Coming off TRT- Defy HPTA Reset Protocol

[copacetic25]

I am curious if anyone knows what sort of HPTA protocol Defy Medical offers. I'm considering coming off TRT. I am currently a Defy patient and they have managed my protocol very well, but I just don't feel a huge benefit from TRT a year later even with Test levels going from 350 to 1100. I believe my initial issues were Adrenal relates and I have turned that around.

I of course will ask my Dr. what he recommends in a week when I speak to him, but wanted to know if anyone knew what Defy's HPTA restart protocol was.

Thanks

 

[ERO]

It is posted on the Defy Medical site here

Please keep us posted as I am about ready to throw in the towel on TRT as well.

See this as well.

 

[Jay]

ERO,

Why throw towel in?

 

[ERO]

ERO,

Why throw towel in?

I dont feel any benefits from TRT either, just like copacetic25. I have the exact same symptoms now as I had before TRT. Lethargy, low to no libido, unable to make any progress in the gym, unable to recover properly from workouts, etc...I too am with Defy and they are great, but I am just throwing money away on treatment that does not work. I may try topical T one more time before throwing in the towel, but I am not holding my breath that TRT will suddenly start "working" after everything I have tried over the last 5 years has not.

 

[Vince]

I dont feel any benefits from TRT either, just like copacetic25. I have the exact same symptoms now as I had before TRT. Lethargy, low to no libido, unable to make any progress in the gym, unable to recover properly from workouts, etc...I too am with Defy and they are great, but I am just throwing money away on treatment that does not work. I may try topical T one more time before throwing in the towel, but I am not holding my breath that TRT will suddenly start "working" after everything I have tried over the last 5 years has not.

I'm really sorry to hear that, you are a great contributor to this form. ERO could you post your protocol.

 

[ERO]

My current protocol is 13 mg of Test Cyp daily, HCG 200 IU daily, no AI as I have never needed one. Also a small bit of compounded T3/T4 daily as well. I have tried everything except pellets (which are decades out of date and I have no interest in). I have never felt anything from any of the various protocols.

 

[Nelson Vergel]

By Jasen Bruce

During the previous years large surge in testosterone prescriptions and TRT clinics there are unfortunately many men who have been misdiagnosed with low testosterone, yet placed on TRT when it may not have been needed in the first place. If you are one of these men and you are considering the discontinuation of testosterone treatments there is a protocol that can help restore your own hormone axis. You do not want to stop testosterone "cold turkey", this will lead to unnecessary symptoms that could last for many months.

This is an example of just one protocol, since there really is no "one way" to do it. This has proven a very effective foundational protocol for Defy, but of course every patient is different and therefore treatments are individualized as needed. A good TRT doctor will customize the approach based upon the patients response.

TRT: Endogenous Restoration protocol for Men Discontinuing TRT

Male patients who have been taking any form of exogenous Testosterone long term, longer than 12 weeks, will have secondary hypogonadism induced by the negative feedback response to the exogenous testosterone use. The purpose of this protocol is to stimulate the testes using HCG so that they are able to produce testosterone once again,while also preparing them to respond to endogenous LH/FSH(gonadotropins).

Tamoxifen is taken beyond the HCG as it is shown, as aSERM, to stimulate the pituitaries release of LH/FSH whole suppressing the negative effects of excess estradiol. Clomid is also commonly used as a SERM. Estradiol can elevate in men who discontinueTRT so it is important to run the SERM for some time after discontinuing TRT to mitigate E2 rebound.

Meds needed: HCG 11,000iu+mixing kit
Clomiphene 50mg #30-#60 tablets
Tamoxifen 20mg #30-#90 tablets
Syringes and supplies for HCG

Basic Protocol Begin protocol 5 days after the last T injection (Cyp/Enanth). If the patient is taking a T cream than begin the protocol one day following the last application of T cream.

First 30 days: HCG 350iu daily sq Tamoxifen 20mg- 1 tablet POQD DHEA 50mg- 1 capsule QHS (Optional) Request Sildenafil (Viagra) or Tadalafil (Cialis) for any ED. Many patients experience ED during initial recovery.

30 day blood work follow up: Draw the following labs: Testosterone F&T; Sensitive Estradiol; CBC; CMP; LH+FSH **

Physician can order additional labs at his/her discretion.

