Peak Testosterone Forum

General Category => Testosterone, Hormones and General Men's Health => Topic started by: billsman on December 19, 2019, 03:20:18 pm

Title: 20+ years of TRT replacement
Post by: billsman on December 19, 2019, 03:20:18 pm
I've been on TRT replacement for about 21 years.  I thought it might be worthwhile to share my experience and thoughts for anyone who is interested. 

I was diagnosed with hypogonadal disorder in my late 20s.  My total testosterone was below 150 even though I had a normal puberty.  I was also diagnosed with a non-secreting pituitary adenoma.  Of course, I had symptoms for several years and it wasn't until I saw an endo who specialized in male testosterone issues that I was finally diagnosed and treated. 

For many years, I took Androgel and was happy with the results.  Then I got married and wanted to have kids.  I was on hCG for 10 years at crazy high doses (2,400 iu, 3x per week).  Had 4 kids and felt good until the last few years when my E2 got out of hand (curiously, my doc had not measured my E2 over the years and only started when I asked).  I had gyno and corrective surgery.  Tried AI, which worked but was tricky to titrate.  Libido was great on hCG.  Test levels were around 700.

Then decided to switch to testosterone shots.  Had elevated hematocrit and had to go on therapeutic phlebotomy.  I was also irritable.  Libido was good.  Phlebotomy resulted in iron deficiency.  Overall, I didn't like the test shots.  I found it difficult to accurately draw .25 ccs of fluid and the irritability was a serious downside.   

Switched back to Androgel about 3 years ago.  B/c it's a daily dose, less up and down.  BUT libido is low even with Test around 600.  But I'm also older now, late 40s, but still feel libido is low.  Strength is good - I go to the gym 3x week.  I was diagnosed with hypothyroid about 3 years ago as well, but replacement therapy has my levels in normal range.  Also, as a side note, I've been on keto (the real deal keto) for about 2 years.  I've lost a lot of weight and all of my cardio and fasting glucose labs are much improved (LDL particle size went from 2200 ->1200; fasting glucose from 99 ->82). 

Some observations:

1.  When you've been on TRT as long as I have been, it's difficult to know what is "normal."  Is low libido normal for a man in his late 40s?  What even is a low libido for a man in his late 40s? 

2.  It's easy to fall into the trap that something is not right if you're pulling labs all the time.  Variations happen and that's normal.

3.  Even really smart, highly trained docs sometimes don't know b/c there's a dearth of info.  I don't blame the docs but it's important to find a doc that's open to suggestions.  I'm lucky that mine is very open minded. 

4.  I do believe that carbs are serious problem for the US population and while keto might not be for everyone, it's worked wonders for me. 

Hope someone finds this info helpful.   
Title: Re: 20+ years of TRT replacement
Post by: golfboy307 on December 19, 2019, 04:38:01 pm
Great post Billsman!  You have had quite a history with TRT! 

A quick comment from a 52 year old on TRT:  My own personal theory is that as the mind ages, libido seems to decrease naturally not matter how dialed in you are on hormones.  My libido is pretty decent, but I have come to accept the fact that I will never have that 18 year old mind set of thinking about sex every waking hour of the day.  Not sure I really want that back anyway. 

Thanks for sharing.
Title: Re: 20+ years of TRT replacement
Post by: Cataceous on December 19, 2019, 07:02:44 pm
Thanks, billsman, for the long-term perspective. I've been having the same internal debate over what level of libido can reasonably be expected as we get older. In the optimistic column is the fact that protocol-tinkering has been helpful in improving libido, and it's certainly decentómore than adequate relative to my spouse. On the other hand, the raw desire is still nothing like it was even 10 years ago, which may be for the better, but I miss it at times.
Title: Re: 20+ years of TRT replacement
Post by: ghce on December 19, 2019, 11:15:13 pm
My libido was extremely high into my early to mid 50's and only decreased as a result of Hypogonadism so I don't believe that decreasing libido is the result of age in itself but purely is a function of your hormonal levels and balance.
Title: Re: 20+ years of TRT replacement
Post by: seppuku on December 22, 2019, 12:46:30 pm
Libido is a complicated beast, more than just having high testosterone.  My latest blood test taken in November came back just over 6 nmol/l (185ng/dl), with calculated free test at half the lowest number of the given range. And yet my libido is pretty high right now, as in twice a day kinda high. Everything else is messed up though (gym results in gutter, body aches etc), but libido's perfect.
Title: Re: 20+ years of TRT replacement
Post by: sh1209 on December 22, 2019, 01:22:41 pm
Really interesting post. Iíve been on trt a decade and libido has definitely been the biggest hurdle. Iíd say Iíve never had even half of what I had naturally with lower numbers no matter what Iíve tried. TRT changes something related to libido because too many men struggle with it. At ten years in I agree Iíve probably forgot what it even feels like to be normal from all aspects. It is interesting that some guys state even with t levels down in the 200-300ng range they still have high libidos. I certainly wish I could figure it out.
Title: Re: 20+ years of TRT replacement
Post by: Joe Sixpack on December 30, 2019, 04:32:48 am
Interesting story Billsman.  BTW I think you are right about carbs.  I'm 57, have 9% body fat, lift weights 4x/week.  I'm in pretty good shape.  Turns out that my after meal glucose was frequently going above 140. So despite being in shape and having low body fat, I was well on my way to diabetes.   

 I gave keto a 3 month run.  Turns out I do better at around 70 grams of carbs a day.  Low carb, but not full blown keto.  My after meal glucose never gets above 120 now. 
Title: Re: 20+ years of TRT replacement
Post by: cujet on December 30, 2019, 06:55:44 pm
Like you, I've been on TRT for half my life.

I prefer topical T, compounded cream 10%. If I cycle it, libido goes into the stratosphere. Both coming off of it, and going back on.
Title: Re: 20+ years of TRT replacement
Post by: ghce on December 31, 2019, 07:22:28 am
Like you, I've been on TRT for half my life.

I prefer topical T, compounded cream 10%. If I cycle it, libido goes into the stratosphere. Both coming off of it, and going back on.

What are your cycle times?
Title: Re: 20+ years of TRT replacement
Post by: TestTube on January 02, 2020, 11:13:37 pm
Thanks for sharing. I might make the switch back to androgel or compounded cream eventually. After years and hundreds of injections I find myself conveniently "forgetting" to inject for several days even though I do subq injections.