Ceasing TRT Cold Turkey After Three Years - Restart Log

[PhantomFear]

This post is going to serve solely as a log of my side effects, blood work and overall thoughts as I attempt to come off TRT - cold turkey - after three years. I'm also going to document changes in body composition and strength levels; I'm not particularly big, strong or lean, but I haven't seen too many logs where this was tracked and I think it'll be quite interesting.

I made a post last week detailing my situation which can be found here. That thread was more to get opinions before I made my decision, and contains a lot of unnecessary detail for those looking solely for experiences of coming off T - hence why I'm making a new thread.

Basic information:
Age: 22
Years on TRT: 3
Last test injection: 11/06/19
Weight: 82kg / 180lbs
Height: 5'11
Body fat: ~22%
Current Physique: 18/06/19
Squat/Bench/Dealfift 1RM's (lbs): 350/180/465

Pre-TRT bloods:
21/03/2016:
Testosterone: 14.2 (10 - 38) nmol/L
SHBG: 41 (11 - 71) nmol/L
TSH: 0.9 (0.3 - 6) mIU/L
HbA1c: 31 (20 - 41) mmol/mol

01/06/2016:
Testosterone: 12.9 (10 - 38) nmol/L
SHBG: 38 (11 - 71) nmol/L

Bloods/protocols over the last year on T:

Issues since starting T:
Erectile dysfunction, zero libido, memory issues, inability to concentrate, constantly cold hands/feet, thinning scalp hair, thinning eye brows, stomach pain/bloating, dry skin, high blood pressure, low oral body temps, palpitations/fluttering heart beat and severe anxiety.

Restart Plan:
I'm unable to use SERM's due to an unrelated medical condition. 200iu HCG every morning and 6.25mg exemestane EOD for two-three weeks while the test clears my system. Following bloods on HCG only to determine whether testis are still functional, HCG and AI will both be discontinued. Bloods will then be taken every four weeks. This plan could change after speaking with my doctor later this week, however.

Documentation:
I'm going to post one update every week detailing whatever changes have occurred. I'm happy to answer any questions in between updates too.

 

[PhantomFear]

Week 1: 18/06/19
It's been a week since I did my last test injection. Don't feel any difference yet, and still have all of the issues that I mentioned in the original post. I did wake up with morning wood, but later in the afternoon I struggled to maintain an erection with my partner. Still early days yet, so unsurprising I haven't felt many changes.

 

[fifty]

Thanks for logging this all!

 

[Vince Carter]

Just side glancing at this, very well done stuff on your part...impressive! Your E though it's the wrong test was extremely high, even with 6.25mg Aromasin EOD. IF the E had ever come down to a reasonable point you could have seen some real improvements, possibly.

 

[PhantomFear]

Just side glancing at this, very well done stuff on your part...impressive! Your E though it's the wrong test was extremely high, even with 6.25mg Aromasin EOD. IF the E had ever come down to a reasonable point you could have seen some real improvements, possibly.

Thanks, Vince - much appreciated! Regarding e2, I spent most of my second year of TRT (bloods shown only show my third year) hovering around 80 - 90 pmol/L and my joints hurt the whole time. Unfortunately here in the UK we don't have access to the sensitive assay, so all of my bloods are standard.

 

[PhantomFear]

Week 2: 26/06/19
Protocol:
200iu HCG every morning, nothing else.

Bloods:
Testosterone: 20.4 (8.64 - 29) nmol/L
Oestradiol: 172 (41 - 159) pmol/L
Free Test: 0.456 (0.2 - 0.62) nmol/L
Albumin: 45.1 (35 - 50) g/L
SHBG: 29.7 (18.3 - 54.1) nmol/L

Sodium: 145 (133 - 146) mmol/L
Potassium: 3.8 (3.5 - 5.3) mmo/L
Urea: 7.5 (2.5 - 7.8) mmol/L
Creatinine: 86 (58 - 110) umol/L

Total Bilirubin: 14 (0 - 21) umol/L
ALT: 30 (0 - 49) iu/L
Alkaline Phosphotase: 91 (30 - 130) iu/L

TSH: 2.5 (0.3 - 6.0) mu/L
B12: 541 (160 - 1000) ng/L
Random Glucose: 4.7 nmol/L

Haemoglobin: 163 (130 - 180) g/L
Total WBC: 4.4 10*9 (4.0 - 11.0) /L
RBC Count: 5.44 10*12 (4.5 - 6.5) /L
Haematocrit: 0.495 (0.400 - 0.500)
Platelets: 150 10*9 (150 - 450) /L

Still waiting on rT3, fT3 and fT4 - will update once available.

