T Nation

Stopping TRT Suddenly; Side Effects?

Hi all.
I have been on TRT (Reandron 1000mg every 12 weeks) since '09.
When I went for a shot the other day my GP told me he wanted me to stop the therapy and see how things went.
I expressed concern about stopping dramatically, but he insisted “we’d see how things went”.

Originally I was prescribed the shots by an endo due to a high level of Androgen resistance.
I’ve had trouble tracking the paper work, but from what I can find my results were;

S testosterone 23.5 nmol/l
FSH 20.2
LH 37

These last two values were apparently elevated (due to medication), and this was mopping up my free test.

I stopped the medication in April, and had a test doen one week before my next injection was due.

The results;
S testosterone 27.4 nmol/l (12.0 - 31.9)
SHBG 95H (12-57)
S Albumin 50 g/L (39-50)
Free test (VC) 268.72 pmol/L (260 -740)

I have been given no PCT, or ANYTHING!
Should I have any worries?

He was very haphazard about just taking me off, didn’t consult my Endo, just said he wanted to see what would happen.

By the way, I’m 31, 84kgs, 17% bf if that helps.

All replies GREATLY appreciated.

=] =] =]

That 1000mg every 12 weeks thing makes my skin crawl. How’d you do on that? I’d think a giant upswing with some really nasty ugly days (weeks?) at the end.

That SHBG number is scary high. Since, as far as I know, lowering SHBG is pretty haphazard (some things, stinging nettle, are said to help). The only thing they can do is pound the body with T and hope some extra survives the lock down.

Just taking you off, especially without a full set of labs, doesn’t sound very wise. Kinda like throwing switches on a spacecraft “just to see what they do.”

I’d suggest three things: talk it over with the existing doc and express your concerns (read up a bunch first), find an anti-aging doc who specializes in TRT and get a second opinion, AND really, really look into lower, more frequent dosing… weekly seems to be the longest reasonable range (mine are twice a week).

If more frequent dosing is logistically difficult (if you have to make an appt and trip to a clinic and so on), ask about self-injection. That’s what I do… nothing to it. Insulin people do it all the time, you can too!

Good luck!

What medicine were you on that supposedly elevated your LH/FSH to such a high level?

[quote]dean3238 wrote:
That 1000mg every 12 weeks thing makes my skin crawl. How’d you do on that? I’d think a giant upswing with some really nasty ugly days (weeks?) at the end. [/quote]

I noticed a big improvement in energy, and a HUGE improvement in libido at first. It seemed to drop, but that may have been me getting used to it. I was told that is is slow release, so there are less swings then more regular test.

Would this be producing unwanted sides? I’m thinking baldness as I’ve started to receed.

I’m seeing the endo that got me onto it in a few weeks. Any specific things you recommend discussing with him?

Cheers brother
=]

[quote]VTBalla34 wrote:
What medicine were you on that supposedly elevated your LH/FSH to such a high level?[/quote]

Dilantin 300 mgs/Day for epilepsy.

They suspected this was the cause, however were unsure.
At the time I didn’t even know what TRT was, just followed instructions like an idiot.

Slice,

SHBG won’t add to balding issues that I’ve ever heard. IIRC, ramping up DHT levels will do that… but that’s another topic.

What it does is it converts T into “non-bioavailable” T… meaning that T might as well be sugar water as far as your body cares. It doesn’t do anything for you (or against you for that matter).

The higher the level, the more T it slurps up into the void. Those levels increase with age, but that should not be a big deal at 31.

Regardless, your level is off the chart. That’s a big red flag for the doc.

[quote]dean3238 wrote:

What it does is it converts T into “non-bioavailable” T… meaning that T might as well be sugar water as far as your body cares. It doesn’t do anything for you (or against you for that matter).

The higher the level, the more T it slurps up into the void. Those levels increase with age, but that should not be a big deal at 31.
[/quote]

That’s how it was explained; it was taking a bigger slice of the pie then it should be.
I’ll make sure I discuss this with the endo.
Any other main topics I should cover?

I’m trying to get as much information as possible this time. Last time I just went in and followed orders.

You didn’t list your E2 levels (or I missed them)… he’ll need to test for that.

Check out the stickies… tons of good stuff there… do a search on-line for TRT info. You can pick up a lot of info that way.

The docs, as you are finding out, have two hands tied around their nuts when it comes to this stuff. You’ll find ones who don’t know shit and don’t want to know, those that know a little but won’t treat because they are terrified of becoming “pushers”, those that know a little and treat the wrong way (too much T, wrong tests, too infrequent dosage, lack of understanding of the other features you might need (AI, HCG), and the rare ones that know their shit and know how to treat.

I suffered for 16+ years before finding a doc who was in that last category. The others looked for any cause other than what was really going on and dumped tons of chemicals in me. Meanwhile, they studiously avoided trying the one thing that worked. They owe me for many, many years of feeling like shit just so they could CYA themselves.

