Ceasing TRT Cold Turkey After Three Years - Restart Log

[xqfq]

Omg I forgot all about magnesium bicarbonate water! I used to make this all the time. I forget why I stopped. But I definitely still have 3-4 bottles of MOM that I bought off amazon. I’m gonna make a batch later tonight. Thanks reminding me about this stuff.

What seltzer water do you use to mix with the MOM?

Not sure it matters, but I use my soda stream. None of that fancy reverse-osmosis filtered water..that's a few steps too far down the rabbit hole for me!

 

[Gman86]

Not sure it matters, but I use my soda stream. None of that fancy reverse-osmosis filtered water..that's a few steps too far down the rabbit hole for me!

Same. I was just buying $1 seltzer water in a plastic bottle at my local grocery store to mix it with

 

[PhantomFear]

Hello everyone; back with another update.

Things have continued to decline unfortunately. Hair and eyebrows are thinning at an extremely rapid rate, libido and overall drive for life are completely absent, fatigue is constant, extremeties are always freezing cold, dry skn + dandruff overload, erections require a lot of stimulation, and gym recovery is non-existant.

Anxiety and overall stress levels are also high. I have a lot of symptoms of sympathetic hyperactivity: pounding heart even when heart rate is low, nervousness, sweaty palms etc.

Most recent bloods:

Testosterone 13.8 nmol/L (Range: 8.64 - 29)
Free Testosterone - Calc. 0.317 nmol/L (Range: 0.2 - 0.62)
Oestradiol 117 pmol/L (Range: 41 - 159)
SHBG 26 nmol/L (Range: 18.3 - 54.1)
FSH 1.51 IU/L (Range: 1.5 - 12.4)
LH 4.3 IU/L (Range: 1.7 - 8.6)
Prolactin 197 mU/L (Range: 86 - 324)
DHEA Sulphate 7.020 umol/L (Range: 5.73 - 13.4)
Progesterone 0.325 nmol/L (Range: 0.64 - 4.7)
TSH 1.83 mIU/L (Range: 0.27 - 4.2)
Free T3 6.09 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 15.500 pmol/L (Range: 12 - 22)

FSH still hasn't recovered six months later; I assume I am infertile. Progesterone is also below range which is interesting considering it directly antagnoises both DHT and e2.

My doctor has agreed to prescribe me test + hcg + aromasin on my old protocol again. I'm rather apprehensive though given my systems as a lot of my problems seem to go beyound simply testosterone and estradiol.

Can anyone see something I'm missing here? Honestly at a loss as to what to do now as although testosterone is on the lower end, I don't think any of my bloods are reflective of just how bad I feel right now.

 

[sh1973]

My thoughts are if trt failed you before, then it’s probably not going to be any different this time. Have you considered trying low dose clomid before jumping back on trt?

 

[PhantomFear]

My thoughts are if trt failed you before, then it’s probably not going to be any different this time. Have you considered trying low dose clomid before jumping back on trt?

Whilst TRT wasn't what I'd hoped it'd be, I felt much better on than I do now. My main concern is that my issue isn't actually testosterone, and that my low-normal levels are from a mix of mental, emotional and cellular stress from a combination of my anxiety disorder and a different underlying issue, likely thyroid + adrenals.

I have all of the symptoms of hypothyroidsm but my bloods don't line up. I believe that my constantly elevated adrenline from mental stress is increasing FFA liberation and serum FFA is high. FFA in the blood inhibits glucose uptake into the cell which is needed for t3 to work correctly, so whilst my fT3 levels are normal, my thyroid function is effectivly hypo.

Clomid is a big no go for me. A lot of people notice eye-floaters and light sensitvity which suggests it alters retinal function. I already have a genetic eye condition centered around the deterioratoin of the retina so it's not something I'm willing to risk.

 

[Gman86]

Whilst TRT wasn't what I'd hoped it'd be, I felt much better on than I do now. My main concern is that my issue isn't actually testosterone, and that my low-normal levels are from a mix of mental, emotional and cellular stress from a combination of my anxiety disorder and a different underlying issue, likely thyroid + adrenals.