Notes:
Two weeks since my last test injection now. I had to remove the 6.25mg aromasin EOD as my joints started to hurt; upon cessation, I had a large breakout in acne and some skin issues too. 20 nmol/L on only 200iu HCG every morning is promising - shows my testis are functional.

Weight: 83.3kg (+1.3kg from baseline).
Probably just a bit of water from dropping the AI.

Erections have been okay and libido has actually been really high this week. Energy levels are a tad down though, and I'm finding it quite hard to wake up in the morning despite having 8+ hours sleep.

Strength in the gym is still going up, though that isn't really going to be an issue until I stop the HCG. No physique update yet as nothings changed.

Hypothyroid symptoms are still present and TSH of 2.5 doesn't look great. For some reason the company I do my bloods with take 16 days to get rT3 results back, so a complete thyroid panel will probably be in next weeks update. Since fT3 always looks good but hypo symptoms are present, I'm suspecting rT3 might be the issue.

I'm going on holiday with the gf and her parents so I'll be staying on HCG for another week. Once I'm home I'll stop the HCG and then things should get interesting haha.

As always any insight is appreciated. Happy to answer any questions if I've missed anything.

 

[PhantomFear]

Week 2.5: 29/06/19
Today was my last HCG injection for the foreseeable future. Going to get bloods in 3-4 weeks after no injections to see where I'm at.

If I had to make a prediction, I'm expecting to return to levels of 8-14 nmol/L with high end e2 due to my propensity to aromatize despite not being overweight and having no apparent liver issues. If that is the case, I may speak to my doctor about using an extremely small dose of exemestane to bring it down a tad. I believe that excessive aromatization is the reason I was low to begin with, with the excess e2 suppressing the HPTA. Looking back I've had many high e2 related issues before even starting T, particularly bad pubertal gyno.

As far as how I'm feeling, gym recovery has tanked severely. Suddenly getting doms after every session despite no increase in volume or intensity, and my elbows, shoulders, knees etc are all feeling really beat up/clicking/cracking all the time. Strength remains the same, however. Erections are achievable but are weak and sometimes tough to maintain. Libido is still decent.

 

[Bjjpapi]

Have you ever tested ferritin, transferrin, total iron binding capacity ?

 

[PhantomFear]

Have you ever tested ferritin, transferrin, total iron binding capacity ?

Ferratin usually comes back about 80 ish, though I haven't had it checked for a few months. It dropped as low as 40 when I was donating blood which is why I stopped donating.

Never had the other two tested, though they will both be part of my bloods in 4 weeks time.

 

[PhantomFear]

Week 3: 02/07/19
Things have gone down hill quite fast after ceasing the HCG. I quickly developed what I assume to be patella tendinitis based upon the type and location of pain, and even air squats hurt too much - impossible to squat with a bar at the minute. Both elbows have flared up badly and I can’t raise my right shoulder above my head. Every joint pops/cracks/grinds every time I move.

Could be unrelated but I’ve also got a swollen lymph node on my right jaw line.

Hoping this is temporary and will subside once my own production is back online. Still waiting on my thyroid bloods which is frustrating.

 

[fifty]

Power through. This shit is addictive. Going from 10 to 30 then back down is rough along the way.

 

[PhantomFear]

Power through. This shit is addictive. Going from 10 to 30 then back down is rough along the way.

Appreciate the support mate

 

[PhantomFear]

Week 3.5: 05/07/19
It's now a week since I did my last HCG injection, and things are actually looking up. The last two days I've been waking up with morning wood, and my erections have been very strong - I actually managed to have sex with my girlfriend without losing my erection half way through for the first time in a while. I'm unsure if a week off of HCG is enough time for my HPTA to be back in the game without the use of any sort of SERM. Could still be the HCG, could be placebo, but either way I'm feeling better overall.

Joint pain has mostly subsided except a little pain with my right shoulder. Still waiting on rT3 and thyroid bloods unfortunately. I'll likely go for some bloods sometime next week.

 

[PhantomFear]

Week 4: 08/07/19
Finally got my thyroid bloods back.

