This is My Story. Need Advice for Restart T After TRT

Pharma / TRT Testosterone Replacement
1

Hello, I’m new here. How do I get my T restarted. I’m secondary hypogonadism due to pituitary complications. I’m 35 and 2 years ago I had a brain bleed leading to a diagnosis of a pituitary mass(cyst or tumor). No plans to have it taken out with sugery. On TRT. Wanna come off and regain my natural T and then try and boost it with AIs SERMS etc.

I’ve been studying for the last month about testosterone all over the web. I’ve read the stickys and specifically the one about restarting here on T nation. It’s very reassuring to read.
I want to come of my Testosterone replacement Therapy and recover my natural testosterone with PCT first before experimenting with other drugs to help naturally boost my T to normal levels. I’m only on my second injection of Reandron 1000. You take it every 10-14 weeks. Coming to the end of the second injection.

Before TRT my T was 230 ng/dl
On TRT my T is 400 ng/dl psossibly higher (not enough blood tests done)

It is really stressful because my endo wont help. I don’t know where to get blood tests and medication. They just say go cold turkey. I’ve read about the horrible withdrawal from stopping TRT and it takes up to a year just to get back to the low T level you had before starting.

I haven’t worked out where to get blood tests. I’m going to have to get the HCG Nolavadex and AI(aromasin) from canadian drug websites. I think the drugs come from india and such places.

I feel sort of abandoned by doctors and am on my own to self manage.

My plan at the moment is to use some HCG for 2 weeks and then go to either nolvadex or low dose aromasin to get my T up. I’m worried about too much estrogen and the T/estrogen ratio and loosing libido.

From my research , I only need HCG if I have testicular atrophy / shrunken balls. And I think I could just skip the HCG and go to nolvadex or aromataze inhibitors.

I’m thinking of using AIs to get T up, and then taper off them slowly and hopefully my T will be higher than 200…my normal level. Thinking maybe I can jump start the body into settling at a higher natural T level with no drugs in the end. Or just take low dose nolvadex and low dose AIs forever… switching between the 2 from time to time.

2 years ago it all started. I had headaches for a week due to a pocket of blood around my pituitary gland. Almost died. After it all settled down after about 8 weeks, I was told I needed to go on cortisol and thyroid replacement and eventually ended up on testosterone replacement.
My cortisoll and thyroid are sorted out now and I’m on low doses. But I want to get off the TRT testosterone replacement therapy.

And recently looking at getting some HCG and reading that you could get hepatitis or HIV. I don’t know anything right now. How to mix and inject HCG, how long, when to take bloods, where to take bloods. Feeling really hopeless and depressed looking at the task ahead.
Just 2 years ago I was really healthy.

So I suppose what I’m asking is for some advice and comments about my plan of restarting my HPTA.
And, what would be the best long term therapy for replacing T. Which would you use:
Clomid
Nolvadex
HCG
Armidex(anastrazole)
Aromasin(exemestane)

I’ve read a lot about doctors using clomid for long term T replacement with possible AIs to manage estrogen.
I’ve read Nolvadex has less side effects, is cheaper due to smaller dosage needed. I’ve also read that they are both horrible heavy drugs used since like 1940s in woman and should not be used long term in in men at small doses.
Armidex has more side effects than aromasin, including vision changes and…
Aromasin make your joints dry. I’m leaning towards aromasin lose dosing.

2

Have you looked at the how to find a local doctor link?

3

No i hadn’t read that one but have now. But I already new everything in that from common knowledge and I know what doctors are like in Australia. Docs are stupid and ignorant. They’ll say why don’t you just do what the endocrinologist says …which is just do nothing. Even if I can get them to prescribe me the meds, which I can probably get from canadian pharmacies, I will be managing my own recovery, because I’m sure I know more about it than the GP docs. So I thought you guys could comment on my situation being secondary hypo (pituitary related).

Do I even need to take HCG after only 4 months on Reandron 1000 TRT ?
Should I just go straight to SERMS ?
Can you just take AIs instead of Nolvadex?
I don’t like the idea of choosing a SERM and dose, and not testing for 4 weeks
Do I go to a doctor for a blood test or can you just go privately to a lab.
Do i need a 3ml needle for injecting HCG or is that only for mixing it up in the vials. Or is it smaller needles for injecting? new needle each time?

4

Australia … sorry to hear that. The US system costs to damn much. But it has an upside

In your case at least it will all cost less and in the end, you will get it done

You said you read all the stickies and the guys here will help with reading your blood test results… Personally I do not know a thing about restarts. By the time I figured out that I had a problem I was 58 and my TRT levels were off the charts low. I really had no choice.

It is the weekend give the guy another day themyth loves restarts maybe hit him up

5

What would be the best SERM for long term TRT?
I’m thinking Arimisin or Arimidex rather than Clomid or Nolvadex

From what i understand
Clomid and Nolva block estrogen receptors
Aromasin and Arimidex deal with Aromatze inhibitors.

It seems to me that blocking estrogen in the body with Clomid and Nolva is just a beating around the bush …when you can go straight to stopping testosterone being converted in to Estrogen with AIs like Asin and Adex.

I think some Testosterone gets Aromatazed into Estrogen for a reason. The whole thing is a self managing system. To stop Aromatization could be dangerous in ways we don’t yet understand.

Also having excess Estrogen in the body that can’t be used by the body, due to Clomid and Nolva blocking the E receptors, could also be dangerous. That Estrogen which can’t be used in body must go out through the liver I think.

Which is the lesser of two evils?

6

You have developed an attitude about things based on confused knowledge.

If your pituitary is damaged, it might not restart as you would like.

