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Author Topic: Has anyone been successful coming off TRT?  (Read 379 times)

wholbrook

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Has anyone been successful coming off TRT?
« on: February 13, 2021, 08:16:08 pm »
Quick back story.

I was in my late 40ís, overweight by 25-30lbs, sleep was bad, like 4 hours a night because of shift work and many other variables.

Nutrition was half half.

3 years into TRT, 100 mg weekly (50mg twice a week) plus .25 of Anastrozole twice week. DHEA 3 times a week. Puts my number at: Total T: 978, free; 284 free % 2.9 Estradiol: 5 DHEA: 370

I am 51 yrs old now and lost all the excess body fat and pretty lean also I went vegan one year ago.

So back to my original question.

I sleep amazing, 7-8 hours nightly, lost weight, nutrition amazing. Any chance of stopping TRT and being successful?

Any thoughts would be greatly appreciated 

ghce

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Re: Has anyone been successful coming off TRT?
« Reply #1 on: February 13, 2021, 09:53:29 pm »
It does sound like you current protocol is working for you, if you quit it you will go back to the way you were before treatment albeit probably worse due to age decline in your T level.
My suggestion is that if it ain't  broke you don't need to fix it.
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

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Re: Has anyone been successful coming off TRT?
« Reply #1 on: February 13, 2021, 09:53:29 pm »


Cataceous

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Re: Has anyone been successful coming off TRT?
« Reply #2 on: February 14, 2021, 01:49:21 am »
If you're really suppressing estradiol to 5 pg/mL then I'd have concerns about the long-term effects. Bone mineral density? Lipids?
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

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Re: Has anyone been successful coming off TRT?
« Reply #3 on: February 14, 2021, 02:21:48 am »
If you're really suppressing estradiol to 5 pg/mL then I'd have concerns about the long-term effects. Bone mineral density? Lipids?

Good catch there cat, that AI dose should be reduced substantially.
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

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Re: Has anyone been successful coming off TRT?
« Reply #3 on: February 14, 2021, 02:21:48 am »


wholbrook

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Re: Has anyone been successful coming off TRT?
« Reply #4 on: February 14, 2021, 02:28:37 pm »
Thank you for the replies.

Agreed with all of them. My Lipids has been off since I started the AI.

The bug issue is whenever I attempt to reduce the AI I begin to swell, I get insomnia, feel generally like crap. I used to think it may be a placebo effect, but nope, it happens each and every time.

I am only taking .3mg with each 50mg injection of T-Cyp twice a week. So in reality I am getting a grand total of .6 per week of Anastrozole and 100mg of T-Cyp. So with that, I get a T of 978 and an Estradiol of 5.

Maybe I need to be a bit more disciplined and just cut out the AI altogether or maybe take just one .3 for the week. Maybe my body just needs time to adapt. Whenever I tried to do that in the past I would quit after 7-10 days and just start taking both AI's twice a week again.

Do you think the body just needs time to adapt? Will it?

Cataceous

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Re: Has anyone been successful coming off TRT?
« Reply #5 on: February 14, 2021, 05:23:15 pm »
When did you measure that 978 ng/dL testosterone relative to injections? If that's a trough then your peak could be pushing 1,500 ng/dL. If so then I would consider a dose reduction of at least a third and up to one half. With the larger reduction I'd increase the injection frequency to at least EOD or TIW. For example, 16 mg T cypionate EOD. You can expect to feel bad for a while with a dose reduction, but the hope is that eventually you feel better overall and don't need to take an AI.

Here's a post in support of lower dosing. I've learned a similar lesson. I was doing ok with total testosterone at a constant 800 ng/dL, but I'm doing better with testosterone peaking at 600-700, and I take the equivalent of 44 mg T cypionate per week.
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

wholbrook

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Re: Has anyone been successful coming off TRT?
« Reply #6 on: February 14, 2021, 05:46:48 pm »
So I take the 50mg of T-Cyp on Monday am and 50 mg on Thursday pm along with .3 AI  on each of those days.

I take my blood work on Thursday am before any injections and on a fast

wholbrook

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Re: Has anyone been successful coming off TRT?
« Reply #7 on: February 14, 2021, 06:47:45 pm »
Also if you donít mind, let me ask you this?

Would it be just as good if I just reduced my injection to 40mg twice a week?

By the way my SHBG averages around 20.7 Just an FYI

Cataceous

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Re: Has anyone been successful coming off TRT?
« Reply #8 on: February 15, 2021, 12:56:53 pm »
Suppose your pre-injection trough is 900 ng/dL and your peak is 1,300 ng/dL. A 20% reduction with unchanging SHBG is going to change the trough and peak to around 700 and 1,000 respectively. This still leaves you well above average. And your SHBG is a bit below average, which means total testosterone should be below average to attain average free testosterone. For example, the Vermeulen free T for the average healthy young man with TT of 650 ng/dL and SHBG of 30 nMol/L is 15 ng/dL. At an SHBG of 20 the total testosterone only needs to be 550 ng/dL to match the free T of 15 ng/dL.

