Is TRT really "for life?"

[DGA3]

Everybody says that once you go on TRT, it's a lifetime decision, but how is it any different than doing a cycle of AS or PH?

Is it possible to cycle TRT and during the "off" time do some sort of PCT?

Just wondering, because if a guy can get his own test production back after an anabolic cycle (via proper PCT), then why can't a guy do the same thing after, say, 6 months of TRT?

Looking forward to your responses! :nervous:

 

[RegisterJr]

The longer you put testosterone into your body, the more your body loses the ability to bounce back and produce its own at the rate it should.

It may be possible to bounce back after a 6 month cycle of test, but doubtful that your natural test production would be where it would've been had you not substituted juice.

TRT is replacement therapy. That, is for life, and is what you need when you eff up your PCT or cycle too long.

 

[GoHardOrGoHme]

Individual dependent. But TRT implies long term androgen use(specifically test cyp). The longer you are on the harder it is to re-establish normal homeostatic balance. So somone on a cycle....may do an 4-16wk cycle. Someone on TRT may be on for YEARS. Big difference.

Ive seen individuals go from abusing steroids for years and years then with a quick PCT have levels of 600+ at 50+ years of age. Then Ive seen people in there 20's that can't get above 200 after 1 cycle. Ive even met individuals who have natural levels in the 100's and they'be never done a cycle, so coming off TRT would leave them back at there normal low levels. There is no rule that applies to everyone, just general phsyiological principles that are worked with. This is why TRT and any hormonal supplementation should ideally be done under the supervision of a healthcare professional.

For the most part the longer you are on the more difficult it is to reactivate the HPT axis. However it isnt impossible, but you will need to do it under the supervision of a savvy endocrinologist probably. There have been quite a number of studies with hypogonadal men (both primary and secondary) that shows reactivation is not impossible.

 

[jimbuick]

Because, usually, when people go on TRT it is because they have low T and negative side effects from having low T.

So, coming off isn't an option. Most people get TRT so that they can feel normal again, and coming off isn't an option because when they do they feel like crap.

 

[kisaj]

Because, usually, when people go on TRT it is because they have low T and negative side effects from having low T.

So, coming off isn't an option. Most people get TRT so that they can feel normal again, and coming off isn't an option because when they do they feel like crap.

Exactly this. People forget that it is testosterone REPLACEMENT therapy and not a temporary boost or cycle. It is taken because it is needed to achieve normal levels.

 

[GoHardOrGoHme]

Exactly this. People forget that it is testosterone REPLACEMENT therapy and not a temporary boost or cycle. It is taken because it is needed to achieve normal levels.

Ideally this is the case. TRT was designed as a therapuetic aid when test levels fall below normal. However, I do not think it is a stretch to say SOME men are put on TRT before this. This is my opinion based on people I have met and have had the privilege to see their lab values prior to TRT.

Example....45yr old male walks in with chief complaint of lethargy, fatigue, weight gain, and loss of libido. Blood work is done revealing a test level of 450ng/dL. Reference range is 270-1070ng/dL. Be definition he does not have levels that would warrant TRT. He is within the normal range, just on the lower side. However I know of individuals personally that have been placed on TRT with levels between 400-500. To be on the low side of normal doesnt mean you need treatment. Normal is a spectrum that indicates what is clinically not significant and therefore to be on the less desirable end of that spectrum doesnt mean you need to be treated. Normal is normal. And aging is normal.

Unless the individual shows up with clinically low levels below the reference range(which does happen at various ages) then TRT is truly not "needed". But would increasing test to the upper limit feel great? Yes it will. And therefore it is sought out.

lethargy, weight gain, loss of libido, and fatigue can be explained beyond low test. The differential diagnosis for these symptoms is quite long.

 

[Spaniard]

Individual dependent. But TRT implies long term androgen use(specifically test cyp). The longer you are on the harder it is to re-establish normal homeostatic balance. So somone on a cycle....may do an 4-16wk cycle. Someone on TRT may be on for YEARS. Big difference.

Ive seen individuals go from abusing steroids for years and years then with a quick PCT have levels of 600+ at 50+ years of age. Then Ive seen people in there 20's that can't get above 200 after 1 cycle. Ive even met individuals who have natural levels in the 100's and they'be never done a cycle, so coming off TRT would leave them back at there normal low levels. There is no rule that applies to everyone, just general phsyiological principles that are worked with. This is why TRT and any hormonal supplementation should ideally be done under the supervision of a healthcare professional.

For the most part the longer you are on the more difficult it is to reactivate the HPT axis. However it isnt impossible, but you will need to do it under the supervision of a savvy endocrinologist probably. There have been quite a number of studies with hypogonadal men (both primary and secondary) that shows reactivation is not impossible.

Like he said, very individual dependent. There is the continued mantra that you cannot rebound, ever. Unfortunately, this is really more or less forum knowledge rather than clinically based evidence.

TRT, like the others have said is supposed to be the absolute last option at correcting existing hormone imbalances. Although many have used it for a temporary solution as well and have rebounded.