So today I’m getting bloods.
On it he’s ordered
FBE
psa
lh
fsh
serum testosterone
shbg

From from what I’ve read here testing for LH/FSH.
And no E2 levels.
Can I just write these in on the form? (Edit; I’ve added E2 and DHT)

lol. Don’t quote me… but I did the same thing in the past. :wink:

puts note saying ‘authorised by dean 3238’

Ha! That’ll make them sit up and take notice.

Checking a box was how I finally got the first doc I talked with to finally check my TT level (and that was all). Next appointment, he matter-of-factly noted the number (I forget what it was, bottom rung of the so-called normal range) and moved on as if nothing had happened.

OK, so new test results in;

S FSH 27.3 (1.5-9.7) HIGH
LH 34.2 (1.8-9.2) HIGH
S Oestradiol 50 (<160)
S Testosterone 22.7 (12.0-31.9)
SHBG 60 (12-57) HIGH
Free Test (VC) 331.38 (260-740)

PSA 0.74 (0.2-2.1)

SHBG is down from 95 (April this year, after my last test shot) to 60 (1st August)

S FSH and LH are still extremely high;
2009; FSH 20.2 LH 37
August 2012; FSH 27.3 LH 34.2

“You do not test LH or FSH when on TRT as you will be shutdown and they will be close to zero.
If FSH stays high with HPTA shutdown, you probably have a FSH producing testicular cancer.”
from one of the stickies.

This has me VERY worried. Seeing the endo next week.

If what they’re injecting you with is testosterone, you shouldn’t have a high FSH/LH… This may be a cause of concern, yes. Unless you’re a freak of nature and the T isn’t shutting you down or something (I don’t know, it could happen?) there may be something wrong. Don’t mean to scare you, but yes when you are on T, those should be very very low.

Edit: Could SHBG “sopping up” all of the T cause the negative feedback of low FSH/LH to NOT happen? This seems like a possibility… If the T is being bound by SHBG, maybe your natural production isn’t stopping

[quote]randallh1989 wrote:
Edit: Could SHBG “sopping up” all of the T cause the negative feedback of low FSH/LH to NOT happen? This seems like a possibility… If the T is being bound by SHBG, maybe your natural production isn’t stopping[/quote]

That was the reason I was put on TRT in the first place; not because of low T, but because of SHBG causing low “free T”.

Would you be able to humour a simpleton like myself and explain what you mean about my natural production not stopping due to this?

=] =] =]

What questions would you guys recommend I ask the Endo when I go in?
Last time I had no idea and just followed orders like an idiot.

[quote]randallh1989 wrote:
Edit: Could SHBG “sopping up” all of the T cause the negative feedback of low FSH/LH to NOT happen? This seems like a possibility… If the T is being bound by SHBG, maybe your natural production isn’t stopping[/quote]

No


OP, I meant to look at the drug you are taking for epilepsy and see what side effects it has and see how it could possibly screw up the HPTA to such a degree, but I did’t get a chance to do so.

But I would be surprised if that were the case. I guess its possible and I dont claim to be a doctor and epilipsey drugs would be WAY outside my area of expertise, but I would look at other causes if I were you.

A pituitary andenoma would be the most likely culprit (I really wish that testicular cancer bit hadn’t been included int he stickey…it is mostly bunk and I’ve never seen anyone on here that this was applicable to, and only a few guys on various testicular cancer boards that I’ve visitied).

Pituitary andenomas are mostly harmless, but can make diagnosing things difficult.

[quote]VTBalla34 wrote:

[quote]randallh1989 wrote:
Edit: Could SHBG “sopping up” all of the T cause the negative feedback of low FSH/LH to NOT happen? This seems like a possibility… If the T is being bound by SHBG, maybe your natural production isn’t stopping[/quote]

No


OP, I meant to look at the drug you are taking for epilepsy and see what side effects it has and see how it could possibly screw up the HPTA to such a degree, but I did’t get a chance to do so.

But I would be surprised if that were the case. I guess its possible and I dont claim to be a doctor and epilipsey drugs would be WAY outside my area of expertise, but I would look at other causes if I were you.

A pituitary andenoma would be the most likely culprit (I really wish that testicular cancer bit hadn’t been included int he stickey…it is mostly bunk and I’ve never seen anyone on here that this was applicable to, and only a few guys on various testicular cancer boards that I’ve visitied).

Pituitary andenomas are mostly harmless, but can make diagnosing things difficult.[/quote]

The drug I was taking (stopped April 2012) was Dilantin (300mgs/day). The reasoning was that they had seen one other case where SHBG was raised under this drug.
Not a very strong case for putting me on TRT I know.
I’ll ask him about A pituitary andenoma and testicular cancer.

As to side effects, my T didn’t seem too low, so they could be psychosomatic, but I’ve been exhausted lately. Sleeping 10-12 hours a night and still having to force myself out of bed.
So tired I turned down a mornng BJ yesterday just so I could go back to sleep.

Feeling down too.
Like I said, it doesn’t seem like my test levels are causing this so in my mind perhaps.

THANKS to everyone helping me out here.

Just got back from the endo. He said he wants me to stay off the TRT and have another blood test in 4 months to see if SHBG keeps dropping.

I didn’t realise that you’d go cold turkey?
thought they would give you HCG or something?