Cycling TRT

[tareload]

24-Hour Urinary Cortisol Results

Good point. Take a gander those of you who may incorrectly think higher endogenous T levels strongly correlate with improved athletic performance, strength, etc, etc. Complicating all of this is the fact that elite athletes’ testosterone levels vary quite a lot. One analysis found that...

forums.t-nation.com

Optimization is code many times for running supra T for noticeable higher FFM while sometimes wishfully thinking there won't be a price to pay. We know enough about supra T and AAS to know that may be risky for many. 400 ng/dl at 40 years old is bad, I need 1500 ng/dl. Be careful. We know endogenous T level is not the deciding factor for male performance at an elite level (see link and papers discussing this therein). Also, how many dudes know what their TT, fT (good luck), SHBG was at 20 years old?

There's a wonderful picture out there that every young dude had a TT of 1000-1500 ng/dl 30 to 50 years ago that is absolutely absurd and not at all supported by the data we have available that goes back to late 60s-early 70s when TT via RIA became commercially available.

Will you increase your FFM on TOT with diet and training dialed in? Absolutely. Is there a price to pay in 3, 5, 10 years? One way to find out but be careful as you may not like the answer. It's great the option is out there with informed consent, but caution seems prudent.

My own anecdotal experience...after 3.5 years on TRT I'm 20 lb heavier at same very low bodyfat level. Was a pre-TRT level of 380 ng/dl with SHBG about 60 nmol/l really my problem in terms of quality of life? No.

Do I need my RT3 at 5 ng/dl and fT3 at top of reference range? No.

Is the idea of T4/T3 therapy or T3 monotherapy with a baseline TSH of 2-3 mIU/L usually insane? Yes.

Are you somehow inferior if your fT3 is near the bottom of ref range with a TSH in range? No probably not.

Does everyone want to be above average? Absolutely.

Are they? No.

Is there a significant risk adjusting your hormone levels higher than where your body wants them for homeostasis (ignoring obvious disease)? We will find out now that TOT and its thyroid equivalent is being practiced more and more.

 

[ivkonst2017]

hypogonadism < TRT < TRT+hCG < TRT+GnRH+...

Generally I agree to that and lets hope that we get more options in the future, but you know many men dont tolerate HCG, with Natesto I guess will be the same

 

[Cataceous]

... On another point I dont agree with you is that levels on TRT cannot be compared to endogenous levels, on replacement usually we need to go higher to achieve the same effect. ...

I'll readily accept that the whole endogenous experience is going to be different from TRT. But if we're talking about testosterone in isolation then which particular effects require greater serum levels and why? Same with the claim about higher T overcoming issues when a guy "screws up his health". Which effects and why? A guy eats a crappy diet and then pushes up his testosterone from 1,000 ng/dL to 1,300 ng/dL and this is somehow going to fix things? The longstanding good advice from the forums is that TRT is not a cure-all, and if you're looking for good health then you need to adopt a holistic approach that includes proper diet and exercise.

 

[ivkonst2017]

The longstanding good advice from the forums is that TRT is not a cure-all, and if you're looking for good health then you need to adopt a holistic approach that includes proper diet and

Totally agree on that, diet lifestyle and optimising all other health issues should be taken into account on the other hand together with TRT - thyroid, liver, IR, metabolic disease and these are just the most common.

But dissecting into the TRT part of all this we should also acknowledge some guys really need more T to get rid of the testosterone related symptoms - why, we dont know yet. My doctor shared with me for many of his new comming patients TRT therapy doesnt work well enough because they just dont take enough for the sole purpose to be within the reference range. And he is treating testosterone together with the issues mentioned above, not just jacking up his patients.

For example for me he focuses now mostly on my liver as the source of most remaining symptoms and we will be trying different protocols there together with optimising the thyroid with NDT and continuation of my caloric deficit and weight loss that has been ongoing for the last 5 months. After these have been settled his plan is to try a bit of ptegnenolone also but only if symptoms and blood work then suggest so.