After 30 days of HCG+Tamoxifen. If the total Testosterone is elevated at the follow up blood test, then it can be assumed that patient is responding well to HCG. Discontinue HCG and titrate tamoxifen dosage to 10mg after last dose of HCG. Continue the Tamoxifen 10mg for 30 more days. Add Clomid 50mg QHS for 30 days.

Set lab reminder for follow up labs 2 weeks after last dosage of Tamoxifen/Clomid. Levels should remain elevated from there. If not, at the physician's discretion the above protocol can be repeated until labs reflect a desired response. Symptomology (the study of your symptoms) must also play a role in determining desired response.

Labs Needed at the end of the protocol (3 weeks after cessation): Testosterone Free and Total; Sensitive Estradiol; LH; CBC; CMP-14; DHEA.

If the patient does not respond to the HCG+Tamoxifen after 90 days (3 cycles), then it can be assumed there is possible primary hypogonadism. This would not have been caused by the TRT, more than likely it has developed naturally with age or has been present for a long time. In this case it is best to suggest continuing TRT so that T levels remain optimal and the patient's life quality and health also remain optimal.

Educate the patient on the importance of maintaining good levels of T, even if that means being treated with TRT.

 

[Dr Justin Saya MD]

By Jasen Bruce

During the previous years large surge in testosterone prescriptions and TRT clinics there are unfortunately many men who have been misdiagnosed with low testosterone, yet placed on TRT when it may not have been needed in the first place. If you are one of these men and you are considering the discontinuation of testosterone treatments there is a protocol that can help restore your own hormone axis. You do not want to stop testosteone "cold turkey", this will lead to unecessary symptoms that could last for many months.

This is an example of just one protocol, since there really is no "one way" to do it. This has proven a very effective foundational protocol for Defy, but of course every patient is different and therefore treatments are individualized as needed. A good TRT doctor will customize the approach based upon the patients response.

TRT: Endogenous Restoration protocol for Men Discontinuing TRT

Male patients who have been taking any form of exogenous Testosterone long term, longer than 12 weeks, will have secondary hypogonadism induced by the negative feedback response to the exogenous testosterone use. The purpose of this protocol is to stimulate the testes using HCG so that they are able to produce testosterone once again,while also preparing them to respond to endogenous LH/FSH(gonadotropins).

Tamoxifen is taken beyond the HCG as it is shown, as aSERM, to stimulate the pituitaries release of LH/FSH whole suppressing the negative effects of excess estradiol. Clomid is also commonly used as a SERM. Estradiol can elevate in men who discontinueTRT so it is important to run the SERM for some time after discontinuing TRT to mitigate E2 rebound.

Meds needed: HCG 11,000iu+mixing kit
Clomiphene 50mg #30-#60 tablets
Tamoxifen 20mg #30-#90 tablets
Syringes and supplies for HCG

Basic Protocol Begin protocol 5 days after the last T injection (Cyp/Enanth). If the patient is taking a T cream than begin the protocol one day following the last application of T cream.

First 30 days: HCG 350iu daily sq Tamoxifen 20mg- 1 tablet POQD DHEA 50mg- 1 capsule QHS (Optional) Request Sildenafil (Viagra) or Tadalafil (Cialis) for any ED. Many patients experience ED during initial recovery.

30 day blood work follow up: Draw the following labs: Testosterone F&T; Sensitive Estradiol; CBC; CMP; LH+FSH **

Physician can order additional labs at his/her discretion.

After 30 days of HCG+Tamoxifen. If the total Testosterone is elevated at the follow up blood test, then it can be assumed that patient is responding well to HCG. Discontinue HCG and titrate tamoxifen dosage to 10mg after last dose of HCG. Continue the Tamoxifen 10mg for 30 more days. Add Clomid 50mg QHS for 30 days.

Set lab reminder for follow up labs 2 weeks after last dosage of Tamoxifen/Clomid. Levels should remain elevated from there. If not, at the physician's discretion the above protocol can be repeated until labs reflect a desired response. Symptomology (the study of your symptoms) must also play a role in determining desired response.

Labs Needed at the end of the protocol (3 weeks after cessation): Testosterone Free and Total; Sensitive Estradiol; LH; CBC; CMP-14; DHEA.