I have all of the symptoms of hypothyroidsm but my bloods don't line up. I believe that my constantly elevated adrenline from mental stress is increasing FFA liberation and serum FFA is high. FFA in the blood inhibits glucose uptake into the cell which is needed for t3 to work correctly, so whilst my fT3 levels are normal, my thyroid function is effectivly hypo.

Clomid is a big no go for me. A lot of people notice eye-floaters and light sensitvity which suggests it alters retinal function. I already have a genetic eye condition centered around the deterioratoin of the retina so it's not something I'm willing to risk.

Have you considered trying the cream? It will allow you to at least avoid using an ai.

 

[PhantomFear]

Have you considered trying the cream? It will allow you to at least avoid using an ai.

I can ask my doctor but if I recall correctly he wasn't the biggest fan of it. I'm not entirely sure why given the great reviews across the board but I'm sure he has his reasons.

I think I'd still need the AI though as HCG will always be a part of my protocol and it aromatises like a b***h haha.

 

[Gman86]

I can ask my doctor but if I recall correctly he wasn't the biggest fan of it. I'm not entirely sure why given the great reviews across the board but I'm sure he has his reasons.

I think I'd still need the AI though as HCG will always be a part of my protocol and it aromatises like a b***h haha.

Haha it definitely does for some. I’m still pretty positive that you won’t need an ai on the cream, even with HCG. DHT opposes high E2 symptoms pretty hard.

 

[PhantomFear]

Haha it definitely does for some. I’m still pretty positive that you won’t need an ai on the cream, even with HCG. DHT opposes high E2 symptoms pretty hard.

Ah okay, that does make sense. A lot of people claim that t -> dht conversion on injections is poor. My issues on TRT do suggest I had poor DHT conversion, which combined with my below-range progesterone levels may have left e2 unoppossed with both being strong antagonists.

I did feel a lot better on exemestane, even when e2 levels were still high. I wonder if the benefits were due to the fact that exemestane itself is a strong androgen and extremely similar to DHT. May be part of the puzzle as to why TRT did nothing for my libido or erections.

 

[Gman86]

Ah okay, that does make sense. A lot of people claim that t -> dht conversion on injections is poor. My issues on TRT do suggest I had poor DHT conversion, which combined with my below-range progesterone levels may have left e2 unoppossed with both being strong antagonists.

I did feel a lot better on exemestane, even when e2 levels were still high. I wonder if the benefits were due to the fact that exemestane itself is a strong androgen and extremely similar to DHT. May be part of the puzzle as to why TRT did nothing for my libido or erections.

You definitely have a good grasp on things. Progesterone and DHT both oppose E2, just like you said. I convert quite well on injections to DHT, but if it’s an issue for you, the cream could definitely be a great option for you. Sucks that your doctor is against it, for whatever reason.

 

[Vvs1]

Ah okay, that does make sense. A lot of people claim that t -> dht conversion on injections is poor. My issues on TRT do suggest I had poor DHT conversion, which combined with my below-range progesterone levels may have left e2 unoppossed with both being strong antagonists.

I did feel a lot better on exemestane, even when e2 levels were still high. I wonder if the benefits were due to the fact that exemestane itself is a strong androgen and extremely similar to DHT. May be part of the puzzle as to why TRT did nothing for my libido or erections.

I know I’ve read on one of the anabolic websites that DHT is also converted from some metabolite with an Andro prefix like androsterone or androstenedione.

 

[Vvs1]

After reading the thread, you should focus on the iron overload. There’s a protocol online called the Root Cause Protocol that focuses on reducing unbound iron that causes oxidative damage.

Look at the ingredients of foods that have zinc and iron and avoid them.

I also have high iron saturation and felt really well avoiding these products and meats with iron.

