Getting ready to stop TRT.... What do I need to know?

[BillyJ03z]

Ok, guys I am coming to the end of the journey of TRT... I have been on since 2010 and I never ever felt optimal, always feeling "meh", libido "meh", sleep horrible, up and down E2/DHT and now thinning hair (yay!)... I'm a low SHBG guy and I have been on Test Cyp and Prop variation of dosing and injection protocol, etc... I'm currently on my last run, past 2 1/2 months running Test Prop @ 15mg ed sq and awaiting my blood work to see where I'm at. Regardless where my numbers fall on this blood work I will most likely drop down to Prop @ 10mg ed sq as I still don't feel right @ 15mg. I am going to try to add preg and progesterone cream and see if that helps. I am on Armour Thyroid and that has helped in normalizing my lipid panel which was always out range, and the Armour raised my SHBG from single digits to 23... I am currently prescribed 200mg's of Bupropion SR (Wellbutrin) to help with my depression and I have been on one week but I don't feel even the slightest benefit (I know it takes up to 6 weeks) but I think my Dopamine may be so far down regulated from being on TRT that I'm probably spinning my wheels with Bupropion at this point.

Anyway, What do I need prepare myself to come off TRT? (My doctor is pretty good and will prescribe what I feel I need if I can articulate why!)

Also, since I have been on TRT the past 10 years what is my prognosis for coming off and recovering?

 

[Strengthandlibido]

Ok, guys I am coming to the end of the journey of TRT... I have been on since 2010 and I never ever felt optimal, always feeling "meh", libido "meh", sleep horrible, up and down E2/DHT and now thinning hair (yay!)... I'm a low SHBG guy and I have been on Test Cyp and Prop variation of dosing and injection protocol, etc... I'm currently on my last run, past 2 1/2 months running Test Prop @ 15mg ed sq and awaiting my blood work to see where I'm at. Regardless where my numbers fall on this blood work I will most likely drop down to Prop @ 10mg ed sq as I still don't feel right @ 15mg. I am going to try to add preg and progesterone cream and see if that helps. I am on Armour Thyroid and that has helped in normalizing my lipid panel which was always out range, and the Armour raised my SHBG from single digits to 23... I am currently prescribed 200mg's of Bupropion SR (Wellbutrin) to help with my depression and I have been on one week but I don't feel even the slightest benefit (I know it takes up to 6 weeks) but I think my Dopamine may be so far down regulated from being on TRT that I'm probably spinning my wheels with Bupropion at this point.

Anyway, What do I need prepare myself to come off TRT? (My doctor is pretty good and will prescribe what I feel I need if I can articulate why!)

Also, since I have been on TRT the past 10 years what is my prognosis for coming off and recovering?

I'm on Wellbutrin too (and Aripiprazole) and I feel it's working great for me. And I abused both steroids and recreational substances for years (if I only knew then what I know now). My mood disorder isn't a problem on this combo; my panic attacks have stopped; I'm hypogonadal still so feelings of wellbeing can be challenging to obtain, but, again, I really feel like the psyche meds are helping a ton. And that's with my burnt-out dopamine receptors. So maybe there's hope.

I like your plan to try with a lower dose that will provide a more natural-looking daily 7 mg of test. I'm just starting my proper TRT journey now after having blasted and cruised for a few years during a midlife body-dysmorphia crisis. And I'm starting low (works out to 6.3 mg of actual test/day) and titrating up slowly as dictated by libido and labs (in that order). So I'm wishing you good luck with this last attempt at a lower dose.

 

[BillyJ03z]

I'm on Wellbutrin too (and Aripiprazole) and I feel it's working great for me. And I abused both steroids and recreational substances for years (if I only knew then what I know now). My mood disorder isn't a problem on this combo; my panic attacks have stopped; I'm hypogonadal still so feelings of wellbeing can be challenging to obtain, but, again, I really feel like the psyche meds are helping a ton. And that's with my burnt-out dopamine receptors. So maybe there's hope.

I like your plan to try with a lower dose that will provide a more natural-looking daily 7 mg of test. I'm just starting my proper TRT journey now after having blasted and cruised for a few years during a midlife body-dysmorphia crisis. And I'm starting low (works out to 6.3 mg of actual test/day) and titrating up slowly as dictated by libido and labs (in that order). So I'm wishing you good luck with this last attempt at a lower dose.

If you don't mind me asking... what brand of Bupropion are you using or are you on Brand name Wellbutrin? Also, I am on Bupropion SR 200mg, what dose and how long did it take for you to feel better?

I want to feel normal, happy, motivated to workout, improve my cognition, have a good libido and get stuff done around the house, but being on TRT for all these years I have been the opposite of those feelings.... I may just go lower than 10mg of Prop and go straight to 8mg (5.6mg pure test).. but then there is the challenge of my low SHBG which I think I may found a work around with Thyroid supplementation as it raised my SHBG from single digits to 23.