TSH 3.48 mIU/L (Range: 0.27 - 4.2)
Free T3 6.32 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 13.700 pmol/L (Range: 12 - 22)
Reverse T3 11 ng/dL (Range: 10 - 24)
FT3 : rT3 37.41 Ratio (Range: > 15)

So it appears rT3 wasn't the cause of the hypo symptoms, but that's the highest I've ever seen my TSH. The lab that ran the bloods is different from the one that usually does them, as my sample had to be shipped the USA since we don't have rT3 here in the UK.

Can I get some thoughts on these? Is it possible that the process of coming off (was on 100iu HCG alone when the bloods were drawn) could have elevated the TSH? I have a lot of the usual hypo symptoms: cold hands/feet, thinning outer eyebrows, dry skin, brittle nails, constipation etc.

 

[PhantomFear]

Week 4.5: 11/07/19
Weight: 78.2kg - down 3.8kg / 8.3lbs from baseline

First time I've jumped on the scale since coming off the HCG. I've made no changes to calorie intake, so have to assume that's mainly water and perhaps a bit of muscle loss.

Massive improvements in anxiety which has now almost completely gone. The entire time on TRT I had major physical anxiety issues, spiking heart rate, hard/pounding heart beat, general feeling of being 'on edge' all the time, palpitations and regular panic attacks. Since dropping everything I've had zero issues in this area, so that's a major step forward for me.

Energy levels have taken a large dip, however. I'm getting 8-9 hours sleep every night, but come 1pm I'm yawning and getting the urge to close my eyes. Erections are hit and miss and libido isn't the best this week.

Starting to take 250mcg iodine every morning to try and help with the thyroid issues; Selenium coming from 2-3 brazil nuts everyday. Started Vit D tablets too as we don't get much sun here in the UK, even in summer.

Having Thyroid antibodies, Total T, e2, LH/FSH and an iron panel early next week. I'll update the thread once the results are in.

 

[Mr S]

Power through. This shit is addictive. Going from 10 to 30 then back down is rough along the way.

What’s addictive? Sorry, I missed something

 

[fifty]

Testosterone

 

[Mr S]

Testosterone

My doctor was explaining to me that one of the reasons testosterone is a controlled substance it’s because of its addictive property. Or rather the dependency men develop. Addiction would be more like I take 100mg and later I need 200mg and so on.

 

[Systemlord]

Week 4: 08/07/19
Finally got my thyroid bloods back.

TSH 3.48 mIU/L (Range: 0.27 - 4.2)
Free T3 6.32 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 13.700 pmol/L (Range: 12 - 22)
Reverse T3 11 ng/dL (Range: 10 - 24)
FT3 : rT3 37.41 Ratio (Range: > 15)

So it appears rT3 wasn't the cause of the hypo symptoms, but that's the highest I've ever seen my TSH. The lab that ran the bloods is different from the one that usually does them, as my sample had to be shipped the USA since we don't have rT3 here in the UK.

Can I get some thoughts on these? Is it possible that the process of coming off (was on 100iu HCG alone when the bloods were drawn) could have elevated the TSH? I have a lot of the usual hypo symptoms: cold hands/feet, thinning outer eyebrows, dry skin, brittle nails, constipation etc.

Your symptoms together with TSH is enough for me to suggest thyroid problems. If thyroid wasn't struggling, TSH wouldn't be elevated and TSH would be at the median levels <1.5.

 

[PhantomFear]

Your symptoms together with TSH is enough for me to suggest thyroid problems. If thyroid wasn't struggling, TSH wouldn't be elevated and TSH would be at the median levels <1.5.

I have a feeling these issues are being caused, or are at least linked to, low cortisol. My progesterone levels have always been well below range despite being on HCG, so it's not unreasonable to assume cortisol is also low.

This makes me think I might be suffering from thyroid 'pooling', with T3 elevated in the blood but unable to enter the cell. The symptoms of excess adrenaline I've experienced since being on TRT, rapid heart rate spikes, palpitations, high blood pressure, panic attracts etc might be explained by this too.

Bloods are indicative of pooling, high T3 and low T4 as insufficient cortisol present to stop T4 converting to T3, accompanied by elevated TSH suggesting T3 isn't entering the cell.

Thyroid pooling.

I'm going to get 24h saliva cortisol tested the same day as thyroid, iron and t labs next week. Will hopefully provide a bit more insight into whats going on.