Quantcast

Author Topic: 20+ years of TRT replacement  (Read 1513 times)

billsman

  • Full Member
  • ***
  • Posts: 139
    • View Profile
20+ years of TRT replacement
« 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.   
« Last Edit: December 19, 2019, 03:22:49 pm by billsman »

golfboy307

  • Hero Member
  • *****
  • Posts: 1099
    • View Profile
Re: 20+ years of TRT replacement
« Reply #1 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.
Age 51, 5'10, 155 lbs
Cholesterol 162 (HDL 59, LDL 87, Trigs 88, LDL-P 850)
Fasting Glucose 65 (down from 97 pre TRT)
A1C:  5.0 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using improved diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  60 mg Test Cyp IM every 5 days.  No AI.
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32
9/15/18 labs:  Total T (trough day):  598 (250 -1100 ng/dl)  Free T 73.9 (46-225) Sensitive E2: 21  Hemocrit 43.7  SHBG 34
2/20/19 labs:  Total T (mid point):  776 (250 -1100 ng/dl) Free T 115.6 (46 - 224 pg/ml) Sensitive E2 24 (<29), DHT 43 (16-79 ng), DHEA-s 244 (70-495 mcg/dl)


Supplements:  Multivitamin, plus additional B12, B6, C, D, K2, Red Yeast Rice, Magnesium, and Coq10  Evening:  Kyolic Garlic, 2mg Cialis, LEF Endothelial Protection

Peak Testosterone Forum

Re: 20+ years of TRT replacement
« Reply #1 on: December 19, 2019, 04:38:01 pm »


Cataceous

  • Administrator
  • Hero Member
  • *****
  • Posts: 6471
    • View Profile
Re: 20+ years of TRT replacement
« Reply #2 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.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 59, Ht: 5'10", Wt: 154 lbs
Protocol: 2.4 mg T propionate subQ qd, 3.2 mg T enanthate qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

ghce

  • Hero Member
  • *****
  • Posts: 1181
    • View Profile
Re: 20+ years of TRT replacement
« Reply #3 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.
Age:59, Height 6' 3" weight 92.5KG
2014 Androderm Patches
2014-2016 Oral Andriol 160mg Daily
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 
Reference Range Adult males  1000-6000 pmol/L

Peak Testosterone Forum

Re: 20+ years of TRT replacement
« Reply #3 on: December 19, 2019, 11:15:13 pm »


seppuku

  • Sr. Member
  • ****
  • Posts: 481
    • View Profile
Re: 20+ years of TRT replacement
« Reply #4 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.

sh1209

  • Hero Member
  • *****
  • Posts: 734
    • View Profile
Re: 20+ years of TRT replacement
« Reply #5 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.

Joe Sixpack

  • Hero Member
  • *****
  • Posts: 2314
    • View Profile
Re: 20+ years of TRT replacement
« Reply #6 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. 
Age: 55, Ht: 5'08", Wt: 155 lbs
Protocol: 25 mg T Cyp + 25 IU HCG M,W,F + 2 clicks T Cream + 15mg DHEA + 15mg Pregnenalone daily.
12/2018 test results: TT: 1054 ng/dL (264-916), FT: 17.2 pg/mL (7.2-24), E2: 21.6 pg/mL sensitive (8.0-35.0)

cujet

  • Hero Member
  • *****
  • Posts: 1152
    • View Profile
Re: 20+ years of TRT replacement
« Reply #7 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.
57 years old
Autoimmune Hashimoto's, near zero natural T production
Cause: severe mononucleosis in my early 30's
Weight 220
Height 5' 10"
180mg NPthyroid (natural desiccated pigs thyroid)
Labs (Oct 2017) , my T=730, TSH 0.03, T3+T4 mid-range normal.
 
10% compounded creme. T=725, which feels just right.

ghce

  • Hero Member
  • *****
  • Posts: 1181
    • View Profile
Re: 20+ years of TRT replacement
« Reply #8 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?
Age:59, Height 6' 3" weight 92.5KG
2014 Androderm Patches
2014-2016 Oral Andriol 160mg Daily
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 
Reference Range Adult males  1000-6000 pmol/L

TestTube

  • Full Member
  • ***
  • Posts: 114
    • View Profile
Re: 20+ years of TRT replacement
« Reply #9 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.

Peak Testosterone Forum

Re: 20+ years of TRT replacement
« Reply #9 on: January 02, 2020, 11:13:37 pm »