Does Shutting Down LH with Testosterone Have Negative Effects?

Henry · Oct 15, 2017

I was on another site (I'm not sure if I can mention other sites here so I'll just play it safe and quote the question and response) and someone asked a question about the downsides of TRT. Here is the question:

"Is this true: there are countless secondary metabolic/hormonal pathways which get affected and down-regulated from long term HPTA suppression. Neurotransmitter balance, digestive health and bacteria, skin health, enzymatic function and expression amkng many other things take a hit."

and this was one of the responses:

"It's absolutely true. You lose both LH and GnRH. LH receptors exist all over the body. Your body loses control of its hormones and to lower them during sickness and sleep. You completely lose and destroy diurnal rythym (the natural state of low/high testosterone during night/day) which allows androgen receptors to resensitize overnight. You have to sleep with your T levels raging as if it was morning. The body normally spikes them along with cortisol to "wake you up," but TRT never gives the body a break. Since you aren't making your own testosterone anymore, many of the pathways towards testosterone start to "overflow" since they aren't being used anymore.
You completely break the natural work of and disrupt your pituitary and hypothalamus and they remain in a constant state of strain or disuse."

I know that hCG is a LH analog so that covers the loss of LH but what about the rest of what was said. Is all this true or just broscience?

Guided_by_Voices · Oct 15, 2017

My two cents is that everything in the quotes you reference has been widely discussed and is easily disproven. If you can’t identify the problems with this person’s logic then you need to continue your study of the subject until you can. There are many great resources on this site and also good books and podcasts such as those from Nelson, Dr. Crisler and others that shed light on all the mentioned points. The most obvious issue should be that the many glowing reports of life-changing benefit from TRT for many of us on this site and elsewhere would not be happening if what this person said was true.

Henry · Oct 16, 2017

Not to be confrontational but since you seem so knowledgeable with your answer, why don't you disprove what he said? I don't see anywhere in your answer in which you did. Why don't you quote parts of the books or link the discussions from this site here that reference or directly answer what's in quotes? You really didn't say anything besides the typical internet answer of "do your own research" (I'm paraphrasing). Now, since you want to know about me, I've been a member here since 2014, I've read the books by Nelson, Comite, Shippen and Fryer, Morgentaler, Gordon (who I was a patient of), Lyfe, Crisler, Scally, and Purser. I'm a patient of Olivieri, who comes highly regarded, even by Nelson, I'm also a member of several forums, Reddit subgroups, etc and I've been on TRT for over 4 years with zero sides and I've even run a few cycles with no problem. I've seen the Youtube videos, podcasts, etc. I'm not saying I'm an expert here, I'm forever learning and always asking questions, but even with all that I've read and experienced, I find what was said in quotes to be something that has me thinking, even a little concerned.

Now, enough about me, let's talk about the quotes since you say that this is all so easily disproven:
"It's absolutely true. You lose both LH and GnRH (this is true since the body's feedback loop shuts this down) . LH receptors exist all over the body (this is true and is the reason why some people report a better sense of 'wellbeing when hCG is added to their protocol). Your body loses control of its hormones and to lower them during sickness and sleep (this is true since a person on TRT can now manipulate their T level with frequency and amount of injections). You completely lose and destroy diurnal rythym (the natural state of low/high testosterone during night/day) which allows androgen receptors to resensitize overnight (this is true on injections, less true on Androgel since Androgel is applied in the morning and causes a spike a couple of hours later and lowers throughout the day. That is why you apply Androgel everyday). You have to sleep with your T levels raging as if it was morning (this is true on injections, which is the most popular method. If you inject once a week, you spike 48 hours after injection and lower throughout the week. If you inject EOD, E3.5 days or everyday, you lower less and stay at your level so there is really no daily highs and lows with injections) . The body normally spikes them along with cortisol to "wake you up (This is true)," but TRT never gives the body a break (this is true on injections, again, since there are no daily highs and lows, it's either at one level all the time, or it lowers over the week because of the cypoinate or enanthate ester). Since you aren't making your own testosterone anymore, many of the pathways towards testosterone start to "overflow" since they aren't being used anymore.
You completely break the natural work of and disrupt your pituitary and hypothalamus (this is true because of the negative feedback loop) and they remain in a constant state of strain or disuse."

