T Nation

Is Restart Protocol Advised in My Circumstance?

#1

I haven’t posted in awhile and have been on TRT since last March. I am thinking about coming off to try a natural restart just to make sure It is my only options. TRT has helped with many symptoms however, it has inexplicably hurt my erections. (recent estradiol and prolactin have come back within normal range so I’m not sure what is causing it.). But long story short I’m wondering if it is even worth the bother of eating super healthy, meditating, healthy fats and a restart protocol or if my numbers just warrant me staying on.

I am 30, weigh about 220, 15 percent bodyfat, have been eating healthy for a long time , previous illicit drug use, mostly in college, no steroid cycle history before TRT. Below are my numbers of some tests I had before I started TRT. I realize that I should have had FSH and t3, t4, etc tested, but it didn’t happen.

My question is, do you think after 10 months, I could give myself a chance to restart my natural T? I’m fear that after a few years, it will be impossible to do and I’m worried about some of the health issues I’ve read including heart issues, fertility issues and raised cholesterol. Another issue is that sometimes I don’t have the same hardness of erection as I used to which is a huge problem. I know certain studies are inconclusive, but I would like to give the natural route one more chance possibly…Do you think with my test results, this is possible or are they so low that I should really just be on it? Thanks.

About:

160 mg test weekly, hcg 400 mcg twice a week (cycled every couple months to prevent possible desensitized leydig cells) and 6.25 mg of aromasin. Here are some of my tests done in the months following up to deciding to go on trt. Most were under 300 ng/dl. In general, the testosterone has helped me with confidence and energy but has hurt erection quality and I fear about being able to come off if health issues arise later in life. My doctor had said that my estradiol was so low, that it was unlikely that a clomid restart would work. I have many recent tests but the main numbers I’m posting are numbers I had prior to TRT.

Nov 7th 17: total t: 282 ng/dl

nov 16th 17: total T: 421 ng/dl (highest I’ve seen it)

feb 2018: total T: 379 ng/dl. Free t: 8.3 (9-27)

march 18, 2018:

Total T: 291 (264-916)
free T: 9 (9.3-26.5)
LH: 2.2 (1.7-8.6)
Prolactin: 5.1 (4-15.2)
estradiol: 6.4 (7.6-42) Low
SHBG: 32 (16.5-56)
TSH- .473 (.45-5.0)

CMP:
Glucose: 81 (65-99)
Urea Nitrogen: 12 (6-20)
Creatinine: 1.09 (.76-1.27)
EGFR (non black)- 92 (>59ml/min/1.73)
EGFR (black)- 106 (>59ml/min/1.73)
BUN/Creatinine Ratio- 11 (9-20)
Sodium- 141 (134-144)
Potassium 4.0 (3.5-5.2)
Chloride- 102 (96-106)
Total CO2- 25 (18-29 mmol/L)
Anion GAP 14 (10-18)
Calcium- 9.0 (8.7- 10.2)
Protein, TOTAL- 6.2 (6.0-8.5)
Albumin, S 4.3 (3.5-5.5)
Globulin 1.9 (1.5-4.5)
A/G 2.3 (1.2-2.2) High
Bilirubin 0.5 (0.0-1.2)
Alkptase 38 (39-117)
AST (GOT) 19 (0-40 IU/L)
ALT (GPT) 23 (0-44 IU/L)

CBC:
WBC:5.8 (3.4-10.8)
RBC: 4.77 (4.14-5.80)
HGB: 14.9 (12.6-17.7)

HCT: 42.3 (37.5-51%)
MCV: 89 (79-97)
MCH: 31.2 (26.6-33)
MCHC: 35.2 (31.5-35.7)
RDW: 13.4 (12.3-15.4)
Placelet CT: 216 (150-379)

MY Lipid profile is skewed because I accidently ate before this particular test. My doctor said my values were normal considering how soon after I took it
:
Cholesterol: 193 (100-199)
Triglyceride 164 (H) (0-149)
HDL Cholesterol:37 (L) (>39mg/dl)
VLDL: 33 (5-40)
LDL Cholesterol : 123 (H) (0-99)
CHOL/HDL Ratio 5.2 (H) (0.0-5.0 units)

#2

Then do it. Or you will keep thinking about it. Am 42 and I think about it but am getting to the point that I am comfortable on trt and that I need it. If I was 30 and would have tried.

The ai your taking could be keeping your e2 low causing Ed and other problems.

You cycling HCG could be preventing you from feeling better. I know there are different theories about it’s use even if for fertility. Some don’t use even if they want fertility but when it’s time for baby they may use clomid and get off trt.
Look at bb @physioLojik he’s wife is having a 3rd baby right now and no HCG for him.

When I tried clomid before Injections I had lowish e2 and testosterone and it raised both.

#3

Yes.

1 Like
#4

Looks like you need TRT. Nothing wrong with stopping and seeing how you do without it. You can always go back on TRT. Can you post your most recent labs?