 

[DorianGray]

This is precisely why Natesto is interesting. You get to sample higher testosterone levels without breaking a functioning HPTA.

That was my point. However, it seems Natesto is in doubt at this point and more research will be done. The sooner the better.

@Cataceous, are you supplementing GnRH? Would it be valid to test status in advance of T therapy, as with: LH Response to GNRH ?

 

[Cataceous]

...
@Cataceous, are you supplementing GnRH? ...

Yes, with the lead-in documented here.

... Would it be valid to test status in advance of T therapy, as with: LH Response to GNRH ?

You could perform a GnRH stimulation test like this if you wanted to know more about the origins of your hypogonadism. If the baseline LH result is already elevated then primary hypogonadism is suspected, and would be considered likely if the post-stimulation LH doesn't rise appreciably. If baseline LH is low-to-normal and it doesn't increase significantly after stimulation then pituitary dysfunction is likely. If baseline LH is low-to-normal and it increases significantly after stimulation then hypothalamic dysfunction is likely.

I suspect that hypothalamic dysfunction is the most common cause of hypogonadism.

 

[Willyt]

Daily prop similar to daily Natesto.....PIPE DREAM!

Perhaps it is a pipe dream, but its worth having the conversation for the reasons Cat mentions below. Heavily suppressing the HPTA over a period of years has a cascading waterfall of implications. The emotional flatness that so many complain about on TRT is reason enough for me to experiment with ways to minimize HPTA shutdown. It will be interesting to see what the blood tests show for the trough following the off-day.

Where would we be at if no one experimented on this forum? - still injecting excessive amounts of T once per week with harpoon needles coupled with endless AI swings and monthly blood donations?

 

[madman]

Perhaps it is a pipe dream, but its worth having the conversation for the reasons Cat mentions below. Heavily suppressing the HPTA over a period of years has a cascading waterfall of implications. The emotional flatness that so many complain about on TRT is reason enough for me to experiment with ways to minimize HPTA shutdown. It will be interesting to see what the blood tests show for the trough following the off-day.

Where would we be at if no one experimented on this forum? - still injecting excessive amounts of T once per week with harpoon needles coupled with endless AI swings and monthly blood donations?

Heavily suppressing the HPTA over a period of years has a cascading waterfall of implications. The emotional flatness that so many complain about on TRT is reason enough for me to experiment with ways to minimize HPTA shutdown.

Unfortunately injecting prop daily even with taking a day off let alone two every week is still going to have a significant impact on suppression of the HPG axis.


Where would we be at if no one experimented on this forum? - still injecting excessive amounts of T once per week with harpoon needles coupled with endless AI swings and monthly blood donations?

As I have stated before if it suits your fancy let alone makes sense.....sure!

 

[ivkonst2017]

Doesnt natesto have often bad nasal side effrcts and isnt jatenzo a lot better option?

 

[Phil Goodman]

This is precisely why Natesto is interesting. You get to sample higher testosterone levels without breaking a functioning HPTA.

What is "optimized testosterone"? It seems as though lately guys are wanting to define this as the highest amount that doesn't cause overt side effects. I've argued that nature already decided on optimum levels—which are found in the averages for healthy young men. These are the levels that lead to the best reproductive success, which arguably correlates well with measures of overall success in life. Yes, average levels are a compromise. Maybe you sacrifice on some traits, like athleticism, but you gain on others, like the ability to maintain a stable relationship. "... men with higher basal T levels are less likely to marry and more likely to divorce..."1

In any case, the context for my anecdote is this precedence, which is also my treatment progression:

hypogonadism < TRT < TRT+hCG < TRT+GnRH+...​

In short, the better I reproduce a normal HPTA, the better I feel. This is in part why I've become a proponent of preserving the HPTA when possible. The theoretical issues also figure in this: For example, all those GnRH and LH receptors with as-yet unknown functions.

