A conservative approach that should promote your goals: use a short-acting form of testosterone; switch to topical finasteride and/or dutasteride; use ibutamoren if IGF-1 is below average.
Short-acting forms of testosterone include nasal gels, buccal troches and micronized testosterone suspension. These can have the significant benefit of less disruption of other hormones. Most directly, LH/FSH and GnRH are not crushed. GnRH in particular has uses outside of the HPTA, and I believe it is reduced at our peril. Upwards of 20-30 other hormones can be negatively affected by conventional TRT, including pregnenolone, DHEA, progesterone, kisspeptin, GnRH, LH, FSH, estradiol, prolactin, DHT, hepcidin, androstenedione, androstenediol, cortisol, TSH, T3, T4, and rT3.
Topical forms of 5-alpha reductase inhibitors involve less risk than oral forms. Finasteride in particular has been shown to be effective with topical delivery. Dutasteride is a larger molecule and may not be absorbed as well.
I think growth hormone secretagogues are double-edged swords. They can confer useful benefits in body composition, but may also be pro-aging. When using do monitor IGF-1 and don't push it too high, i.e. high in range or above.
Over time I have adopted all of these, and with respect to TRT and 5ar-i, I wish I had done so from the start instead of learning the hard way.