 

[Strengthandlibido]

If you don't mind me asking... what brand of Bupropion are you using or are you on Brand name Wellbutrin? Also, I am on Bupropion SR 200mg, what dose and how long did it take for you to feel better?

I want to feel normal, happy, motivated to workout, improve my cognition, have a good libido and get stuff done around the house, but being on TRT for all these years I have been the opposite of those feelings.... I may just go lower than 10mg of Prop and go straight to 8mg (5.6mg pure test).. but then there is the challenge of my low SHBG which I think I may found a work around with Thyroid supplementation as it raised my SHBG from single digits to 23.

I'm on Bupropion HCl extended-release tabs of 150 mg from Slate Run Pharmaceuticals, so not Wellbutrin. I'm not sure how long it took, but I feel it was only a couple of weeks, almost definitely less than a month. What I am sure of is that my behavior and outlook by month two were night-and-day different from what I was pre-medication. Everyone around me notices it, too, much to their relief. I really wish I'd gotten on these meds many years ago.

I've heard good things about Natesto and nasal testosterone gel (TNG) in general. If you're that willing to toy with low doses (which is rad), maybe you'd consider the benefits of the nasal route. @Cataceous believes this should be the first attempt at HRT, before even low-dose TRT, which still suppresses the HPTA and other vital hormones for wellbeing and libido. TNG seems not to have nearly the same suppressive effect and that could be vital for some fellows for whom TRT just never works psychologically/sexually.

 

[DFL]

I'm just going to chime in on depression and Bupropion. 4 years ago when I started TRT I was 50 years old and extremely depressed after divorce and business problems (though my depression is not only situational). TRT gave me a very mild mood boost. I started Bupropion around 2.5 years ago, ending up at 300XL daily. That gave me I'd say a 40% overall improvement, which is huge. Another benefit has been increased libido, which continues to this day.

However, I just had an experience I want to share. A nurse practitioner I see recommended TMS (Transcranial Magnetic Stimulaition) maybe 1.5 years ago. I finally got around to giving it a try, and I finished 36 appointments 2 weeks ago. My depression is now in remission. In terms of depression scale:

Pre-Bupropion: 21
Pre-TMS: 11
Post-TMS: 3

I feel better than I have in 25 years. It's quite an experience! Wish I had tried it sooner. I know it does not work that well for everyone, but if your insurance will cover it it's certainly worth a shot. My out of pocket was $1200 (treatment runs around $7K) and it's the best money I have ever spent. It would have been worth paying the whole amount.

Hope that helps someone...

 

[BillyJ03z]

I'm just going to chime in on depression and Bupropion. 4 years ago when I started TRT I was 50 years old and extremely depressed after divorce and business problems (though my depression is not only situational). TRT gave me a very mild mood boost. I started Bupropion around 2.5 years ago, ending up at 300XL daily. That gave me I'd say a 40% overall improvement, which is huge. Another benefit has been increased libido, which continues to this day.

However, I just had an experience I want to share. A nurse practitioner I see recommended TMS (Transcranial Magnetic Stimulaition) maybe 1.5 years ago. I finally got around to giving it a try, and I finished 36 appointments 2 weeks ago. My depression is now in remission. In terms of depression scale:

Pre-Bupropion: 21
Pre-TMS: 11
Post-TMS: 3

I feel better than I have in 25 years. It's quite an experience! Wish I had tried it sooner. I know it does not work that well for everyone, but if your insurance will cover it it's certainly worth a shot. My out of pocket was $1200 (treatment runs around $7K) and it's the best money I have ever spent. It would have been worth paying the whole amount.

Hope that helps someone...

At this point, I'm looking for any help at all..... I haven't slept good for the last 10-15 years... Had apnea test done and they said I very rarely hit REM and If I do it is quick... I wake up every hour or 2 like clockwork... Last night I must have woke up every 30 minutes and today I am wrecked beyond belief... The feeling of being extremely tired, physically sore, bobble headed feeling and I can not fall asleep to save my life. I will look into TMS, as Im 2 weeks in on Bupropion and no improvement

 

[DFL]

At this point, I'm looking for any help at all..... I haven't slept good for the last 10-15 years... Had apnea test done and they said I very rarely hit REM and If I do it is quick... I wake up every hour or 2 like clockwork... Last night I must have woke up every 30 minutes and today I am wrecked beyond belief... The feeling of being extremely tired, physically sore, bobble headed feeling and I can not fall asleep to save my life. I will look into TMS, as Im 2 weeks in on Bupropion and no improvement

Certainly give it a little more time. Also, for me, the difference between 200SR and 300XL was very significant. It CAN increase insomnia. I take 3mg instant Melatonin, and also 5mg Melatonin which combines 2mg instant with 3mg slow release. Never takes longer than 15 minutes for me to get to sleep unless I drink strong coffee in the afternoon. It has helped me a lot with early waking insomnia.

