Surgery While on TRT?

FINALLY got the go ahead from one neuroendo I’m seeing to get my pituitary adenoma removed! I’m beyond excited.

However, while she seemed better versed in TRT than most, she insisted I’d have to stop for surgery to avoid blood clots. AND she’d want me off it after surgery to see where my natural levels land.

I honestly can’t imagine brain surgery on top of stopping TRT. Not to mention the plan is to have the surgery done without opiates (personal choice). This all sounds like the worst hell I’ll ever go through.

Has anyone gone under the knife while on TRT?

Yes, all the time. However, it is not unusual (actually, I’d say typical) for the surgeon to want it d/c beforehand, especially so if hct and hgb are high. I know some doctors who simply went with phlebotomy prior to surgery. As long as CBC was within normal, they were fine with test.

As for stopping test post op, she probably is hoping your levels will be normal after the adenoma is removed.

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My blood remains pretty thin (within range though) which is good. I’ve started the habit of giving blood when I can to avoid issues with this too.

My next step I think is going to be giving her my case to stay on TRT afterwards. Honestly, as much as it’s a hassle and costs money, it works for me, and I’m trying to minimize the challenge of getting through post-op complications. In other words not the time for experiments. I would be open to trying discontinuing it after I’ve recovered.

There is hidden motive, she wants to see if your natural production increases after removal of the pituitary adenoma. As for the clotting, this is nonsense. I was never told to stop TRT when having my three nasal surgeries under heavy sedation.

The idea of making you weaker for this surgery is actually a poor decision, you should know people with the highest testosterone recover surgeries faster than anyone else and got out of the hospital sooner.

TRT doesn’t cause blood clots, underlying conditions cause blood to clot. TRT can cause erythrocytosis which doesn’t cause blood to clot, a form of cancer Polycythemia Vera however does.

This is just a case of ignorance and reducing personal liability if something should happen during surgery.

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Thanks, I’m gonna bring especially the last point to the table when I make my argument.

I would be happy to reduce my dose temporarily if it’d make them feel better.

Then again, I’m talking to two surgeons and both have been in favor of TRT.

You should consult with your other doctors in favor of TRT and maybe they can alleviate your neuroendo concerns.

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If you want to stay on trt after the surgery, why have the surgery in the first place? Typically the whole point is to get your natural T production going again and come off trt. Is there another reason?

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Two shoulder surgeries on TRT and the last included HGH and none of them ever knew.

Per one surgeon, T production is usually the first to go with this surgery.

Also my prolactin has been elevated for a while and the drugs don’t help.

TRT improved my life overall but hasn’t fixed everything. The consensus seems to be the tumor is causing the rest of the issues.

Plus after I felt T in the 400s, I’ll never go back to that dark place.

Haha you didn’t tell them?

I just told my PCP a couple of months ago after she ran bloodwork for Test without telling me.

The last one thought I was healing incredibly fast (which I was) thanks to plentiful hormones coursing thru my veins

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Play the game. You won’t die if you’re off for a while. She is actually being very responsible as a doctor and looking out for your best interests. If you do not need something, you should not take it. Wanting to see what effect the adenoma is having is reasonable, and you can only know by going off. If your levels don’t come up where they should be, she is not likely to argue - and in fact will be more agreeable to your TRT if anything. Clinging to the treatment like an addict is very suspect conduct. Going off and seeing where the numbers land lets her know that you want to feel normal and that’s all the TRT is for. It’s not “the man” keeping you down.

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Ok, that seems reasonable, the goal is to try to get prolactin under control, not necessarily boost LH to get your T production up.

If it were me I might try a restart and see where I end up, but I certainly understand not wanting to go back, if I could dodge a decade or 2 of injections I would. How old are you? What t level do you feel good on?

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Fair points man, thanks. I’ll have to see what the other surgeon and endo say as well. Guess I just gotta go with the flow.

Worst case my T won’t come back up and I start again with my protocol that works with Defy.

35 and my TT is around 750. Felt worse when it was higher. But big improvement bringing it up.

Forgot to tell her today too my weight normalized since going on TRT. Used to have to eat 5k calories a day to barely hit 150lbs. That part always got the attention of other doctors.

Now I eat and work out like a normal person and maintain 160-165.

Clinging to having healthy level of hormones is akin to an addict, really? I mean let’s make it so these men really suffer needlessly and when they complain of the symptoms of androgen deprivation therapy, we’ll just tell them stop acting as though you are an addict addicted to testosterone.

It’s all in how it seems. Blind insistence without regard for the reasonableness of the medical advice, coming from a medical professional, is not reasonable. The doctor is not trying to violate the Geneva Convention, she’s trying to evaluate physical change resulting from a surgery. Fighting tooth and nail in this case is like an addict being told he can’t have his heroin anymore, or at least would seem that way to people with malpractice insurance and a prevalence of doctor shopping for addictive substances.

What kind of surgery are you going to have, a gama knife?

And if it is open surgery what the hell do you mean by going without opioids?

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Nah through the nose. Not messing with radiation and it’s mediocre results.

And yea, there’s a big thing here now about recovering faster without pain killers. I have a strong personal aversion to them and want to avoid them at all costs.

This won’t shock you, but I have heard GPs state they won’t prescribe testosterone because it will lead patients to want more and more.