Considering weaning off of TRT

[sirgawain]

I started this journey about a year ago when I felt my sex drive and performance were limited. I was tested and came out at around 550 on T and the clinic recommended 140 weekly, which put me at about 1100 at the low. I was also put on an AI as the doctor strove to drive me under 25 on estrogen. While he achieved that, my libido didn't change. I stopped the AI months ago. Libido again didn't change, so the AI wasn't doing anything productive from a "feeling" POV.

So here I sit, injecting every week, having to go have blood taken out of me every 3 months to lower my RBC, and other than small balls, I am not sure what I've gotten out of the experience. Is it possible that 550 was "just fine" and that my lack of libido was something else?

I don't know if I was hoping for a miracle or what, but between this and the trimix I need to take these days, I am so tired of needles...

Maybe I'm just grumpy. But, some questions:

1. If I do stop TRT, do my balls come back or are they gone forever?
2. Is there a safe protocol for weaning off so you don't make things worse?

I may decide to stick with it, but I'm just surprised that I'm not feeling much different than before I started.

 

[S1W]

Sounds like you’re taking too much - many guys complain that they don’t feel well at high levels (and with a trough of 1100 on weekly injections, your peak is likely very high.

If libido is the main thing you’re seeking to change (and you’re sick of needles), consider scrotal testosterone cream. Drop the AI when you start the cream. That definitely gave my already high libido a noticeable boost. 100mg (2 clicks) AM and 50mg (1 click) PM worked well for me.

5mg daily tadalafil. Can add Viagra on demand as needed.

If that doesn’t work out for you, you can always come off of TRT then.

 

[JYD21]

I'm gonna follow this post. I lost my libido, 45, girlfriend of 4 years getting annoyed, and I almost started TRT last week. My labs are middle range and 'good' for my age.

I did not want to resort to TRT for the reason you started this thread.

I wake up with raging boners at least half the week, so my doc and therapist tell me my lack of libido is something else, and not so much my 'bio-equipment'.

I've had a lot of stress in the last year, after a layoff and starting my own business, breaking an IRA to pay bills, etc. Also, I've never been in a 4-year monogomous relationship, so I'm not used to the same (amazing) woman sexually for that long; I've enjoyed my share of variety in my never-married life, so my therapist believes that is some of my issue.

My point is, I'm tackliing the brain, psychological aspect of my lagging libido before I go TRT. I started Buproprion last week, so see how that goes, and I am working things out in therapy doing CBT with my girlfriend.

I'm curious what others will say about your balls growing back.

Either way, I hope it works out for you and please keep us posted, brother.

 

[Vince]

I started this journey about a year ago when I felt my sex drive and performance were limited. I was tested and came out at around 550 on T and the clinic recommended 140 weekly, which put me at about 1100 at the low. I was also put on an AI as the doctor strove to drive me under 25 on estrogen. While he achieved that, my libido didn't change. I stopped the AI months ago. Libido again didn't change, so the AI wasn't doing anything productive from a "feeling" POV.

So here I sit, injecting every week, having to go have blood taken out of me every 3 months to lower my RBC, and other than small balls, I am not sure what I've gotten out of the experience. Is it possible that 550 was "just fine" and that my lack of libido was something else?

I don't know if I was hoping for a miracle or what, but between this and the trimix I need to take these days, I am so tired of needles...

Maybe I'm just grumpy. But, some questions:

1. If I do stop TRT, do my balls come back or are they gone forever?
2. Is there a safe protocol for weaning off so you don't make things worse?

I may decide to stick with it, but I'm just surprised that I'm not feeling much different than before I started.

Here's a recent thread, on the subject.

When would this protocol be started for someone coming off twice weekly TRT doses?

I am getting results of a semen analysis and if they are poor, I'm contemplating doing the following after talking to my doctor as one of my options. When would one start this protocol? How long after the last test cyp injections? The protocol for HPTA normalization contains (edited on Dec...

www.excelmale.com

 

[MIP1950]

Depression, thyroid, long term stress...or, maybe, as you said, even though your gf is great in bed, something in you changed in relation to the relationship. If so, that's a tough one but people change. It's part of human nature. There doesn't have to be a reason. We're a complex, mysterious speicy.(sic) Monogamy can be stressful, even with a wonderful partner or spouse. That's why some couples open up their relationship to see other people. I'm no expert. Been married 26 years, together 29 and I came to realize, in couples therapy, several years ago that my wife has serious emotional problems and sexual issues. We're also co-dependent. Two fucked up people in a dysfunctional marriage. Keep working on it.