 

[PhantomFear]

You definitely have a good grasp on things. Progesterone and DHT both oppose E2, just like you said. I convert quite well on injections to DHT, but if it’s an issue for you, the cream could definitely be a great option for you. Sucks that your doctor is against it, for whatever reason.

Haha thanks, still a lot to learn but I'm slowly getting there. I've sent him an email asking to try the cream so we'll see what he says.

 

[PhantomFear]

After reading the thread, you should focus on the iron overload. There’s a protocol online called the Root Cause Protocol that focuses on reducing unbound iron that causes oxidative damage.

Look at the ingredients of foods that have zinc and iron and avoid them.

I also have high iron saturation and felt really well avoiding these products and meats with iron.

I've come across the root cause protocol before. Whilst a lot of the info did resonate with me, the site came across quite 'sales heavy' with their push of specific 'RCP supplement bundles' and appointments with specific RCP doctors (most of which aren't actually MD's).

With that said I do acknowledge that my iron is a serious issue, I've actually just booked an appointment to go donate blood today.

Would you mind explaining your situation a bit more? How you came to have high iron saturation, what you do to correct, how you feel before / after correction etc. Thanks!

 

[Gman86]

@Vvs1 I’d also like to know how you came to the conclusion that you have iron overload. What is your ferritin level, does that factor in when determining iron overload, or is it mostly based on total iron, iron saturation and/ or total iron binding capacity?

Ive listened to almost all of Morley robbins interviews. Not sure what to make of it all. His stuff on vitamin D makes sense, but so many people do well supplementing with vitamin D, so it’s extremely confusing. It also makes it confusing when there’s so many men that have low iron, and feel so much better after supplementing with iron. Plus, for the thyroid to work properly, it requires optimal iron levels.

 

[Charliebizz]

You ever think about trying a little prog cream. I used it a few years back. I felt better on it but was nervous about using it long term with all the fear mongering on the boards.

I’m similar to you where trt in any form has never resolved most of my issues except maybe exercise recovery. My personal opinion is for guys like me low t is just a sign something is wrong. But replacing it isn’t the answer. It’s almost like how when you diet way to hard your body throws the breaks on and slows you metabolism down. Same with low t. There is a reason the signal is reduced. My total is always between 210-350. Been that way for 11 years. I’ve tried trt many times. It just doesn’t work for me. Yet I still was able to get my wife pregnant 2 times basically as soon as we started trying.

some people’s issues are a lot more straight forward. Age related decline. Testicle injury or pituitary tumor. But for guys like us we seem to be missing something. And some times throwing trt in the mix just adds fuel to the fire.

trust me bro it’s easy to spiral when you don’t feel good. And then you see all these men doing good on trt. It’s only natural to want to try it over and over. But guys like us have something deeper going on and trt would be a nice simple fix but seems we going to have to work a lot harder. Fyi I’ve proven a few times to my dr that trt lowers my cortisol unless I take a low dose ssri with it. Goes to show you how much neurotransmitters and hormones go together also.

 

[Vvs1]

I've come across the root cause protocol before. Whilst a lot of the info did resonate with me, the site came across quite 'sales heavy' with their push of specific 'RCP supplement bundles' and appointments with specific RCP doctors (most of which aren't actually MD's).

With that said I do acknowledge that my iron is a serious issue, I've actually just booked an appointment to go donate blood today.

Would you mind explaining your situation a bit more? How you came to have high iron saturation, what you do to correct, how you feel before / after correction etc. Thanks!

I had prior blood tests with high iron saturation, with a low normal ferritin.

About a month ago, I decided to go back to some of the RCP supplements, stay away from meats and fortified foods, and eat a lot of eggs, and I had a major breakthrough for a few weeks. There has to be some kind of mechanism it triggers.

I only used supplements I have lying around. Their protocol they send you is filled with affiliate links, but I buy all my supplements from local stores.

Maybe there was no correlation between the supplements and my improvement. I think it was worth sharing since your iron is high.