And for all the glowing reports of life changing benefits from TRT it's a compromise, as with many medicines. Insulin therapy is lifesaving to many diabetics, and they praise it, but it's not as good as natural control, I know because there are many diabetics in my family so pointing out the many glowing reviews or life changing benefits does not answer the question in quotes, it's trying to change the subject or avoiding the discussion. Also, there are people who have problems on TRT. Remember, there are people who have to take AI's or give blood to battle polycythemia, etc. There aren't too many people in their 20's with naturally high testosterone that need to constantly give blood or use AI's.

Let me give one example. If I'm on T cypionate and I inject every 3.5 days, or even EOD or every day, which is what's recommended by many on this board, my T levels will always stay at whatever level you're at. It won't go lower in the morning, it'll be a straight line on a chart. Now, that's not how the body is naturally is it? It's higher in the morning and lower in the afternoon. Another example, there are people who don't take hCG so now they lose the LH signal (hCG is a LH analog). People have reported a better sense of well being when hCG is added to their protocol. What about FSH? You lose that. You can take hCG to replace LH (and trace amounts of FSH) but are you going to spent all the money and use HMG to replace FSH? I don't know anyone who does.

I'm not trying to knock TRT, it's provided me great benefits, as it's done for many others, but most of the people I know would rather be natural with a high level, if they could instead of dealing with TRT. Also, I know that TRT is just a compromise, as with most medicines.

lowe2sucks · Oct 16, 2017

don't use trt then whats the problem
life with low testosterone can be miserable

Henry · Oct 16, 2017

lowe2sucks said:
don't use trt then whats the problem
life with low testosterone can be miserable

We all know that life with low testosterone can be miserable. So, what's your point?

lowe2sucks · Oct 16, 2017

my point was that if you are worried of these nuances (absence of activation of LH receptors etc etc) why do you stay on trt.. I don't think the "benefits" of being untreated low T would be better the benefits of trt.

Henry · Oct 16, 2017

I've been on it for so long because it works for me. I've been on injections and Androgel. Both worked very well. No blood donations, no AI's no issues. I have no complaints but I'm not blind to it either. As with any medicine, there is always a side effect. My body has adjusted to it but some people have issues and there are compromises.

Also, as we all know here, there are people who have undiagnosed Low T and they are fine (one of my friends that saw Dr. O with me stoped TRT and is back to a 360 or so level. He's just fine. His insurance stopped covering it so he stopped). People need to look at all aspects. We are both in a thread right now where there is a 23 year old man with a 443 T level and the wife and another posted are recommending TRT. Why? Have other things been checked? What about his thyroid? What about his sleep, exercise, diet, etc. Why not find the root of the problem before recommending he jump on TRT? Sometimes, it's a lifestyle change that can cause T levels to jump. What if he has a varicocele? What if he has sleep apnea? 443 is not a bad number. What if he can naturally raise it 100 points without having to get on the needle for the rest of his life? Now, if everything gets checked, he makes the lifestyle changes, etc and he's still at 443, then TRT could be an option, but to recommend TRT, HCG and HMG to a 23 year old with a 443 T level, who is looking to get pregnant, without looking at other factors, is kinda foolish. I know we all love TRT (that's why we're here) but there should be some thought behind it.

I never said there were benefits to low T, but there are compromises to TRT, that's the reality. Some people can deal with it and have no problems (like me with a 1300 T level on Androgel with no problems) and some have issues.

FeelingLost · Oct 16, 2017

Subscribing to this thread.
Thanks for the question and info Henry. I am too new to TRT to add to the discussion.
I want to look into this "diurnal rythym (the natural state of low/high testosterone during night/day) which allows androgen receptors to resensitize overnight."
I'm one of those that responds well to daily Gels/Creams this diumnal rythym sounds like a pretty good reason to stay on it.

