How do I come off TRT?

[IamTT]

I am hoping to find some guidance or personal experience when it comes to coming off TRT.

I am about 7 months in to TRT. I take 100 mg of cypionate per week, subcutaneously. I pin 3 times per week to make up the 90mg. Sometimes I'll take 100mg a week.

After about 6th week on TRT, I started HCG at 600 twice, sometimes thrice a week. A few months ago I began to get nipple sensitivity and bloodwork showed that my Estrodial was in the high end of the normal range. So I began on half an mg of Arimidex (Anastrozol generic) per week. That seems to have brought down the Estrodial a little and nipple sensitivity is now gone. I also take one IU of GH each night, 6 nights a week (which I've been doing for several years).

I am 49 and started on TRT for a couple of reasons. Anti-aging was one. I wanted to continue trying to optimize my health. I was feeling sluggish and low motivation, low mood. I've struggled with depression on and off in my life and that was the other reason I started TRT. Before beginning (in May this year), my free test was 6.4 pg/ml and the reference range was 4-30 pg/ml (I am in South America). My total test was 432 ng/dl. Currently, my free test is at 25 pg/ml and my total test is at 688.

I feel slightly better than when I started but I don't feel amazing or even good. I feel better than before I started, but I would categorize how I feel now as slightly below average. My mood and confidence levels are still quite low. Libido is normal, a bit better than pre-TRT. I go to the gym about 3-4 times a week and it has helped improve my superficial appearance. But energy/motivation is low so it's a struggle just to workout.

I don't feel there have been strong enough changes to justify continuing. I don't have a doctor where I am who understands TRT let alone how to come off it. I am hoping that some of the people here, who are experienced and knowledgeable, might be able to give me their thoughts on what I have written. All opinions welcomed. And considering my circumstances, what might be a good protocol to come off TRT.

Thanks so much. This forum has been an invaluable source of information and I appreciate that so much!

 

[Vince Carter]

Probably inneffective Estrogen management which seems to be the toughest part of all of this. Probably too much Anastrozole, some nipple issues on TRT are transient and benign and not an indication that E is elevated or a problem. .5mg is a heavy dose by most standards. Low E is much worse that high E.
I'd just continue with your dose of Cyp and eliminate the Anastrozole, retest in 6 weeks. And don't do this sometime is 90, sometimes it's 100mg...use one dose and stick with it. There's no reason youre bouncing up and down like that.

 

[IamTT]

Thanks so much for your feedback Vince. I'm new too all of this so would you mind elaborating on what you mean by ineffective Estrogen management?

A bit more context regarding being on AI and E2 levels...I’ve been on an AI since last month. I take half a mg per week which I had read was not a heavy dose. My concern and the reason I started the AI was not only the nipple sensitivity but the E2 levels I exhibited. Nipple sensitivity started in August. I started trt in May and E2 level was 24. So I had been on TRT for 4 months before the nipple sensitivity began. I tested for E2 again in September and the level was 26, so not much of a change. I was fine to not do anything about the nipple sensitivity, knowing that it is common and was willing to ride it out until things settled. But in November I tested it again and it had shot up to 77. I started with half a mg of Arimidex per week after that result (since November), E2 is back down to 36.

 

[Vince Carter]

Any explanation thru the lab to how you shot up from 26 - 77? Same lab? Same conditions? I see a lot of guys that post labs and say "E2" when you go back and examine their labs you can see that the lab has used different tests each time...there is no single/1 test available for E. If the exact same test is not being used each time you can't compare the results.

 

[Vince]

The most common dose of AI is .125mg twice a week. I'm surprised to see your total T is only at 688, if your free T it's not too high, I would consider increasing your testosterone dose. It takes time to get dialed in. It's hard sometimes but remember trt is not a sprint but a marathon.

 

[IamTT]

It was a different lab Vince Carter. I live in South America and they don't do the sensitive Estrodial test that I've read is the test to do. So likely the 77 was not correct. The Lab was the most reputable lab in the city but I re-tested at a different lab a month later aster being on AI and as mentioned, it was 36.

 

[IamTT]

The most common dose of AI is .125mg twice a week. I'm surprised to see your total T is only at 688, if your free T it's not too high, I would consider increasing your testosterone dose. It takes time to get dialed in. It's hard sometimes but remember trt is not a sprint but a marathon.