 

[Guided_by_Voices]

Several things...TRT is more a journey than a single-variable fix. For example, DHEA is, for me, just as much of a factor as T, if not more. Your dose seems astronomical; I and many others seem to do best with a much lower dosage. 90mg per week puts me around 800 and anything higher makes me feel "off". Experimenting with a micro dose of PT-141 twice a week may be worth a try. So, bottom line, I would not view it as a yes/no, on/off decision but rather something that you need to refine over time. I also, for personal reasons, come off for about two months a year and that has also helped me figure out what is helping me most.

 

[Phil Goodman]

Several things...TRT is more a journey than a single-variable fix. For example, DHEA is, for me, just as much of a factor as T, if not more. Your dose seems astronomical; I and many others seem to do best with a much lower dosage. 90mg per week puts me around 800 and anything higher makes me feel "off". Experimenting with a micro dose of PT-141 twice a week may be worth a try. So, bottom line, I would not view it as a yes/no, on/off decision but rather something that you need to refine over time. I also, for personal reasons, come off for about two months a year and that has also helped me figure out what is helping me most.

Interested in how you approach the two months off. Just cold turkey then jump back into the same dose after two months? How many times have you done it, and how do you feel when off? Is there and adjustment period when you start back?

 

[Jucaro]

I started this journey about a year ago when I felt my sex drive and performance were limited. I was tested and came out at around 550 on T and the clinic recommended 140 weekly, which put me at about 1100 at the low. I was also put on an AI as the doctor strove to drive me under 25 on estrogen. While he achieved that, my libido didn't change. I stopped the AI months ago. Libido again didn't change, so the AI wasn't doing anything productive from a "feeling" POV.

So here I sit, injecting every week, having to go have blood taken out of me every 3 months to lower my RBC, and other than small balls, I am not sure what I've gotten out of the experience. Is it possible that 550 was "just fine" and that my lack of libido was something else?

I don't know if I was hoping for a miracle or what, but between this and the trimix I need to take these days, I am so tired of needles...

Maybe I'm just grumpy. But, some questions:

1. If I do stop TRT, do my balls come back or are they gone forever?
2. Is there a safe protocol for weaning off so you don't make things worse?

I may decide to stick with it, but I'm just surprised that I'm not feeling much different than before I started.

I wish I had TT 550, then I would never have sterted TRT. Actually I feel great at 550 TT under trt. I don't say everybody is the same, but probably your problem with libido and low performance was not about low testosterone.

 

[LakeGuy81]

I also am having libido issues with a long-term partner, and decided to get off TRT for the past year to get my blood pressure and some anxiety issues under control. My natural levels are lower than yours, probably 270-350 range, and Dr. Saya has me on 5mg daily Tadalafil, and that's it. Although my libido isn't raging, with the Tadalafil I've had some very good sexual encounters off TRT the past 12 months. The sex frequency is only about once a week or so, and mostly on the weekends. For me, I have noticed a high correlation in stress and libido. I am less stressed on Sundays, for instance, and therefore I've noticed my libido seems higher on Sundays because there's less on my mind? Then the Tadalafil seems to really help too, it gives just that little boost I need to "get in the mood." I'm 39 and don't even think I have ED, or at least full blown ED, but I highly recommend trying low dose Tadalafil if you go off TRT. I also recommend Defy and Dr. Saya.

Before I jumped off TRT last year, I was also running at like 1,000-1,100, via scrotal T-Cream, and my libido was about the same it is now? I definitely think stress, and the mind, play a HUGE role in libido, it's not just lab #'s.