 

[PhantomFear]

You ever think about trying a little prog cream. I used it a few years back. I felt better on it but was nervous about using it long term with all the fear mongering on the boards.

I’m similar to you where trt in any form has never resolved most of my issues except maybe exercise recovery. My personal opinion is for guys like me low t is just a sign something is wrong. But replacing it isn’t the answer. It’s almost like how when you diet way to hard your body throws the breaks on and slows you metabolism down. Same with low t. There is a reason the signal is reduced. My total is always between 210-350. Been that way for 11 years. I’ve tried trt many times. It just doesn’t work for me. Yet I still was able to get my wife pregnant 2 times basically as soon as we started trying.

some people’s issues are a lot more straight forward. Age related decline. Testicle injury or pituitary tumor. But for guys like us we seem to be missing something. And some times throwing trt in the mix just adds fuel to the fire.

trust me bro it’s easy to spiral when you don’t feel good. And then you see all these men doing good on trt. It’s only natural to want to try it over and over. But guys like us have something deeper going on and trt would be a nice simple fix but seems we going to have to work a lot harder. Fyi I’ve proven a few times to my dr that trt lowers my cortisol unless I take a low dose ssri with it. Goes to show you how much neurotransmitters and hormones go together also.

I tried pregneonolone a while back but it gave me varicose veins. Had zero before, then following preg supplementation had a bunch pop up which also coincided with vein pain. A few studies on pubmed claimed that progesterone can cause varicose veins, so I always assumed it was excess preg -> prog and steered away from supplementing prog as a result. Given prog is the direct precursor to cortisol I'm interested to see where my cortisol levels are.

Did you use hcg on T? Your low cortisol could be from the absence of LH from HPTA suppression resulting in inadequate cholesterol -> preg conversion, with all downstream hormones suffering as a result. Preg is extremely important for neurotransmitter production too, so that might also explain why the SSRI boosted your levels. Just a thought, I could be completely off the mark.

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I completely agree with everything you said. I have a lot of ideas / theories bouncing around my head at the moment, and while the exact specifics of each differ, they all lead back to one central issue: chronic stress of some form.

Our testosterone levels are low. Testosterone, and all anabolic systems within the body (especially thyroid function), rapidly decline during times of stress as the body directs energy towards internal systems essential to life - i.e organ function. It makes no sense to have anabolic hormones like test, dht, thyroid and prog elevated when catabolic hormones like cortisol and adrenaline are elevated during stress, as essentially they have opposite roles within the body. As a result, the anabolic systems are suppressed until the stress is elevated.

This is fine within normal physiology when all systems are in working order. However, problems arise when the body is in a constant state of stress, be it mental or cellular, and the anabolic systems are constantly suppressed. Not only do catabolic hormones directly suppress the production of anabolic hormones, they also suppress their ability to exert their action. T3 is one of the main determinants of the metabolic rate and requires glucose as substrate for effective oxidative metabolism. Both adrenaline and cortisol increase lipolysis and liberate free fatty acids into the blood for metabolism to provide energy during times of stress. FFA metabolism directly inhibits glucose metabolism meaning blood glucose levels remain elevated (eventually leading to insulin resistance), and even when glucose does enter the cell, its mainly metabolised using the glycolytic pathway which is extremely energy inefficient and leads to excessive lactic acid production.

I see evidence of the above in myself everyday. I used to have zero trouble exercising, but now even brisk walks lead to the painful 'runners side stitch' from lactic acid buildup; intense exercise isn't possible at all anymore. My constant fatigue also stems from this inefficient energy generation. This also explains why I have all of the symptoms of hypothyroidsm despite normal bloods - adequate thyroid hormone is in the blood, it just can't exert its action. Every part of my body is deteriorating: my teeth are quickly decaying, my hair and eyebrows are rapidly thinning, my skin always cracking / dry, I'm always fatigued and my mental health is in tatters. This is all because my body is chronically stressed and driving all of its resources towards addressing said stress. My face has aged 10 years in the past two (wrinkles, dark undereye circles, development of the shiny calcified bald scalp of old men) and I truly believe it's due to metabolic and cellular decline. Things like hair, vibrant skin and teeth aren't essential to life, so during times of stress their energetic demands aren't prioritised. Constant stress = constant sympathetic response = constant stress hormone elevation = constant metabolic suppression = all of our issues.

