Feeling dead inside after stopping TRT

[Gene Devine]

I don't see any labs. Like to see full hormonal, CBC and metabolic panels including Thyroid labs, Cortisol and Prolactin. Many of the sides the OP has listed could be caused by many other physiological conditions besides just testosterone optimization.

 

[Janosch]

So I agree with Systemlord. Your doctor is just a little behind on how to properly dose Clomid. 50mg/ day is an old school dose. Most doctors, that know what they’re doing, dose it at 12.5mg/ day, or 12.5mg EOD, to start. The most I would ever use of clomid per day would be 25mg. I personally tried 50mg/ day, due to having a doctor that wasn’t the best, it was the worst I have ever felt in my life. Zero libido, penis stopped working, extremely depressed, had suicidal thoughts often, low energy, just overall felt horrible. And I am not prone to depression. I was never depressed before that really, and haven’t been depressed since. The thoughts I had on clomid were very scary. Never knew hormone fluctuations could cause such drastically different thinking. Was definitely a big learning experience for sure. Here were my labs on 50mg of clomid per day, and 0.25mg of anastrozole twice per week. So 0.5mg of anastrozole total per week. My SHBG usually runs around the high 40’s/ low 50’s for the record.

Total T - 1535 (250-1100 ng/dL)
Free T - 98.5 (46.0-224.0)
Bio T - 198.4 (110.0-575.0 ng/dL)
SHBG - 91 (10-50)
E2 Sensitive - 51
DHT - 78 (16-79)
Prolactin - 3.9 (2.0-18.0)

Those were my labs after 2 months on clomid. So it doesn’t take too long for it to raise endogenous testosterone levels. My levels probably were that high after 1-3 weeks of 50mg/ day. But just don’t expect your levels to stay elevated once you stop clomid. That’s not how it works. There’s no such thing as a “restart”. Your levels will always go back to baseline after discontinuing clomid. I had my levels tested 2 months after stopping clomid, and my levels were exactly where they were at baseline. No more, no less. And I’m not just going by my experience, this is the experience you’ll see from anyone that does clomid. Levels will always go back to baseline. So don’t expect clomid to “jumpstart” your testicles or anything. Sorry to be a cloud of negativity lol, but it’s just how it works. “Restarts” are an old wives tale.

Very helpful! And whatever is to the 1:30 ratio between E2 and T, you were right there. I appreciate the time you took sharing your experience.

Where did your testosterone sit when you initiated TRT?

Absolutly. Even too high of a testosterone dose changed my emotions for the worse And on that dose my labs still looked decent. We are all so different.

Charliebizz, my last Total T prior to TRT was 265 and 11.5. It dropped over the course of about one year from 360 down to 265. Unfortunately my PCP did not test E2 or SHBG.

 

[Charliebizz]

Very helpful! And whatever is to the 1:30 ratio between E2 and T, you were right there. I appreciate the time you took sharing your experience.




Charliebizz, my last Total T prior to TRT was 265 and 11.5. It dropped over the course of about one year from 360 down to 265. Unfortunately my PCP did not test E2 or SHBG.

My natural testo fluctuates from 250-390 over the years

 

[Janosch]

My natural testo fluctuates from 250-390 over the years

Did you ever go back on a lower dose of Clomid to treat your low T?

 

[Janosch]

I don't see any labs. Like to see full hormonal, CBC and metabolic panels including Thyroid labs, Cortisol and Prolactin. Many of the sides the OP has listed could be caused by many other physiological conditions besides just testosterone optimization.

Based on advice I had been given on this forum, I had some detailed labs run back in August 2018. At the time I provided my labs, I did not really get much feedback. If there is anything you see, I would love to hear it.

Total T=892
Free T=23.67
SHBG=24.18
E2 (sensitive)=23
Estrone=23.4
DIOH T=531
DHEA Sulfate=191.2
Reverse T3=22.2
Free T3=3.71
Free T4=1.50
TSH=2.01
T Peroxidase IgG=<3
Progesterone=0.308
PSA=0.895
Prolactin=12.69
Hematocrit=52.5

 

[Charliebizz]

Did you ever go back on a lower dose of Clomid to treat your low T?

I tried it again before my last attempt at trt. Didn’t feel any difference. Same for being on trt again. I’m currently off a 6month run of trt for about 3 weeks now and feel no different on or off. Biggest difference is I feel better mentally off trt

 

[Janosch]

I tried it again before my last attempt at trt. Didn’t feel any difference. Same for being on trt again. I’m currently off a 6month run of trt for about 3 weeks now and feel no different on or off. Biggest difference is I feel better mentally off trt

Sorry to hear that man. I know it's frustrating. I hope you'll get some inspiration as to what to try next or do differently! I have gone through a process of elimination, making sure thyroid is not an issue, hemoglobin is not too high, possible side-effects of medication, sleep, etc. I ran about every lab there is, all of which seemed normal. I guess what is left is keeping testosterone levels high enough in relation to Estradiol and SHBG. Currently doing keto diet to eliminate fat to limit aromatization. I hope clomid will help. If not, hell, I'll get back on TRT and I guess have to settle for mediocre. Kind of sucks being 53 years old. Again, thanks for your feedback and best for you!