Here's a little example for you. Everyone at my station, well, everyone used to be on TRT. 3 of them wanted kids, so they ceased TRT for 2-3 months and used hCG provided by the clinic, rebounded and knocked their wives/girlfriends up. A lot of the dudes when I first started here about 4 years ago were on TRT at 22, 24 and 28. After I bugged the **** out of them to get off they finally listened and after 2, 3, and 4 years of being on TRT they rebounded to previous levels following a clinical PCT with Clomid and hCG. This clinic also utilizes hCG every few months to keep the testes active.

My dad was also on TRT for a year and a half, came off without a PCT and rebounded to higher than pre-TRT levels.

Why am I saying all this? To encourage getting on TRT and getting off? Absolutely not. The point is, a lot of the stories you hear about people never rebounding or getting at least close to pre levels is largely influenced by forum mentality. Most men will rebound. The thing to keep in mind, is how bad will it suck when you're not most men and your dick is broken? Is it worth it? In my opinion, no. Any clinic that isn't a glorified steroid shop is going to keep you around 800 tops, which in the big scheme of things, even if you're at 400 ng/dl isn't going to be worth the lengthy recovery.

The guys here when they ceased TRT had a hard time getting in the gym, one of them slept a lot from lack of energy etc. The thing is, you'll likely rebound but if you go through hell to rebound even with pharmaceuticals to help you what's the point?

The main difference with a short cycle vs TRT is the length of time it will take your body to return to its once pre-TRT state and the increased risk of not getting back to where you once were. You will likely rebound, after a lengthy amount of time of course. During that time there's a good chance you'll lose your gains anyways, so while the advice may be somewhat misguided on saying you'll never rebound, it's with good intent to let you know a very real possibility, albeit a relatively small one.

 

[Spaniard]

Ideally this is the case. TRT was designed as a therapuetic aid when test levels fall below normal. However, I do not think it is a stretch to say SOME men are put on TRT before this. This is my opinion based on people I have met and have had the privilege to see their lab values prior to TRT.

Example....45yr old male walks in with chief complaint of lethargy, fatigue, weight gain, and loss of libido. Blood work is done revealing a test level of 450ng/dL. Reference range is 270-1070ng/dL. Be definition he does not have levels that would warrant TRT. He is within the normal range, just on the lower side. However I know of individuals personally that have been placed on TRT with levels between 400-500. To be on the low side of normal doesnt mean you need treatment. Normal is a spectrum that indicates what is clinically not significant and therefore to be on the less desirable end of that spectrum doesnt mean you need to be treated. Normal is normal. And aging is normal.

Unless the individual shows up with clinically low levels below the reference range(which does happen at various ages) then TRT is truly not "needed". But would increasing test to the upper limit feel great? Yes it will. And therefore it is sought out.

lethargy, weight gain, loss of libido, and fatigue can be explained beyond low test. The differential diagnosis for these symptoms is quite long.

Another great point, levels realistically mean very little in a clinical setting. Unless your symptomatic, a large percentage of the time TRT will not be offered. Going back to individuality, 400 to someone else may be like 900 for me.

 

[kisaj]

Yes and no. Any of us that have been on TRT know that the clinics were set up to make money and that most doctors really do not understand hormone therapy, so we are required to do out homework and research. So your point is so very true regarding many men being on TRT that really do not need it and proper testing and troubleshooting had never been done. They are also filled with many unnecessary additions right off the bat.

Low levels of "normal" levels of test no longer need to be tolerated and a 45 yo man does not need to be happy with low levels in a range that covers 21-80 years. Yes, there are many things that can be in play with lethargy, weight gain, libido, etc..This is part of the initial work that should be done with labs and ruling out things that can be in play. Many times it is as simple as lifestyle improvement, other times it can be something else.

 

[Spaniard]

Yes and no. Any of us that have been on TRT know that the clinics were set up to make money and that most doctors really do not understand hormone therapy, so we are required to do out homework and research. So your point is so very true regarding many men being on TRT that really do not need it and proper testing and troubleshooting had never been done. They are also filled with many unnecessary additions right off the bat.

Low levels of "normal" levels of test no longer need to be tolerated and a 45 yo man does not need to be happy with low levels in a range that covers 21-80 years. Yes, there are many things that can be in play with lethargy, weight gain, libido, etc..This is part of the initial work that should be done with labs and ruling out things that can be in play. Many times it is as simple as lifestyle improvement, other times it can be something else.

You missed my point. Low blood levels of testosterone to you may be completely normal to someone else. Meaning they wouldn't have to tolerate symptoms of low levels because they are asymptomatic. You may present with symptoms at 400 whereas Joe blow is completely unaffected by levels of 400 entirely due to individual variation. There would be no clinical indication to put someone on TRT unless they present with symptoms despite blood levels being low.