 

[sammmy]

I'm on Wellbutrin too (and Aripiprazole) and I feel it's working great for me. And I abused both steroids and recreational substances for years (if I only knew then what I know now). My mood disorder isn't a problem on this combo; my panic attacks have stopped; I'm hypogonadal still so feelings of wellbeing can be challenging to obtain, but, again, I really feel like the psyche meds are helping a ton. And that's with my burnt-out dopamine receptors. So maybe there's hope.

I like your plan to try with a lower dose that will provide a more natural-looking daily 7 mg of test. I'm just starting my proper TRT journey now after having blasted and cruised for a few years during a midlife body-dysmorphia crisis. And I'm starting low (works out to 6.3 mg of actual test/day) and titrating up slowly as dictated by libido and labs (in that order). So I'm wishing you good luck with this last attempt at a lower dose.

In this case, the major improvement may be coming from Aripiprazole, not Wellbutrin. Aripiprazole is a peculiar anti-psychotic, and mood stabilizer, that actually stimulates some dopamine and libido. Most other anti-psychotics depress libido. Aripiprazole is actually added to antidepressants to mitigate their negative sexual side effects.

I've tried Wellbutrin in the past and it didn't give me any anti-depressant effect, just made me more irritable, but everyone is a different system to treat.

 

[CKO]

I'm just going to chime in on depression and Bupropion. 4 years ago when I started TRT I was 50 years old and extremely depressed after divorce and business problems (though my depression is not only situational). TRT gave me a very mild mood boost. I started Bupropion around 2.5 years ago, ending up at 300XL daily. That gave me I'd say a 40% overall improvement, which is huge. Another benefit has been increased libido, which continues to this day.

However, I just had an experience I want to share. A nurse practitioner I see recommended TMS (Transcranial Magnetic Stimulaition) maybe 1.5 years ago. I finally got around to giving it a try, and I finished 36 appointments 2 weeks ago. My depression is now in remission. In terms of depression scale:

Pre-Bupropion: 21
Pre-TMS: 11
Post-TMS: 3

I feel better than I have in 25 years. It's quite an experience! Wish I had tried it sooner. I know it does not work that well for everyone, but if your insurance will cover it it's certainly worth a shot. My out of pocket was $1200 (treatment runs around $7K) and it's the best money I have ever spent. It would have been worth paying the whole amount.

Hope that helps someone...

Thanks for posting this. I started TMS today and I'm hopeful it will help. I've been through a lot of treatments/medications in the past decade wrestling with PTSD/Depression. I just went through EMDR which was very helpful for dealing with trauma and anxiety/hyper vigilance. Coming out of EMDR I realized how severe my depression actually is. My provider highly recommended it.

 

[MIP1950]

I'm just going to chime in on depression and Bupropion. 4 years ago when I started TRT I was 50 years old and extremely depressed after divorce and business problems (though my depression is not only situational). TRT gave me a very mild mood boost. I started Bupropion around 2.5 years ago, ending up at 300XL daily. That gave me I'd say a 40% overall improvement, which is huge. Another benefit has been increased libido, which continues to this day.

However, I just had an experience I want to share. A nurse practitioner I see recommended TMS (Transcranial Magnetic Stimulaition) maybe 1.5 years ago. I finally got around to giving it a try, and I finished 36 appointments 2 weeks ago. My depression is now in remission. In terms of depression scale:

Pre-Bupropion: 21
Pre-TMS: 11
Post-TMS: 3

I feel better than I have in 25 years. It's quite an experience! Wish I had tried it sooner. I know it does not work that well for everyone, but if your insurance will cover it it's certainly worth a shot. My out of pocket was $1200 (treatment runs around $7K) and it's the best money I have ever spent. It would have been worth paying the whole amount.

Hope that helps someone...

You're the first person I've read who gave an account of their experience with TMS. I have bipolar, with depression now being the dominant symptom. My psychiatrist has said that I now might be able to get it covered by insurance. The clinic she's with uses Neurostar TMS. The only other option is ECT and unless I'm actively suicidal, which I'm not, I don't want my memories lost and thought processes damaged.

 

[Dicky]

At this point, I'm looking for any help at all..... I haven't slept good for the last 10-15 years... Had apnea test done and they said I very rarely hit REM and If I do it is quick... I wake up every hour or 2 like clockwork... Last night I must have woke up every 30 minutes and today I am wrecked beyond belief... The feeling of being extremely tired, physically sore, bobble headed feeling and I can not fall asleep to save my life. I will look into TMS, as Im 2 weeks in on Bupropion and no improvement

I am late to this thread. But did your doctor give you any solutions for not hitting REM sleep for very long?