 

[Jucaro]

I also am having libido issues with a long-term partner, and decided to get off TRT for the past year to get my blood pressure and some anxiety issues under control. My natural levels are lower than yours, probably 270-350 range, and Dr. Saya has me on 5mg daily Tadalafil, and that's it. Although my libido isn't raging, with the Tadalafil I've had some very good sexual encounters off TRT the past 12 months. The sex frequency is only about once a week or so, and mostly on the weekends. For me, I have noticed a high correlation in stress and libido. I am less stressed on Sundays, for instance, and therefore I've noticed my libido seems higher on Sundays because there's less on my mind? Then the Tadalafil seems to really help too, it gives just that little boost I need to "get in the mood." I'm 39 and don't even think I have ED, or at least full blown ED, but I highly recommend trying low dose Tadalafil if you go off TRT. I also recommend Defy and Dr. Saya

Tadalafil seems to increase testosterone levels by itself. In other hand, It doesn't improve libido by itself, but the fact of feeling able to have easy erections give me big libido with tadalafil.

 

[Guided_by_Voices]

Interested in how you approach the two months off. Just cold turkey then jump back into the same dose after two months? How many times have you done it, and how do you feel when off? Is there and adjustment period when you start back?

I’ve done it about 4 times. I wouldn’t necessarily recommend it, I just like to experiment, I believe in minimum effective dose, and I have the situational flexibility to do it, so I have tried it to see how I do and what I can learn. I see no reason to ever come off “cold turkey” so I always have used a low (12.5mg every other day dose of Clomid). I feel surprisingly well when I’m off but it has let me hone in on the things that TRT is doing and I am definitely not at 100% when I am off. One of the major lessons for me is that the benefit of TRT is often less about T level and more about having your hormones locked in place so that hard training, stress, imperfect sleep, etc does not create the additional problem of low hormones. I have not yet found a way to workout on a schedule based around a 7-day week (due to the inevitable two-day rest period that implies) without being on TRT. Perhaps micro-dosing short-duration anabolics while off would allow that but that is another experiment. I probably won’t come off this year and see how I do with a two year uninterrupted ”on” period. I just resume the dose when I start back and I settle into my TRT self in a week or two.

 

[MIP1950]

I’ve done it about 4 times. I wouldn’t necessarily recommend it, I just like to experiment, I believe in minimum effective dose, and I have the situational flexibility to do it, so I have tried it to see how I do and what I can learn. I see no reason to ever come off “cold turkey” so I always have used a low (12.5mg every other day dose of Clomid). I feel surprisingly well when I’m off but it has let me hone in on the things that TRT is doing and I am definitely not at 100% when I am off. One of the major lessons for me is that the benefit of TRT is often less about T level and more about having your hormones locked in place so that hard training, stress, imperfect sleep, etc does not create the additional problem of low hormones. I have not yet found a way to workout on a schedule based around a 7-day week (due to the inevitable two-day rest period that implies) without being on TRT. Perhaps micro-dosing short-duration anabolics while off would allow that but that is another experiment. I probably won’t come off this year and see how I do with a two year uninterrupted ”on” period. I just resume the dose when I start back and I settle into my TRT self in a week or two.

For some, or perhaps many, as we get into our 60's and beyond, 'locking in' our hormones to keep the body and brain on an even keel is challenging, though I won't say, impossible. I subscribe to the concept, though it requires curiosity and strong motivation to keep experimenting and testing until one achieves that state of balance.

 

[Guided_by_Voices]

By "locking in" I mean that the release of T-cyp, for example, keeps levels fairly steady in cases where natural production would fall, even if peak levels are about the same. There is a POV I think is valid which is that many people continue their healthy activity levels, but when their hormones start to decline it leads to a vicious cycle of over-training, poor sleep and stress-intolerance. TRT largely prevents that even if peak levels are not much higher than non-TRT peaks. I'm also aware that there is a view that "natural" fluctuations in T are somehow desirable, however I have not been able to find any benefit from variations beyond the peaks and troughs of twice weekly injections.

 

[nippy]

Hey. Thanks for the post . I feel every word you said. It's the same for Me ... Libido died so got my testosterone checked. It came back low. . I've been in trt for three years . I've tried high amounts and low amounts . I've tired gel and cream . I've had injections sub q and IM still the libido hasn't changed . I've had thyroid . Prolactin and cortisol checked . I e tied everything to boost my libido and the only thing that worked was 400mg of test per week ... This isn't a good amount and that was a one off weekly amount to boost my levels . So I've decided over the last 8 weeks to slowly drop the amount I'm Injectng and from today I stop... I will have bloods done again in 8 weeks then I'll see one of the best endos in the UK at Newcastle RVI.... So will be interesting to see what he says...

