Derek (More Plates More Dates) TRT: What a Celebrity Pays vs. A Regular Patient

Who Is Derek from More Plates More Dates?

Derek is a Canadian content creator, researcher, and entrepreneur who built the largest independent testosterone and performance-pharmacology education channel on YouTube. He started the channel in 2016 and has since published hundreds of hours of content covering bloodwork interpretation, TRT protocols, and the science of hormonal optimization.

He is not a licensed physician, but he reads primary literature at a level that puts many patients ahead of their own doctors by the time they walk into a clinic. That combination of reach and depth makes his protocol choices unusually influential. When Derek describes his testosterone dose on camera, tens of thousands of viewers arrive at their next appointment asking for the same thing.

His Publicly Discussed Hormone History

Derek has disclosed on video that he began exploring performance-enhancing compounds in his early twenties, ran anabolic cycles, experienced suppression, and eventually transitioned to what he describes as a long-term TRT-adjacent approach. He has discussed post-cycle therapy (PCT) failures and the clinical realities of secondary hypogonadism that can follow exogenous androgen use.

Secondary hypogonadism after anabolic steroid use is well-documented. A 2020 cross-sectional study published in PLOS ONE found that 57% of long-term anabolic steroid users met criteria for hypogonadism after cessation, with mean total testosterone of 189 ng/dL compared to 427 ng/dL in non-users (1).

Why His Content Matters Clinically

Derek's audience does not passively watch. They act. They order labs. They bring printouts. Clinicians who understand what Derek teaches are better positioned to meet patients where they are, catch errors in self-directed protocol design, and redirect enthusiasm toward evidence-based care.

Derek's Publicly Discussed TRT Protocol

Derek has described his working TRT protocol across multiple videos and interviews. The figures below are drawn from his own public statements, not from private records.

Testosterone Dose and Ester

He has cited testosterone cypionate at roughly 125 to 175 mg per week, injected subcutaneously or intramuscularly. He splits doses into twice-weekly injections to reduce peak-to-trough fluctuation in serum testosterone, which also tends to lower estradiol excursions.

That approach aligns with published pharmacokinetic data. Testosterone cypionate has a half-life of approximately 8 days, and twice-weekly dosing produces more stable serum levels than single weekly injections, reducing the amplitude of estradiol spikes that drive aromatase-related side effects (2).

The Endocrine Society 2018 Clinical Practice Guideline on male hypogonadism recommends testosterone therapy for men with classic hypogonadism symptoms and consistently low morning total testosterone below 300 ng/dL on two separate measurements (3).

Estradiol Management

Derek talks about estradiol management in detail that most clinicians reserve for fellowship training. He advocates using the sensitive estradiol assay (LC-MS/MS) rather than the standard immunoassay, noting that standard assays cross-react with other steroids and can misread male estradiol by 20 to 40%.

He has discussed anastrozole use cautiously, preferring the lowest effective dose and questioning whether many men overuse aromatase inhibitors unnecessarily. That position is consistent with published evidence: a 2020 study in the Journal of Clinical Endocrinology and Metabolism found that suppression of estradiol below 10 pg/mL in men on TRT was associated with decreased bone mineral density and impaired sexual function (4).

HCG and Fertility Preservation

Derek has discussed human chorionic gonadotropin (HCG) as a co-therapy to maintain intratesticular testosterone production and testicular volume during exogenous testosterone use. He typically references doses of 250 to 500 IU administered two to three times per week.

HCG stimulates Leydig cells via LH-receptor binding. A randomized trial published in the Journal of Clinical Endocrinology and Metabolism confirmed that 500 IU HCG every other day maintained intratesticular testosterone concentrations during exogenous testosterone administration, preserving spermatogenesis in most participants (5).

Bloodwork Cadence

Derek tracks labs obsessively. His publicly discussed panel includes: total testosterone, free testosterone (calculated and direct), sex hormone-binding globulin (SHBG), sensitive estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), complete blood count with hematocrit, comprehensive metabolic panel, lipid panel, PSA, and thyroid panel. He runs full labs every 8 to 12 weeks when adjusting a protocol and every 3 to 6 months when stable.

What Celebrity-Level TRT Actually Costs

"Celebrity" in this context does not mean a red-carpet actor necessarily. It describes anyone accessing concierge-tier hormone care: private anti-aging clinics, direct-pay concierge physicians, compounding pharmacies with personalized formulations, and quarterly executive health panels.

