Coming Off TRT - Help

Pharma TRT
41

[quote]KSman wrote:
Probably valid issues, but probably not needed. How much will that cost above serum?

IT IS $60 FOR TT AND ESTRADIOL. I FIGURED WE WOULD DO IT ONCE TO SEE HOW IT COMPARES, LINES UP WITH SYMPTOMS, ETC.

With transdermals, FT spikes after application. So that is changing and the timing of the test creates a snap shot of a moving target. What does than mean? Issue with any form of test.

With injections, FT does not move fast so lab results are more indicative of reality.

So, how do you feel. E2 seems good. T levels look good. How you feel is really the bottom line, everything else is secondary if you feel good.

I FEEL BETTER BEARING IN MIND THAT EVERYTHING IS STILL FILTERED WITH TAPERING OFF OF THE BENZO. I HAVE SEEN INCREASES IN LEAN BODY MASS, MORE MORNING WOOD AND MY MOOD IS IMPROVING. I THOUGHT MY E2 WOULD BE HIGHER BECAUSE I WILL SHED A TEAR AT ANYTHING HAPPY OR SAD ON A TV SHOW.

Watch hematocrit. High BP, head aches, muscle aches? If labs indicate that your T dose should be higher, you really cannot go there. If you donate blood and suddenly feel better, guess what that means.

YEAH, MY H&H WENT HIGH ON INJECTIONS. I HAVE HIGH BLOOD PRESSURE FROM COMING OFF THE BENZO BUT AM CONTROLLING IT WITH A BETA BLOCKER FOR NOW. LAST TIME I DONATED BLOOD AND ACTUALLY FELT LIKE CRAP FOR A WEEK. THIS WAS ONE REASON FOR DOING THE BLOOD SPOT. ACCORDING TO DR. ZAVA AT ZRT, THE MAIN REASON THAT H&H INCREASES ON TRANSDERMALS IS BECAUSE PATIENTS TRY AND HIT SERUM LEVELS WHICH DO NOT RESPOND TO CREAMS AND THEY END UP WITH ROID LEVEL DOSING. IN HIS EXPERIENCE HE BELIEVES THE ABSORBTION IS CLOSER TO 90% RATHER THAN 10% AND MOST PATIENTS NEED MUCH LESS T IN TRANSDERMAL FORM.

SHBG is lowish; good. So TT does not need to be high. FT and bio-T is the bottom line.

MY FT HAS ALWAYS BEEN HIGH. EVEN BEFORE TRT WHEN MY LEVELS WERE 303, THE LAB REPORTED MY FT AT THE TOP END OR OUT OF RANGE. I DON’T GET IT AND I CERTAINLY DIDN’T FEEL LIKE I HAD ADEQUATE FT!!

[/quote]
My answers are embedded in your text above.

Also, my DHT values just came in. 135 on a range of 16-79. Holy crap. I wanted to boost it but perhaps I shouldn’t be putting as much on the scrotum. I’m surprised all my hair hasn;t fallen out and I’m not out humping the neighbor’s dog.

42

So my doctor order a ZRT blood spot test to compare with the venous results. I posted in another entry about why ZRT feels that topical doses are way too high and why venous samples are not accurate for topical T but are good for injections. I just received the results from the blood spot test. I will list the normal venous results and these for comparison. The blood spot was collected 23 hours after my previous application of Testosterone cream so it should have stabilized or dropped to about baseline then.

Total Testosterone

Venous 543 ng/dl (348-1197)
Cap Blood Spot 7129 ng/dl (400-1200) Not a typo!!