 

[MIP1950]

Hey. Thanks for the post . I feel every word you said. It's the same for Me ... Libido died so got my testosterone checked. It came back low. . I've been in trt for three years . I've tried high amounts and low amounts . I've tired gel and cream . I've had injections sub q and IM still the libido hasn't changed . I've had thyroid . Prolactin and cortisol checked . I e tied everything to boost my libido and the only thing that worked was 400mg of test per week ... This isn't a good amount and that was a one off weekly amount to boost my levels . So I've decided over the last 8 weeks to slowly drop the amount I'm Injectng and from today I stop... I will have bloods done again in 8 weeks then I'll see one of the best endos in the UK at Newcastle RVI.... So will be interesting to see what he says...

I'm one of the contrarians on this site. Though many would say that 400 mg per week would disqualify as TRT, if that's the dose that jump started your libido/erectile function, IMO, that could indicate some type of cellular resistance. Yes, guys in the bodybuilding community inject such doses and higher but they're doing it strictly for the anabolic effect, not sexual function, which I consider to be wrong reasons and could certainly damage their health over the long term.

There was/is someone on this site whose handle I can't recall, who was doing 300 mg per week and that was the ideal dose for him. You can only hope that the endo you'll be seeing, whom I believe you said was not with the NHS, will be smart and open minded. Keep us updated.

 

[nippy]

I'm one of the contrarians on this site. Though many would say that 400 mg per week would disqualify as TRT, if that's the dose that jump started your libido/erectile function, IMO, that could indicate some type of cellular resistance. Yes, guys in the bodybuilding community inject such doses and higher but they're doing it strictly for the anabolic effect, not sexual function, which I consider to be wrong reasons and could certainly damage their health over the long term.

There was/is someone on this site whose handle I can't recall, who was doing 300 mg per week and that was the ideal dose for him. You can only hope that the endo you'll be seeing, whom I believe you said was not with the NHS, will be smart and open minded. Keep us updated.

Hi. Thanks for the reply... Sadly the endo is with the NHS. He is supposed to be one of the best in the UK. I sent me a letter to day if he wants to be a patient of his then I need to stop all treatment for 8weeks then get bloods done then he will see me... I said does that include getting my E2 checked . He said there's no really any point in checking that ... I thought oh hell. That means he's the same as the others . Brain washed.... So I'm lost should I try cold turkey .. and prove to him I have low test and that my E2 is in the gutter... Or do I go back and increase my test and see how that goes. Obviously not 400-300 mg.. I was on 200in the past but my free t was too high . May be I could drop to 150 a week ... So when you say cellular resistance .. what does that mean ...

Thank you

 

[sirgawain]

Thanks for all the input -- I will be meeting with my TRT doc soon. My primary doctor felt my T was way too high at the "low" and would like to know what my number is midway between shots...but he knows he is not managing that, it was just his opinion.

If you stop this, do your balls come back or are mine raisins forever now?

 

[MIP1950]

Hi. Thanks for the reply... Sadly the endo is with the NHS. He is supposed to be one of the best in the UK. I sent me a letter to day if he wants to be a patient of his then I need to stop all treatment for 8weeks then get bloods done then he will see me... I said does that include getting my E2 checked . He said there's no really any point in checking that ... I thought oh hell. That means he's the same as the others . Brain washed.... So I'm lost should I try cold turkey .. and prove to him I have low test and that my E2 is in the gutter... Or do I go back and increase my test and see how that goes. Obviously not 400-300 mg.. I was on 200in the past but my free t was too high . May be I could drop to 150 a week ... So when you say cellular resistance .. what does that mean ...

Thank you

Sorry to hear that you're being sent to a by the book narrow minded endo. Regarding cellular resistance, from what I've read and discussed with my urologist, for reasons unknown, standard dosing of T(100 to 200 mg) doesn't produce the desired results, even if the labs look good, or even excellent. Some malfunction in the hypothalamus is what my doctor says. For some men, a dose that is much higher is 'seen' by malfunctioning or desensitized androgen receptors, as with you responding to 400 mg. I'm not going to say it's that simple and straightforward. If the hypothalamus is malfunctioning, thyroid medication might be needed, even though labs read normal. That is where a doctor who THINKS is needed, not someone who just looks at labs. Maybe there's vitamin D resistance. Just read an abstract about that and it's utterly fascinating. I'm guessing that the private doctors in the UK are expensive, as well as the private men's clinics. Keep trying, man. Don't give up.

