Ceasing TRT Cold Turkey After Three Years - Restart Log

[Charliebizz]

I tried pregneonolone a while back but it gave me varicose veins. Had zero before, then following preg supplementation had a bunch pop up which also coincided with vein pain. A few studies on pubmed claimed that progesterone can cause varicose veins, so I always assumed it was excess preg -> prog and steered away from supplementing prog as a result. Given prog is the direct precursor to cortisol I'm interested to see where my cortisol levels are.

Did you use hcg on T? Your low cortisol could be from the absence of LH from HPTA suppression resulting in inadequate cholesterol -> preg conversion, with all downstream hormones suffering as a result. Preg is extremely important for neurotransmitter production too, so that might also explain why the SSRI boosted your levels. Just a thought, I could be completely off the mark.

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I completely agree with everything you said. I have a lot of ideas / theories bouncing around my head at the moment, and while the exact specifics of each differ, they all lead back to one central issue: chronic stress of some form.

Our testosterone levels are low. Testosterone, and all anabolic systems within the body (especially thyroid function), rapidly decline during times of stress as the body directs energy towards internal systems essential to life - i.e organ function. It makes no sense to have anabolic hormones like test, dht, thyroid and prog elevated when catabolic hormones like cortisol and adrenaline are elevated during stress, as essentially they have opposite roles within the body. As a result, the anabolic systems are suppressed until the stress is elevated.

This is fine within normal physiology when all systems are in working order. However, problems arise when the body is in a constant state of stress, be it mental or cellular, and the anabolic systems are constantly suppressed. Not only do catabolic hormones directly suppress the production of anabolic hormones, they also suppress their ability to exert their action. T3 is one of the main determinants of the metabolic rate and requires glucose as substrate for effective oxidative metabolism. Both adrenaline and cortisol increase lipolysis and liberate free fatty acids into the blood for metabolism to provide energy during times of stress. FFA metabolism directly inhibits glucose metabolism meaning blood glucose levels remain elevated (eventually leading to insulin resistance), and even when glucose does enter the cell, its mainly metabolised using the glycolytic pathway which is extremely energy inefficient and leads to excessive lactic acid production.

I see evidence of the above in myself everyday. I used to have zero trouble exercising, but now even brisk walks lead to the painful 'runners side stitch' from lactic acid buildup; intense exercise isn't possible at all anymore. My constant fatigue also stems from this inefficient energy generation. This also explains why I have all of the symptoms of hypothyroidsm despite normal bloods - adequate thyroid hormone is in the blood, it just can't exert its action. Every part of my body is deteriorating: my teeth are quickly decaying, my hair and eyebrows are rapidly thinning, my skin always cracking / dry, I'm always fatigued and my mental health is in tatters. This is all because my body is chronically stressed and driving all of its resources towards addressing said stress. My face has aged 10 years in the past two (wrinkles, dark undereye circles, development of the shiny calcified bald scalp of old men) and I truly believe it's due to metabolic and cellular decline. Things like hair, vibrant skin and teeth aren't essential to life, so during times of stress their energetic demands aren't prioritised. Constant stress = constant sympathetic response = constant stress hormone elevation = constant metabolic suppression = all of our issues.

Its all good and well knowing the above, but without being able to identify what the underlying chronic stressor actually is, there's no way to address it. This is where modern medicine has failed us. If you go to the gp and explain all of the above, they'll look at you like you're crazy and try and prescribe a SSRI / beta blocker because they think you're an anxious hypochondriac. Yes doctor, I am extremely anxious, but that's because my body is failing in front of my very eyes but you tell me I'm normal, and that its all in my head because the blood test's fall withthin range... I'm considering going into medicine once I've completed my current physiology undergrad. People shouldn't have to be theorising on online forum like this just to feel normal, and things aren't going to change anytime soon.

This is also why TRT fails us. Whilst flooding the system with exogenous hormones can mitigate some of the damage done by the chronic elevation of stress, it does nothing to actually address the stressor, and can oftentimes exacerbate the issue if said exogenous hormone also effects the function of the thyroid and adrenal glands which are already impaired - i.e elevated estradiol from trt can directly inhibit thyroid function further worsening the situation. My TSH always increased in response to my e2 / prolactin on TRT.

