Increasing LH on trt

[Steve78]

I think cataceous did this? Basically I was going to drop my trt to 80 mg a week from 112 ( TT 600, free T 235 (35-155), and add 25 mg enclomiphene and 500 much gonadorelin troches and check labs in a month. Good idea or horrible?

 

[Systemlord]

As far as increasing LH while on TRT, keep dreaming, not going to happen.

 

[Steve78]

I’m pretty sure @Cataceous did this.

 

[Cataceous]

Yes.

Pituitary restart while on TRT: promising initial results with GnRH plus enclomiphene

TL;DR: Over a period of seven weeks, treatment with GnRH and enclomiphene raised LH and FSH from around 0.1 mIU/mL to about 1.0 mIU/mL, even though TRT and hCG dosing were continued. Subjective results have been encouraging. I had written previously on the subject of GnRH suppression on TRT...

www.excelmale.com

You do have a decent chance of getting some LH production. Subjective results are more variable, perhaps depending on the effects enclomiphene has on estrogenic activity and whether this is good or bad for the individual. In the long run I'd aim for the lowest dose that gives decent results. In the short run the relatively high dose of 25 mg/day might speed up the restart.

If you're saying those are 500 mcg troches of gonadorelin then ideally they would be split in a lot of pieces and used a few time a day. I only need 20 mcg per injected dose to see results. How efficient is troche absorption? 50%? If so this would say that 50 mcg doses might be adequate if there are enough of them. The Royal Medical Center results suggest that infrequent large doses can still work. But then your LH pulses are also infrequent, and it's not clear if there are subjective benefits from this.

 

[Steve78]

Yes.

Pituitary restart while on TRT: promising initial results with GnRH plus enclomiphene

TL;DR: Over a period of seven weeks, treatment with GnRH and enclomiphene raised LH and FSH from around 0.1 mIU/mL to about 1.0 mIU/mL, even though TRT and hCG dosing were continued. Subjective results have been encouraging. I had written previously on the subject of GnRH suppression on TRT...

www.excelmale.com

You do have a decent chance of getting some LH production. Subject results are more variable, perhaps depending on the effects enclomiphene has on estrogenic activity and whether this is good or bad for the individual. In the long run I'd aim for the lowest dose that gives decent results. In the short run the relatively high dose of 25 mg/day might speed up the restart.

If you're saying those are 500 mcg troches of gonadorelin then ideally they would be split in a lot of pieces and used a few time a day. I only need 20 mcg per injected dose to see results. How efficient is troche absorption? 50%? If so this would say that 50 mcg doses might be adequate if there are enough of them. The Royal Medical Center results suggest that infrequent large doses can still work. But then your LH pulses are also infrequent, and it's not clear if there are subjective benefits from this.

I was shooting for more natural feel to my trt but maybe it’s best to keep my trt and hcg but add some fsh to the mix? I’m looking for larger testicles as they are smaller even after I’ve been using hcg for years

 

[Cataceous]

I was shooting for more natural feel to my trt but maybe it’s best to keep my trt and hcg but add some fsh to the mix? I’m looking for larger testicles as they are smaller even after I’ve been using hcg for years

Adding FSH can help with fertility and probably testicular volume, but I've seen nothing to suggest more general improvements in the TRT experience. While the data on GnRH are limited, there are at least some theoretical underpinnings to explain the possible benefits. I continue to use it because it does feel more natural—more like pre-hypogonadism than at any previous time on TRT. The perceived benefits include restored libido, reliable sexual function and better cognition.

Another option for you is to add some FSH and also use the gonadorelin. This avoids the potential unpredictability of enclomiphene. You sacrifice making your own LH/FSH, but you're still effectively adding back three of the hormones suppressed by TRT, or four if you include the testosterone itself (gonadorelin->GnRH, hCG->LH, FSH->FSH, T->T). One can continue down this path of restoration by investigating the effects of progesterone, kisspeptin and oxytocin.

 

[Steve78]

Adding FSH can help with fertility and probably testicular volume, but I've seen nothing to suggest more general improvements in the TRT experience. While the data on GnRH are limited, there are at least some theoretical underpinnings to explain the possible benefits. I continue to use it because it does feel more natural—more like pre-hypogonadism than at any previous time on TRT. The perceived benefits include restored libido, reliable sexual function and better cognition.

Another option for you is to add some FSH and also use the gonadorelin. This avoids the potential unpredictability of enclomiphene. You sacrifice making your own LH/FSH, but you're still effectively adding back three of the hormones suppressed by TRT, or four if you include the testosterone itself (gonadorelin->GnRH, hCG->LH, FSH->FSH, T->T). One can continue down this path of restoration by investigating the effects of progesterone, kisspeptin and oxytocin.

Appreciate the advice! So you are saying do the trt test, gonadorelin and fsh and not use the enclomiphene?