 

[madman]

I'm one of the contrarians on this site. Though many would say that 400 mg per week would disqualify as TRT, if that's the dose that jump started your libido/erectile function, IMO, that could indicate some type of cellular resistance. Yes, guys in the bodybuilding community inject such doses and higher but they're doing it strictly for the anabolic effect, not sexual function, which I consider to be wrong reasons and could certainly damage their health over the long term.

There was/is someone on this site whose handle I can't recall, who was doing 300 mg per week and that was the ideal dose for him. You can only hope that the endo you'll be seeing, whom I believe you said was not with the NHS, will be smart and open minded. Keep us updated.

ED/libido are multifactorial.

As you should very well know there is much more involved when it comes to libido let alone ED than just having healthy hormones.

He stated..... I e tied everything to boost my libido and the only thing that worked was 400mg of test per week ... This isn't a good amount and that was a one off weekly amount to boost my levels .

He basically drove his T levels up from one high-dose injection which most likely spiked dopamine temporarily.

Even then if one continued to follow such a ridiculous protocol of 400 mg T/week it is highly doubtful the boost in libido would be maintained long-term let alone one would feel great overall.

When using exogenous T many factors can come into play when it comes to what dose of T is needed to achieve a healthy FT level.

The dose T, SHBG level, injection frequency, metabolism, the sensitivity of the AR, polymorphism of the AR, and CAG repeat length (long/short), bodyweight.

Most men can easily achieve a healthy let alone absurdly high trough FT on 100-150 mg T/week whether split twice weekly (every 3.5 days), M/W/F, EOD let alone daily.

Sure some may need the higher end dose of 200 mg T/week to achieve such but it is far from common.

Regarding the thrown-around term androgen resistance used on the numerous forums littered on the internet especially the ones where everyone and their brother that was struggling on a trt protocol claimed that they need to be running absurdly high trough TT/FT levels to feel good!

If you want to put any weight behind the sensitivity of the AR (androgen receptor) and polymorphism of the AR/CAG repeat length (short/long).....sure!

Some men may need to be running what would be considered very high T levels 1800-2000 ng/dL because of a decreased sensitivity of ARs to androgens due to having a higher CAG repeat length.

Even then the number of men who have a high number of CAG repeat lengths would be far from common.

Highly doubtful one would need absurd doses of T 400 mg/week to overcome this so-called androgen resistance let alone polymorphism of the AR/higher CAG repeat length.

Men's Response to Testosterone Depends on their CAG Repeats in Their AR Gene.

Androgen Sensitivity: Beyond the Well-Known © Irina A. Khripun*, Sergey V. Vorobyev Rostov State Medical University, Rostov-on-Don, Russia The gonadal and extragonadal effects of testosterone in men have been actively studied in recent years. To date there is no doubt an increased risk of...

www.excelmale.com

One of the mechanisms by which the action of testosterone is realized is sensitivity to androgens, determined by the length of CAG repeats in the androgen receptor gene. An increase in the number of CAG repeats reduces their activity and is manifested by low sensitivity to testosterone. In contrast, a decrease in the number of trinucleotide repeats is accompanied by an increase in the sensitivity of receptors to androgens.


In recent years, researchers have especially focused on the study of the first exon AR gene, which is characterized by repeats of the sequence of three nucleotides - cytosine, adenine, and guanine - CAG. The CAG triplet encodes the amino acid glutamine, therefore, the amount of glutamine in the protein depends on the number of trinucleotide repeats. So, a smaller number of CAG repeats correspond to a lower degree of conformational changes in the receptor, which makes the connection of the hormone and receptor stronger and leads to an increase in the transcriptional activity of AR. In contrast, with an increase in the number of CAG repeats, the relationship between androgens and the receptor becoming weaker, and transcriptional activity AR is decreasing.


For men of the European population, the number of CAG repeats from 9 to 37 is considered normal. However, there are population differences in this standard. So, the average number of CAG repeats per the AR gene for Europeans is 21, for Africans - 17, for Asians - 23. At the same time, for example, 25 CAG repeats though fit into normative values often associated with weakening the action of androgens, manifested by the corresponding clinical symptoms [8].

 

[MIP1950]

ED/libido are multifactorial.