I've found the field of hormone replacement therapy as a whole severely lacks the required level of complexity to actually fix these issues, and that often leaves a lot to be desired. X hormone is low? Let's just replace it without any real investigation as to why its low outside of "are you morbidly obese?". Oh look, now y hormone is low due to taking x hormone, let take something for that too. Before you know it every system in the body is dysregulated and you end up where I am now.

I have no idea where to even start when trying to find the underlying issue, as essentially everything is interlinked so you have no clue what is causing what. My iron levels are high, my prog is low, my thyroid function is extremely poor, my test levels are on the low end, my white blood cell count is low - but which one of those, if any, is actually the cause of the rest? Who knows, and the scary thing is I don't envisage myself finding out anytime soon.

That got unintentionally long and depressing haha, but it's just a brief overview of how I'm looking at this whole situation at the minute. I left out all of the specifics and pathways I'm considering, but if I find anything concrete I'll post the whole thing at some point.

it lowers my cortisol very fast. I start feeling low cortisol symptoms with in the first few weeks. I feel like it has to do more with neurotransmitters then the hormone side. Nt seem to react much faster then hormones for me. I did try Hcg mono. And with trt also. I do not feel well at all with hcg in the mix.

your situation is crazy. You went on trt didn’t feel much. Then went off and felt better for a bit and now are on a rapid decline. I personally have never got worse then I was before trt. My only issue that is worse is widespread muscle and joint pain. Can’t pin point what causes it as it is Intermittent. But it did start when I first meat my hormones up by under eating and overtraining. Best thing I did to feel better was quitting lifting. I still play hockey and do cardio but lifting weights crushes my cortisol. Or at least my symptoms of low cortisol come back hard. On trt I can tolerate the work outs a tiny bit more but not enough where I can go regularly like I used too. It sucks cause I love lifting and it’s the only way I can lose weight easy.

 

[Vvs1]

I appreciate you taking the time to share your experience. Can I ask exactly what supplements you take and at what dosges if it's not too much hassle?

Were you ever tested for hereditary hemochromatosis? I believe our issues are due to mineral dysregulation due to our normal ferritin, but I might get tested anyway.

I started out with liquid Copper and a potassium pill every night, both at 100% DV. I added in Magnesium Threonate, Bacopa, Transdermal Magnesium, whole food vitamin C & D, vitamin D drops. Some occasional items include Ashwaganda and desiccated adrenal pills and sometimes liquid zinc/copper combo, and antioxidants like açaí.

Everything was mostly the 100% daily recommended value. I overdosed on vitamin D on accident. Have to keep away from iron in foods.

I have not been tested for anything hereditary.

 

[Gman86]

I went back on his protocol thinking that it can’t hurt. I do find his message can be confusing as I had to research what he meant by our bodies being copper deserts. I believe that’s a big deficiency, and that matches my RBC copper that was the very bottom of the range.

It makes sense that there’s zinc and iron in nearly all processed foods.

Ya everyone thinks you need a ton of zinc, and very little copper, but it might very well be the opposite. One of the best things I’ve done for my health, and was from the advice of Morley robbins, I’m pretty sure, is either eating beef liver or taking desiccated beef liver capsules on a regular basis. They’re literally nature’s multivitamin. It’s insane all the vitamins and minerals it has. Mother Nature always knows best, and from what I remember, it has more copper than zinc. I could be wrong on that one. But to understand the ratios of zinc and copper that we require, all we have to do is look at the ratios seen in foods that have both zinc and copper.

 

[xqfq]

Have you ever considered HCG monotherapy? It seems worth a shot. I liked this video on the subject:

this Polish doctor seems to have success with it in his population. If you ever felt okay before your hypogonadism, then HCG mono might be worth a try?

 

[Vvs1]

Ya everyone thinks you need a ton of zinc, and very little copper, but it might very well be the opposite. One of the best things I’ve done for my health, and was from the advice of Morley robbins, I’m pretty sure, is either eating beef liver or taking desiccated beef liver capsules on a regular basis. They’re literally nature’s multivitamin. It’s insane all the vitamins and minerals it has. Mother Nature always knows best, and from what I remember, it has more copper than zinc. I could be wrong on that one. But to understand the ratios of zinc and copper that we require, all we have to do is look at the ratios seen in foods that have both zinc and copper.

