T Nation

TRT or Not, Advice?

Hi guys, first post here! Background. I’m 39, had TT test of 388 10 years ago. Found to have a vericocele then and had it fixed. Never had post surgery bloods done. Ran a few cycles over the past 10 years. Late 2016 did a test deca cycle (500 each) and did power pct from dr scaly. 10 weeks after the cycle my TT was 40! My endo put me on trt and been doing great.

However, I have thoughts of coming off…This is going to sound stupid but I struggle with coming off trt mainly for the thought of getting my natural test back even though I was never above 388 natural in my life…
I think I like the idea of my hpta working, not shutting down an organ (my testes etc) and I often think it’s more natural/safer than being on synthetic test…that is, why does my natural test not raise my hematocrit but synthetic does?

Anyway, I hate coming off, so my question is, doing hcg while on trt serves the same function right? My testes still work in a sense while I have extra test in me, best of both worlds I guess. Am I missing something? Should I come off or is that stupid? Not sure why I struggle with this…

Thanks and sorry if a dumb first post! I read a lot before posting and people like roush know their stuff!

I struggle with this to. Am 41. After starting trt recently I noticed facial hair growth. Veins showing in my arms. I was probably low normal for a while. I guess when I was younger body compensated well. But once I started have ED issues that’s a different ball game.
Then I think let me live with a t of 400 and use Viagra. But Viagra is medicine too. It’s so fing confusing

So you want to live a mediocre life with your T levels below 400, who cares if your HPTA is working if you have symptoms of low T. You want to preserve suboptimal T levels why? Just add HCG to your TRT protocol to keep them alive and maintain fertility.

How do you feel on TRT, it must not be that good if you want to come off. Everyone has ED is the beginning do to TRT seizing control of your HPTA system, months from now your erections will greatly improve. My erections are still improving 8 months later.

Thanks! Best advice yet! Will continue trt

HPTA restart hinges on if primary or secondary hypogonadism.

Your PCT was probably rubbish as most methods are wrong. Scaly PCT is definitely brain dead.

We had a young guy here who did a deca only cycle and that killed his HPTA and could not restart. Deca is dangerous alone for some guys. Oral hair loss drugs can do the same.

Is your TRT protocol good? Probably not or not been managed properly.

Please post protocol details in mg’s and iu’s and your current labs with ranges.

Please read the stickies found here: About the T Replacement Category

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Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

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I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

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Thanks for the response!

My trt protocol is 26 mg subQ every 3 days with 120 iu hcg every 3 days. No AI…
i feel good on it and let me try to post my labs:

What is your free test like? Your TT is pretty low, not very much higher than when you were natty.

But your HCT is high, and so are the other blood values, would like to know what your free test is.

How do you feel? When was this test taken (trough)?

When I first started TRT, I had some major anxiety issues, I had to start slow and work my way up…

The first few months when i was injecting very low amounts of test, my TT was only in the 500, only like 100 points higher than when i was natty. I felt nothing really.

But your blood levels are indicating your free test is probably high, or you are more inclined to produce H/H issues.

Had SHBG tested? this will also determine how often you should be injecting.

My endo doesn’t check free test or SHBG

My natty levels weee never above 388 so at 450-550 I feel pretty good!

My hematocrit was 57 after a 500 deca run for 13 weeks. I’m getting weekly phlebotomy now.

Labs were taken day after shot…

Again, thanks for helping!!!

What did the Dr say about 125 e3d of HCG? Am interested because I read many times that even those low doses work to keep testes alive.

My endo says no to hcg but I want my balls alive, lol.

I adjusted dose so I don’t need a AI

I first started at 250 every 3 days and my E2 went to 49. I dropped to 120 and my E2 is 29 so I don’t need an AI which crashes my lipids.

I get hcg from a hrt clinic, but the doc there will essentially put u on anything u want

I wonder if am injecting 1x a week will keep testes alive since towards the end of the week t and e2 should be low and trigger lh?? Not sure.

Your LH/FSH are probably very low now. You could test to see if you wanted.

In any case, if your testes are not getting smaller or pulling up tight, you are doing reasonably well. At age=39, we can assume that fertility is not a concern? Injecting once a week may increase E2 and affect QOL. hCG is the solution.

Why an endo? - almost all of them fail.

Fertility is not an issue at this point.
My balls are slightly smaller but I’m trying not to have to need an AI because it crashes my lipids.
My LH is zero… I was off everything for 12 weeks last year and my LH was 0 and TT was 40.

Still tired a little but more stress as I get older, job, family etc.

My wife said I can only get on trt if an endo supports the decision

“anastrozole had no clinically significant effect on the serum lipids”

But that is another study of a group that hardly relates to a TRT context.

Some body builders going for very low E2 to get to very low fat levels can mess up lipids, but I think the problem is caused by low E2 and not a direct effect of the AI.

Are you saying that you have crashed lipids with an AI in the past or that you are wanting to avoid something that you think might happen that you read about somewhere. We do not have guys here having such issues.

Between an incompetent endo and your wife you have zero degrees of freedom.

[With your LH=zero, a SERM might not be able to do anything as your pituitary might not be responsive.]

I couldn’t agree more, if neither is informed then you OP ends up the one suffering. It’s just me but if I had to choose the wife or TRT then I’ll file for divorce immediately! My health is forever, wives statistically are not!

Well when I was on arimidex my hdl dropped my 10…
And thanks guys that’s why I’m here!

Should I go up and to higher dose test and hcg?
Like 30 -50 mg test every 3 days, .25 arimidex every 3 days and 500 hcg Q3 days and check labs in a month?

Bump for Ksman or systemlord

Thanks guys!!!

You respond very well to T, for me to reach your level I need more T. I wouldn’t make big adjustments to your protocol because you could sail right past your sweet spot where you feel best. You need to be mindful of your hematocrit, how steadily has it been coming down since starting the phlebotomy? As long as it’s consistently coming down I would recommend 30-35mg twice weekly. Where is your E2 on your current protocol?

HCT is under 50 now… E2 is 29…

I use 120 units hcg every 3 days. I keep it low so I don’t need an AI.
Is it too low? How do I know if it’s enough? My balls don’t feel much smaller but that’s not very scientific.
Any other ways of knowing? Checking DHEA and pregnenolone levels?