel awesome but you usually come back down to your mean after some time. TRT is useful for somme but it's not magic.