Unless of course, these men go to steroid shops that we are in agreement with

 

[GoHardOrGoHme]

Low levels of "normal" levels of test no longer need to be tolerated and a 45 yo man does not need to be happy with low levels in a range that covers 21-80 years. Yes, there are many things that can be in play with lethargy, weight gain, libido, etc..This is part of the initial work that should be done with labs and ruling out things that can be in play. Many times it is as simple as lifestyle improvement, other times it can be something else.

This is for the sake of conversation rather than argumentation, so please do not read this as hostility. Read it for the sake of having a productive back and forth.

Just wanted to highlight that to say low levels that one "no longer need to be tolerated" implies that it is symptomatic. If symptoms are a result of low test then TRT is useful and recommended...however many times low test within the normal range is asymptomatic. This is why bloodwork pre and post cycle is recommended. An individual doesnt know if re-establish the HPT axis on symptoms many times. General populace tends to think...wait my libido is down, must be testosterone is low, its far from that simple. Or...Im not making gains like I used to, I think I have low T....again not so simple.

Also remember, to say most doctors dont know about TRT is a negative statement that demonstrates a lack of understanding. Most doctors dont know how to conduct a triple bypass, it doesnt mean they aren't good physicians. Hormone related issues are for hormone specific doctors....just like cancer specific issues needs an oncologist. Don't faulty a family physician for not knowing something out of their scope of practice.

Also, someone isnt required to do their own homework on clinically significant hypogonadism...you get you primary care, they do the appropriate bloodwork, then they get refferred to an endo and the problem is taken care of. Or sometimes the primary care phsyician feel comfortable enough to take care of that on the spot with the appropriate scope of biochemical physiology to know when the treatment is beneficial or is indeed becoming harmful. The problem comes when people want to get on test for none clinical reasons.

But im sorry I cannot agree with the mindset that your average person can gain enough understanding via personal research to condone manipulation of homeostatic mechanisms that take years for professionals to get a grasp on.

 

[kisaj]

You missed my point. Low blood levels of testosterone to you may be completely normal to someone else. Meaning they wouldn't have to tolerate symptoms of low levels because they are asymptomatic. You may present with symptoms at 400 whereas Joe blow is completely unaffected by levels of 400 entirely due to individual variation. There would be no clinical indication to put someone on TRT unless they present with symptoms despite blood levels being low.

Unless of course, these men go to steroid shops that we are in agreement with

I was trying to reply to GoHardOrGoHme and your response came in before mine.

I agree with you and do not believe people should go on hormone replacement based on numbers alone. My comment is regarding men who have symptoms and low numbers who are told they are in "normal" range and are fine. Or on the other hand, told to go on test without proper evaluation to see if it is really needed as it can sometimes be as simple as a lifestyle adjustment.

 

[kisaj]

This is for the sake of conversation rather than argumentation, so please do not read this as hostility. Read it for the sake of having a productive back and forth.

Just wanted to highlight that to say low levels that one "no longer need to be tolerated" implies that it is symptomatic. If symptoms are a result of low test then TRT is useful and recommended...however many times low test within the normal range is asymptomatic. This is why bloodwork pre and post cycle is recommended. An individual doesnt know if re-establish the HPT axis on symptoms many times. General populace tends to think...wait my libido is down, must be testosterone is low, its far from that simple. Or...Im not making gains like I used to, I think I have low T....again not so simple.

Also remember, to say most doctors dont know about TRT is a negative statement that demonstrates a lack of understanding. Most doctors dont know how to conduct a triple bypass, it doesnt mean they aren't good physicians. Hormone related issues are for hormone specific doctors....just like cancer specific issues needs an oncologist. Don't faulty a family physician for not knowing something out of their scope of practice.

Also, someone isnt required to do their own homework on clinically significant hypogonadism...you get you primary care, they do the appropriate bloodwork, then they get refferred to an endo and the problem is taken care of. Or sometimes the primary care phsyician feel comfortable enough to take care of that on the spot with the appropriate scope of biochemical physiology to know when the treatment is beneficial or is indeed becoming harmful. The problem comes when people want to get on test for none clinical reasons.

But im sorry I cannot agree with the mindset that your average person can gain enough understanding via personal research to condone manipulation of homeostatic mechanisms that take years for professionals to get a grasp on.

I agree on your first point and clarified in the post to Spaniard.

To say most doctors do not know about hormone replacement is a true one and is in no way negative. It is just a fact that people seeking help or on the initial stages to see if anything is wrong find that primary care is lacking in knowledge. That is why referrals to specialists should be requested.

As for the last points, well, that just simply isn't true. You need to be diligent and do plenty of your own research and study into your own health to understand better. It is irresponsible to not be aware. The information is there and available and you need to ask questions and also know when to question someone when it comes to your health. If you were actually in a position to be dealing with the doctors and specialists that TRT patients do many times, you would likely have a different opinion.

 

[GoHardOrGoHme]

I must have imposed a negative connotation to your comment about doctors. That would be my error.