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#5

yeah I kind of want to but people make it sound pretty terrible to try to stop…nah aromasin is weak especially at the amount i’m on. I’ve tried not taking an ai and its the same kind of thing. i got off anastrazole because that actually did crash my e2. its really strong. But yeah I would just hate to not be able to have sex or lift weights for months if i stopped.

#6

This post is from awhile ago but the problems I’m having are still valid. Not getting proper erection hardness or taking a long time, out of whack cholesterol, high triglycerides, high blood pressure, and now, strange TSH, FT4 readings. My protocol is as follows: 80 mg test cyp 2x per week, hcg 250 mcg 2x per week, aromasin as needed (have crashed e2 on four different occasions so I’m extremely careful with dosing usually 6.25 every 2 weeks but my e2 never gets that high)…Do you guys usually do nolva/clomid to get off TRT and drop the HCG? Or do you think theres anything else I can do to my protocol to give myself a better chance at success? I’ve been on for like 15 months now but i’ve run into so many health issues since being on it I’m wondering if its worth it for me…I’m getting a thyroid and pituitary MRI next week because the low FT4 and TSH is kind of alarming. My TSH has always been closer to 1.0.

#7

CBC With Differential/Platelet

WBC

5.8NORMAL

Reference Range: 3.4-10.8 x10E3/uL

RBC

5.34NORMAL

Reference Range: 4.14-5.80 x10E6/uL

Hemoglobin

14.6NORMAL

Reference Range: 13.0-17.7 g/dL

Hematocrit

44.5NORMAL

Reference Range: 37.5-51.0 %

MCV

83NORMAL

Reference Range: 79-97 fL

MCH

27.3NORMAL

Reference Range: 26.6-33.0 pg

MCHC

32.8NORMAL

Reference Range: 31.5-35.7 g/dL

Neutrophils

57NORMAL

Reference Range: Not Estab. %

Immature Granulocytes

0NORMAL

Reference Range: Not Estab. %

Lymphs

30NORMAL

Reference Range: Not Estab. %

Monocytes

10NORMAL

Reference Range: Not Estab. %

Eos

3NORMAL

Reference Range: Not Estab. %

Basos

0NORMAL

Reference Range: Not Estab. %

Platelets

236NORMAL

Reference Range: 150-379 x10E3/uL

Neutrophils (Absolute)

3.3NORMAL

Reference Range: 1.4-7.0 x10E3/uL

Immature Grans (Abs)

0.0NORMAL

Reference Range: 0.0-0.1 x10E3/uL

Lymphs (Absolute)

1.8NORMAL

Reference Range: 0.7-3.1 x10E3/uL

Monocytes(Absolute)

0.6NORMAL

Reference Range: 0.1-0.9 x10E3/uL

Eos (Absolute)

0.2NORMAL

Reference Range: 0.0-0.4 x10E3/uL

Baso (Absolute)

0.0NORMAL

Reference Range: 0.0-0.2 x10E3/uL

RDW

13.9NORMAL

Reference Range: 12.3-15.4 %

Vitamin D, 25-Hydroxy

Vitamin D, 25-Hydroxy

23.9LOW

Reference Range: 30.0-100.0 ng/mL

Vitamin D deficiency has been defined by the Institute of Medicine and an Endocrine Society practice guideline as a level of serum 25-OH vitamin D less than 20 ng/mL (1,2). The Endocrine Society went on to further define vitamin D insufficiency as a level between 21 and 29 ng/mL (2). 1. IOM (Institute of Medicine). 2010. Dietary reference intakes for calcium and D. Washington DC: The National Academies Press. 2. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. JCEM. 2011 Jul; 96(7):1911-30.

Hgb A1c with eAG Estimation

Estim. Avg Glu (eAG)

103NORMAL

Hemoglobin A1c

5.2NORMAL

Reference Range: 4.8-5.6 %

Lipid Panel w/ Chol/HDL Ratio

Cholesterol, Total

146NORMAL

Reference Range: 100-199 mg/dL

Triglycerides

230HIGH

Reference Range: 0-149 mg/dL

HDL Cholesterol

36LOW

Reference Range: >39 mg/dL

VLDL Cholesterol Cal

46HIGH

Reference Range: 5-40 mg/dL

LDL Cholesterol Calc

64NORMAL

Reference Range: 0-99 mg/dL

T. Chol/HDL Ratio

4.1NORMAL

Reference Range: 0.0-5.0 ratio

CMP14

Calcium

9.4NORMAL

Reference Range: 8.7-10.2 mg/dL

Glucose

80NORMAL

Reference Range: 65-99 mg/dL

BUN

12NORMAL

Reference Range: 6-20 mg/dL

Protein, Total

6.3NORMAL

Reference Range: 6.0-8.5 g/dL

Albumin

4.3NORMAL

Reference Range: 3.5-5.5 g/dL

Bilirubin, Total

0.3NORMAL

Reference Range: 0.0-1.2 mg/dL

Alkaline Phosphatase

51NORMAL

Reference Range: 39-117 IU/L

AST (SGOT)

