T Nation

Coming Off TRT after 6 Months?


#1

Hello.

I would like to start by thanking the forum members for their contributions in this forum. Finding somewhat credible information or guidelines on this topic is difficult but this place is very helpful.

Status: 33 years old, secondary hypogonadism, Test-levels pre-treatment just under acceptable blood test standards for Test, since then 6 months Testogel 50mg (1 satchet) taken once a day. Recent spermcount reveals 1 million per ml count which is very low. Testicles are smaller than before but still of ok size. Me and my wife are trying to conceive. That factor along with the horror stories of prolonged TRT-use have me wanting to quit the TRT since I was borderline to begin with.

  1. I am hoping to get comments and recommendations on my pct-plan:

Weeks 1-4:
Continue Testogel 1 50mg satchet every day.
HCG 250iu EOD

Weeks 5-8:
Half-satchet of Testogel every day (4 weeks taper down on the test)
HCG 250iu EOD

Weeks 8-12:
Nolvadex 20 mg ED

Week 13:
Nolvadex 20 mg EOD

Weeks 14-15:
Nolvadex 10 mg EOD

  1. This will be my first time taking HCG. Is 8 weeks typically enough to get the testicles and fertility back online?

  2. Is the nolvadex plan too long?

  3. Other plans online recommend continuing hcg after stoping Test (http://defymedical.com/blog/item/14-how-to-stop-testosterone-safely-and-possibly-reset-youir-hormone-axis)??

  4. Other plans online recommend taking both clomid and nolva (http://defymedical.com/blog/item/14-how-to-stop-testosterone-safely-and-possibly-reset-youir-hormone-axis and https://www.evolutionary.org/the-perfect-post-cycle-therapy-pct/) but I have seen KSman on this forum explicitly state that serms should not be mixed on pct??

If anyone has the time to look over this and comment I would be thankful.


#2

Seems like a long time get off Testogel…I believe that stuff only has a half life of 8 hours so I would consider that.

the HPTA restart sticky recommends getting labs after 4-6 weeks to check TT FT E2 (assuming no outside testosterone) to see if you begin producing T. This still of course bypasses the HPTA but it rules out primary hypogonadism.

Again I refer to the HPTA restart sticky and it is 20 mg Nolvadex EOD for 4-6 weeks (then labs again). If things are good then taper off.


#3

Thank you for your response grungephreak. I had read the sticky but the amount of differing information all over the internet is so overwhelming that it can be hard to come up with a sound pct plan that fits your needs. I will read it again.

I will modify the nolva to 20 mg. EOD for 4-6 weeks followed by a blood test testing for Testosterone then taper off if good.

According to my plan wont blood tests be skewed in weeks 5-6 since I will still be taking a half satchet of testogel per day? I was planning to do a spermcount at the beginning of week 5. If the sperm count is dramatically up that must mean that intra-testicular testosterone is up as well?? (meaning that the hcg is working)


#4

My apologies, I was trying to say I believe your plan is to stay on Testogel is long time to stay on it. While I have never done a restart as I stay on TRT, I would end the Testogel by week 2 or taper off in week 3. The HcG should be doing its job by then. @KSman can correct me if I am wrong here.

Yes, if your sperm count is up (if you are secondary it should be) then the HcG is doing its job.


#5

You are wanting to give up on TRT because it was not done properly.
The problem is the ignorance of the doctors.
You can easily learn what you need then try to get that done.

Please try doing TRT differently before giving up.

Were you absorbing the T-gel?
Post labs with ranges.

Can you post pre-TRT labs?
At your age, LH/FSH, E2 and prolactin also needed testing to see if there was a correctable cause. Might then know if PCT is doomed to a low-T existence.

We know that guys with low thyroid function can be very poor absorbers of T gels and creams. TSH levels? Not using iodized salt can cause problems. See last paragraph of this post.

TRT shuts down LH/FSH and testes get smaller, fertility easily affected and testes might ache. You need to inject 250iu hCG subq EOD at part of your TRT. And almost all guys need anastrozole to manage E2 at favorable levels.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#6

I have been on TRT for 11 years and I am not a horror story. TRT has been provided a huge increase in quality of life and health/vitality for me and all of the hundreds of guys here who manage to have things done correctly.


#7

Thank you for the reply KSman.

My doctor has pre-trt bloodwork and intra-trt bloodwork. I will post it when I can get a copy.

So a weird thing happened. My hcg prescription was through ovidrel pens since the doctor thought that 250 mcg of HCG was the standard dose (i.e. 250iu). Turns out 250 mcg HCG (the whole pen) is 6.500iu !!! I have already taken whole two of these shots in in a 3 day period. I read up on HCG today and noticed the high amount of iu in the pen and called the doctor. He admitted making a mistake thinking that the dosage was 250mcg not 250 iu as per the research i had printed out for him. So i am formally off the hcg and the prescription has been rescinded.

However… I still have 6 pens at home. These are click pens showing “250” with 25 clicks. Therefore im assuming that 1 click has 6.500iu/25=260 iu per click. Spreading the 6 pens over 3 weeks would give me hcg 2 times a week as prep for going off test and starting nolva. Is 3 weeks too short a time on hcg?

2 clicks of the pen would give me 520 ius x 2 times per week. Would that be too small a dosage?

Otherwise I will not be taking anymore hcg for the next 7-10 days since I completely overloaded my system with 13.200iu of hcg in 3 days (2x.6500). Should I wait longer than 7-10 days?

And KSman. What I meant about TRT horror stories was stories of uninformed user relying on the advice of uninformed doctors creating bad situations that are hard to recover from. Looks like I may just have had one of these situations myself(or narrowly escaped one) but I think that since i only injected the large dose two times I should be ok as long as I give the testicles time to recover.


#8

That amount of hCG has these problems, some of which may be minor for short term dosing.

High hCG effects:

  • desensitization of LH receptors in the testes
  • very high intratesticular testosterone [ITT] that drive high T–>E2 inside the testes creating high serum E2 levels. Note that anastrozole cannot work inside the testes as a competitive AI when ITT is so high, ITT can could be over 100x serum T levels.

hCG has a longer half-life. Suggest that you stop all hCG for a week then resume.

You can to one click EOD.

I still think that from a quality of life perspective you should focus on doing TRT right instead of rejection based on things been done wrong.


#9

Thanks. Will do.

Do you mean one click (260iu) EOD? (the “to” is throwing me off :wink: just making sure)

I will seriously consider TRT later in life. I have a feeling that the TRT community will see A LOT of advances in the next 10 years in useage methods, research and products offered.


#10

I have finally acquired a prescription for Tamoxifen so im ready to start pct. Will report back with sperm count and bloodwork.

My girlfriend has a new prescription of Letrozole 2,5 mg to help her ovulate. Would it be helpful for me to take the letro after PCT at a dose of 1,25 mg (half a pill) once a week as a sort of post-post cycle therapy?

Also KSMan, I trust your advice but when i read up on tamoxifen pct online the typical dosage is almost always starting with 40 mg daily followed by 20 mg daily. You recommend 20 mg eod. Is there research to support this and are the higher dosages unnecessary and/or older protocol?


#11

WTF! I am really struggling with that one.
I think that it was go to one click of the hCG in the pens.


#12

The higher doses create high levels of LH [and FSH]. This can:

  • create very high E2 levels
  • risk desensitization of the testes
  • going to lower dose creates a go slow signal for the testes

See the HPTA restart sticky.