However there is a difference in being required to do research because certain doctors dont know, and being an active member in your healthcare. And reaching a diagnosis and treatment of true hypogonadism is not the responsibility of the lay person, thats the doctors responsibility. Just like it isnt the lay person isnt required to research proper diagnosis and treatment regiments tuberculosis. Therefore by definition the doctor is required to do research to aid the patient. Asking questions about a health condition good common sense, but it is the doctor's is actual responsibility to educate you whether you ask or not.

Information is there....its finding the good information that is the problem. And many times its found in expensive textbooks and costly subscriptions to research journals. And frankly that is actually quite difficult to pin down at times because medicine is ever evolving and changing and what was once dogma 10 years ago is now thrown out. Even some textbooks disagree on certain things...so how can a common person who has very little backgroung in these sciences be able to determine what is good information and what is outdated hogwash?

For example...Ive seen tons of conversation on GH supplementation on dozens of forums however I have yet to see a good conversation about the G-coupled receptor cascade that regulates the release of GHRH or the JAK/STAT2 receptor or how several other peptide signalling that truly regulate the pulsing of GH. Furthermore the effects of disrupting the balance of somatostatin, prolactin, IGF-1 and all their respective signaliing cascades when supplementing peptides or GH itself. This is something I garned in a classroom lectures supplemented with textbooks and countless hours of directed study with professors clarifying misconceptions I have along the way, giving me a much better understanding and respect that this is an axis that cannot be fooled with haphazardly like people do. Before this...I had done many hours of personal research and didnt even have 1/100 of the whole picture of what really goes on. The whole "you need to find the right dose for you" is an atrocious understatement of the plethora of reactions going on in the body. So i stand by what I said that the average Joe using gear does not have the appropriate understanding of homeostatic mechanisms even though they did research beforehand. Ive been on both sides of the spectrum...the lay person who does many hours of personal research...and not the individual gaining an education in the same area. Its night and day.

And it is not irresponsible to be unaware of things in all cases. Just like its not irresposible for me to not learn how to fly a plain... or understand the higher level phsyics concepts that govern the natural laws in the universe we live in. For the normal person not being aware of the millions of clinical conditions out there isnt irresponsible. And in the spectrum of health concerns, low test(in fully adult, well developed middle aged men) is on the light side. There are clinical emergencies that if not identified can lead to serious consequences very quickly. Low test is not one of them. There is a huge difference in taking steroids for personal gain and taking them for medical treatment. You cant blur the line and I may be getting the feeling you are blurring the line a bit in this conversation.

 

[Spaniard]

I was trying to reply to GoHardOrGoHme and your response came in before mine.

I agree with you and do not believe people should go on hormone replacement based on numbers alone. My comment is regarding men who have symptoms and low numbers who are told they are in "normal" range and are fine. Or on the other hand, told to go on test without proper evaluation to see if it is really needed as it can sometimes be as simple as a lifestyle adjustment.

My bad kisses

 

[Spaniard]

I must have imposed a negative connotation to your comment about doctors. That would be my error.

However there is a difference in being required to do research because certain doctors dont know, and being an active member in your healthcare. And reaching a diagnosis and treatment of true hypogonadism is not the responsibility of the lay person, thats the doctors responsibility. Just like it isnt the lay person isnt required to research proper diagnosis and treatment regiments tuberculosis. Therefore by definition the doctor is required to do research to aid the patient. Asking questions about a health condition good common sense, but it is the doctor's is actual responsibility to educate you whether you ask or not.

Information is there....its finding the good information that is the problem. And many times its found in expensive textbooks and costly subscriptions to research journals. And frankly that is actually quite difficult to pin down at times because medicine is ever evolving and changing and what was once dogma 10 years ago is now thrown out. Even some textbooks disagree on certain things...so how can a common person who has very little backgroung in these sciences be able to determine what is good information and what is outdated hogwash?

For example...Ive seen tons of conversation on GH supplementation on dozens of forums however I have yet to see a good conversation about the G-coupled receptor cascade that regulates the release of GHRH or the JAK/STAT2 receptor or how several other peptide signalling that truly regulate the pulsing of GH. Furthermore the effects of disrupting the balance of somatostatin, prolactin, IGF-1 and all their respective signaliing cascades when supplementing peptides or GH itself. This is something I garned in a classroom lectures supplemented with textbooks and countless hours of directed study with professors clarifying misconceptions I have along the way, giving me a much better understanding and respect that this is an axis that cannot be fooled with haphazardly like people do. Before this...I had done many hours of personal research and didnt even have 1/100 of the whole picture of what really goes on. The whole "you need to find the right dose for you" is an atrocious understatement of the plethora of reactions going on in the body. So i stand by what I said that the average Joe using gear does not have the appropriate understanding of homeostatic mechanisms even though they did research beforehand. Ive been on both sides of the spectrum...the lay person who does many hours of personal research...and not the individual gaining an education in the same area. Its night and day.