Its all good and well knowing the above, but without being able to identify what the underlying chronic stressor actually is, there's no way to address it. This is where modern medicine has failed us. If you go to the gp and explain all of the above, they'll look at you like you're crazy and try and prescribe a SSRI / beta blocker because they think you're an anxious hypochondriac. Yes doctor, I am extremely anxious, but that's because my body is failing in front of my very eyes but you tell me I'm normal, and that its all in my head because the blood test's fall withthin range... I'm considering going into medicine once I've completed my current physiology undergrad. People shouldn't have to be theorising on online forum like this just to feel normal, and things aren't going to change anytime soon.

This is also why TRT fails us. Whilst flooding the system with exogenous hormones can mitigate some of the damage done by the chronic elevation of stress, it does nothing to actually address the stressor, and can oftentimes exacerbate the issue if said exogenous hormone also effects the function of the thyroid and adrenal glands which are already impaired - i.e elevated estradiol from trt can directly inhibit thyroid function further worsening the situation. My TSH always increased in response to my e2 / prolactin on TRT.

I've found the field of hormone replacement therapy as a whole severely lacks the required level of complexity to actually fix these issues, and that often leaves a lot to be desired. X hormone is low? Let's just replace it without any real investigation as to why its low outside of "are you morbidly obese?". Oh look, now y hormone is low due to taking x hormone, let take something for that too. Before you know it every system in the body is dysregulated and you end up where I am now.

I have no idea where to even start when trying to find the underlying issue, as essentially everything is interlinked so you have no clue what is causing what. My iron levels are high, my prog is low, my thyroid function is extremely poor, my test levels are on the low end, my white blood cell count is low - but which one of those, if any, is actually the cause of the rest? Who knows, and the scary thing is I don't envisage myself finding out anytime soon.

That got unintentionally long and depressing haha, but it's just a brief overview of how I'm looking at this whole situation at the minute. I left out all of the specifics and pathways I'm considering, but if I find anything concrete I'll post the whole thing at some point.

 

[PhantomFear]

I had prior blood tests with high iron saturation, with a low normal ferritin.

About a month ago, I decided to go back to some of the RCP supplements, stay away from meats and fortified foods, and eat a lot of eggs, and I had a major breakthrough for a few weeks. There has to be some kind of mechanism it triggers.

I only used supplements I have lying around. Their protocol they send you is filled with affiliate links, but I buy all my supplements from local stores.

Maybe there was no correlation between the supplements and my improvement. I think it was worth sharing since your iron is high.

I appreciate you taking the time to share your experience. Can I ask exactly what supplements you take and at what dosges if it's not too much hassle?

Were you ever tested for hereditary hemochromatosis? I believe our issues are due to mineral dysregulation due to our normal ferritin, but I might get tested anyway.

 

[Vvs1]

@Vvs1 I’d also like to know how you came to the conclusion that you have iron overload. What is your ferritin level, does that factor in when determining iron overload, or is it mostly based on total iron, iron saturation and/ or total iron binding capacity?

Ive listened to almost all of Morley robbins interviews. Not sure what to make of it all. His stuff on vitamin D makes sense, but so many people do well supplementing with vitamin D, so it’s extremely confusing. It also makes it confusing when there’s so many men that have low iron, and feel so much better after supplementing with iron. Plus, for the thyroid to work properly, it requires optimal iron levels.

I went back on his protocol thinking that it can’t hurt. I do find his message can be confusing as I had to research what he meant by our bodies being copper deserts. I believe that’s a big deficiency, and that matches my RBC copper that was the very bottom of the range.

It makes sense that there’s zinc and iron in nearly all processed foods.