T Nation

Going Off TRT Cold Turkey

been on TRT for 4 years, was taking .20 mg Test E daily with a .0125 mg AI EOD. I am 34, 5"7, 20ish body fat. I have been with defy however I was constantly having trouble keeping my hormones balanced and had issues of dead dick, severe sweating/overheating, severe bloat, etc.

I decided to try going to some local doctors/Endos and even the ones at mayo clinic who all recommended I get off TRT as well as the thyroid medication defy put me on. I was desperate so I listened and two months later I am feeling even worse than I did before which is to be expected.

They still don’t want me back on TRT even with my levels so low so I am trying to figure out what my best step would be. currently, I am considering the following.

  1. my LH is at 4 but my test is still dropping so thinking of suffering longer and let my test drop below range so they put me back on it
  2. just start TRT again
  3. go with the first protocol that I didn’t seem to have trouble with which was Test C 200 mg/month

I am open to any suggestions or any recommendations for a doctor/clinic that would be able to help with this, im actually looking at marek health as defy hasnt been great. below is my bloodwork, 3/12/21 is the last time I did it while still on TRT ( I don’t know why my test dropped 200 pts when I was doing daily shots).

I’m certain the only reason your doctors recommend staying off the TRT is because your Total T is >300, no critical thought beyond that and sadly western medicine is still playing catch up in the hormone world.

The fact you feel worse after stopping the TRT tells me your problem is T related and you just never got any sort of hormone balance. It seems a lot of these reputable institutions (Mayo Clinic) aren’t much different than your average endo with hormone related treatments and diagnosis as it relates to testosterone.

I believe you might have an iron problem on the TRT and thats its causing some or all of your issues. The problem is doctors see normal hemoglobin and take no action, only iron deficiency without anemia is a thing that can come with severe debilitating symptoms.

Your hemoglobin after tripling your Free T levels didn’t increase much at all, but again you need sufficient iron in order to increase the hemoglobin. Your IGF-1 is kind of low for a 34 year old, definitely well below average. The below average IGF-1 can be explained by insufficient iron.

There are a lot of things here pointing to an iron problem.

You should consider Jatenzo, gel capsule taken twice daily if you didn’t feel well on injections or can’t make it work. I never felt good on injections once my hormone levels became steady, felt great within 2 weeks after dosing changes though.

I have been on Jatenzo for only 6 days and I have never felt as good as I do now on TRT, no sides whatsoever, I’m only experiencing benefits and tomorrow I will reach a steady state which only takes 7 days, gone are the days I had to wait 6 weeks for levels to stabilize.

@systemlord

How is your libido on Jatenzo? I’m curious as nothing has worked for me libido wise for TRT thus far.

I see the costs are expensive…

Maybe the short action of the Jatenzo is kinda mimicking this? It’s as if every dose is a dose change

I think you really hit the nail on the head as thats what I have been leaning towards but the doctors kept talking me out of it. I have been taking an iron supplement of 325 mg ferros sulfate daily and its only brought my iron levels up slightly to just be int he green. I want to start taking it two to three times a day to really increase my ferretin levels. I would love to try that, do you get it from a clinic?

There are no generic brands, so can’t get it from any compounding pharmacies. You can get a prescription from any doctor, but you want insurance to cover it otherwise it’s expensive, without insurance it’s $850-$1200 per month.

My copay for 90 day supply is $4 and the reason the costs are low is because my doctor provided a medical exception code since I’ve had treatment failure for 4 years on injections, gels and creams.

The Jatenzo allows for higher DHT levels versus injections and higher Free T levels versus gels and creams.

I take 100mg of chelate iron because it’s better absorbed and has less side effects than ferrous sulfate.

Maybe you can start a thread on jatenzo. I would love to know more. Like dosages and what dosage you start at. And safety.
What is safer injecting or pills?

I rather take a pill then inject.

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did you have super low t that you were able to have insurance cover it and would increased DHT not increase hairloss?

as for the iron, i will get that version, is there a brand you would recommend and is 100 enough or would I need to up it since my iron levels are so low

I only require a diagnosis of hypogonadism, but the treatment failure was a big factor for insurance covering Jatenzo in my case. It’s really going to depend on your insurance and coverage. If you’ve had treatment failure on injections and gels, I see no reason why you couldn’t also get a medical exception code and have Jatenzo covered if it is medically necessary.

The problem you face is ignorant doctors. As far as hair loss, it was already starting before I went on TRT and don’t really care much, I care more about having optimal hormones and having a high quality of life.

I have had good results with The Vitamin Shoppe brand, 25-28mg ferrous fumarate 300 capsules for $15. The chelate iron better absorbed and therefore you need less, but with the ferrous sulfate you need more since it isn’t as easy to absorb.

I initially needed 200mg, but I needed to taper down to 100mg after 3 months.

Get on Test C. Test E is finicky even if everything checks out.

What’s your thoughts on Enanthate Middleages?
I’ve tried it myself, felt 'ok but never any more than that, kind of ok but ‘flat’ if that makes sense?

Theyre both practically the same. The difference is enanthate acts within hours where Cypionate has to build up within weeks. Half lifes are similar to each other. But I prefer Cypionate over all esthers. It just takes time to feel the effects. Ive had weeks in which I feel flat too, but sometimes its just life. I mean there really isnt much to look forward to when you’re older, married and sober. Lol, there are hobbies, and friends but Covid has had an impact on how we interact and feel. So life is not exactly filled with excitement. Have you tried Cypionate?

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Hi, no, not tried Cyp as a single ester, is it a bit longer lasting than E?

Same here, enanthate feels like low octane, the cypionate feels more potent.

Perfect description of what I felt, so much about feelings rather than numbers this game isn’t it👍

You need TRT, dont get off after 4 years. talk about a miserable and horrific life. They will ruin you man.

Just because trt doesnt fix every issue doesnt mean TRT is not needed or working. A ssytem is eluding to, there could be a multitude of issues from behavior to other blood markers that you need to resolve.

As a male, i have no clue what makes anyone think you dont need T at optimal levels. Espcially doctors.

yea i was desperate and i had like 5 doctors telling me to do it and i did, initially they told me I would only take a month off but then it went to 2 months to 3 months to even 6 months. I think I finally bottomed out because i didnt leave bed for days and said fuck it and went back on trt but thinking my old protocol of 200 mg month of cynpiante is the way to go but i might start off with enanthate as someone mentioned its faster. I just wish I could find a doc or clinic that can help me manage this better

I will def look into jat more and i will get the iron supplement, what should i be aiming to get my iron levels at?

I also want to say you have been extremely helpful and making me feel like im not going crazy as i deal with these docs, i really want to thank you. is there a doctor or clinic you would recommend as well? I honestly will pay anything at this point to get proper care as between defy and the 20 or so other doctors i tried haven’t been help

My libido is hard to diminish even with low-T numbers, its getting the plumbing to cooperate and am noticing much harder erections lately (bigger veins) and as time goes on I’m able to maintain them for longer periods of time.

I’ve lost 12 pounds in 2 weeks with only three gyms days in that time. The only time I lost 12 pounds on injections is when I had IBS symptoms from vitamin D deficiency, so basically starvation do to being unable to absorb food.

Sounds like youre headed in the right way.

So jealous of ppl having libidos. I’ve come to the conclusion it just may not happen for me. And i may not be able to ever have a normal relationship.

Depressing for sure.