And it is not irresponsible to be unaware of things in all cases. Just like its not irresposible for me to not learn how to fly a plain... or understand the higher level phsyics concepts that govern the natural laws in the universe we live in. For the normal person not being aware of the millions of clinical conditions out there isnt irresponsible. And in the spectrum of health concerns, low test(in fully adult, well developed middle aged men) is on the light side. There are clinical emergencies that if not identified can lead to serious consequences very quickly. Low test is not one of them. There is a huge difference in taking steroids for personal gain and taking them for medical treatment. You cant blur the line and I may be getting the feeling you are blurring the line a bit in this conversation.

In the spirit of continuing the conversation, I'll say a few things to both your and Kisaj's points.

In Kisaj's defense, unfortunately, he has some solid points (not unfortunate for him but for medicine). A lot of the docs, most PCP's and even some endocrinologist's, do use some pretty outdated methods. I almost said a lot lol but instead I'll say some endocrinologist's still won't put a pretty viable candidate on TRT simply for the negative stigma that testosterone comes with.

The same can be said about any field of medicine though, there are good docs and then there are bad docs but this is life. There are good and bad people in every profession.

Then to your point there are certainly good doctors that simply won't put a patient on testosterone due to possible negative preexisting health concerns as you are aware. It all comes down to being an informed patient and finding a good doctor like you will be. For example, if you were Kisaj's doctor you guys would together be able to figure out a perfect or damn near perfect solution

 

[kisaj]

I must have imposed a negative connotation to your comment about doctors. That would be my error.

However there is a difference in being required to do research because certain doctors dont know, and being an active member in your healthcare. And reaching a diagnosis and treatment of true hypogonadism is not the responsibility of the lay person, thats the doctors responsibility. Just like it isnt the lay person isnt required to research proper diagnosis and treatment regiments tuberculosis. Therefore by definition the doctor is required to do research to aid the patient. Asking questions about a health condition good common sense, but it is the doctor's is actual responsibility to educate you whether you ask or not.

Information is there....its finding the good information that is the problem. And many times its found in expensive textbooks and costly subscriptions to research journals. And frankly that is actually quite difficult to pin down at times because medicine is ever evolving and changing and what was once dogma 10 years ago is now thrown out. Even some textbooks disagree on certain things...so how can a common person who has very little backgroung in these sciences be able to determine what is good information and what is outdated hogwash?

For example...Ive seen tons of conversation on GH supplementation on dozens of forums however I have yet to see a good conversation about the G-coupled receptor cascade that regulates the release of GHRH or the JAK/STAT2 receptor or how several other peptide signalling that truly regulate the pulsing of GH. Furthermore the effects of disrupting the balance of somatostatin, prolactin, IGF-1 and all their respective signaliing cascades when supplementing peptides or GH itself. This is something I garned in a classroom lectures supplemented with textbooks and countless hours of directed study with professors clarifying misconceptions I have along the way, giving me a much better understanding and respect that this is an axis that cannot be fooled with haphazardly like people do. Before this...I had done many hours of personal research and didnt even have 1/100 of the whole picture of what really goes on. The whole "you need to find the right dose for you" is an atrocious understatement of the plethora of reactions going on in the body. So i stand by what I said that the average Joe using gear does not have the appropriate understanding of homeostatic mechanisms even though they did research beforehand. Ive been on both sides of the spectrum...the lay person who does many hours of personal research...and not the individual gaining an education in the same area. Its night and day.

And it is not irresponsible to be unaware of things in all cases. Just like its not irresposible for me to not learn how to fly a plain... or understand the higher level phsyics concepts that govern the natural laws in the universe we live in. For the normal person not being aware of the millions of clinical conditions out there isnt irresponsible. And in the spectrum of health concerns, low test(in fully adult, well developed middle aged men) is on the light side. There are clinical emergencies that if not identified can lead to serious consequences very quickly. Low test is not one of them. There is a huge difference in taking steroids for personal gain and taking them for medical treatment. You cant blur the line and I may be getting the feeling you are blurring the line a bit in this conversation.

I appreciate you taking the time to type all that, but you really aren't disagreeing with me. I never have said that a patient is responsible for diagnosing themselves. It is a process of elimination, as I say continually in the these threads when a poster says their test levels are low and their doctor wants to put them on 200mg of test a week. Read the forums and talk to people and you'll see how annoyingly common this is not just here, but in general. My own doctor knows that him and his peers are not up on the latest. Is that their fault, no. It isn't their specialty. But, even endos do not agree on proper approach, as I went to 2 before finding a really good one.

Going back to my original comments- there is no reason for a patient to blindly accept what a doctor tells them based on what we know today. It is their responsibility to be involved and understand what is going on.

Regarding your parting comment about me blurring the line between taking steroids and medical treatment- well, I am not even sure where that came from. Not once have I mentioned anything close to taking steroids and have only pressed on the point of patient responsibility. Nor do I understand the point of the last paragraph at all as this is a conversation about hormone treatment and not comparing this to life threatening medical treatment.

My points are made, but I do feel this conversation is now just digressing into looking for a way to disagree. If there is anything else you'd like to discuss regarding the topic at hand, I am all for it.