If your goal is to attain more physiological numbers then a 40% dose reduction makes more sense. This is 30 mg twice a week. Then your trough free testosterone would roughly match the peak free testosterone of the average young man. Your peak free T would still be much higher, probably over 20 ng/dL. Your new peak total testosterone could be around 800 ng/dL.

Unfortunately dose reductions can be challenging. Typically guys feel bad initially and convince themselves they must need above-average testosterone to feel good. But if they endured the transition then they might find things getting better. It can take months to fairly evaluate the results of such a protocol change. I believe it's worth doing because the TRT experience is better overall when you don't have to grapple with side effects such as high estradiol and high hematocrit.
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

wholbrook

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Re: Has anyone been successful coming off TRT?
« Reply #9 on: February 15, 2021, 02:12:07 pm »
That was very well explained. Thank you for your time. I am skipping my dose today to allow the numbers to come down, also skipping Anastrozole altogether. When I start up again on Thursday pm, I will be trying somewhere around 30-35mg twice a week. I will take your advice and give it 90 days then reanalyze things moving forward. It will be a relief not to take Anastrozole any longer.

Cataceous

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Re: Has anyone been successful coming off TRT?
« Reply #10 on: February 15, 2021, 02:49:06 pm »
If you're willing then do report back on how it goes. Hopefully you won't need the AI any more.
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

wholbrook

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Re: Has anyone been successful coming off TRT?
« Reply #11 on: February 17, 2021, 03:51:50 pm »
Good day to you Cataceous and others.

Just before I start the new protocol of lowering my T-Cyp I did want to ask you this based on the below blood work over the course of two years or so. B,old work is done every 6 months and on my trough day (12 hours before my next injection. (50mg Mon, am. 50 Mg Thurs pm) Blood work down at 8am on a Thursday.

So if I read properly through the years, I am assuming if I have an Estradiol of lets say 5 based on. That amount of T but a total T of lets say 978 on a trough day, would it be ok to cut all together my AI which was .3 twice a week? By doing that wouldnít that then increase my Estradiol thus also reducing my T automatically since I thought the higher your E goes the lower your T goes. Is this correct?

If so, then before I start the new protocol of lowing the T, maybe I should just come off the AI thus solving all the issues of bone density, lipid issues, and joint issues.

See the below lab work.

Your thoughts would be greatly appreciated.

June 2019 8am (Labcorp)
T-830
Free-183
Free%-2.2
Estradiol-6.4
SHBG-27.5

Jan 2020 8am (Labcorp)
T-777
Free-186
Free%-2.4
Estradiol-8.0
SHBG-13.6

March 2020 8am (Labcorp)
T-901
Free-261
Free%-2.9
Estradiol-6.7
SHBG-19.8

Aug 2020 8:15am (Quest)
T-530
Free-121
Free%-N/A
Estradiol-8.0
SHBG-16

September 2020 8:45am (Labcorp)
T-978
Free-284
Free%-2.9
Estradiol-5.0
SHBG-20.7

 

Cataceous

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Re: Has anyone been successful coming off TRT?
« Reply #12 on: February 17, 2021, 06:52:44 pm »
The amount of testosterone required to make estradiol is small. This is because 1 ng/dL of testosterone aromatizes to 10 pg/mL of estradiol. So if you stop the aromatase inhibitor and your estradiol jumps to 55 pg/mL then in theory your total testosterone falls from 978 ng/dL to 973 ng/dL, a trivial change.

The situation is different for natural men with intact HPTAs. Free estradiol, via negative feedback, is a significant regulator of testosterone production. Thus for natural men a large increase in estradiol is highly suppressive and leads to a large decrease in testosterone.
« Last Edit: February 18, 2021, 06:54:07 pm by Cataceous »
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

billsman

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Re: Has anyone been successful coming off TRT?
« Reply #13 on: February 18, 2021, 06:43:29 pm »
I don't want to discourage you, but after about 15 years of treatment, I stopped for about 2 months.  Levels were very low, less than 200.  The fatigue was a killer.   

cujet

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Re: Has anyone been successful coming off TRT?
« Reply #14 on: February 28, 2021, 12:01:20 am »
I've been on T replacement for longer than most here. I do occasionally ween myself off of it for reasons unrelated to the need for T. Sometimes I run out, sometimes I have other health issues that are made worse by T.

LH is normal in me, but testicles don't produce. They swell up, start to hurt annoyingly and eventually settle down most of the time to a dull ache that never seems to go away. T levels stabilize at 25 ng/dl, near nothing.

I don't feel well like that, and strangely, confidence completely evaporates. I become like a worrying old lady.
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.

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Re: Has anyone been successful coming off TRT?
« Reply #14 on: February 28, 2021, 12:01:20 am »