Interesting topic and I’d be intrigued to hear from people who’ve tried various approaches to cycling TRT and/or other approaches to maintain HPTA function. Of course, to do that it would be ideal to go in with a nice system already in place. Unfortunately due to today’s environment that aspect seems harder and harder to maintain. Our endocrine systems are under constant barrage from the world around us. Couple that with the fact that people are so different with so many variables at play and it seems that it would be impossible to definitively show a “best approach”. As you point out though, hypogonadism is at the bottom of the list for you in terms of desired states so it seems avoiding that as much as possible is a reasonable approach. Does that mean cycling to minimize that state but also taking breaks to allow the HPTA a chance to function as intended occasionally? Does that mean simply mimicking a functioning HPTA while not really having it function as intended is the best route?

I agree with you that there is probably some value in restarting the HPTA though. But how do we determine the path that optimizes the benefits while minimizing the discomfort of getting to that point?

 

[DorianGray]

Well, it's not a clear path, Phil and certainly one that affects individuals differently. Somewhat like trying to determine the real world looking through a stained glass window. Thankfully, due to the varied experiences of people on this forum, we can piece together a bigger picture. For me, I'm off TRT for about three weeks now and feeling better than I have in a while. I'm continuing with HCG but weaning off also. Increased my level of exercise and tilted toward more weightlifting.

 

[Phil Goodman]

Well, it's not a clear path, Phil and certainly one that affects individuals differently. Somewhat like trying to determine the real world looking through a stained glass window. Thankfully, due to the varied experiences of people on this forum, we can piece together a bigger picture. For me, I'm off TRT for about three weeks now and feeling better than I have in a while. I'm continuing with HCG but weaning off also. Increased my level of exercise and tilted toward more weightlifting.

How long were you on? Either way I’m glad you’re feeling better so hopefully that trend will continue. Are you planning on adding anything after the HCG is done? And that question segues into something I was wondering in regards to this thread:

Would dosing natesto or jatenzo bring your HPTA back online to help with a transition off of TRT? Not specifically a question for you, but something I’ve thought about before. It seems they minimize HPTA shutdown, but would that translate to an effective kickstart? Would your body say “ok, looks like we need to start producing T again because we aren’t getting flooded with it anymore” or would it go “T is still coming from somewhere so no need to start production back up yet”. I imagine it would vary from person to person, but I’d be interested to see people who go from injections straight to one of those two and then get tested for LH and FSH 8-12 weeks later.

 

[DorianGray]

How long were you on? Either way I’m glad you’re feeling better so hopefully that trend will continue. Are you planning on adding anything after the HCG is done? And that question segues into something I was wondering in regards to this thread:

Would dosing natesto or jatenzo bring your HPTA back online to help with a transition off of TRT? Not specifically a question for you, but something I’ve thought about before. It seems they minimize HPTA shutdown, but would that translate to an effective kickstart? Would your body say “ok, looks like we need to start producing T again because we aren’t getting flooded with it anymore” or would it go “T is still coming from somewhere so no need to start production back up yet”. I imagine it would vary from person to person, but I’d be interested to see people who go from injections straight to one of those two and then get tested for LH and FSH 8-12 weeks later.

I was on cream + HCG for over a year. Prior to that, about two on T-cyp, which I quit cold turkey, then about a one ten month break before the cream/HCG. T level came back to about previous levels ~680. Of course so did the lower free T and higher SHBG. But, how much this time is more a race against higher age than physiological response, I think. Anyway, will get testing in a couple months.

 

[Phil Goodman]

I was on cream + HCG for over a year. Prior to that, about two on T-cyp, which I quit cold turkey, then about a one ten month break before the cream/HCG. T level came back to about previous levels ~680. Of course so did the lower free T and higher SHBG. But, how much this time is more a race against higher age than physiological response, I think. Anyway, will get testing in a couple months.

Sounds like you and I are in a similar boat from the perspective of good total test but low free. I certainly think a good workout routine will be beneficial for you, but the SHBG aspect is something to be cognizant of. Both heavy lifting and caloric deficits can drive up SHBG, so you’ll probably have to tinker with your workout schedule to make sure you allow enough recovery time to avoid overtaxing the body and sending your SHBG too high.