 

[GoHardOrGoHme]

Two preliminary points:

1) If I misinterpreted your post about blurring the line, then it is my imposing previous mindsets of other individuals to something you said and I have to take fault for that. My apologies if this was done in error.

2) I will re-state this is for the sake of conversation. For the most part we to agree however if you feel the conversation is digressing then it isnt worth continuing. I dont mean to argue nor do I mean to disagree blindly. It's simply to talk about an issue that is prevalent in healthcare. If it is of consolation the AOA Health watch recently put out an issue regarding TRT and guidelines for family phsyicians for diagnosis and treatment. So the climate is changing.


A clarification point on accusation you are making towards me:
- I never stated a patient should blindly agree. My contention came when a patient feels the need to diagnose themselves without proper training. There is a huge difference. I believe the patient should be ACTIVE in their healthcare. Meaning they have the ability to disagree, seek other opinions, do personal research, and have an educated conversation about their health. So likewise, do not misinterpret my intentions in this conversation.

Please realize I am making a clear delineation between individuals who want TRT for performance vs those who want TRT as a treatment for true primary or secondary hypogonadism. This is the stance I am elaborating on and it appears you agree. Where there is adisagreement is that you are implying that I want patients to be mindless zombies in their healthcare. I simply do not believe that and I am never meant to give off that vibe.

Your comment that stated"if you were actually in a position to be dealing with the doctors and specialists that TRT patients do many times, you would likely have a different opinion."

Implies...or actually directly states ignorance on my part. It is an accusation not based in fact but rather how you interpret my posts. However even though I am unfamiliar with your education or your personal experience, it appears you are ignorant of mine. I have dealt with doctors and specialists and patients regarding TRT. I am less ignorant then you think. Furthermore my education allows me a behind the scenes view of why doctors may not know as much about TRT as you may desire. TRT is a therapy for an improved quality of life, not because having low T is truly detrimental to your health LIKE diabetes, tuberculosis, atrial fibrillation, perforation of the GI, and the list goes on. Many men have low levels and are completely asymptomatic and live a happy, healthy, normal life.


I am not saying prolonged low T doesnt increase the possibility of certain ailments...but TRT also increases the probability of other ailments. So its a give and take scenario that doctors are cautious to start a patient on.

So in the spirit of keeping this conversation on amiable terms, cheers! Lets not argue over trivial misinterpretations.

 

[kisaj]

Cheers to you as well, I do not feel this was ever an argument. I'd love to see you post more in these sections as you sound like you could provide some valuable information if you have access to professionals as you mention.

As for me, my background is a former competing athlete that has trained and trained with many coaches over the years. This has exposed me to the medical side of the industry many years ago and made me somewhat of an anomaly in that I have preemptively working with a doctor since I was 25. It has also allowed me to become friends with many people in the medical community, specifically related to hormone therapy. My mindset has always been to be ahead of a problem rather than reacting to one. I've worked with several endos and take a very proactive approach to my TRT.

 

[DGA3]

Great discussion, everyone!

GoHardOrGoHome made a good point when he said: "Please realize I am making a clear delineation between individuals who want TRT for performance vs those who want TRT as a treatment for true primary or secondary hypogonadism."

I would fall in the category of wanting TRT for performance, as I have no health issues at all (physical or mental). However, I am a lifelong lifter (even entered some bodybuilding competitions in the '90s) who, at 57 years old, is looking for some "extra help" besides protein shakes and creatine.

I have dabbled with some very mild PH's before (Forerunner Labs' Alpha Mass, for example) with success (no sides or shutdown), but was thinking that maybe TRT would be a better (safer?)way to go. I have a 54-year-old brother who is seriously into powerlifting, and he met a doc at a powerlifting seminar who he now goes to, and this doc has him on TRT (topical creme from a compounding facility), so I thought maybe I'd give it a try.

However, if it doesn't seem to do anything for me after a few months, I wondered about the shutdown/restart I would have to go through. From what I have read here, it looks like it is different for every individual.

More thoughts?

 

[kisaj]

The thing to keep in mind is that the restart can become more difficult as we age and if you shut yourself down at 57, your chances may be lower of resuming at your current levels. Do you know where you stand now? The reason this is important even in the context of performance is that there is little to be gained in size or strength moving within physiological ranges unless you are at the near bottom. From a performance standpoint, I was still working in the 1100 club at 200 levels and maintained good mass while competing in my sports, so it can certainly be done. Now I maintain in the 700-800s and body comp, recovery and strength did go up considerably, but that would not have been the case if I were to move from lets say a 400 level to a 700 level.

If your levels are healthy, you may benefit more from increasing free (unbound) test.

 

[bigguyn10ec]

Great answers, I will post my experience asap.

 

[GoHardOrGoHme]

Kisaj is right, the older you are the harder it is to restart. However under the right guidance it may be possible...but at this point its pure speculation. Again im sure we can find people in this forum on both ends of the spectrum.