The Concierge / High-Access Tier

At this tier, a patient like Derek would expect to pay:

• Physician or NP consultation fee: $150, $350 per visit, with quarterly visits standard
• Comprehensive lab panels: $400, $900 per draw at a private lab (Quest or LabCorp self-pay, or boutique lab)
• Testosterone cypionate (compounded): $60, $120 per month for 100 to 200 mg/week dosing
• HCG (compounded, 10,000 IU vial): $75, $150 per month at standard TRT-support dosing
• Anastrozole or other ancillaries: $20, $60 per month
• Clinic platform or concierge membership: $100, $400 per month

Running those numbers, an engaged patient at this tier spends $300, $800 per month, or $3,600, $9,600 per year. Some elite concierge programs that include same-day physician access, genetic panels, continuous glucose monitoring review, and annual DEXA scans can push total annual spend past $15,000.

Why Compounded Testosterone Is Common at This Tier

FDA-approved testosterone cypionate (Depo-Testosterone, Pfizer, 200 mg/mL) is available as a generic and costs $30, $80 per 10 mL vial at retail pharmacies. Concierge patients often receive compounded cypionate at custom concentrations (e.g., 200 mg/mL in a smaller volume vial, or 40 mg/0.2 mL pre-filled syringe) for convenience rather than cost savings.

The FDA distinguishes between 503A compounding pharmacies (patient-specific) and 503B outsourcing facilities (larger batch production). Both must use pharmaceutical-grade active pharmaceutical ingredients (6). Patients and clinicians should verify that any compounding pharmacy they use is registered with the FDA.

The Standard Telehealth TRT Patient

The same clinical outcome is achievable at dramatically lower cost through telehealth-based TRT platforms. At HealthRX and comparable platforms, a typical monthly spend looks like this:

• Provider visit and ongoing monitoring: included in platform fee
• Platform subscription: $99, $149 per month
• Testosterone cypionate (FDA-approved generic, pharmacy): $25, $60 per month with GoodRx or platform discount
• Baseline and quarterly labs: $50, $120 through partner labs
• Anastrozole (generic): $10, $25 per month if indicated

Total: approximately $170, $350 per month, or $2,040, $4,200 per year. Lab costs can be lower with in-network insurance coverage, though many TRT-related labs are covered under standard endocrine benefit codes.

The table below summarizes the cost comparison at each tier:

| Cost Category | Celebrity / Concierge Tier | Standard Telehealth Tier | |---|---|---| | Physician access | $150, $350/visit | Included | | Testosterone (monthly) | $60, $120 (compounded) | $25, $60 (FDA-approved generic) | | HCG (monthly, if used) | $75, $150 | $50, $100 | | Labs (quarterly avg.) | $400, $900 per draw | $50, $120 per draw | | Ancillaries | $20, $60 | $10, $25 | | Platform / membership | $100, $400 | $99, $149 | | Estimated monthly total | $300, $800 | $170, $350 |

The Clinical Evidence Behind Standard TRT Protocols

Whether a patient follows Derek's detailed protocol or starts with a straightforward 100 mg testosterone cypionate weekly injection, the underlying evidence base is the same.

The Bhasin Landmark Trials

The foundational TRT dose-response data come from Bhasin et al., published in the New England Journal of Medicine in 2001. That study (N=61) demonstrated dose-dependent increases in lean mass, strength, and sexual function with exogenous testosterone, establishing the pharmacological rationale for modern TRT dosing ranges (7).

The Testosterone Trials (T Trials)

The T Trials, a coordinated set of seven double-blind, placebo-controlled trials conducted in men aged 65 and older with low testosterone (below 275 ng/dL), reported in JAMA in 2017. Sexual function improved significantly in the testosterone group. The bone trial showed increased volumetric bone density. The cognitive function trial did not show a statistically significant benefit (8).

A separate T Trials report in JAMA Internal Medicine found an increase in coronary artery non-calcified plaque volume in the testosterone group, underscoring the need for cardiovascular monitoring in all TRT patients, regardless of whether they are following a celebrity protocol or a standard clinical one (9).

Cardiovascular Safety: The TRAVERSE Trial

The most recent and largest cardiovascular safety data come from the TRAVERSE trial, published in the New England Journal of Medicine in 2023. TRAVERSE randomized 5,246 men aged 45 to 80 with hypogonadism and pre-existing or high-risk cardiovascular disease to testosterone gel or placebo. Non-inferiority for major adverse cardiovascular events was demonstrated, but the testosterone group showed higher rates of atrial fibrillation, acute kidney injury, and pulmonary embolism (10).

These findings reinforce current Endocrine Society guidance that TRT should not be initiated in men with recent cardiovascular events, and that hematocrit monitoring is essential because testosterone-induced erythrocytosis raises thrombotic risk (3).

Hematocrit: The Most Overlooked Safety Variable

Testosterone stimulates erythropoiesis via EPO upregulation. Hematocrit above 54% is a standard threshold for dose reduction or temporary cessation of therapy. Derek has discussed this on his channel in detail, including the practice of therapeutic phlebotomy for patients who develop erythrocytosis on TRT.

