Why do so many Quit TRT?

[Arcane]

seems most people who get on TRT eventually quit. Why?

If you quit, how long were you on and what made you get off? are you happier now that youre no longer on TRT?

 

[Systemlord]

seems most people who get on TRT eventually quit. Why?

The above is not true, the men having problems, which are in the minority, quit.

Those men, not all of them, but a lot of them are looking for a shortcut, a quick fix, and they realize they have to put work in to get better and so they quit.

It took me 7 years to find a protocol that works, 7 years is a long time to struggle with what seems like a treatment that doesn’t work all of the time. I had to learn how to eat healthy, learn how to cook, which is not something I’ve ever had to do before.

A lot of men that come onto these forums with issues, they don’t know how to change their lifestyle and they’re waiting for TRT to do all the work for them. By the time they realize they have to change, they don’t know how or don’t have the mental fortitude to change.

These men are not wired for survival, have no warrior mentality, to do whatever it takes!

 

[SteveCleves]

Because it turns out that TRT is not the magic fountain of youth, feel like you’re 18 again, Superman juice that they were sold.

In reality, TRT or HRT or hormone optimization is just one piece of the wellness puzzle and most men are not willing to do all the other things that are required like diet changes, exercise changes etc. there’s a lot more to it than just 200mgs of test a week and bobs your uncle!

Also other things like not having the right dose, needle fatigue etc.

 

[Vince]

For me it only took one injection and it changed my life forever. In a very positive way. It's been close to 9 years now since I started TRT.

 

[BigTex]

Where do you get the data stating most people who start TRT eventually quit? USA TODAY reports that "the TRT market is estimated to rise to USD 2.46 billion by 2029" Seems to me most people are completely happy with TRT and don't come to boards like this to talk about how happy they are.

One of the biggest problems seems to be that a few who start TRT are expecting TRT to preform miracles. Many guys who even start using anabolic steroids as athletes feel the drugs are a substitute for having to train properly, eat properly and get plenty of rest. It is just a tool in the process. Quite a few are impatient and don't understand that this is a slow process and patients need to be used working with your doctor.

Quite a few don't realize what they are getting into having to take a medication by injection for the rest of their lives. This isn't a short term fix. Quite a few expect TRT to solve all the problems in your life. Many of these problems are perpetuated by the clinics that push TRT as a cure-all for men over 35. It will stop the aging process and turn you into a stud in bed, solve problems in your marriage. Trust me from taking testosterone since 1980 none of this is true. I has helped me retain muscle mass but as you age sarcopenia still happens. It has helped me keep my test levels at a higher normal range. It also has helped me stay out of the doctor's offices but I also am very physically active and eat well, plus I get plenty of sleep and don't drink, smoke or do recreational drugs of any kind. I live a clean life. I have never had sex issues and never had mental issues and would not expect TRT to solve in problems like this. TRT helps me feel that way I have since 1980 when I started and nothing else. In other words, I feel normal, other than growing older.

I have had the E2 issues and also had HCT problems. There are simple ways to fix this but it doesn't happen over night. Most guys here are constantly changing up things in a panic and end up complication problems that take time to solve. Many guys come to boards like this wanting free advice, when they should be getting their advice from a qualified TRT doctors. We have some very good ones listed here. What is good about this board is the option to learn about the whole process. We are all individual and the more you learn about TRT, the more you can help your doctor solve your individual issues.

 

[Charliebizz]

Most people that have issues with trt are over thinkers. That seems to be the bottom line. And typically the types you see on these forums.

almost all the people I know personally on trt. Never joined a forum or care to for that matter. They just got it prescribed by the dr and all is well. For me personally it probably took me so long to feel well on trt because I researched the shit out of it first and lead me to the forums and Facebook groups.

 

[TLR]

I personally think some people just don’t react well to higher levels of testosterone or it’s metabolites and they don’t get positive results….this, combined with unrealistic expectations, as previously stated, leaves many figuring it’s not worth the hassle. I tried to go off (twice) until I figured out I was over dosing FOR ME, despite what docs were telling me. I’ve accepted this is probably as good as it gets….but I’m better off than I was before I started.

 

[electrify]

Most people that have issues with trt are over thinkers. That seems to be the bottom line. And typically the types you see on these forums.

almost all the people I know personally on trt. Never joined a forum or care to for that matter. They just got it prescribed by the dr and all is well. For me personally it probably took me so long to feel well on trt because I researched the shit out of it first and lead me to the forums and Facebook groups.

I've wondered if the initial drop in T triggers anxiety/OCD neural pathways in people that take time to resolve even beyond the TRT.

