Coming off trt after 3 years

[Dks888]

Hey everyone, I'm 33 and have been on testosterone enanthate + hcg for 3 years and have decided to come off.

Do I immediately start taking hcg daily or so I wait until the testosterone has cleared? I find all the protocols rather confusing so any advise would be greatly appreciated.

Thanks in advance!

 

[Systemlord]

I'm not sure what your reasoning is but it would seem you have testicular failure indicated by your previous labs showing very high LH so not sure why you are wanting to stop TRT.

You should start the HCG long before stopping the TRT.

 

[Dks888]

My LH was normal prior a year or two prior to the blood work you refer to and only did the blood work while travelling Vietnam. Having consulted a specialist in London he recommended I get off trt, showing him that blood work + the older.

So if I stop today, I should get on hcg daily right away?
Thanks

 

[Systemlord]

My LH was normal prior a year or two prior to the blood work you refer to and only did the blood work while travelling Vietnam.

My blood work was normal years prior to being diagnosed with hypogonadism. Newer blood work is normally more relevant than old blood work.

I would be weary of taking advice from a doctor going off old lab work and ignoring the most relevant newer lab work.

So if I stop today, I should get on hcg daily right away?

My previous post had stated getting on HCG long before ceasing TRT, so this means sooner rather than later.

Having consulted a specialist in London he recommended I get off trt, showing him that blood work + the older.

The UK doctors are often referred to as still living in the stone ages in regards to TRT, be careful who you get advise from.

Just out of curiosity what has this "specialist" in London recommended as far as a restart protocol for coming off TRT?

 

[Dks888]

Gotcha, I appreciate the feedback. Frankly I'm struggling greatly with trt and my libido has just plummeted to 0/10. Given I've just done the whole thing without supervision or proper blood work as well has just made me want to "get out" and reassess the situation.

Frankly he didn't suggest much so I can see how that doesn't look great, I was prescribed clomiphene and he recommended I get on that rather than T.
Thanks again

 

[S1W]

To answer your question more directly - if you choose to go off TRT, it seems that simply stopping everything, including hcg, is the simplest solution and perhaps the fastest route to a recovered HPTA.

 

[Systemlord]

To answer your question more directly - if you choose to go off TRT, it seems that simply stopping everything, including hcg, is the simplest solution and perhaps the fastest route to a recovered HPTA.

This is what I did and it only took four and a half weeks to get my HPTA functioning again and for a day I felt the effects of naturally high testosterone and then a return to baseline the next day.

 

[Dks888]

Seems to me it you simply stop it can take a very long time to get back to pre-treatment levels, no? Surely a good reason for all the trt docs on the forum to suggest a restart protocol?

 

[Systemlord]

Seems to me it you simply stop it can take a very long time to get back to pre-treatment levels, no?

It doesn't usually take a long time to regain a normal functioning HPTA, what can take a long time is getting fertile again which can take a minimum of 6 months.

 

[madman]

Seems to me it you simply stop it can take a very long time to get back to pre-treatment levels, no? Surely a good reason for all the trt docs on the forum to suggest a restart protocol?

In general recovery of the hpta will come down to dosage of testosterone/AAS used, duration of use, type of AAS used whether T only or T+AAS or T + multiple AAS), age of the individual.

Older men would tend to have a more difficult time recovering than younger men.

Higher doses and a longer duration of use will have a greater negative impact on the recovery of the hpta.

Use of nandrolone or trenbolone will have a greater negative effect on the recovery of the hpta.

On average most men on trt are injecting 100-200 mg/week of testosterone only and the duration of use can be anywhere from months to years depending on whether the individual continues trt indefinitely or decides to come off such as in your case.

Use of pct will in no way prevent the crash following hpta recovery it will just speed up the recovery process and minimized the length of being in a hypogonadal state.

The main goal of pct is to not only increase LH production which will stimulate the Leydig cells in the testes to produce endogenous testosterone (ITT) but most importantly making sure the testes are responsive to the LH stimulation as in many cases when on trt or steroids if no hCG was used during this time than the Leydig cells become dormant and the seminiferous tubules shrink which results in testicular atrophy due to shutdown of the hpta and LH/FSH production. This results in the Leydig cells no longer producing endogenous testosterone and the Sertoli/germ cells no longer producing sperm.

Use of hCG when on trt or steroids should aid in the recovery process when coming off as it mimics LH and will keep the Leydig cells active (producing some degree of ITT).

Even without the use of a pct, the natural production of LH will kick in fairly quickly but natural endogenous production of testosterone can take much longer as the critical aspect of the recovery process is the responsiveness of the Leydig cells in the testes to the LH.

No one can say exactly how long it will take you to recover let alone how you will feel during the transition.

Some men on trt choose to stop cold turkey (no pct) and recover okay with some bumps along the way whereas others may struggle before things get better.

Others choose to implement a pct which may make the transition much quicker/smoother but again everyone is different as again there are numerous factors involved.

 

[madman]

FSH and hCG dual therapy may result in the more rapid recovery of sperm to the ejaculate

024 Dual Therapy with rFSH and HCG Results in a Significantly Shorter Time to Return of Spermatogenesis than Combination HCG and Clomiphene (2021) K. Campbell, J. Sullivan, R. Valero Carrion, J. Kraus, B. Stocks, A. Lawrence, L. Lipshultz Introduction: The use of testosterone replacement...

www.excelmale.com

Conclusions: Our results reiterate that FSH in combination with hCG may be considered as an alternative to combination hCG and clomiphene in the treatment of testosterone-induced azoospermia. FSH and hCG dual therapy may result in the more rapid recovery of sperm to the ejaculate being three times faster in the FSH group. Additionally, patients who have failed dual therapy with hCG and clomiphene should be considered for subsequent FSH.

Sperm Take Up to 3 Years to Recover After Anabolics

https://www.medscape.com/viewarticle/938379#:~:text=Contrary%20to%20prior%20understanding%2C%20many,Society%20of%20Medicine%20webinar%20series. Contrary to prior understanding, many hormones related to spermatogenesis take longer to recover than previously thought, and up to 3 years in some...

www.excelmale.com

"In answer to what is the prognosis for recovery in men after androgen misuse? The endocrine system mostly recovers in the first year but sperm take much longer to recover," he concluded.

 

[Dks888]

Thank you for your feedback!

 

[Markus77]

Gotcha, I appreciate the feedback. Frankly I'm struggling greatly with trt and my libido has just plummeted to 0/10. Given I've just done the whole thing without supervision or proper blood work as well has just made me want to "get out" and reassess the situation.

Frankly he didn't suggest much so I can see how that doesn't look great, I was prescribed clomiphene and he recommended I get on that rather than T.
Thanks again

Being on trt without supervision made your labido crash?

 

[ERO]

A lot of folks on TRT, including myself never find good libido even when working with the best doctors.

 

[hombre]

Dr. Saya just puts me on Enclomiphene with no HCG (still waiting almost two weeks for it from Empower). I had some sporadic HCG use last year here and there, maybe it was enough and HCG is not really that necessary when Enclomiphene is used