When I started in May this year, my free T was 6.4 pg/ml. As of this month, it's 25 pg/ml

 

[Sean Mosher]

With that much inconsistency in those test results like Vince Carter said I'd drop the AI and re-test in 6 weeks.
If they don't have the sensitive test, make sure you get Total T, FreeT and SHBG at a minimum.
To echo what the other Vince said, there's probably some room to increase your dose as well.

 

[IamTT]

Thanks Sean and thanks Vince. I will try that and re-test in 6 weeks. I did get my SHBG and FSH done this month as well. SHBG was 25.4 nmol/L and FSH was .10 mui/ml

 

[equel]

Correct protocol, optimal one, would have u feeling pretty damn good friend. I suggest you try to find your sweetspot instead of going back to low natural levels.

 

[IamTT]

Correct protocol, optimal one, would have u feeling pretty damn good friend. I suggest you try to find your sweetspot instead of going back to low natural levels.

Appreciate the support. So I'll try and go up slightly and do 110 mg a week and see how that feels. Any additional thoughts would be much appreciated if there are any.

 

[at15]

you need to reset. 40 mg cypionate twice per week. no anastrozole. no hcg.

 

[IamTT]

you need to reset. 40 mg cypionate twice per week. no anastrozole. no hcg.

Hi, thanks for suggesting that. I'm quite inexperienced as you can see by my post and really feeling my way at this stage, hence the reason for posting on this forum. So how long do you suggest that I do this re-set? I have been on HCG to stay fertile as well as for appearance. When would I resume that in your opinion? Anything you can elaborate on would be greatly appreciated.

 

[at15]

Hi, thanks for suggesting that. I'm quite inexperienced as you can see by my post and really feeling my way at this stage, hence the reason for posting on this forum. So how long do you suggest that I do this re-set? I have been on HCG to stay fertile as well as for appearance. When would I resume that in your opinion? Anything you can elaborate on would be greatly appreciated.

5-6 weeks then check your blood work. I say this because if you had estrogen issues at 90-100 per week you need to come down a bit. After this you can consider adding low dose hcg. 250-300iu twice per week or 100iu daily.

 

[[email protected]]

I suffered at blood levels of 500-600 ng/dL. My low T symptoms didn’t go away till my total T was 1200+. My SHBG is 14, so I have to inject often, and take 200mg/week.
But I’ve found out recently that my thyroid is underperforming and that my body has difficulty converting b12 into its active forms, which can cause an underperforming thyroid, which in turn can elevate symptoms of low T so more T is needed. High T levels can mask/protect against the problems associated with other issues but I didn’t know what some of those issues were until now.
Each person is individual, that’s why the range is so broad. Majority of men do well in the 500-700 range, while some function better on less or more than that.
Presently I don’t take an AI and haven’t needed one since dropping body fat.

 

[JohnTaylorHK]

I am 49 and started on TRT for a couple of reasons. Anti-aging was one. I wanted to continue trying to optimize my health. I was feeling sluggish and low motivation, low mood. I've struggled with depression on and off in my life and that was the other reason I started TRT....

I think it's worth mentioning that for any supplement/medication, there needs to be a proven medical condition to warrant intervention. Wishing to optimize one's health and thereby live longer, is a laudable aim. IMVHO, many males on TRT are living a lifestyle that is not conducive to this goal. Drug addictions (including Smoking, drinking, Sugar), eating bad foods, no (significant) exercise are all symptoms of a lifestyle that will eventually cause your body to give up and you to die earlier. We should ensure that we address these issues (the REAL causes of aging) before jumping on the Testosterone "Magic Pill" wagon. BTW, I'm not stating that T is in any way bad, it's just another tool that can possibly used after all other (natural) interventions have failed.

Namaste

John

 

[BigBamBoo]

I just posted my stopping TRT experience. For me, I have high SHBG, so the Doctor told me using clomid would not be advised as it will increase SHBG.

So....expecting the worse, but knowing I would be mentally able to deal with it....I stopped cold turkey. No tappering down. No other meds. Just stopped.

That was six weeks ago. And for me, there was no crash. No depression. No nothing.

I am feeling much better...better than when I was on TRT.

Yes, I know that I am getting old and time is not on my side. But for now, I am going at it naturally.
I am sure I will revisit TRT, but I hope to get another 5+ years without it.

Good luck to you and hope it goes as smoother for you as it was for me.

 

[JohnTaylorHK]

@big Bam Boo: It's not for everyone, Sir. The most important thing is how you feel, that's what quality of life is all about. Good luck, and may you have many more years! Namaste