T Nation

Max Age for Restart. Long-Term AAS Suppression?

Hi all,

I have trt docs standing by but have 1 other issue holding me back.

I have 500 something total but ~60-70 shbg with a below range free T. It’s 7 with 9-25 range.
I did have normal lh/fsh last time I tested but that was only once and these are pulsatile.

I’m 36, in decent shape but do have drive/mood/energy issues occasionally.
Thyroid/cortisol/vitamins are fine.

QUESTION: I did use a cycle when I was much younger, more than 10 years ago now, and i was previously on trt for 2 years. I used low dose hcg throughout. But, now, as I read the literature on Anabolic Steroid Induced Hypogonadism (ASIH), I’ve seen guys that were seemingly suppressed for years from cycles.

I did use clomid, but I didn’t tolerate it well and certainly didn’t last many months like some restart protocols call for. Clomid did seem to increase my T. I also saw an assertion (in a legit journal) that clomid can desensitize the pituitary to GNRH (they called it LHRH but apparently they’re the same), while nolva actually increases sensitivity. Surely, this isn’t permanent. The more I read about it, very little seems permanent as long as there’s no physical damage.

So, is 36 too late to attempt any restarts?
Has anyone tried months long, low dose ( 5 -10 mg nolva) restarts and tested FREE or BIOAVAILABLE testosterone a few months after stopping all meds?
At what age is the average so low that the boost from average to younger is worth it? Meaning, it’s a waste of time to worry about getting back normal levels because normal for a 40 year old sucks anyways.

I ask thinking I would be fine if I get my natty 170 bioavailable up to 250 or so. If I did do trt again, I’d probably keep my doses lower and shoot for 350-500 bioavailable and 20 free T. So I wouldn’t be getting much more than youthful levels.

I realize part of this is personal preference but still would appreciate any good ideas.
I did use the search but the results were hit or miss.

What is your Vit D, D1,25, Albumin, and medication/supplement list?

Vit D usually around 40. Albumin is usually around 4.3-4.5.

Meds/supps:

100 mcg T4 /day
multivitamin most days.
vitamin D in the winter w/ k2. 2,000 iu or so.
mixed tocopherols - avg. 100-200 iu/day
Calcium/magnesium at night.
Vitamin C 500 mg
choline if I’m not eating eggs.
Protein to get to 150 g/day. Whey/beef/collagen mix I make myself.
Creatine

How is your sleep?

sleep is okay. groggy in the morning and overall energy could be better.
Not sure how I could improve it really.

Are you on a CPAP? Do you have apnea? Bad sleep could be singlehandedly doing you in.

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Agree with him. Sleep is huge for a healthy hormonal balance. Including much more. Get the app that listens to you while you sleep to see if you are having issues. Not sure how it helps but another guy said he used it . I think it was @NH_Watts

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Yeah its called snore lab and its an iPhone app. Also that way if you go down the path of treatment (device or surgery) you can compare. I got a cheap dental guard I wear at night and it pretty much cured my snoring. I also use an eye mask to block out all light.

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I can look into a sleep app.
I doubt it’s having much effect on my T though.

You can doubt, but it jacks you up, and it does it a little at a time over time so you don’t realize it.

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You’ll never produce enough testosterone to overcome your very high SHBG, you need supraphysiological levels to have good Free T levels.

High SHBG=low Free T.

I posted a series of podcasts on my log here regarding the importance of sleep. The host, Dr. Peter Attia, when doing his residency was hypogonadal due to lack of sleep. His testosterone tested around 250 ng/dL. Once he started getting adequate sleep his T came back to normal. So don’t dismiss the importance of sleep. It plays a part in hormones, metabolism, and life expectancy to name a few.