Agreed. I never took a multivitamin due to containing biotin, which messes with lab results.

I forgot to mention I took Betaine HCI before some meals.

 

[PhantomFear]

Have you ever considered HCG monotherapy? It seems worth a shot. I liked this video on the subject:

this Polish doctor seems to have success with it in his population. If you ever felt okay before your hypogonadism, then HCG mono might be worth a try?

I've was on 200iu a day for a while but it just made me feel worse. E2 is a big issue for me on HCG.

 

[PhantomFear]

Just dropping a quick update.

Back on TRT for the time being. Starting out on just 12.5mg Test Cyp daily until my HCG arrives, then I'll be moving to my old protocol of 7.5mg Cyp, 100iu HCG and 2.5mg Exemestane daily.

Haven't been on 12.5mg cyp long and I'm already experiencing many of the old issues I faced on TRT: heart palpitations, acne, face bloat, ed and exhausted in the mornings. Libido is still absent, but that's been gone for years now.

Once things have stablised and bloods are looking good I'll be trying NDT to address thyroid and adrenal issues. My understanding of the relationship between thyroid, adrenals and sex hormones has expanded greatly since I first made this post seven months ago. My issues far surpass T alone which is why TRT never worked, and I have quite a few ideas why.

If I find anything concrete or get new bloods I'll post again.

 

[Charliebizz]

Just dropping a quick update.

Back on TRT for the time being. Starting out on just 12.5mg Test Cyp daily until my HCG arrives, then I'll be moving to my old protocol of 7.5mg Cyp, 100iu HCG and 2.5mg Exemestane daily.

Haven't been on 12.5mg cyp long and I'm already experiencing many of the old issues I faced on TRT: heart palpitations, acne, face bloat, ed and exhausted in the mornings. Libido is still absent, but that's been gone for years now.

Once things have stablised and bloods are looking good I'll be trying NDT to address thyroid and adrenal issues. My understanding of the relationship between thyroid, adrenals and sex hormones has expanded greatly since I first made this post seven months ago. My issues far surpass T alone which is why TRT never worked, and I have quite a few ideas why.

If I find anything concrete or get new bloods I'll post again.

so why are you back on if it causes such issues. I too am going back on despite many issues on trt. I’m just getting desperate to feel normal again

 

[atlien2488]

Just dropping a quick update.

Back on TRT for the time being. Starting out on just 12.5mg Test Cyp daily until my HCG arrives, then I'll be moving to my old protocol of 7.5mg Cyp, 100iu HCG and 2.5mg Exemestane daily.

Haven't been on 12.5mg cyp long and I'm already experiencing many of the old issues I faced on TRT: heart palpitations, acne, face bloat, ed and exhausted in the mornings. Libido is still absent, but that's been gone for years now.

Once things have stablised and bloods are looking good I'll be trying NDT to address thyroid and adrenal issues. My understanding of the relationship between thyroid, adrenals and sex hormones has expanded greatly since I first made this post seven months ago. My issues far surpass T alone which is why TRT never worked, and I have quite a few ideas why.

If I find anything concrete or get new bloods I'll post again.

Damn, seems like you've had similar issues that I've had on TRT with ED to some extent. Weirdly with me, my libido isn't that bad but I've had quite a a few occasions where I cease to get erect, when before I started TRT there would be no question that I would be. I'm so not ready to take clomid, HCG, AIs. It just seems so painful to come off when I mentally feel great on T. I see a lot of erection issues in us younger guys especially (You're like 8 years younger than me but still). I think a lot of it is mental, overthinking, trying to tinker too much with our bodies to reach that "perfect" level.

I wish you the best though...for what it is worth, I saw much more results/feeling of wellbeing with a lower dosage, I used to be on 160 mg but have been on 120 mg (60mg 2x per week) for the last few months and might go down further if I decide to not get off. Surprisingly, I only dropped about 100 ng/dl to 700 or so on the third day from 800 ng/dl on so much higher of a dosage (inject twice a week) That helped a lot with blood pressure issues, TSH/t3 out of whack, bloating and just feeling "out of it--kind of an exhausted feeling that I can't really but my finger on, ". Almost like extreme brain fog. Not much with ED unfortunately but we'll see what the future holds...Also, dropped AIs completely, and I'd feel horrible for weeks, erections non-existent. Didn't matter what the dosage, they'd tank my e2. Good luck to you.