I remember at the beginning of my issues I used to think high E2 was creating symptoms but over time and one day when I got better it literally did not affect me at all. I was able to even not take TRT for a week and mentally was still fine, but just felt low libido and some moodiness. Also in the beginning of TRT I remember cortisol did drop but eventually it just stopped happening and my HPA maintained itself, like cortisol levels of 18 ug/dL despite it. Even at times I didn't take preg or HCG.

I've wondered, maybe people need to also just live their life and let the T and behavior rewire the neural pathways and HPA over time?

Of course now I have other health issues (emotional blunting) that began last year after covid/alc/caffeine but these are unrelated to hormonal stuff. Interestingly, its only after that started that over time my cortisol has come down again but I can tell it's due to the stress of the health issue or the impact of those things and not TRT as I have plenty of blood work over the years.

 

[Arcane]

Where do you get the data stating most people who start TRT eventually quit? USA TODAY reports that "the TRT market is estimated to rise to USD 2.46 billion by 2029" Seems to me most people are completely happy with TRT and don't come to boards like this to talk about how happy they are.


View attachment 38435

One of the biggest problems seems to be that a few who start TRT are expecting TRT to preform miracles. Many guys who even start using anabolic steroids as athletes feel the drugs are a substitute for having to train properly, eat properly and get plenty of rest. It is just a tool in the process. Quite a few are impatient and don't understand that this is a slow process and patients need to be used working with your doctor.

Quite a few don't realize what they are getting into having to take a medication by injection for the rest of their lives. This isn't a short term fix. Quite a few expect TRT to solve all the problems in your life. Many of these problems are perpetuated by the clinics that push TRT as a cure-all for men over 35. It will stop the aging process and turn you into a stud in bed, solve problems in your marriage. Trust me from taking testosterone since 1980 none of this is true. I has helped me retain muscle mass but as you age sarcopenia still happens. It has helped me keep my test levels at a higher normal range. It also has helped me stay out of the doctor's offices but I also am very physically active and eat well, plus I get plenty of sleep and don't drink, smoke or do recreational drugs of any kind. I live a clean life. I have never had sex issues and never had mental issues and would not expect TRT to solve in problems like this. TRT helps me feel that way I have since 1980 when I started and nothing else. In other words, I feel normal, other than growing older.

I have had the E2 issues and also had HCT problems. There are simple ways to fix this but it doesn't happen over night. Most guys here are constantly changing up things in a panic and end up complication problems that take time to solve. Many guys come to boards like this wanting free advice, when they should be getting their advice from a qualified TRT doctors. We have some very good ones listed here. What is good about this board is the option to learn about the whole process. We are all individual and the more you learn about TRT, the more you can help your doctor solve your individual issues.

yeah but what are the retention rates

 

[Charliebizz]

I've wondered if the initial drop in T triggers anxiety/OCD neural pathways in people that take time to resolve even beyond the TRT.

I remember at the beginning of my issues I used to think high E2 was creating symptoms but over time and one day when I got better it literally did not affect me at all. I was able to even not take TRT for a week and mentally was still fine, but just felt low libido and some moodiness. Also in the beginning of TRT I remember cortisol did drop but eventually it just stopped happening and my HPA maintained itself, like cortisol levels of 18 ug/dL despite it. Even at times I didn't take preg or HCG.

I've wondered, maybe people need to also just live their life and let the T and behavior rewire the neural pathways and HPA over time?

Of course now I have other health issues (emotional blunting) that began last year after covid/alc/caffeine but these are unrelated to hormonal stuff. Interestingly, its only after that started that over time my cortisol has come down again but I can tell it's due to the stress of the health issue or the impact of those things and not TRT as I have plenty of blood work over the years.

Me personally, had anxiety and obsessive thoughts Long before having low t. I also had my anxiety under control before low t. And didn’t have much of an issue when t was low either. Now the overthinking has been stuck with me since childhood.

 

[Gman86]

Me personally, had anxiety and obsessive thoughts Long before having low t. I also had my anxiety under control before low t. And didn’t have much of an issue when t was low either. Now the overthinking has been stuck with me since childhood.

Any idea where those obsessive thoughts and anxiety stem from? It’s so crazy how things that happen throughout our childhood development can have and affect on us the rest of our adult lives.

 

[BigTex]

yeah but what are the retention rates

One of the problems I see is all of the cookie cutter formulas running among our TRT clinics. Everyone is put on the same dose combined with an AI whether you need it or not. Here is where the law of individuality comes into play, matching the right patient with the right drug formulation is so important to ensure patient satisfaction and compliance which is essential for maintaining long-term compliance.

Most guys hear all of these advertisements about TRT and fall for the "magic bullet." Taking any long term medication is difficult for most. Having to do IM injections once or more a week for the rest of your life is a difficult concept for most. Combine that with expecting TRT is going to solve all of your problems, its just not worth it to many.