A 2021 systematic review in the Journal of Clinical Endocrinology and Metabolism confirmed that erythrocytosis occurs in approximately 5.7% of TRT patients overall, with injectable formulations carrying higher risk than transdermal formulations, likely due to supraphysiologic peak testosterone levels with injections (11).

What the Average Patient Misses That Derek Gets Right

Derek's content quality is unusual because he consistently does three things that most patients, and some providers, skip.

He Uses the Right Estradiol Assay

Standard estradiol immunoassays are calibrated for female reference ranges and cross-react with testosterone metabolites in men, overestimating estradiol by a clinically meaningful margin. The LC-MS/MS sensitive assay gives accurate male estradiol readings and should be used when monitoring men on TRT. Quest Diagnostics lists this as the Estradiol, Sensitive (#30289) panel; LabCorp offers it as Estradiol, Ultrasensitive, LC/MS/MS (#140244).

This distinction matters because inappropriate aromatase inhibitor prescribing based on falsely elevated standard-assay estradiol readings exposes patients to bone loss, lipid deterioration, and impaired sexual function, all well-documented consequences of estradiol over-suppression (4).

He Tracks SHBG to Interpret Free Testosterone

Total testosterone is a poor standalone marker of androgen status when SHBG is abnormal. High SHBG binds more testosterone, reducing biologically active free testosterone even when total testosterone reads within the normal range. Low SHBG does the opposite, producing symptoms of androgen excess at lower total testosterone levels.

Derek consistently emphasizes checking SHBG alongside total testosterone. The Endocrine Society guideline specifies that free testosterone should be calculated using a validated equation when SHBG is suspected to be abnormal, and that symptoms should guide clinical decision-making alongside laboratory values (3).

He Documents Before-and-After Labs

Perhaps the most practically useful habit Derek models is running comprehensive baseline labs before any protocol change and repeat labs 6 to 8 weeks after. This before-and-after structure is what separates systematic hormone management from guesswork. At HealthRX, every protocol adjustment is bracketed by labs for exactly this reason.

How HealthRX Approaches TRT Differently From Concierge Clinics

The clinical protocol at HealthRX is built on the same evidence Derek cites. The differences are operational, not scientific.

Starting dose is 100 mg testosterone cypionate weekly by subcutaneous injection, with the option to split into 50 mg twice weekly for patients sensitive to estradiol swings. Labs at baseline include total testosterone, free testosterone (calculated), SHBG, sensitive estradiol, CBC, CMP, lipid panel, and PSA for men over 40.

At week 8, labs are repeated and the provider reviews symptoms, lab values, and any side effects before any dose adjustment. Hematocrit above 52% triggers a discussion of dose reduction or injection frequency change before phlebotomy is considered. HCG is available as an add-on for patients concerned about fertility or testicular atrophy.

The monthly all-in cost for a HealthRX TRT patient using a standard protocol runs $170, $350. A patient following a Derek-level monitoring protocol, including sensitive estradiol, SHBG, and quarterly comprehensive panels, lands at the higher end of that range. That is still 40 to 60% less than concierge-tier care for the same clinical outcome.

The Endocrine Society position, stated in the 2018 guideline, is direct: "We suggest that clinicians inform patients of the symptoms of testosterone deficiency and offer testosterone therapy to men with low testosterone levels and consistent symptoms, with the expectation of benefits in sexual function, mood, and energy." (3)

That guidance applies equally to the patient paying $800 per month at a concierge clinic and the patient paying $199 per month through a telehealth platform.

Red Flags in Self-Directed TRT (What Derek's Followers Get Wrong)

Derek is careful. His audience is not always careful in the same way. The most common clinical errors HealthRX providers see in patients who have been self-directing based on online content include:

Starting Too High

Patients arrive requesting 200 mg per week as a starting dose because they read that experienced users run that amount. Starting above 150 mg per week without baseline labs and clinical indication increases erythrocytosis risk and makes it harder to distinguish therapeutic response from pharmacological supraphysiology.

Skipping PSA Before Starting

PSA screening before TRT initiation is standard for men over 40 per Endocrine Society guidelines. Testosterone therapy in the presence of undiagnosed prostate cancer may accelerate tumor growth. Men who start TRT without baseline PSA have no way to interpret later values meaningfully (3).

Sourcing from Unregulated Suppliers

A percentage of Derek's audience attempts to source testosterone or HCG from gray-market or black-market suppliers. Counterfeit testosterone products have been documented to contain no active ingredient, incorrect concentrations, or microbial contamination. The FDA's MedWatch database contains adverse event reports from counterfeit injectable testosterone products (12).

Physician-supervised, pharmacy-dispensed testosterone is the only medically and legally appropriate route for TRT in the United States.