 

[PhantomFear]

so why are you back on if it causes such issues. I too am going back on despite many issues on trt. I’m just getting desperate to feel normal again

I went back on for the same reason as yourself. It's been eight months since I made this thread and things aren't improving - I just want to feel normal again.

With that said I had to cease treatment again after two weeks. The palpitations I previously mentioned started to get extremely severe, but thankfully they went away after I stopped T.

I believe all of my issues are adrenal related (the fatigue, tooth decay, hair / eyebrow loss, hypothyroid symptoms etc), though I do believe I need to be on T due to my history of testicular surgeries. If you start T when the adrenals are already weak it just makes the situation worse.

Your low cortisol is the reason you haven't seen much improvement on T in my opinion. Have you ever used higher doses of HCG? TRT will exacerbate adrenal issues because LH plays a large role in adrenal function and cortisol production:

LUTEINIZING HORMONE CORRELATES WITH ADRENAL FUNCTION IN POSTMENOPAUSAL WOMEN

Ovarian and adrenal steroid production: regulatory role of LH/HCG

The effect of prolactin, human chorionic gonadotropin, insulin and insulin-like growth factor 1 on adrenal steroidogenesis in isolated guinea-pig adrenal cells - ScienceDirect

 

[PhantomFear]

Damn, seems like you've had similar issues that I've had on TRT with ED to some extent. Weirdly with me, my libido isn't that bad but I've had quite a a few occasions where I cease to get erect, when before I started TRT there would be no question that I would be. I'm so not ready to take clomid, HCG, AIs. It just seems so painful to come off when I mentally feel great on T. I see a lot of erection issues in us younger guys especially (You're like 8 years younger than me but still). I think a lot of it is mental, overthinking, trying to tinker too much with our bodies to reach that "perfect" level.

I wish you the best though...for what it is worth, I saw much more results/feeling of wellbeing with a lower dosage, I used to be on 160 mg but have been on 120 mg (60mg 2x per week) for the last few months and might go down further if I decide to not get off. Surprisingly, I only dropped about 100 ng/dl to 700 or so on the third day from 800 ng/dl on so much higher of a dosage (inject twice a week) That helped a lot with blood pressure issues, TSH/t3 out of whack, bloating and just feeling "out of it--kind of an exhausted feeling that I can't really but my finger on, ". Almost like extreme brain fog. Not much with ED unfortunately but we'll see what the future holds...Also, dropped AIs completely, and I'd feel horrible for weeks, erections non-existent. Didn't matter what the dosage, they'd tank my e2. Good luck to you.

Thank you for sharing your experience.

You say your TSH / t3 is out of whack? Would you mind sharing your bloods?

I'm not surprised to hear you tolerate lower dosages if you have thyroid issues. When thyroid and adrenal function is low the body can't handle higher dosages.

 

[PhantomFear]

Hello everyone, back with another update.

Nothing's changed over the last few months. Teeth are still rapidly decaying, I still have all the symptoms of hypothyroidism, brain fog is still severe, hair and eyebrows are still falling out, erections are still weak and libido is still absent.

My symptoms combined with my extremely low progesterone suggest I have some serious adrenal issues.

Progesterone: 0.445 (Range: 0.64 - 4.7) nmol/L.

My progesterone levels are well below range. A study of 1056 men found that mean serum progesterone levels were 1.21 nmol/L ± 0.41 SD, roughly three times higher than my current levels. Moreover, their given standard deviation suggests that my progesterone levels represent an extreme outlier. Mean progesterone levels were taken from the following review:

Progesterone: the forgotten hormone in men? - PubMed - NCBI

The documented symptoms of low progesterone in men also resonate with many of my current issues:

• Erectile dysfunction
• Memory loss
• Hair loss
• Absent libido
• Fatigue
• Depression and Anxiety

Interestingly, many of those symptoms are also associated with the hair loss drug finasteride. I’ve never taken the drug myself (and never will), but when I read the reports of those who have, I find their symptoms mirror my own closely. 5-alpha reductase is extremely important for progesterone metabolism - from Wikipedia:

“The major metabolic pathway of progesterone is reduction by 5α-reductase and 5β-reductase into the dihydrogenated 5α-dihydroprogesterone and 5β-dihydroprogesterone, respectively. This is followed by the further reduction of these metabolites via 3α-hydroxysteroid dehydrogenase and 3β-hydroxysteroid dehydrogenase into the tetrahydrogenated allopregnanolone, pregnanolone, isopregnanolone, and epipregnanolone.”