Estradiol

Venous 23 pg/ml
Cap Blood Spot 18 pg/ml (12-56)

Obviously these results would lend credibility to their claims that topical application leads to supraphysiological levels, if the test is accurate. I have not had superhuman strength, raging libido, foul temper, excessive acne or anything that would lead me to believe that I have that high of a level but this raises some questions. If the level of TT at the tissue level is that high would there be side effects, should I lower dose, etc…

43

Alright. I am switching back to injections. Even though I get burning painful lumps, I figure at least I know what dose I am getting and don’t have to question these damned blood spot results. Also, my libido and mood have plumetted in the past 3 weeks. They peaked and then took a hell of a nose dive (DHT and E2 were good but waiting on latest). I have recently added HCG back into the mix and will see what that does.

44

I have received some new results. Granted everything except the thyroid is saliva, but in case they give any clues to overall state of mind and body…

Serum

Hematocrit 53.7% (39.8-52) I donated blood after this
TSH - 1.46 (0.34-5.6)
FT3 - 2.6 (2.3-4.2) read 3.2-3.3 is optimum?
FT4 - 1 (0.6-2) read 1.2-1.3 is optimum?
Hepatic function appeared normal

Saliva

Cortisol 4 panel
AM- 20 (13-24)
Noon- 7 (5-10)
Afternoon- 6 (3-8)
Night- 4 (1-4)
DHEA+DHEAs- 9 (3-10)

17-OH Progesterone- 43 (22-100)
Total Salivary SIgA- 10 (25-60) LOW

DHEA/S- 14 (3-10) HIGH
Progesterone- 90 (5-95)
Androstenodione- 593 (151-350) HIGH
Estrone- 70 (30-58) HIGH
Testosterone- >200 (50-80) HIGH
Estradiol- 4 (1-3) HIGH
DHT- >125 (22-72) HIGH

Any thoughts!!

45

As far as not feeling on-target, your fT3 and fT4 are well below optimal/mid_range.

Whats the CURRENT iodine status and body temperature data?

46

[quote]KSman wrote:
As far as not feeling on-target, your fT3 and fT4 are well below optimal/mid_range.

Whats the CURRENT iodine status and body temperature data?

[/quote]

My body temps are actually right around 98.1 when i wake up and I have Iodine in my daily superfood (250mcg) and supplement another 250mcg. I have also done periods of Iodoral 12.5 and not felt much of a difference although i understand it can take more than that.

My thyroid frequently hurts and I have had a nodule in the past and a family history of hypothyroid.

47

Had a follow-up with my doctor today. He said that he agrees my thyroid levels are not great. He prefers FT3 to be around 3.5 and mine is 2.6. Instead of meds first we are trying a supplement with 500mg Tyrosine and 250 mcg Iodine.

We will see how that works.

48

Noted.

49

Sounds familiar. I have pretty much been through what you have except for no HCG but in my case the free T was always off the chart low. I felt okay when on clomid and my doc had me on a T cyp injection once every 14 days for 4 months trying to see if the clomid would kick in. At first the Clomid might’ve helped because I felt okay but towards the latter part of the 4 months I felt crappy on my off week. Finally when I said screw this, I was feeling low energy, depressed, no libido same old. It seems at my age (I’m 40) the T just will not come back on its own. I also tried Androgel when I first started and it sent my FT to .6. Given the cost of those Gels I’m not sure how the companies remain in business. Must be all the hyped up advertising. I also began donating blood because of the high Hemacrit.

50

I am also trying to see if anything in here can point to out of the blue anxiety and depression and fear. My testosterone is decent, my DHT is high, my estradiol is good by blood, but slightly elevated by saliva, and my thyroid is a little sluggish. Anyone have any thoughts???

51

Ok. So my doc wants to try and do a restart again. He said this time just start tapering down the test while using HCG, and I sent him a message asking for clarification as to how this is gonna work. The last time around I did the Clomid then Nolvadex and it didn’t work. So where do i go from here? I read so many different protocols and I am just lost.