None of those drugs causes joint problems. Joint problems are a result of a dose that lowers E2 too much. You need to understand enough to understand direct VS indirect symptoms.

You do not stop aromatization, you reduce it to achieve a desired amount of aromatization and E2.

SERMs increase E2, you may then need anastrozole to achieve a target E2 level.

If you take E2 really low with anastrozole, LH, FSH and T can increase but you will not feel good. If a recommended E2 level using anastrozole does not deliver decent T, you can use low dose SERM to see what you can do. Again, the SERM is used to modulate, not stop anything.

When using a anastrozole and/or SERM, LH/FSH labs will tell you if the pituitary is releasing useful amounts of LH/FSH. If LH/FSH remains low, you need TRT.

7

Is there a particular reason you want to stop? Not sure I see the benefits when you have a medical need. I waited a good bit and had tons of tests done to see if I could avoid TRT. I went on it as a last resort because basically, its a medical need for me. As KSman said, you may not have a choice. A pituitary mass is likely to cause high levels of prolactin which will do funny things to your hormones. Can’t get rid of that until the mass is gone or prolactin levels seek normalcy.

8

Why i want stop exogenous trt. It all started when i took a selfie and thought my hair looked thin. 35years and had no previous sign of hair loss. Doesnt run in the family either. Trt didnt really give me much more energy which is why i tried it. Only thing noticed was alot more confidence and a more extroverted personality.
I thought about sperm loss and HPTA shutdown. I think you only want it when you dont have it. I want my sperm back. I want to be man that way. I didn’t like having to be on exogenous TRT forever. You can’t just stop without huge problems. I didn’t feel too bad even on 7-8nmol/l T, and I didn’t know anything about SERMS before I began T injections TRT. I would tried SERMS first if I had known about them.
If I could take, say, clomid to raise T only slightly, that way, without all the side effects of TRT injections then I would have tried that first for sure. My endo said I could easily come off TRT by taking some kind of injection. Later discovered that was hcg. When I informed of wanting to quit TRT and gave them all the info from the web about PCT, the endo wouldn’t give me HCG or anything to help restart. Now trying to get nolvadex. Already got hcg and starting tomorrow.
Ive read that you take hcg until labs dictate. What does that mean. Wait until hcg shows a decent increase in t and e?

9

HCG will increase your LH and jump start your body into producing its own T. You can combine this with clomid. You will want to run this for several weeks or more to gear up your own T production.

10

I believe that letting e levels balance themselves is best. If your t is higher then your e will be higher also. There is a certain ratio that is best for sex drive and libido.
Im worried about losing libido on mono serm therapy . Im happy to let my body balance its own E. But taking serms confuses the body. I am currently very confused about how to tune in Serms with AIs.
Also i read that if using an AI with nolvadex…it must aromasin ? Because anastrazole works against nolva or something like that.
Im a bit scared of self managing trt with serms. I’d like to have a doctor on board who at least knows as much as me.
Can you take low nolvadex without having to take AI.
Why is clomid mono therapy all over the web…but nothing about nolvadex monotherapy.
I would be happy to just be at T 400. So low dose serms.

11

Clomid after hcg right ?
Hcg alone or better with AI. ?
Was on Reandron1000. T was 400 I think. What sort of hcg dosing to get the testes working again. I havent got AIs yet so i dont want to dose to high on hcg to need AIs.
Im thinking start 150iu every day for week . THEN 250iu EOD for a week. Then 250iu every day. I have 6200iu of hcg total. Its good quality pure stuff. Pharmacy grade. I paid enough for it. Can always buy more.
How long to get bloods after hcg.

12

You don’t need an AI with the HCG. Do clomid and HCG at same time. Read below from protocol. KSman recommends Nolvadex over Clomid if you can get it.

https://forums.t-nation.com/t/hpta-restart-for-trt-w-application-to-gear-pct/211723?u=ksman

13

Thanks. Ive read that thread many times. I think it says hcg first and then nolvadex with ai

14

Follow the sticky, if you have been on Long enough to have had your testes shrunken a little, use hCG for 4-6 weeks to get them back into the game. Then do nolvadex per the sticky to get your body to produce LH/FSH.

15

Thanks. I read that testical size is not a great indicator of atrophy. You can have normal size but still have unseen atrophy where leydig cells are deactivated…or something

16

Wondering why it takes so long to restart cold turkey. If you stop trt your testosterone will soon be very low. Your estrogen will soon be used up and not replaced. Low estrogen would signal the hypothalamus and pituitary to try to make LH

And why do you need hcg for LH when you can just take nolvadex and clomid to get LH.

17

Absolutely wrong.

Tea_time: Your attitude is your worst enemy. You are incapable of absorbing anything in a manner that serves your self-interest, which is not the same as you perceive.

18

Ksman sorry if im wrong.
I dont mean to offend anyone or act stupid here. I only try to learn and share information and theories. I do my best to only write if i know what i am saying and have researched first. I ask questions and try to fish for information that i think cant find elsewhere.

19

I am on hcg 200iu everyday. Will be starting nolvadex soon but i havent found a source for it yet. Still looking the right doctor. I have print outs of information and a letter to the doctor of my history and intention.
I think doctors dont like being shown printed information from the Internet. They like to think they know it already.

20

Just take the info you get from this forum and disregard the crap you find elsewhere.

You need to understand the points made here and the background so you know more than the doctors so you can advocate for your self and not get run over by idiot doctors.

In the stickies I state that one should not stack hCG+SERMs and explain why. Do the reading.

Read/study the stickies. Do not expect to gain understanding by fishing little bits here and there.