If the patient does not respond to the HCG+Tamoxifen after 90 days (3 cycles), then it can be assumed there is possible primary hypogonadism. This would not have been caused by the TRT, more than likely it has developed naturally with age or has been present for a long time. In this case it is best to suggest continuing TRT so that T levels remain optimal and the patient's life quality and health also remain optimal.

Educate the patient on the importance of maintaining good levels of T, even if that means being treated with TRT.

My good friend Nelson Vergel has provided great information regarding HPTA recovery after using androgens.

This is outdated and was a compilation of several separate protocols. Over the years (and currently) have zeroed in on our current protocol (with some case-by-case variation):

HCG 300-400iu daily X 14 days, FOLLOWED by Clomid 25mg daily X 28 days (6 week cumulative regimen).

 

[Nelson Vergel]

This is outdated and was a compilation of several separate protocols. Over the years (and currently) have zeroed in on our current protocol (with some case-by-case variation):

HCG 300-400iu daily X 14 days, FOLLOWED by Clomid 25mg daily X 28 days (6 week cumulative regimen).

No Tamoxifen? Got rid off the DHEA?

 

[Dr Justin Saya MD]

No Tamoxifen? Got rid off the DHEA?

Tamoxifen only if Clomid not tolerated. DHEA only if indicated based on lab DHEA-sulfate level.

 

[Eric5150]

No taper on HCG or Clomid? hard stop on both?

14 days HCG alone? Than 28 days clomid alone?

 

[Etownone]

Going to do this.

"HCG 300-400iu daily X 14 days, FOLLOWED by Clomid 25mg daily X 28 days (6 week cumulative regimen)."


Just really concerned of ED.
I know it's coming....
Anyone here know how long it can last? Weeks, months?

 

[Mr S]

Going to do this.

"HCG 300-400iu daily X 14 days, FOLLOWED by Clomid 25mg daily X 28 days (6 week cumulative regimen)."


Just really concerned of ED.
I know it's coming....
Anyone here know how long it can last? Weeks, months?

Don’t forget to add Cialis Daily 5mg to take care of ED. It does help tremendously.

 

[BigBamBoo]

In my particular case, I was advised to stop cold turkey by Defy because I have very high SHBG (70-75+).

They said I could take hCG for a couple of weeks, but that was optional.

So...I just stopped. No crash. In fact after 2-3 weeks I felt REALLY good. That last about 3-4 months and then I started dragging ass again at the gym.

I am again in the situation as I was before and am thinking of trying something else.

Good luck to you OP. Hope you feel better.

 

[hktest]

This is outdated and was a compilation of several separate protocols. Over the years (and currently) have zeroed in on our current protocol (with some case-by-case variation):

HCG 300-400iu daily X 14 days, FOLLOWED by Clomid 25mg daily X 28 days (6 week cumulative regimen).

Is it still the current protocol? Does it start 5 days after last pin?

 

[Vince]

Is it still the current protocol? Does it start 5 days after last pin?

After last testosterone injection, then 14 days of HCG, then after HCG, clomid starts.

 

[hktest]

After last testosterone injection, then 14 days of HCG, then after HCG, clomid starts.

Thanks for your reply. Just to confirm, start protocol straightaway after last pin, no waiting time?

 

[hktest]

Thanks for your reply. Just to confirm, start protocol straightaway after last pin, no waiting time?

I am asking because the original protocol from Defy was to start after 5 days of last pin, however the HCG was for 30 day and now it’s only 14 days. Moreover, I have seen another post of someone doing the protocol above but waited 14 days after last pin.

 

[Cataceous]

For anyone interested, a recent Defy restart protocol is:

• Discontinue testosterone
• Start 300 IU hCG daily for 2 weeks
• Stop hCG, start 25 mg enclomiphene daily for 6 weeks
• 0.125 mg anastrozole three times per week during both hCG and enclomiphene
• Stop everything, followup labs with CBC, TT, FT E2, LH, SHBG, PRL

 

[hktest]

For anyone interested, a recent Defy restart protocol is:

• Discontinue testosterone
• 300 IU hCG daily for 2 weeks
• 25 mg enclomiphene daily for 6 weeks
• 0.125 mg anastrozole three times per week with hCG and enclomiphene
• Followup labs with CBC, TT, FT E2, LH, SHBG, PRL

So HCG and enclomiphene start together immediately next day after last test pin?