Logan45 · Oct 16, 2017

Hey Henry,

Interesting topic. I have been on TRT for a little over a year and actually have given some thought to the impact this has on my body due to it not being a natural cycle/rhythm. All the research I have read always seems to have conflicting statements from experts who stand on opposite sides of the fence on this topic. Then again I get a little weary of statement especially if there is some sort of financial gain to be made off the research. Unfortunately there has not been any long term studies that either defends or negates the hypothesis.

Logan45 · Oct 16, 2017

FeelingLost said:
Subscribing to this thread.
Thanks for the question and info Henry. I am too new to TRT to add to the discussion.
I want to look into this "diurnal rythym (the natural state of low/high testosterone during night/day) which allows androgen receptors to resensitize overnight."
I'm one of those that responds well to daily Gels/Creams this diumnal rythym sounds like a pretty good reason to stay on it.

Hey FeelingLost,

Awesome you feel great on gels and it is working. I know many people who started off with androgel and after a few months they have said there is a backslide on the positive things they were receiving. Not sure if this has to do with the body adjusting to the exogenous testosterone or it truly is giving a negative return.

If you don't mind me asking how long have you been on gels?

FeelingLost · Oct 16, 2017

Logan45 said:
Hey FeelingLost,

Awesome you feel great on gels and it is working. I know many people who started off with androgel and after a few months they have said there is a backslide on the positive things they were receiving. Not sure if this has to do with the body adjusting to the exogenous testosterone or it truly is giving a negative return.

If you don't mind me asking how long have you been on gels?

I don't want to de-rail Henry's thread I'd be glad to talk with you via PM.

7 month- Testim 1% gel mono changed doctors
2 month- 20% cream, .125 Anastrozole EOD, 800ui HCG weekly (400uix2)

Nelson Vergel · Oct 16, 2017

Henry said:
I was on another site (I'm not sure if I can mention other sites here so I'll just play it safe and quote the question and response) and someone asked a question about the downsides of TRT. Here is the question:

"Is this true: there are countless secondary metabolic/hormonal pathways which get affected and down-regulated from long term HPTA suppression. Neurotransmitter balance, digestive health and bacteria, skin health, enzymatic function and expression amkng many other things take a hit."

and this was one of the responses:

"It's absolutely true. You lose both LH and GnRH. LH receptors exist all over the body. Your body loses control of its hormones and to lower them during sickness and sleep. You completely lose and destroy diurnal rythym (the natural state of low/high testosterone during night/day) which allows androgen receptors to resensitize overnight. You have to sleep with your T levels raging as if it was morning. The body normally spikes them along with cortisol to "wake you up," but TRT never gives the body a break. Since you aren't making your own testosterone anymore, many of the pathways towards testosterone start to "overflow" since they aren't being used anymore.
You completely break the natural work of and disrupt your pituitary and hypothalamus and they remain in a constant state of strain or disuse."

I know that hCG is a LH analog so that covers the loss of LH but what about the rest of what was said. Is all this true or just broscience?

Where did you get that? Crisler?

It is an interesting hypothesis that may have some value but, unfortunately, I have not seen any data on the subject after reading all hCG papers for an upcoming webinar.

user_joe · Oct 16, 2017

I can't bring myself to be concerned with theories like this. The effects of the shutdown are theories. Every study I see on TRT keeps pointing to making men healthier. Improved lipids, less cardiac events, etc. it's actually a little surprising to me.

Life sucked with low T. Consequences that may be negative are what they are. Gotta live life. Guess I'm working with a different philosophy with regard to health.

Henry · Oct 16, 2017

Nelson Vergel said:
Where did you get that? Crisler?

It is an interesting hypothesis that may have some value but, unfortunately, I have not seen any data on the subject after reading all hCG papers for an upcoming webinar.