Also take into consideration on average, testosterone lowers about 1% per year after age 30(this is a rule of thumb and there are of course exceptions), so if you were to restart yourself, and in the BEST case scenario establish normal function for your age, they will be lower due to the body slowly shutting down test production as it ages. so at 57, theoretically your best levels are 27% lower then when you were 30. Just food for thought.

 

[trt tom]

Great thread, always learning. I'm 52 and just started lifting hard 6 months ago. Freakish gains on 250mg a week. Full re-comp. My doc and friends are speechless. People are now asking me stupid steriod questions . Bottom line, everyone reacts different. I've got guys in their 20 and 30's , at my gym, on gear, just staring at me in the mirror. They look bloated and stressed. They ask me what type of cycle I'm on, tell them zero, just a 250 T.R.T. and blessed genetics. Sadly, not making too many friends in my gym. Great board, good info with some really educated members. Happy I joined.

 

[trt tom]

Forgot, one more thing. I'm living the 80% 15% 5% rule. Diet has been everything for me. Giving up my social life , ie boozing, Mickey D's late nights etc. To accomplish my goals. It's hard work, expensive and time consuming. This is where I think many fail. Just my .02

 

[kenpoengineer]

Welcome to AM trt Tom! Fellow "geezer lifter" here. Lol. Start a workout log here as a suggestion. It will keep you accountable and help with learning about diet and lifting.

 

[DGA3]

At my yearly physical this summer, I had bloodwork done. My doc only ordered the "basics" like cholesterol, liver, prostate, etc., but I asked him to throw in test level as well.

Here are the results:

Testosterone Total = 2.88 ng/ml

Range is listed as 1.68-7.46

On the low end, right? However, as I said before, I have no physical or emotional issues, and I still seem to be able to build muscle quite easily (a result of 40 years of training?), so TRT would not be for anything other than performance.


Maybe it would be better to just do another mild run of Alpha Mass . . . :very happy:

Now I'm off to make eggs for breakfast - had a great shoulder and arm workout last night, and need my protein now! :sly:

 

[bigguyn10ec]

In Jan of 2013, I had been feeling very run down, emotional and just overall crappy. I lost interest in everything, I was getting a belly no matter what I did at the gym, I was just going backward. Now I had been working out steady for years but all the sudden things was different. I went and got checked, He figured that as my fitness level that should not be the issue but , test came back and I was at total test of 141 !. Yea really low.
He put me on trt. Now up until then the hardest thing I have taken was a creatine , whey and D-aspartic acid. So we knew it was not from a cycle or something.
We have tried several dosing options, but have ended up with 200mg a week of cyp.
Now this sounds great but you have remember even with me getting 200mg a week of the good stuff my test level is still at highest around 400.
I really would love to have it higher, for the gains. But I am just happy to be feeling better, have some interest in things again, and sleep solid now.

Some think that people with TRT have a unfair advantage but all it does is bring us back up to feeling normal again.
I am planning of running a either a blast a cruise cycle or just a simple PH, because on trt the Post cycle will be easy .

 

[kisaj]

In Jan of 2013, I had been feeling very run down, emotional and just overall crappy. I lost interest in everything, I was getting a belly no matter what I did at the gym, I was just going backward. Now I had been working out steady for years but all the sudden things was different. I went and got checked, He figured that as my fitness level that should not be the issue but , test came back and I was at total test of 141 !. Yea really low.
He put me on trt. Now up until then the hardest thing I have taken was a creatine , whey and D-aspartic acid. So we knew it was not from a cycle or something.
We have tried several dosing options, but have ended up with 200mg a week of cyp.
Now this sounds great but you have remember even with me getting 200mg a week of the good stuff my test level is still at highest around 400.
I really would love to have it higher, for the gains. But I am just happy to be feeling better, have some interest in things again, and sleep solid now.

Some think that people with TRT have a unfair advantage but all it does is bring us back up to feeling normal again.
I am planning of running a either a blast a cruise cycle or just a simple PH, because on trt the Post cycle will be easy .

When do you inject and get your blood draw for labs?

 

[bigguyn10ec]

I pin once a week and test about every 3 - 5 months. Unless I am feeling different I will go sooner.

 

[TheIronAsylum]

still reading thread but



are there more side effects /health concerns if you bump up your test to the higher levels then just normal for long term or short term?
iv always wondered what mine are i need to get a blood test? i wish i would have gotten one when i was younger 21-18 and see what the numbers were at the peak compared to now at 26. i definitely feel a difference but wouldnt know for sure

 

[kenpoengineer]

Blood tests are fairly cheap. About $50 gets you CBC, total test and E2. Check out female hormones panel at privatemdlabs dot com.

 

[DGA3]

Are there more side effects /health concerns if you bump up your test to the higher levels than just normal for long term or short term?

My brother (power lifter mentioned earlier in this thread) uses a stronger topical than normal, and is encouraged to by his doc! They run blood tests a few times a year, and I guess everything must be fine, or his doc wouldn't be giving him the ok to use more than normal.