Whilst the cause of the issues that follow finasteride use are different to myself, I believe that the end result is the same – impaired progesterone activity at the tissue level. My progesterone metabolism itself has not been impaired through 5-ar inhibition, but my deficient levels have lead to the same result. I believe this is why many of my issues resemble that of post-finasteride syndrome.

Many report that progesterone supplementation reduces libido, causes erectile dysfunction and leads to a general ‘feminisation’ when used in men. Like all hormones, I believe balance is the key. An elevated level of progesterone will likely cause the above issues, but I don’t think this should be interpreted as deficient levels being of no concern. Elevated levels of estradiol will cause all three of the aforementioned issues, but seeing levels well below the normal reference range would still be of great concern. Like estradiol, I believe progesterone needs to be optimal (i.e, not too high, and not too low) if good health is to be achieved.

The problem is I don't think supplementing progesterone is the answer here. Progesterone is low because my adrenal activity has been suppressed by TRT and the absence of LH. I used HCG during my last year on T, but the dosages were too low to improve adrenal function to any significant degree.

Relationship between LH and adrenal function:

LUTEINIZING HORMONE CORRELATES WITH ADRENAL FUNCTION IN POSTMENOPAUSAL WOMEN

Ovarian and adrenal steroid production: regulatory role of LH/HCG

I'm going to pursue fixing adrenals before starting testosterone injections. I have a few options to consider:

- 500iu HCG 2-3x per week to stimulate adrenals directly
- Dessicated adrenal glandular to provide adrenals with adequate precursors
- Progesterone Cream
- Natural Dessicated Thyroid for hypothyroid symptoms and low fT4

I'll likely start one of the above tomorrow. I'm only starting one at the time, otherwise there'll be too many variables and I won't know what's responsible for whatever benefits / issues arise. I'll keep this thread updated with my progress.

 

[Charliebizz]

I went back on for the same reason as yourself. It's been eight months since I made this thread and things aren't improving - I just want to feel normal again.

With that said I had to cease treatment again after two weeks. The palpitations I previously mentioned started to get extremely severe, but thankfully they went away after I stopped T.

I believe all of my issues are adrenal related (the fatigue, tooth decay, hair / eyebrow loss, hypothyroid symptoms etc), though I do believe I need to be on T due to my history of testicular surgeries. If you start T when the adrenals are already weak it just makes the situation worse.

Your low cortisol is the reason you haven't seen much improvement on T in my opinion. Have you ever used higher doses of HCG? TRT will exacerbate adrenal issues because LH plays a large role in adrenal function and cortisol production:

LUTEINIZING HORMONE CORRELATES WITH ADRENAL FUNCTION IN POSTMENOPAUSAL WOMEN

Ovarian and adrenal steroid production: regulatory role of LH/HCG

The effect of prolactin, human chorionic gonadotropin, insulin and insulin-like growth factor 1 on adrenal steroidogenesis in isolated guinea-pig adrenal cells - ScienceDirect

I’m back on doing 100mg per week so far so good. I have no side effects and some mental improvements so far. Nothing profound but at tt of 168 natural depression really was setting in. Only difference this time around I’m taking low dose Siri with the higher t dose. Dr mariano wrote how low dose ssri can help people with low cort on trt.

 

[PhantomFear]

I’m back on doing 100mg per week so far so good. I have no side effects and some mental improvements so far. Nothing profound but at tt of 168 natural depression really was setting in. Only difference this time around I’m taking low dose Siri with the higher t dose. Dr mariano wrote how low dose ssri can help people with low cort on trt.

Can't imagine how you felt at 168. What's your e2 at that level?

Do you have a link or source for where Dr Mariano said that? I've read that before too but I can't remember where. Have you ever tried HCG at higher dosages to see where your cortisol goes?