I've seen bits and pieces of it but I've been nothing concrete. I saw this reply on the testosterone section of Reddit. Someone asked the question and that was the poster's response. His response made me think and I've been doing research on it. I've been google searching since last night and find a few things true, but I don't haven't read anything bad about it except for this guy's post.

My personal opinion is that these do happen, you do lose GnRH, etc but the body adjusts. I was on injections for 6 months and I didn't have a problem with 60mg's every 3.5 days and my T level was 1440. I slept well, no sides etc. I then transitioned over to Androgel and have been on it for 3.5 years. My T level is currently 1300 and I feel fine on it. I would guess that our body adjusts to what this poster stated and we continue to live better with TRT.

Henry · Oct 16, 2017

Logan45 said:
Hey FeelingLost,

Awesome you feel great on gels and it is working. I know many people who started off with androgel and after a few months they have said there is a backslide on the positive things they were receiving. Not sure if this has to do with the body adjusting to the exogenous testosterone or it truly is giving a negative return.

If you don't mind me asking how long have you been on gels?

I spoke to someone about this one time and he told me about myxedema. I mentioned what I read about people getting on Androgel and then backsliding months later.

He gave me 2 theories:
1. The person gets on and gets the boost in T and is doing great. Nice T levels, etc. Then, because of negative feedback, his body stops producing T and now he's relying solely on Androgel. The Androgel isn't enough, symptoms come back and when he sees his doc, his T is lower than what it was before. The doc can up the dose and that can help, but sometimes, the person can't absorb enough Androgel and Androgel won't work for them.
2. The next one was interesting. He said that he read about someone on Androgel and had hypothyroidism. They could not absorb it and it was because the guy had myxedema, the thickening of skin due to low thyroid function and with that, the person will have a hard time absorbing Androgel.

Will Brink · Oct 16, 2017

Henry said:
I never said there were benefits to low T, but there are compromises to TRT, that's the reality.

Then you pretty much answered your own Q. Whether he's correct or not, there's a risk/benefit to everything, and the risks of low T fairly well established, and plenty of data showing various improvements in men who go from low T to healthy T via TRT, so what next? The answer is, nothing. Of course TRT will impact natural feedback loops etc, some of which is known and is not, and the bottom line here is, if you need TRT, it's a moot issue, and leads to unneeded stress, etc. I'd need to see actual sources for those claims made in your OP to comment, but per above, it TRT benefits for those who need it, far outweighs the risks in my view. Full stop.

Will @ www.BrinkZone.com

Guided_by_Voices · Oct 16, 2017

Some example observations:
- Regarding the original post, the idea that fluctuating T levels allow the “androgen receptors to resensitize” is contradicted by the experience of people who use much higher T levels than most on TRT. I have not paid much attention to that since it is not relevant to me, but I remember from when I was researching TRT implications that there has been much discussion of this topic and it seems that, if anything, consistently high T levels may increase the number or action of androgen receptors, just the opposite of what you claim to be true. Further, if this was an issue, we might expect to see that people required ever-increasing T replacement doses to achieve equivalent symptoms, however I do not remember seeing any reports of this from users or doctors or anyone. I suggest you go to some of the more thoughtful steroid sites and review this topic. Perhaps I am wrong, but the best evidence seems to say this is a non-issue or actually a benefit of TRT.
- I agree that lack of fluctuation might in theory be an issue (that is part of the reason I use daily Test Prop and I think Dr. Crisler likes gels for the same reason) however if it really was an issue then I would think that people on long-esters would report sleep or mood disruption, however we seem to typically see just the opposite: good sleep and improved mood. As an aside, it is hard to take the original quote seriously when it is loaded with sloppy generalizations like “countless pathways” (huh, I think the pathways are pretty well-known and counted) and “raging” T levels (my T levels are not angry at all.)
- Further, the original quote makes no attempt to acknowledge the potential advantages of steady-state levels. For me, having gone on and off TRT several times, one of the biggest benefits seems to be that I can tolerate a youthful exercise load with T levels that are not far above my “natural” levels, and I attribute this (perhaps incorrectly) to the lack of fluctuation in T. Obviously, a healthy activity level has many benefits in itself, and which I suspect for most people will far outweigh any (as yet unknown) negatives from lack of fluctuation.
- I haven't been following the thread about the 23yo, and while I agree that other things leading to a root cause fix should be investigated, I also think it is often wrong to avoid fixing the symptom while a root cause (which might never be found) is investigated. Jeopardizing a marriage or job, etc. in pursuit of the ideal fix doesn't seem like a good idea to me.
- The author of the statement in question does not suggest an alternative, and the unstated implication is that because the author has accepted a gradual decline in abilities, then everyone else should too. That, to me, is just loser-thinking, something I want to avoid, and which Will Farrell had the perfect comment on in Wedding Crashers: “What an idiot!...but hey, that just leaves more for you and me.”
- I am a big believer in remaining as natural as possible without going into decline, however Josh Mittledorf's post called “There is no such thing as Natural anti-aging” is a good read (as are all of his posts) to get some perspective on the limits of staying “natural”, since it appears that we are “naturally” pre-programmed to go into decline. So, I fully expect and am prepared to become increasingly less natural over time. Instead of worrying about having perfect “natural” T levels, I am much more focused on being grateful that we live in a time and place where we have the ability to improve our quality of life with every passing year, provided that we study and take advantage of what is available.

