T Nation

Observations After Stopping TRT - Update - Gynecomastia surgery 4/24


Yes legit Nolvadex/tamoxifen for his first choice for a PCT. I though he should ask Defy about the Novedex XT to see if it was better.


Thanks. I am going to give it one last try. If I can’t get to a good place naturally I’ll be back on for life.

What’s your situation? How old, what led you to TRT etc… I was a blown up titty man on TRT with HCG.


They are going to put me on Clomid so I have a plan. That was what defy wanted to do although I know a lot of folks here say just Nolvadex is the way to go.

I wanted to make another observations. When I started TRT I got annoyed easily and was kind of aggressive with a “I don’t give a fuck” attitude underneath. I had a let the chips fall where they may I have a right to be angry kind on this one attitude. I never worried I wouldn’t be able to maintain that in a controlled way if I was challenged. That died down and I ended up in a pretty good place where stuff didn’t bother me and if something did I was able to either address it or let it roll off my back.

Almost 4 weeks off T and this morning at a packed event for my kids sporting championships and everything is bugging the living shit out of me but in a bad way. It’s that mental thing. When you are topped off with T you definitely handle things better mentally. That’s an observation I wanted to share.


I would never take advice from here over Defy. Let me share part of an email from a friend who went on Clomid he’s 34 years old. His first lab was his natty numbers before clomid.
1st Labs:
Total Testosterone: 480 (range is 348 - 1197)
Free Testosterone: 6.7 (range is 8.7 - 25.1)
DHEA: 300 (range is 102.6 - 416.3)
Luteinizing Hormone: 9.0 (range is 1.7 - 8.6)
Estradiol: 18 (range is 8.0 - 35.0)

Started 25mg daily Clomid

2nd Labs:
Total Testosterone: 966 (range is 348 - 1197)
Free Testosterone: 12.8 (range is 8.7 - 25.1)
DHEA: 380 (range is 102.6 - 416.3)
Luteinizing Hormone: 12 (range is 1.7 - 8.6)
Estradiol: 27 (range is 8.0 - 35.0)


Is your friend going to stop clomid to see where he’s at Natty?


This was back in 2016. I met this guy from another mens health/TRT forum and we started PMing each other. He wanted kids and did not want to take any chances. Clomid was the best way I knew at the time. The last time we spoke he was feeling strong and confident an working hard to make a baby. I should PM him and see how he is doing. Once he got fixed he stopped posting on the forum an that was my only way to contact him.

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I wanted to update this to mention something that came to my attention recently. I have seen guys talking about how Nolvadex has become a preferred treatment for PCT. Nolvadex is of course Tamoxifen Citrate.

Here is something to consider. Somewhere around 7% of all Europeans/Caucasians do not have the enzyme activity required to metabolize tamoxifen into endoxifen. They are “poor metabolizers” along the CYP2D6 pathway. The drug needs to be metabolized in order to work right otherwise it does nothing for you.

I was considering obtaining some Nolvadex and was taking steps to do so when I realized that was not going to do anything for me because I myself am a poor CYP2D6 metabolizers. I know this because when I had my bout with chronic pain and got depressed (more like crazy since I was in unrelenting pain in my balls/scrotum) I saw a guy that did the genetic testing to help match people up with drugs. That’s how I know. I never took any of the drugs he prescribed anyway because after my reversal surgery the pain from the nerve entrapment had been cleaned up/excised and of course the drop in pain made me better (fucking duh).

So bottom line. Some of you guys that are on here a lot advising guys it’s something to consider. This is not junk science it’s real. Many people don’t understand the science behind using genetic testing to help prescribe psych meds/meds in general thinking that is’s some sort of empirical thing that matches genes to outcomes. No, that’s not it. It has to do with looking at known genetic issues relating to liver metabolism that relies on certain enzyme activity some people are known to have deficiencies in based on genes. It’s known stuff.

Based on this Clomid is probably a surer thing for most white guys because it does not require that liver enzyme activity in order to work.


I’m a month and a day since my last injection.

I stopped HCG this week and will take the Clomid when it arrives. I expedited delivery so I’m hoping it gets here soon.

I have a lot of joint pain primarily in my knees and low back. Overall very achy. Definitely more tired.

Emotionally I am noticing I’m a lot more introverted and pretty beat at the end of the day. I had been doing a lot of cooking while on TRT and have less energy and interest lately.

It’s the emotional part that is interesting and because I am used to being in a degree of pain, probably the worst of it. The mental part is tough. I’m more introverted and socially more awkward. I was very kind of comfortable in social interactions while on T. I am wondering if other folks notice this. It is kind of an anti-anxiety thing. It knocks down interpersonal anxiety quite a bit. Based on what I hear about Clomid I’m thinking I should wait until after my vacation to take it. Some people here have indicated it makes them “hormonal”.

Anyway, that one symptom, introversion and twitchiness, is the main one that I’m not liking.


In this situation introversion would be the opposite of confidence so that makes sense. I was WAY less engaging with people when I was low before TRT.


This is really interesting I never knew that. 7% is still pretty low
Since there are no really bad sideeffects I would still try Nolvadex to see if it helped with a PCT.
Is that genetic test expensive?


When I was tested it was expensive. However, there is a 99 dollar kit that tests how well you metabolize Tamoxifen.