As you should very well know there is much more involved when it comes to libido let alone ED than just having healthy hormones.

He stated..... I e tied everything to boost my libido and the only thing that worked was 400mg of test per week ... This isn't a good amount and that was a one off weekly amount to boost my levels .

He basically drove his T levels up from one high-dose injection which most likely spiked dopamine temporarily.

Even then if one continued to follow such a ridiculous protocol of 400 mg T/week it is highly doubtful the boost in libido would be maintained long-term let alone one would feel great overall.

When using exogenous T many factors can come into play when it comes to what dose of T is needed to achieve a healthy FT level.

The dose T, SHBG level, injection frequency, metabolism, the sensitivity of the AR, polymorphism of the AR, and CAG repeat length (long/short), bodyweight.

Most men can easily achieve a healthy let alone absurdly high trough FT on 100-150 mg T/week whether split twice weekly (every 3.5 days), M/W/F, EOD let alone daily.

Sure some may need the higher end dose of 200 mg T/week to achieve such but it is far from common.

Regarding the thrown-around term androgen resistance used on the numerous forums littered on the internet especially the ones where everyone and their brother that was struggling on a trt protocol claimed that they need to be running absurdly high trough TT/FT levels to feel good!

If you want to put any weight behind the sensitivity of the AR (androgen receptor) and polymorphism of the AR/CAG repeat length (short/long).....sure!

Some men may need to be running what would be considered very high T levels 1800-2000 ng/dL because of a decreased sensitivity of ARs to androgens due to having a higher CAG repeat length.

Even then the number of men who have a high number of CAG repeat lengths would be far from common.

Highly doubtful one would need absurd doses of T 400 mg/week to overcome this so-called androgen resistance let alone polymorphism of the AR/higher CAG repeat length.

Men's Response to Testosterone Depends on their CAG Repeats in Their AR Gene.

Androgen Sensitivity: Beyond the Well-Known © Irina A. Khripun*, Sergey V. Vorobyev Rostov State Medical University, Rostov-on-Don, Russia The gonadal and extragonadal effects of testosterone in men have been actively studied in recent years. To date there is no doubt an increased risk of...

www.excelmale.com

One of the mechanisms by which the action of testosterone is realized is sensitivity to androgens, determined by the length of CAG repeats in the androgen receptor gene. An increase in the number of CAG repeats reduces their activity and is manifested by low sensitivity to testosterone. In contrast, a decrease in the number of trinucleotide repeats is accompanied by an increase in the sensitivity of receptors to androgens.


In recent years, researchers have especially focused on the study of the first exon AR gene, which is characterized by repeats of the sequence of three nucleotides - cytosine, adenine, and guanine - CAG. The CAG triplet encodes the amino acid glutamine, therefore, the amount of glutamine in the protein depends on the number of trinucleotide repeats. So, a smaller number of CAG repeats correspond to a lower degree of conformational changes in the receptor, which makes the connection of the hormone and receptor stronger and leads to an increase in the transcriptional activity of AR. In contrast, with an increase in the number of CAG repeats, the relationship between androgens and the receptor becoming weaker, and transcriptional activity AR is decreasing.


For men of the European population, the number of CAG repeats from 9 to 37 is considered normal. However, there are population differences in this standard. So, the average number of CAG repeats per the AR gene for Europeans is 21, for Africans - 17, for Asians - 23. At the same time, for example, 25 CAG repeats though fit into normative values often associated with weakening the action of androgens, manifested by the corresponding clinical symptoms [8].

On the practical side, my urologist has patients that only respond when their total is 1500 or higher and it's a given that their free T is also high. The reasons why some men only respond to high doses of testosterone, whether injected, topical or pellets isn't really known and the knowledgeable doctors who prescribe TRT, will treat until there's symptom resolution. I referred to an abstract in Frontiers of Immunology about vitamin D resistance and the two possible causes stated are either VDR polymorphisms or pathogens that block or blunt vitamin D receptors. And the way to treat is to keep titrating until the resistance is overcome.

Whether in the case of testosterone or vitamin D or even thyroid resistance, the only practical way is to push the dose but, in the case of testosterone, there could be deleterious effects or problems from prolonged high dosing. It isn't perfect, but until the underlying mechanisms of resistance are discovered and can be corrected, treating until symptom resolution is all we have.