themud · Oct 16, 2017

Henry said:
I spoke to someone about this one time and he told me about myxedema. I mentioned what I read about people getting on Androgel and then backsliding months later.

He gave me 2 theories:
1. The person gets on and gets the boost in T and is doing great. Nice T levels, etc. Then, because of negative feedback, his body stops producing T and now he's relying solely on Androgel. The Androgel isn't enough, symptoms come back and when he sees his doc, his T is lower than what it was before. The doc can up the dose and that can help, but sometimes, the person can't absorb enough Androgel and Androgel won't work for them.
2. The next one was interesting. He said that he read about someone on Androgel and had hypothyroidism. They could not absorb it and it was because the guy had myxedema, the thickening of skin due to low thyroid function and with that, the person will have a hard time absorbing Androgel.

Low T sucked so bad for me that if I died in 10 years feeling better like I do now, it would be worth it to me. I have life insurance for the wife and kids. To feel like I did previously my work performance would go down, my libido was down, I started exercising less, I had thoughts of panic and frustration. No thank you.

As it is today I actually bought a hunting dog/pup and I had to get up for a while in the middle of the night to take him out, and up at 4 or 5 again and then walk him. I get home from the walk and workout, come home and have the energy to have a conversation with my wife. Before I was waking up at 530 or 600 and didn't have the energy to do basic calisthenics and was falling asleep at 730 or 800 pm and was zoned out. This coming from a guy with multiple offices, and who ran ultramarathons and triathlons.

Like I always have told people. If I live to 100 fine, but I would rather have the energy and stamina and live to 65.

