Help Please - going to try PCT Restart after 22 years of TRT

[MTNMan6000]

Hello all,

Thank you all for your help and guidance in advance. I sincerely appreciate it.

PROBLEM
I've been on TRT for over 22 years after using light anabolics in college at the age of 20. I used Testosterone for 22 years. I have been to many doctors around the world, most of which are named on this forum. I have used injectable, creams, patches, and new orals (they are great) in all dosages. However, my HCT is high and the biggest issue in my opinion is low LH/FSH and GnRH for cognition/mood. The mood and cognition issues are real for me. The data in Down syndrome use with GnRH is interesting and telling in my opinion for cognition. It is my belief this is a major issue with long-term TRT. I see no easy way to support GnRH on TRT. As an aside, I have had every diagnostic test you can image.

QUESTION
1) What is a good PCT protocol for what my objective is?
2) Is Kisspeptin an option to support GnRH? If so, what dose?
3) Is Gonadorelin an option? If so, what dose?
4) What other things should I be thinking about during this process?

Thank you again.

 

[Systemlord]

biggest issue in my opinion is low LH/FSH and GnRH for cognition/mood. The mood and cognition issues are real for me. The data in Down syndrome use with GnRH is interesting and telling in my opinion for cognition.

If you have pituitary failure, or secondary hypogonadism (low LH and FSH) stimulating the pituitary with GnRH will do nothing.

Multiple studies show cognitive improvement on TRT, unlikely this is your issue.

Men who abuse steroids do suffer from cognitive decline after many years of use, dementia, and Alzheimer’s like symptoms.

Based on the information you’ve provided, the latter is most like your issue.

TRT can lower pregnenolone, a precursor to luteinizing hormone.

1) What is a good PCT protocol for what my objective is?

HCG @ 2000 units per week, 3-4 times per week for 15 days, followed by clomid for 2-3 months. The longer you’re on TRT, the longer it may take to recover your HPTA.

 

[Gman86]

@Systemlord has a good point. If GnRH/ LH/ FSH suppression was an the main issue, how do we explain all the guys that have been on exogenous testosterone for years and year and years, and still feel great cognitively, and in fact much better than when they had a functioning HPTA? I listen to all of Joe Rogan’s podcasts, for example, and he is doing great cognition wise. Reports feeling happy and in a good mood all the time, while also feeling great cognitively. Which I believe, based on the hundreds of hours I’ve watched/ listened to him. As far as HRT goes, he just takes low dose testosterone and peptides, as far as I know. Don’t think he takes anything to backfill things like preg, DHEA, prog, etc.

Obv everyone is different, and having bottomed out GnHR/ LH/ FSH levels could very well effect some guys negatively, but the fact that it doesn’t effect everyone negatively, at least subjectively from their reports, tells us a lot, imo

 

[Gman86]

What’s the data with GnHR and down syndrome? @MTNMan6000

there is always a chance that even guys that report feeling great cognitively could in fact feel better, if they didnt have suppressed GnHR/ LH/ FSH levels, and just don’t realize that they could feel even better. Humans are extremely adaptable, and can get used to feeling all sorts of ways, and just accept it as their baseline. And dont realize how poorly they felt until they end up feeling better

 

[TLR]

In 2018 at age 48 after 7 years of TRT I tried a Clomid / HCG restart under the supervision of a doctor mentioned quite frequently on this forum. After six weeks my gonadotropins were elevated, my balls were bigger than they’ve ever been in my life, but my total T was 348 and free T was 7….and I felt like shit….bad enough that I went back to TRT because it was worse than the issues I was having with TRT…..I wish you luck, and hope you have a different result. I just think age and being shutdown for a long period make it hard to come back online, although my natural levels were shit also before TRT.

 

[Cataceous]

If you have pituitary failure, or secondary hypogonadism (low LH and FSH) stimulating the pituitary with GnRH will do nothing.
...

Secondary hypogonadism is considered to include hypothalamic dysfunction, in which case the pituitary is usually fine and able to react to GnRH. Hypogonadism of hypothalamic origin is probably the most common form. Beyond that, GnRH has functionality outside of its role in the HPTA. It's plausible that there are benefits in restoring some GnRH even when it doesn't result in production of the gonadotropins. At the very least, stimulating all those extra-pituitary GnRH receptors is going to do more than "nothing".

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I have a high self-esteem ...

Referring to a particular colleague, my mentor used to say, "often wrong, never in doubt".