 

[kisaj]

Don't let anyone lead you to believe that when you go over physiological levels that there are not increased chances for sides. Hemo and RBC increases, BP tends to go up, and estrogenic sides increase- especially for someone prone. Are there people that can run this long term without any issue- sure. But that does not mean that the additional sides and health risks do not accompany higher than normal levels either way.

 

[trt tom]

Kisaj is spot on. I've been on a 250 per week , but decided to run it hot at 400 per week. Just got bloods back and everything is just about the same as the 250. Only thing off is the LDL's. Jumped up quite a bit. I'm upping the fish oils, flaxseed, and Apple cider vinegar(raw) to help combat it and more cardio. It only cost me 10 bucks for full blood panels. I'm allowed to get them every 2 months. So if you up it, please do the bloods. My doc is fully on board as long as I get the blood work. She suggested maybe running some Adex just in case. Just filled the script to be safe. Train hard, more important, train smart.

 

[officefat]

really digging this thread. I'm 6 weeks into TRT from a local clinic and absolutely feel fantastic but I still have many doubts about committing to TRT for life. Part of me feels like i should just use the script for pharma grade legal cycles and another part of me feels like life is really good and its worth doing for life. My levels were meh but I had low-t symptoms and the g/f was not happy. Last few weeks have been awesome: +40lbs on bench in 6 wks, g/f ecstatic, good energy, amazing workouts, etc. But man, cant help but feel like the clinic would have put me on T no matter what and maybe a real endo could get me feeling good w/o a lifetime of shots.

TRT is alluring! PH affects the liver. Gear is illegal and WtF is really in UGL gear?

TRT is a big commitment and it feels like these "innovative" men's health clinics are more about money than diagnosing and curing. That is awesome if you just want a script to save up and blast a few times a year for 10x UGL cost, but ****ty if you're on the edge and may need TRT or could have something treated to alleviate low t symptoms.

 

[kisaj]

I guess you just need to ask yourself if you really needed to be on and if its worth it. Clinics don't care about you and will give anybody test.

 

[hulkzilla87]

I'm three weeks into a 10 week perscribed 200 mg a week test cyp with .5 anastrazole mwf an HCG 500 iu days 5 and 6. I'm 28 years old and my test came back at 160 was thinking of only doing 1 shot of 500 iu a week saving some and kind of pct off for a couple weeks as its 300$ per script

 

[kisaj]

What do you mean a 10 week test prescription? Who would ever prescribe such a thing?

 

[JudoJosh]

What do you mean a 10 week test prescription? Who would ever prescribe such a thing?

Some do. I know a few endos who would, like mines for starters.

 

[kisaj]

What is the point of shutting you down and then pulling you off? Adding exogenous test is not going to "kick start" natural production, so why would you do this.

 

[JudoJosh]

It's a band aid for those who come in with super low test. They would put the person on test for a bit while they run other test and monitor how the person responds to the test. If everything comes back good and they respond well then they DC the test and give them hCG and sometimes clomid to try and restart test production and see if they can get normal levels back.

This approach is not unheard of. I know at least 3 endos who do this (because they tried to with me)

 

[kisaj]

I had one endo mention this while I was on my endo search and after discussing this with the others I went to, they seemed to believe this is backwards thinking because rather than introduce a variable while determining if primary or secondary, it would be best to stay at current baseline. The thing is, you even state that it is a bandaid, so why make it more difficult on yourself if it is not necessary? It would seem that it would make much more sense to start with a clomid reboot to attempt natural production rather than add exogenous, discontinue, and then try to restart. It really sounds like a waste of time.

 

[JudoJosh]

I did t say it was a good idea, I just said it isn't unheard of.

In your initial post that I responded to you seemed shocked to hear a doc would prescribe a short term test cycle. I was just saying, the practice isn't unheard of.

 

[sammpedd88]

Some do. I know a few endos who would, like mines for starters.

That's not a good protocol at all. Basically that's a prescribed cycle. TRT is not cycled. If he's trying to restart his natural production of test, then clomid would be a better alternative. So many dr's don't have a clue about treating low T.

 

[hulkzilla87]

1 x 10 ml x 200 mg bottle of test cypionate

 

[hulkzilla87]

As long as I keep paying they will keep sending I don't think they want me to come off they actually want to sell me dhea and gh I was just thinking of trying to pct off and reteste. Doctor says he wants to keep my test around 1000 but again my labs said my testosterone was at 160

 

[hulkzilla87]

And my boners are ridiculous and general well being is amazing just wanted to get some opinions from the pros

 

[kisaj]

The fact that your doctor is chasing a number, in combination of putting you on a 10 week script, and trying to sell you other items right from the beginning without even knowing a test only baseline tells us that he doesn't really know what he is doing. If you are going into this for a little cycle or to simply get testosterone, then it looks like you found a good route. If you are truly believing you need to be on TRT, then this would not be the doctor that has your best interest in mind.

 

[hulkzilla87]

Is TRT really "for life?"

And the only anabolic I have e et taken had been 4 perfect prohormone cycles in the past 3 years and I assumed this is why I have low T I pct to protocol and waited the right time