 

[Charliebizz]

Sorry to hear that man. I know it's frustrating. I hope you'll get some inspiration as to what to try next or do differently! I have gone through a process of elimination, making sure thyroid is not an issue, hemoglobin is not too high, possible side-effects of medication, sleep, etc. I ran about every lab there is, all of which seemed normal. I guess what is left is keeping testosterone levels high enough in relation to Estradiol and SHBG. Currently doing keto diet to eliminate fat to limit aromatization. I hope clomid will help. If not, hell, I'll get back on TRT and I guess have to settle for mediocre. Kind of sucks being 53 years old. Again, thanks for your feedback and best for you!

Hey most times I try to keep a positive out look on it. I’m not doing to bad in grand scheme of things. Just do not feel like a 36 year old should. But I still do everything I want and get plenty of joy out of life. I actually do my best when I just try to forget about all this hormone shit and stay off the forums but I always tend to want more and then I go back down this hrt/trt journey.

I should also add test positive for lymes as far back as 1998. So I’ve always had some form of energy issues and more aches and pains then usual. But I’m Grateful I do not suffer like some people do with lymes and even low t. My biggest health huddle was low cortisol and since going on low dose ssri most my symptoms have resolved. So it may all just be lingering Lyme issues.

 

[YBWV]

Based on advice I had been given on this forum, I had some detailed labs run back in August 2018. At the time I provided my labs, I did not really get much feedback. If there is anything you see, I would love to hear it.

Total T=892
Free T=23.67
SHBG=24.18
E2 (sensitive)=23
Estrone=23.4
DIOH T=531
DHEA Sulfate=191.2
Reverse T3=22.2
Free T3=3.71
Free T4=1.50
TSH=2.01
T Peroxidase IgG=<3
Progesterone=0.308
PSA=0.895
Prolactin=12.69
Hematocrit=52.5

Looking at your (six month old) Labs I would say that, although you had good levels of TT and FT, your Prolactin was too high and your DHT was too low. Both of which would negatively impact your sexual function.

It could be your Prolactin was temporarily spiked (eg if measured some hours after an ejaculation); do you have the level from other blood draws?
If Prolactin levels stay high over a protracted period it's somewhat akin to being kept in a refractory state and the motivation/reward for sex can become subjugated.

I assume that the DHT figure is ng/L and therefore 53 ng/dl. Healthy eugonadal males have DHT levels ~10% of TT.
With your TT of around 900 that would indicate DHT of ~90. 53 is possibly toward the top of the Lab's range but is likely insufficient for good function.

If you do decide to revisit TRT after the Clomid restart then I would suggest that you consider a protocol that includes transdermal T Cream. There are several recent threads discussing the potential benefits.

 

[Charliebizz]

Looking at your (six month old) Labs I would say that, although you had good levels of TT and FT, your Prolactin was too high and your DHT was too low. Both of which would negatively impact your sexual function.

It could be your Prolactin was temporarily spiked (eg if measured some hours after an ejaculation); do you have the level from other blood draws?
If Prolactin levels stay high over a protracted period it's somewhat akin to being kept in a refractory state and the motivation/reward for sex can become subjugated.

I assume that the DHT figure is ng/L and therefore 53 ng/dl. Healthy eugonadal males have DHT levels ~10% of TT.
With your TT of around 900 that would indicate DHT of ~90. 53 is possibly toward the top of the Lab's range but is likely insufficient for good function.

If you do decide to revisit TRT after the Clomid restart then I would suggest that you consider a protocol that includes transdermal T Cream. There are several recent threads discussing the potential benefits.

Dr john preached you should also test prolactin fasting. Two times mine came back high I ate before my blood draw. When ever I fasted it was perfect.

 

[PhilM7]

Thanks for mentioning the fact about fasting. I have wondered if I should fast before my blood tests, and you have answered that question.

 

[Ronnny]

Dr john preached you should also test prolactin fasting. Two times mine came back high I ate before my blood draw. When ever I fasted it was perfect.

How many hours fasting recommended before Prolactin test?

 

[Charliebizz]

How many hours fasting recommended before Prolactin test?

I’m don’t remember exactly how many hours but I never eat past 9pm. And my blood draw usually at 8am.

 

[1Draw]

Charliebizz your symptoms could very well be caused by your high Reverse T3.....Yours is at 22 and it needs to be 15 or lower.... good article here!

Reverse T3 Treatment Guide + How to "Flush" it out of Your Body

I would look into why its high - low iron/ferritin, sickness, surgeries, etc... and get on a T3 protocol to reduce it....

 

[Charliebizz]

Charliebizz your symptoms could very well be caused by your high Reverse T3.....Yours is at 22 and it needs to be 15 or lower.... good article here!

Reverse T3 Treatment Guide + How to "Flush" it out of Your Body

I would look into why its high - low iron/ferritin, sickness, surgeries, etc... and get on a T3 protocol to reduce it....

Last time I tested my rt3 was 15 and range was 8-25

 

[1Draw]

OK good to know. I was going by your post of labs done in August 2018. You listed Reverse T3 at 22.2. If you've had tested since August and its at 15, then you are good there.