T Nation

Why is TRT for Life?


#1

I realize there have been very few studies done on men on TRT, and most answers for these questions would be speculation. None the less, I'm wondering...

If hCG is used to prevent testicular atrophy and subsequent replacing of testicle tissue with scar tissue, what permanent changes can occur because of TRT? HCG would switch the shutdown from the testicles to the pituitary, correct? Can permanent changes occur in the pituitary? If so, would there be a benefit to discontinuing TRT for a few weeks every 12-16 weeks, and then taking nolvadex? I would think that restarting pituitary LH output for a month every four months would help keep the pituitary healthy. The purpose of this would so that if TRT needs to be discontinued for whatever reason (for example, fertility reasons), there would be a greater chance of a successful restart.

If hCG is taken with TRT, would there be shutdown anywhere besides the pituitary? From what I understand, hCG allows for almost normal testicular function. Is it possible that the differences between hCG, and endo LH and FSH could cause permanent changes in the testicles.

I believe the permanence of TRT is overstated. There was a birth control study done in China, in which eugondal men were given testosterone only TRT at, if I remember correctly, 200mg per week for 2.5 years. In the study, 95% of the men resumed normal testosterone production after several months.

I don't plan to start TRT until I'm at least 30, and until I've cryo-ed some sperm. But, I'd like to learn about it now.


#2

It's for life if you want the benefits for life. If you needed it at all, once you are on it, you will want the benefits for life! Yes, the majority of men (as your study suggests) will return to "natural" baseline if they come off it, that is old news--but if you needed it in the first place then why stop? My baseline before treatment was crap, and I felt like crap. I'm happier, my marriage is better, I'm better at my job and at school. Why would I ever stop?

I'm not sure about your assumption that HCG causes "pituitary shutdown". This would actually be pretty disastrous, since the pituitary produces a whole assortment of hormones and is at the center of the endocrine system--it doesn't just tell your nuts to make T! "Pituitary shutdown" would probably be life-threatening, or at the very least devastating to overall health. I'm positive we would have heard by now if low-dose HCG was putting men in the hospital!

Leydig cell desensitization is a concern, but very manageable as long as you stick to small doses (250iu EOD for example) and there's no tempting reason I know of to mess with larger doses, anyway. If you have some research that indicates such effects, please share.


#3

Same here my baseline was weak, I will never stop Test even if I have to buy without a scrip!!!!!!!!!!!!! Got a great Endo though and says 6 to 800 is good total test!!! This is the only Doc who has EVER SAID THIS TO ME!!!!
Also the only Doc to put me on Armidex..


#4

I'm not sure what is so confusing about TRT being for life. You don't go on TRT unless your natural production has completely went to shit. If there was any to improve natural production to bring a person back to a fucntional level of testosterone then that would be done instead of TRT.

TRT => fucked natural production => nothing to restart

Now, if you are using TRT as a cover for blasting and crusing steroid cycles then what you are suggesting might be heplful in the longrun.


#5

etherbunny,

my level was 90.66 before trt, although there is problem with my bloodwok it will be corrected.

the testosterone medicine is very effective and the way i felt was is remarkable. for me i will

have to be dilligent in my care and do what necessary to improve the quality of my life. i wouldnt

go back to before TRT why would i ? and i only can go forward with hope...


#6

Agree that returning to normal production levels is not the goal for most of us here. Returning to the production levels our bodies had when we were 16 years old is the goal for most here. Currently there is no way to force the male body to return to those levels on it's own, so we pursue that goal through TRT. Sadly TRT is still pretty cutting edge stuff and it's far from perfect!

I wish every day that a true cure could be made, but there is no incentive for the pharma companies to even look at something like that because they have so many of us buying up the monthly Androgel at $500 a month.


#7

Absolutely brother. My test was 266 and free T was 2.33 in one test and 3.5 in another (I believe due to a testicular torsion I had as a teenager). I do not want my system to restart and get back to that level. An injection once a week to feel great everyday and be happier than i’ve every been? I’ll gladly take it.


#8

I would guess that most guys don’t take TRT to be average for their age; they want to be at least a bit better than average. It is in many cases not quite “replacement” but rather “enhancement.”

Not that there is anything wrong with that.

It doesn’t have to be for life. Most guys will resume their prior natural production even without a medical “restart” even after a couple of years on TRT, especially if HCG was used while on TRT. You are correct that HCG will shut down the pituitary/hypothalamus component of the HPTA, but the bottleneck for recovery from TRT is usually (though not always) testicle atrophy, which can be avoided with HCG.


#9

Guys doing T as “gear” for body building can permanently break their HPTA’s. So the suggestion that guys who are on TRT because their HPTA’s were not working are able to recover is demented. Count on things getting worse, not better.

Taking hCG, T+hCG or T shuts down pituitary production of LH/FSH.


#10

Eugonadal = testes working fine. They had no hypogonadism so we cannot compare this by any means to people who has hypogonadal state.

If you are suffering from hypogonadism, you won’t heal after stopping trt.

TRT and HRT ( Ie. clomid becoming more popular treatment method ) are simply the only currently known treatment methods for mankind.

If hypogonadism is left untreated, one can always pray and hope for the best but telling yourself “well some day it just fixes itself, nps!” but nah, it won’t.

It’s usual for people to underestimate hypogonadal health issues and think it’s ok you just feel crappy but that’s kinda it.

To majority of people, it can take years to realize they could even suffer from hypogonadism, and are taking depression meds instead etc.

Bottom line is, don’t leave it untreated, there are a lot more health problems than being on trt where one really has really little if anything to worry about IF the protocol is sensible, unfortunately it’s often not.

However, example risk of getting prostate cancer through trt is myth and proven wrong unless you had it before.

For people worrying about kids and who suffers from hypogonadism, do sperm count before starting treatment and take appropriate labs.
Learn more about hrt treatments like clomid etc. Expect nothing when trying to conceive a baby. Depending on sperm status, hrt only gives a percentages of hope, not guaranteed success.