Long-term treatment patterns of testosterone replacement medications - PubMed

In this analysis, high discontinuation rates were observed. The treatment pattern of TRT may be related to the disease state rather than dosing, daily use, or mode of administration.

pubmed.ncbi.nlm.nih.gov

Results: The patient characteristics were similar for patients who received topical TRT or short-lasting TRT injections. Of the patients who discontinued therapy during the follow-up period, the percentages of patients who were still on therapy after 3 months were 52% and 31% for topical TRT and short-lasting TRT users, respectively. For cyclic users, there was an attrition rate of approximately 40% to 50% of patients in each cycle. For both topical TRT and short-lasting TRT injections, the gap between stopping and restarting therapy tended to decrease over time.​

​

Symptomatic response rates to testosterone therapy and the likelihood of completing 12 months of therapy in clinical practice - PubMed

Approximately two-thirds of men with TD who begin TTh will experience symptomatic benefit and will complete at least 12 months of treatment. Benefit was noted in a majority by 3 months.

pubmed.ncbi.nlm.nih.gov

Conclusion: Approximately two-thirds of men with TD who begin TTh will experience symptomatic benefit and will complete at least 12 months of treatment. Benefit was noted in a majority by 3 months.​

​

Seems since some of the TU pills have some around, the retention rates have risen as it is much easier to take a pill as opposed to doing injections or using creams. Is this any different from any other long term medication? NO.....nonadherence can account for up to 50% of treatment failures, around 125,000 deaths, and up to 25% of hospitalizations each year in the United States.

Medication Adherence: The Elephant in the Room

www.uspharmacist.com

 

[Guided_by_Voices]

Any idea where those obsessive thoughts and anxiety stem from? It’s so crazy how things that happen throughout our childhood development can have and affect on us the rest of our adult lives.

Unresolved emotional trauma seems to be increasingly recognized as a driver of some health-issues.

 

[Guided_by_Voices]

yeah but what are the retention rates

You're the one who claimed they were low, not us. There are likely no valid statistics on retention rates for the reasons BigTex and others have stated. Raw statistics would not be relevant for individual decision-making.

 

[Bbobtucker]

My personal opinion is, if I ever quit, it'd be because the protocol is a pia to me. But then I always remember how miserable I was before getting dialed in so I carry on. I just get tired of remembering to do shots 2x week w/ 2 different meds, morning and night pills, and labs and what not from time to time. But it works and I'm going to keep doing it until the technology improves and hopefully I can do less and go further between shots or pills or whatever.

 

[Charliebizz]

Any idea where those obsessive thoughts and anxiety stem from? It’s so crazy how things that happen throughout our childhood development can have and affect on us the rest of our adult lives.

It Seems very common in most of my bloodline. So I’m not really sure.

 

[Gman86]

My personal opinion is, if I ever quit, it'd be because the protocol is a pia to me. But then I always remember how miserable I was before getting dialed in so I carry on. I just get tired of remembering to do shots 2x week w/ 2 different meds, morning and night pills, and labs and what not from time to time. But it works and I'm going to keep doing it until the technology improves and hopefully I can do less and go further between shots or pills or whatever.

What’s ur full protocol? Glad to hear that u feel dialed in

 

[Gman86]

It Seems very common in most of my bloodline. So I’m not really sure.

Gocha. So it’s probably a mix of particular hormones/ neurotransmitters being off in a particular way throughout ur family genetically, as well as a nurtured tendency for the brain to work this way through seeing others in the family think the same ways while u were growing up and developing. Good old mix of nature and nurture

 

[Gman86]

Unresolved emotional trauma seems to be increasingly recognized as a driver of some health-issues.

Absolutely! Chronic stress is extremely deleterious to a person’s health. The body tends to sacrifice a lot of the day to day functions of the body, to deal with the stress. Stress is supposed to only be an acute response. Whether that be physical or mental stress. The body isn’t made to deal with chronic stress. The body can sacrifice its day to day functions temporarily, without much issue, but when it has to sacrifice them for extended periods of time, that’s when everything starts to break down. That can include the breakdown of every part of the human body. Physical, mental, hormonal, etc.

But u nailed it. A huge stressor that I don’t think many people realize they even have, can be unresolved emotional trauma. It can absolutely be a chronic lingering background stressor, that can cause a host of issues.

 

[vinnylid]

I started TRT because mine was 250 and had been dropping every year. The clinic told me that I needed to get to a healthy level, but it would not cure my ED issues at 79. TRT may help libido, but had no impact on a better erection. I added Trimix injection for that, which helped my overall mental stability. As has been stated over and over, TRT is not a cure all, but just another piece of the health puzzle. If a person does not produce their own testosterone, why would they stop TRT. I target it mid-range, which meets my expectations.