Henry · Oct 16, 2017

Guided_by_Voices said:
Some example observations:
- Regarding the original post, the idea that fluctuating T levels allow the “androgen receptors to resensitize” is contradicted by the experience of people who use much higher T levels than most on TRT. I have not paid much attention to that since it is not relevant to me, but I remember from when I was researching TRT implications that there has been much discussion of this topic and it seems that, if anything, consistently high T levels may increase the number or action of androgen receptors, just the opposite of what you claim to be true. Further, if this was an issue, we might expect to see that people required ever-increasing T replacement doses to achieve equivalent symptoms, however I do not remember seeing any reports of this from users or doctors or anyone. I suggest you go to some of the more thoughtful steroid sites and review this topic. Perhaps I am wrong, but the best evidence seems to say this is a non-issue or actually a benefit of TRT.
- I agree that lack of fluctuation might in theory be an issue (that is part of the reason I use daily Test Prop and I think Dr. Crisler likes gels for the same reason) however if it really was an issue then I would think that people on long-esters would report sleep or mood disruption, however we seem to typically see just the opposite: good sleep and improved mood. As an aside, it is hard to take the original quote seriously when it is loaded with sloppy generalizations like “countless pathways” (huh, I think the pathways are pretty well-known and counted) and “raging” T levels (my T levels are not angry at all.)
- Further, the original quote makes no attempt to acknowledge the potential advantages of steady-state levels. For me, having gone on and off TRT several times, one of the biggest benefits seems to be that I can tolerate a youthful exercise load with T levels that are not far above my “natural” levels, and I attribute this (perhaps incorrectly) to the lack of fluctuation in T. Obviously, a healthy activity level has many benefits in itself, and which I suspect for most people will far outweigh any (as yet unknown) negatives from lack of fluctuation.
- I haven't been following the thread about the 23yo, and while I agree that other things leading to a root cause fix should be investigated, I also think it is often wrong to avoid fixing the symptom while a root cause (which might never be found) is investigated. Jeopardizing a marriage or job, etc. in pursuit of the ideal fix doesn't seem like a good idea to me.
- The author of the statement in question does not suggest an alternative, and the unstated implication is that because the author has accepted a gradual decline in abilities, then everyone else should too. That, to me, is just loser-thinking, something I want to avoid, and which Will Farrell had the perfect comment on in Wedding Crashers: “What an idiot!...but hey, that just leaves more for you and me.”
- I am a big believer in remaining as natural as possible without going into decline, however Josh Mittledorf's post called “There is no such thing as Natural anti-aging” is a good read (as are all of his posts) to get some perspective on the limits of staying “natural”, since it appears that we are “naturally” pre-programmed to go into decline. So, I fully expect and am prepared to become increasingly less natural over time. Instead of worrying about having perfect “natural” T levels, I am much more focused on being grateful that we live in a time and place where we have the ability to improve our quality of life with every passing year, provided that we study and take advantage of what is available.

Thank you for this post and I say it with sincerity. Even though I've done very well on TRT, I'm always on the search for more information and I'm always reading and some theories, like this one, make me think. When I read this poster's response, it really had me thinking and I thought to post it here since I find the people here very knowledgeable on TRT. I'm one of those people who live with a daily T level of 1300 and have been doing it for a while. I've also run a couple of cycles of 600mg's per week for 12 weeks and I've been fine, so far.

I still find this response very interesting and I'm still researching it.

Henry · Oct 16, 2017

themud said:
Low T sucked so bad for me that if I died in 10 years feeling better like I do now, it would be worth it to me. I have life insurance for the wife and kids. To feel like I did previously my work performance would go down, my libido was down, I started exercising less, I had thoughts of panic and frustration. No thank you.

As it is today I actually bought a hunting dog/pup and I had to get up for a while in the middle of the night to take him out, and up at 4 or 5 again and then walk him. I get home from the walk and workout, come home and have the energy to have a conversation with my wife. Before I was waking up at 530 or 600 and didn't have the energy to do basic calisthenics and was falling asleep at 730 or 800 pm and was zoned out. This coming from a guy with multiple offices, and who ran ultramarathons and triathlons.

Like I always have told people. If I live to 100 fine, but I would rather have the energy and stamina and live to 65.

Sorry you had that experience. I didn't even know my T levels were 290, 277 and 225 four years ago. I didn't feel the symptoms. I had energy, libido, etc. I was tested because of fertility and that's when the doc surprised my wife and I and told us I had low T. Now, I was an avid cross fitter with a 245 bench, 495 deadlift and 325 squat after my first year. I probably could have continued but the doc offered it and after doing some research, I decided to give it a try.

Now, I will say this, the changes have been wonderful. The biggest is in my confidence. My libido hasn't changed (I've always been a horny toad) and I've alway had energy. I also retain muscle mass better too. Back to confidence, that's what makes TRT worth it for me. I was a manager and I was deathly afraid of meetings and public speaking. I was freeze. After TRT, I became outgoing and my fear went away. That was life changing for me.

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