 

[Charliebizz]

Can't imagine how you felt at 168. What's your e2 at that level?

Do you have a link or source for where Dr Mariano? I've read that before too but I can't remember where. Have you ever tried HCG at higher dosages to see where your cortisol goes?

I started getting really depressed. I’m a happy guy even at tt of 300 I was ok mentally. At tt of 168 my e2 was 14.

I haven’t been able to find the post about ssri helping but I seen the one about trt messing with cortisol through nt. It was over at peaks forum.

Hcg always made me feel crappy. So fare low dose ssri and 110mg a week I’m doing ok. So I will stay the coarse

 

[PhantomFear]

Hello everyone, back with another update.

Cholesterol
Total Cholesterol 3.72 mmol/L (Range: 0 - 5)
LDL Cholesterol 2.28 mmol/L (Range: < 3)
Non HDL Cholesterol 2.71 mmol/L (Range: < 4)
HDL Cholesterol X 1.01 mmol/L (Range: > 1.1)

Inflammation
CRP HS X 11.5 mg/L (Range: < 5)

Sex Hormones
Testosterone 19.4 nmol/L (Range: 8.64 - 29)
Oestradiol X 166 pmol/L (Range: 41 - 159)

Adrenals
DHEA Sulphate 6.590 umol/L (Range: 5.73 - 13.4)
Cortisol AM X 120.000 nmol/L (Range: 166 - 507)
Progesterone <0.159 nmol/L (Range: 0.64 - 4.7)

Thyroid
TSH 1.58 mIU/L (Range: 0.27 - 4.2)
Free Thyroxine 14.100 pmol/L (Range: 12 - 22)

Vitamins and Minerals
Folate - Serum 6.69 ug/L (Range: > 3.89)
Vitamin B12 - Active >150 pmol/L (Range: > 37.5)
Vitamin D 76.7 nmol/L (Range: 50 - 175)
Magnesium - Serum 0.96 mmol/L (Range: 0.7 - 1)
Zinc - Serum 11.41 umol/L (Range: 11.1 - 19.5)

Iron
Iron 15.69 umol/L (Range: 5.8 - 34.5)
TIBC 53.99 umol/L (Range: 45 - 72)
Transferrin Saturation 29.06 % (Range: 20 - 50)
Ferritin 91.8 ug/L (Range: 30 - 400)

AM Cortisol is tanked, Progesterone is undetectable, T:e2 ratio is awful, HDL has tanked and CRP is extremely worrying. The only positive is that my iron status has returned to normal after high dose magnesium supplementation + blood donation. I’ve been quite sick for the past two weeks with a cold, so that could have had an impact.

I’ll talk to my doctor next week, but I’m not too sure where to start here. Progesterone cream is likely given it’s the precursor to cortisol and my levels are undetectable, but simply adding in another hormone doesn’t fix the fact my adrenals aren’t functioning properly. I’ll keep dropping updates when I decide what to do next.

 

[Rock H. Johnson]

Why use progesterone and not pregnenolone for adrenals, cortisol etc...
And did you try taurine for adrenals?

 

[PhantomFear]

Why use progesterone and not pregnenolone for adrenals, cortisol etc...
And did you try taurine for adrenals?

High doses of pregnenolone have never made a difference to my progesterone levels - this was verified over various different blood tests. It also gave me varicose veins.

 

[Novaman]

As a dentist I wanted to comment on the teeth decay issues. Beyond the obvious causes of tooth decay- namely sweets and poor home care, there are other potential causes that are less obvious- possible causes being gastric reflux and dry mouth. Could either of those be an issue for you ?

 

[PhantomFear]

As a dentist I wanted to comment on the teeth decay issues. Beyond the obvious causes of tooth decay- namely sweets and poor home care, there are other potential causes that are less obvious- possible causes being gastric reflux and dry mouth. Could either of those be an issue for you ?

I'm aware everyone with bad oral care clams this, but I do genuinely take great care of my teeth. I brush 2-3 times per day without fail, floss every other night and regularly use mouthwash. The only sugary / acided food I consume are drank with a straw.

I have noticed quite severe dry mouth recently. I'm not sure if this is related to my hormonal issues.

The rate at which my teeth are decaying in relation to my dental hygiene and diet suggests that something more severe and worrying is going on.