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

[Jntsrgn]

Just want to add my protocol.... I take 20mg of Test Cyp on MWF (down from 60mg) along with 250 IU of HCG and 75 IU of HMG. My total T last draw was 1100 and Free T 244. E2 is always 60-70 without symptoms and I do not take any Anastrozole. Adding the HCG and HMG brought me from a completely absent sperm count to 15 million fully functional swimmers on my last analysis. I was able to become fertile without stopping TRT.

 

[Mastodont]

Is there anyone who has tried infrequent large doses of gonadorelin? Curious if gonadorelin is enough to prevent testicular shrinkage if taken daily or even eod-e3d.
In my country it's only available for cows, dont know if i could identify as one and get it prescribed, but it is 50micrograms per ml, larger doses might be problematic subq.

 

[Cataceous]

Is there anyone who has tried infrequent large doses of gonadorelin? Curious if gonadorelin is enough to prevent testicular shrinkage if taken daily or even eod-e3d.
In my country it's only available for cows, dont know if i could identify as one and get it prescribed, but it is 50micrograms per ml, larger doses might be problematic subq.

As mentioned later in this post on the previous page, Royal Medical Center is or was using such protocols. I haven't noticed patients of theirs making comments here, but it's possible there are reports elsewhere. It would be good to know if the relatively infrequent, but robust pulses of LH and FSH are sufficient to prevent testicular atrophy. I don't recall if we nailed down the exact protocol, but I believe it was either 50 or 100 mcg taken once or twice a week.

 

[KNDyMan]

I've been looking for people who have discovered pulsatile GnRH as an adjunct to TRT to keep the HPG axis running as I recently discovered this protocol which makes me feel worlds better on TRT. It was important to me to try to keep the factory running as I may want to discontinue TRT at some point in the future.

So I started looking for solutions and discovered hCG and GnRH thanks to some forum posts like these, and dove into the literature around hypogonadism and fertility treatments and compared them to the protocols from TRT clinics (which I am not convinced are evidence-based, the weekly high-dose GnRH does not seem like it would be very effective, IDK though). I wanted to avoid AIs and SERMs as well.

I found the hCG (500 IU q4d or 1000 IU q7d) with TRT (50mg q2d) seemed to increase my aromatization sides (acne, nipple swelling, tight prostate/slow urination, etc) but GnRH substantially decreased them. My theory is that the real LH/FSH in a pulsatile fashion diverts most of your aromatization to your testicles where it belongs instead of secondary tissues (why did this not happen with hCG? keep in mind hCG has a really long half-life so your leydig cells are constantly activated instead of pulsed like natural LH release - maybe that has something to do with it?).

Unfortunately the pulsatile GnRH protocol is really inconvenient - 10 mcg q2h, which is a lot of pokes per day, and overnight, your FSH producing mRNA will decay. Commercial fertility treatment pulsatile GnRH solutions like LutrePulse - which is based on the OmniPod insulin pump (looking into the open source artificial pancreas community to see what they have in this vein) - use gonadarelin _acetate_ in solution, not just gonadarelin. GnRH without the acetate is unstable and will hydrolize, oxidize, and break down in water within a couple of days and lose potency quickly. Many fertility clinics seem to prepare GnRH for pulsatile injection with a sterile 0.1M sodium acetate buffer at pH 5.0 and that seems to maintain potency for weeks or months, but still maintains short serum half-life needed for pulsatility (unlike modified GnRH like triptorelin).

I had also looked into kisspeptins, but like SERMs I was afraid of some of the cardiovascular possibilities seen in studies, and I also think based on my amateur endocrinologist understanding, stimulating the KNDy network directly with kisspeptins might be redundant with the pulsatile GnRH. I feel like based on the side reduction so far, I could potentially increase my TRT dose without getting into AI territory.

Anyways, sorry for necro-ing the thread, this is my first post on this forum so I'm not sure what the etiquette is but it looks like this thread was posted to several times over the years so hopefully I'm not committing a major faux pas and this information is useful to someone out there.