He wants to try a restart because my levels prior to trt were upper 400s, I don’t have any real subjective benefits, and my Hematocrit and Hemoglobin respond so poorly. My LH levels have always been around 1.1 - Low since I was in my 20s. I feel no real benefit from when I was not on TRT but have I damaged my hopes of ever recovering and am I subject to living with the same quality of life but with the hassle of injecting T? I hope not, so I need a good plan for a restart. Please…

  1. Triptorelin? has this gained anymore acceptance and would it be worthwhile?
  2. HGH - He made an off the cuff remark that HGH therapy could bring things back?
  3. Try the SERMs again?
  4. Just taper the test and HCG while dosing with SERMs?
  5. Drop the HCG and taper the test while taking a SERM?
  6. Just taper the test without any other meds???

The Clomid made me feel like crap the last time I took it.

Thanks guys. Hopefully someone will chime in,

52

[quote]cirerecrem wrote:
Ok. I made it about 1 month on the PCT and have given up on quitting for now. Here are my latest labs. My doctor says even though we only gave it 1 month, we should have seen some increase in LH/FSH from the clomid. Since they are still tanked and my Total T has dropped to 120, I’m going back on TRT. [/quote]

You didn’t give it enough time. When I came off I was also in the 100s after 1 month. One month would have been barely enough for the T-cyp in your system to be eliminated, never mind to start recovery. In my case it took 3-4 months before my T was back in the upper 400s.

The benzos may have been interfering with your LH recovery or quite possibly you still had too much exogenous T in your system. Maybe give it another try once you are off them. But you should expect to not feel great for maybe 1-3 weeks at around the 1 month mark, and you should expect your libido to be off between 1 and 3 months after stopping. This is if you stop suddenly as you did. If you want a better transition, you can slowly taper off over the course of 2-3 months. (2 weeks is not a taper.)

53

[quote]seekonk wrote:

[quote]cirerecrem wrote:
Ok. I made it about 1 month on the PCT and have given up on quitting for now. Here are my latest labs. My doctor says even though we only gave it 1 month, we should have seen some increase in LH/FSH from the clomid. Since they are still tanked and my Total T has dropped to 120, I’m going back on TRT. [/quote]

You didn’t give it enough time. When I came off I was also in the 100s after 1 month. One month would have been barely enough for the T-cyp in your system to be eliminated, never mind to start recovery. In my case it took 3-4 months before my T was back in the upper 400s.

The benzos may have been interfering with your LH recovery or quite possibly you still had too much exogenous T in your system. Maybe give it another try once you are off them. But you should expect to not feel great for maybe 1-3 weeks at around the 1 month mark, and you should expect your libido to be off between 1 and 3 months after stopping. This is if you stop suddenly as you did. If you want a better transition, you can slowly taper off over the course of 2-3 months. (2 weeks is not a taper.)[/quote]

Thanks. I have been off the benzos for over a month now so hopefully that will help. I know I didn’t give it much time before but I was feeling the hell of coming off the benzos too and couldn’t tough it out!! I went almost 2 weeks on just HCG and felt great but then waited until that 2 weeks to start clomid.

Is there anything you did or recommend to minimize the down time? Supplements, etc to boost things and get the boys up to speed again?

Also, my question with the taper is I thought that as long as you were introducing exogenous T no matter what the dose, you would stay shut down? So then you would be looking at misery throughout the taper as your levels just keep dropping with no make up T coming from the testes?

Also, did you have luck with a straight taper, drop the HCG and taper the T, taper T and HCG, SERMS, or what? I am thinking of stopping the HCG soon, and taking nolvadex while I am tapering down the Testosterone for 6-8 weeks. Just not sure if I need to continue with an AI.

Thanks again for your help.

54

As a side note, my doctor ordered a comprehensive thyroid work up. Only 5 days after supplementing with the RDA of iodine - so a very low amount. My TSH, ft3 and ft4 were all in the optimal range (not the lab range) and I was negative for anitbodies and immuno. So they improved within weeks of the previous testing showing they were sub-optimal. There is no way it was the iodine in my mind. I think perhaps things are still recovering from my low dose benzo use for 5 years and I should expect there to be fluctuations and not stress about them for at least 6 months to a year while my body tries to reach homeostasis.

