Bloodwork Results During HPTA Restart

Whats up guys,

First post here and wanted to get some feedback on my current restart attempt. Any questions, constructive comments, etc. are appreciated.

Let me give a little background, I’ve been on doc monitored trt for a little over 3 years (75 mg test cyp Sun/Thurs). I’m 33 yrs old.

I’ve had issues with back and chest acne while on. I’ve done cycles of accutane twice before since I was in my early 20’s. This past year the cystic acne on my back and chest was getting so bad and scarring was becoming a serious issue.

My derm was aware of my TRT treatment, protocol, bloods, etc. and agreed that accutane was the route to go. We started low, 40 mg’s weekly, no luck. 40 mg’s daily, no real response. Bumped it up in a tiered fashion and got all the way up to 120 mg daily. (My bloods were coming back fine, no side effects other than additional purging and dry lips.)

As we we’re nearing the end of final total cumulative dose, there still wasn’t the same response we’d seen from my accutane treatments in the past. I also wasn’t responding in a way that was typical for patients they’d seen at that dose.

In agreement with my derm and trt doc, we decided to stop TRT for awhile, see how my body responded, continue low dose accutane, then bump the accutane dosage up after giving my body a break.

Since stopping TRT and beginning restart protocol my cystic acne has cleared considerably.

Heres a breakdown of the restart attempt so far:

My TRT doc recommended I just stop test and see what happened. I’ve crashed before and it wasn’t something I could sustain. Here’s how the protocol has gone down in absence of my TRT doc:

*When the decision was made to stop I switched to test prop, allowing cyp ester to clear, cleaving period would be shorter with prop.

*The last two weeks of injecting test prop, I incorporated 250 mcg EOD of HCG.

After prop ester cleared:

weeks 1-4: continued HCG: 250 mcg EOD, Arimidex .25 mg weekly
weeks 5 - currently week 7): 10 mg Nolva ED, Arimidex .25 mg weekly

Blood work was taken week 6 just got the results. Attached:

Usually when a guy gets acne while on TRT it’s always uncontrolled E2, just last week I broke out in acne everywhere and lowered my dose, I’m acne free a week later! I noticed you said you were on 75mg twice weekly, don’t know many guys who can control their E2 without the use of an AI. I broke out in acne on 25mg EOD, can’t imagine how it would be on 75mg twice weekly. The fact that you stopped TRT because of acne tells you should fire your doctor, it’s an easy fix.

Thank you for your input!!

We tried a number of protocols including EOD. After the first year, I started SQ injections for more stable levels. I’d never had blood work come back that warranted an AI. If anything my E2 would show results on the low side t:e ratio. Not often though, my docs and I were always really pleased with the results my blood work yielded while on TRT.

Usually low dose accutane works for me. This year it did not. Not even high dose. Now that I’m off TRT I’m responding quite well. No active cysts in the pasts few weeks. Just healing scars.

Our goal is to get my bloods to a place thats healthy and manageable during the healing process. Run bloods again, begin another round of accutane if everything checks out. (These are the disfiguring type of cysts I’ve been getting that require lancing at times).

Ideally after this restart, I’ll feel well enough to not need trt during the next accutane course. The challenge is getting my bloods where they need to be from an HPTA perspective.

Any critiques on protocol and feedback on bloods is appreciated fellas!! thank you.

TL:DR = My FT is quite low is this typical 6-7 weeks into a restart after 3 years TRT? If so, should I bump nolva from 10 mg ED to 20 mg ED? when would be the best time to recheck blood work?