Look up “Kailos Tamoxifen test” and you’ll find it. It uses a cotton swab and envelope. You just swab your cheek. It’s called Tamoxifen response but that just means it’s checking if what kind of CYP2D6 metabolizer you are. It’s suspect it’s a popular test because women need to know if the medication they are taking to keep them in remission from breast cancer will actually work for them. It’s a very smart and much needed application for genetic testing technology.

Being one of those 7% sucks because Codeine doesn’t work that well and a lot of other drugs don’t either if you have little to no CYP2D6 enzyme activity. Codeine needs CYP2D6 to be broken down into it’s active metabolite, morphine.

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I got my Clomid yesterday and started taking it. I guess it’s been almost 6 weeks since I stopped TRT. My weight is still down at around 210. I was on vacation and did not do my dumbells, situps or free hand exercises much while out of town but walked a ton. I had gotten a script for Viagra because I could to see what it’s like. I’ll tell you what, I am fairly cardiovascularly healthy and even on TRT was having trouble staying engaged with my wife who seems to take forever to climax now. With even a little (quarter pill) of that stuff there are no worries keeping your “focus”. We’ll see how the clomid works.

I had posted on another thread that the doctor who prescribed it said that the smaller, more frequent doses of HCG I was taking sometimes are less effective in maintaining fertility and testicular size as a a couple larger doses. That might explain why my sperm count dropped dramatically in the last month. I was on TRT when I changed my dosing.

I’m still probably going to get gynecomastia surgery. I think Finasteride got that started 20 years ago and being overweight for a a few spells in the last 20 years did not help plus having fairly low T levels. I can feel the glandular tissue as well. It is not one obvious solid mass but is kind of stringy and fibrous and little more dense and diffuse. I don’t think there is any way I will ever get that down to a place where It doesn’t look like crap. I was leaning forward on vacation with my shirt off by the pool and my wife had taken a picture and it looked bad, lol. standing up straight not to much due to the fact I actually have pecs but damn when leaning down the titty factor was redonkulous. I will keep you all apprised on that as there are other guys on here that may be considering it. I think my issues balancing estrogen will on T probably didn’t help and may have made me a little worse. Not saying that’s the norm.

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I look forward to reading about your progress with clomid and the surgery.


Clomid is coming fine I suppose. No complaints. I don’t feel as confident as I did on TRT but I don’t feel like absolute hell either.

The Dr. at Defy was new and screwed up and forgot to attach/send a script over to Empower so the order was stuck there for close to 2 weeks. One of which I was out of town on vacation. Once I called to see what was going on they jumped on it and got it to me in like one day. I got an apology and a credit. Nothing but positive things to say about Defy.

I scheduled my lipo/excision surgery for my gynecomastia. It’s mostly on the left and I can feel it and it should be interesting to see what happens. I don’t have a big round discrete mass in there. It’s stringy and I can tell it’s going to be a bit of work for them to take care of. Hopefully it won’t look like shit when the guy is done. I’m just sick of being in decent shape and still being self conscious when I take my shirt off at the beach or pool. I never noticed how much it bugged me until the last few years.
I am going to be scared shitless the day of surgery I would imagine. I keep focusing on how nice it will be to have a chest like a man again. I have posted pics of myself on here. It isn’t overtly womanly like some poor guys but there is a swell on the left side now that is just a nonstarter for me. Fuck that.

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I got the surgery on Wednesday. I’m less than 48 hours out but already liking the results.

If I had to pin my gyno on any one thing I’d say it was Finasteride. I remember a buddy making a joke about it that kind of hit me out of left field. We were both laughing and wasted at the beach getting ready to go out to a beach bar. My buddy said “you look like you could suckle a bear”. When I got married my wife and I got fat. You tend to over cook when first married. Lots of two helping meals. I remember my wife teased me once and called me “big fat hairy titty man” at some point around the same time. I was like “It’s all muscle” because I always had good pecs … So this was probably a year and a half after starting propecia. That’s the first time in my life anyone said anything about it to me. That was in the late 90’s.

It seems like it kind of waxed and waned over the years. I did some really strict keto regimes and lost a lot of weight in the early 2000s which probably masked it then last year when I was up to 220 and started having hormone issues last year I went from “I can live with it” gyno to “Even with a shirt it looks bad” gyno.

I have a compression vest on now and am working from home. I have two drains in which will stay in until I stop oozing.

It’s a very unpleasant surgery but I was not losing that tissue no matter what I did so it made working out seem pointless

I’ll post a pic when the drains are out.

I’m taking clomid right now btw and doing okay on it.

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Damn dude. Cheers to recovery and getting the attention you needed. You are on the other side now and nothing but good things to look forward to in this regard.


Thanks for your support. I really appreciate it.

It’s a scary thing to do.

Key points -> I didn’t rush into it and I chose someone I trusted to do it. Top notch doctor.


Was it a general anesthesia or local? And Im sorry if that questions sounds diminishing to your surgery, I honestly don’t know anything about it.


It was kind of twilight. I wasn’t fully out. I was looped good though. I could not see anything as a drape was over my face. I remember some stuff like a guy saying he was done on the left. Then they went back to the left. I had a moment of a lot of pain, even under anesthesia when they pulled some fibrous tissue out on the right. I was kind of out of it but I remember it and remember wincing even as looped as I was. My buddy runs the OR so he was there and that was a great comfort. I knew he would not let them screw me up and I know that fact he knows the doctor means I got good care. Careful, precise care.

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Amazing. We should all be so fortunate.