55

I have been holding steady at 60mg per week for a few weeks now while I wait on a solid plan from my doctor on how to get things restarted. However, I have noticed that I have been feeling much better at 60mg than I did at 100mg. I have consistent nocturnal erections, things hang better, I am less greasy, body odor has improved, think my mood has improved some, etc.

Perhaps I am one of those that really doesn’t have the need for higher doses and does better on smaller amounts. Nonetheless, still trying to figure out how to restart the HPTA when it didn’t show any signs before after Clomid/Nolva for a month.

56

I agree with seekonk that you might not have given the Clomid enough time to restart. You were also on a real low Clomid dose (100mg per week) for a restart. That’s more of a maintenance dose for someone who is not shut down from TRT. Could it have been the low T levels rather than the Clomid that made you feel so bad ?

Most steroid users begin PCT by tapering off TRT on to HCG for a few weeks. Then they switch to a fairly high dose of Clomid of 100 mg per day, tapering to 50 mg after a couple of weeks. They use these high doses for a short period of time of 4 or 6 weeks. There are no studies on the safety of long term Clomid use but usually the negative side effects appear at higher doses used in PCT. Many doctors (including mine) prescribe lower doses of Clomid as long term monotherapy for low t. It’s my doctor’s first choice for treating secondary low t. He has had guys on it for 8 years with no side effects. He originally prescribed me with 25mg per day. It took a while but the highest i got at that dose was 491 with only slight symptom improvement. He then upped the dose to 37.5 mg which brought me to levels between the 550’s and 590’s which was a great improvement. My response to the Clomid was minimal compared to what younger men usually experience. I’m not as comfortable with the 37.5 mg per day dose as my doc is so I tried switching to Nolvadex at 20 mg per day. After 30 days my T level dropped to 422 so I went back on the 37.5 dose of Clomid. I was back to 559 after 6 weeks. If you search forums you will find a lot of other guys who don’t get the same T level boost from Nolvadex. Now I’ve backed off to 25 mg to see if I can get by on a more sustainable dose. I’m trying to hold out until Enclomiphene gets FDA approval for long term use. It’s similar to Clomid but supposedly without the substance that causes the side effects.

For a younger guy like yourself with a baseline in the upper 400’s, a small maintenance dose of 12.5 mg per day or every other day could have been all you needed to raise your levels to 600 or better. Personally, I hate to see young guys being put on HRT for life, when their levels are in the 400’s, without first trying low dose Clomid.

57

Very good info. Thanks for the post freddy. Next time i will give the clomid longer. it very well may have been tanked testosterone levels that caused the misery.

58

Alright. Giving the restart a go again and will try and do it right (or sorta right based on all the conflicting info)

Today - stopping the T and starting HCG 500iu 3x/week to resensitize testes. After 4 weeks will have labs drawn to see if I am even producing again on my own.
If successful I will then drop the HCG and start a SERM. My doc still swears by Clomid but I also have tamoxifen so I will see when the time comes.

59

I will probably have to start a new post for this, but… I am about 3 months off of benzos and I am finally getting back into the gym. However, I have been back twice and although I don’t feel much weaker, it almost feels like my CNS doesn’t like the lifting as it triggers feelings of anxiety, jitters, palpitations, etc. My question is does this sound like a cortisol or adrenaline or norepenephrine issue, or does it sound like my CNS may just be too sensitive? If the CNS then I will just keep taking it slow and working my way up.

If one of the others would I benefit from a cortisol lowering scheme using phosphatidylserine, Vitamin C or any thing else you guys might receommend?

Thanks

60

Crazy after not having hcg for a few weeks, two injections bring back fullness to things, make things hang better, etc. I hope it’s a sign that testes are still functional and maybe I can move on to the pituitary and get it going again.