 

[Cataceous]

... So you are saying do the trt test, gonadorelin and fsh and not use the enclomiphene?

I would include low doses of hCG in that, since you won't be making your own LH. I think it's a reasonable thing to try. I didn't go this route because I was trying to get away from using hCG. But it's possible that this would be as good or better, given that you don't need to worry about the vagaries of enclomiphene. The main thing is to see if it's feasible to take fairly frequent, small doses of gonadorelin to better mimic nature.

 

[Steve78]

What about a combo of kisspeptin and gonadorelin in addition to a lower trt test dose?

 

[Dr.V.P.C.]

Yes it's possible
Change to transdermal EOD
Put some Clomid
Will recover in some months

 

[bixt]

Yes it's possible
Change to transdermal EOD
Put some Clomid
Will recover in some months

Theoretically I can see this working, but does a guy then have to live life one day on one day off?

 

[Cataceous]

What about a combo of kisspeptin and gonadorelin in addition to a lower trt test dose?

It's possible that the right kisspeptin protocol would stimulate reasonable production of GnRH, making gonadorelin redundant. However, if you want endogenous LH and FSH then you still have to deal with negative feedback from estrogens at the pituitary; a SERM is probably necessary.

 

[Dr.V.P.C.]

Theoretically I can see this working, but does a guy then have to live life one day on one day off?

Not at all. Test EOD works well, the EOD is only in the bloodstream, the molecule of test bind to the androgen receptor and works for some days. You won't even feel different between the day you use or not.

 

[FunkOdyssey]

Theoretically I can see this working, but does a guy then have to live life one day on one day off?

It seems to me this is not too dissimilar from the popular EOD propionate protocols. Some people strongly prefer it over ED propionate and talk about better libido.

 

[TLR]

Yes it's possible
Change to transdermal EOD
Put some Clomid
Will recover in some months

Just clarifying because I’ve never heard of this before….is this done in an effort to eventually get off TRT, or is this the actual protocol…?

 

[TLR]

It seems to me this is not too dissimilar from the popular EOD propionate protocols. Some people strongly prefer it over ED propionate and talk about better libido.

I heard Dr Kominiarek say he has some patients who do better on scrotal cream EOD, but he didn’t give any particulars. I don’t see how that doesn’t lead to big peaks and troughs, but what the hell do I know….I’m still trying to figure this shit out after 12 years….

 

[FunkOdyssey]

I heard Dr Kominiarek say he has some patients who do better on scrotal cream EOD, but he didn’t give any particulars. I don’t see how that doesn’t lead to big peaks and troughs, but what the hell do I know….I’m still trying to figure this shit out after 12 years….

It certainly would lead to big peaks and troughs, just like EOD propionate would. As Dr VPC said above though, the effects of the hormones on symptoms, well-being, etc doesn't perfectly track blood levels. Think about how long it takes some guys that quit cold turkey to start feeling withdrawal.

 

[Dr.V.P.C.]

Just clarifying because I’ve never heard of this before….is this done in an effort to eventually get off TRT, or is this the actual protocol…?

Can be done in both situations .
Note that not every testicle responds well to serm stimulation , and some can handle higher test cream dosages without supression of the axis than others.

 

[bixt]

Can be done in both situations .
Note that not every testicle responds well to serm stimulation , and some can handle higher test cream dosages without supression of the axis than others.

Highly interesting stuff Dr!

Have you had any experience with for example with low dose Propionate EOD or E3D + a SERM, being able to raise LH?

 

[bixt]

Test EOD works well, the EOD is only in the bloodstream, the molecule of test bind to the androgen receptor and works for some days. You won't even feel different between the day you use or not.

Fascinating!

Lets see what chat gpt has to say on this (I havn't seen this on any forums, nor have the time to read literature on this, so Chat GPT will give us the consensus of what's out there. I paste the relevant parts only):

Q: How long do androgens bind to the AR for?

A: The binding duration itself can range from seconds to hours. However, the overall signaling effects can persist for longer periods due to the downstream effects of gene activation.


Q: You said that the overall signaling effects can persist for longer periods due to the downstream effects of gene activation. how long roughly in days?

A: The duration for which the signaling effects of androgen-AR binding persist can vary widely depending on the specific genes being activated, the cell type, and the overall physiological context. In some cases, the effects of androgen signaling can be relatively short-lived, lasting hours to a day, while in other cases, the effects can be more sustained, lasting several days to even weeks.

For example, in the context of muscle growth and protein synthesis, the effects of androgen signaling can be relatively rapid, leading to increased protein synthesis within hours of activation. However, the long-term effects on muscle growth, tissue remodeling, and other physiological changes can extend over a period of days to weeks.

In the context of gene expression changes, certain genes may show transient upregulation in response to androgen signaling, while others may exhibit longer-lasting changes that persist for days. The exact duration of these effects will depend on factors like the stability of the activated gene products, the presence of feedback mechanisms, and other regulatory processes.