17NORMAL

Reference Range: 0-40 IU/L

Potassium

4.5NORMAL

Reference Range: 3.5-5.2 mmol/L

Sodium

141 NORMAL

Reference Range: 134-144 mmol/L

Chloride

103NORMAL

Reference Range: 96-106 mmol/L

Creatinine

0.94 NORMAL

Reference Range: 0.76-1.27 mg/dL

ALT (SGPT)

24NORMAL

Reference Range: 0-44 IU/L

Carbon Dioxide, Total

23 NORMAL

Reference Range: 20-29 mmol/L

BUN/Creatinine Ratio

13 NORMAL

Reference Range: 9-20

Globulin, Total

2.0NORMAL

Reference Range: 1.5-4.5 g/dL

A/G Ratio

2.2NORMAL

Reference Range: 1.2-2.2

eGFR If NonAfricn Am

108NORMAL

Reference Range: >59 mL/min/1.73

eGFR If Africn Am

125 NORMAL

Reference Range: >59 mL/min/1.73

Anion Gap

15.0NORMAL

Reference Range: 10.0-18.0 mmol/L

TSH Rfx on Abnormal to Free T4

TSH

0.373 LOW

Reference Range: 0.450-4.500 uIU/mL

T4,Free (Direct)

0.78 LOW

Reference Range: 0.82-1.77 ng/d

Vitamin B12 and Folate

Vitamin B12

412NORMAL

Reference Range: 232-1245 pg/mL

Folate (Folic Acid), Serum

9.6NORMAL

Reference Range: >3.0 ng/mL

Testosterone,Free and Total

Testosterone, Serum

788 NORMAL

Reference Range: 264-916 ng/dL

Adult male reference interval is based on a population of healthy nonobese males (BMI <30) between 19 and 39 years old. Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103.

Free Testosterone(Direct)

25.3HIGH

Reference Range: 8.7-25.1 pg/mL

Sorry if its kind of jammed together, it was easier then screenshotting a bunch of clips together…both my free test and total test are looking great but still have erection issues

The E2 is missing but last time was at like 24 or so…right in the middle

#8

If you have erection issues, you should be looking at E2. That crap in the stickies about ideal range should be disregarded completely. Drop the AI. Give it two weeks and see how you are. Seriously. I like 68 E2 a lot more than 18 E2.

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#9

You have thyroid problems, TRT isn’t to blame. Low TSH usually indicates hyperthyroidism, need to test Free T3 and Reverse T3.

#10

Well it’s always been within range usually between .5 and 1.0 and I’ve taken it quite a few times within the last year so it is kind of odd that it’s thrown off after taking trt…but yeah I’m hoping it’s not related to trt and I’m wondering if solving the thyroid problems will solve erection issues and such. My doc said since t4 free is low and tsh is low this time, it is likely a pituitary problem which I will hopefully get to the bottom of soon. In terms of thyroid, only an mri and further testing will give me more answers but I’ve been having erection issues even when my tsh was near 1.0 which my doc says is prime.

#11

A low TSH indicates pituitary is happy with the amount of thyroid hormones, but your thyroid hormones are low, so pituitary gland is not functioning properly.

#12

Yeah in that regard, I definitely agree. Do you think they’re low enough to be a tumor or something on the pituitary? or just slightly low and might be a imbalance of me not getting enough iodized salt or iodine from kelp from my thyroid. Or just the fact that they’re both low means my thyroid is fine and my pituitary is the only answer to get an MRI for? Again, I am getting further tests this week for ft3, t3, f4, ft4, reverse t and tsh again and an MRI but am just wondering if theres anyway I can raise those numbers naturally or if anyone else has similar issues with numbers like these? I don’t get paranoid easily but I’m pretty freaked out over it being a cancerous mass or something on my pituitary gland lol lets hope its not.

#13

Yeah, all that shit baffles me - SHBG, T3, just don’t understand it.

Here’s what I do know. I started TRT at 51 with a total T of 170. I was skinny fat at 6’1" and 178. After a year I was still 6’1", but I weighed 196 and was muscular. My body fat was down, I looked good.

Sixteen weeks ago, after four years on, I got off. After sixteen weeks my test was 250 - it went up, woohoo.

But, I was down to 180 again, and skinny fat.

I started pinning again last week.

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#14

Man, I’m already not feeling good…I’m wondering if I should just get back on the TRT and drop the dosage a bit. The erection hardness factor and this new low TSH/ Low FT4 are the only things holding me back from getting back on it. In addition to a primary care doc and an endo who told me it was terrible to be on and a urologist who said the jury is still out on the safety of the treatment. I missed 2 shots and already feel like shit and it might not be the best time in my life to try to get through PCT. Do you think my numbers that were low for the thyroid markers warrants getting off TRT? Had the MRI today so we’ll see if there’s anything I can gain from that. I’ve just heard a lot of mixed opinions on whether TRT alters thyroid numbers. Everything else about TRT I love.