 

[DS3]

At this point, I'm looking for any help at all..... I haven't slept good for the last 10-15 years... Had apnea test done and they said I very rarely hit REM and If I do it is quick... I wake up every hour or 2 like clockwork... Last night I must have woke up every 30 minutes and today I am wrecked beyond belief... The feeling of being extremely tired, physically sore, bobble headed feeling and I can not fall asleep to save my life. I will look into TMS, as Im 2 weeks in on Bupropion and no improvement

Have you added pregnenolone/progesterone before bed as you stated in the OP?

 

[BillyJ03z]

I am late to this thread. But did your doctor give you any solutions for not hitting REM sleep for very long?

Nope....

 

[BillyJ03z]

Have you added pregnenolone/progesterone before bed as you stated in the OP?

I've added 20mg DHEA, 50mg Preg in morning... and 10mg topical Progesterone cream at Bedtime.... No changes so far....

 

[MIP1950]

Have you added pregnenolone/progesterone before bed as you stated in the OP?

My psychiatrist, who also is a neurologist, told me that most sleep doctors only look for apnea, but there are other neurologic dysfunctions that can cause sleep disorders. Talk with the neurologist. Don't let the doctor BS you. You need answers. For context, I've had treatment resistant bipolar illness for a bit over 17 years, along with non-restorative sleep. Addicted to Klonopin for all those years. Everyday is a struggle.

You're trying bupropion and considering TMS, so I'm to presume you're going to a psychiatrist? What is his or her opinion regarding your severe sleep problems? I know this is miserable and ruining your life but don't give up.

 

[BillyJ03z]

My psychiatrist, who also is a neurologist, told me that most sleep doctors only look for apnea, but there are other neurologic dysfunctions that can cause sleep disorders. Talk with the neurologist. Don't let the doctor BS you. You need answers. For context, I've had treatment resistant bipolar illness for a bit over 17 years, along with non-restorative sleep. Addicted to Klonopin for all those years. Everyday is a struggle.

You're trying bupropion and considering TMS, so I'm to presume you're going to a psychiatrist? What is his or her opinion regarding your severe sleep problems? I know this is miserable and ruining your life but don't give up.

Nope not seeing a Psychiatrist..... I do often think that maybe my sleep issues are Neurological as evidenced by my sleep study (I barely hit REM). I used to work as a Federal Air Marshal for 13 years (dealing with constant time zone changes, different sleep schedules, jet lag, etc.) and I positively know this is what contributed/started my issues. I've been on Bupropion for about 3 solid weeks and I feel nothing.. I thought maybe I wasn't feeling anything because I was using Generic bupropion, so my doctor just prescribed brand Wellbutrin (which cost $250 through my insurance... f'n ridiculous) and I will see if that makes a difference..

 

[DS3]

I've added 20mg DHEA, 50mg Preg in morning... and 10mg topical Progesterone cream at Bedtime.... No changes so far....

How about Magnesium and/or Melatonin?

 

[MIP1950]

Nope not seeing a Psychiatrist..... I do often think that maybe my sleep issues are Neurological as evidenced by my sleep study (I barely hit REM). I used to work as a Federal Air Marshal for 13 years (dealing with constant time zone changes, different sleep schedules, jet lag, etc.) and I positively know this is what contributed/started my issues. I've been on Bupropion for about 3 solid weeks and I feel nothing.. I thought maybe I wasn't feeling anything because I was using Generic bupropion, so my doctor just prescribed brand Wellbutrin (which cost $250 through my insurance... f'n ridiculous) and I will see if that makes a difference..

Agree that it would seem that constantly changing time zones, shifting sleep schedule and jet lag could be the triggers for circadian rhythm dysfunction. The neurologist/sleep specialist had nothing to say about any of that? Sleep dysfunction is at the core of bipolar, too. Sleep problems precede the emergence of the illness. Did you go to a private sleep clinic or a university sleep clinic?

I had a sleep study 9 years ago and the doctor, though he had excellent credentials, didn't seem to care that I couldn't tolerate CPAP nor would he speak with my psychiatrist at the time(in Maryland) who is a renowned researcher with the NIMH. He was a prick. Some doctors don't like a challenge. If they can't figure it out, they lose interest.

 

[BillyJ03z]

How about Magnesium and/or Melatonin?

200mg Magnesium at bedtime with selenium and zinc... 10mg melatonin...

 

[BillyJ03z]

Agree that it would seem that constantly changing time zones, shifting sleep schedule and jet lag could be the triggers for circadian rhythm dysfunction. The neurologist/sleep specialist had nothing to say about any of that? Sleep dysfunction is at the core of bipolar, too. Sleep problems precede the emergence of the illness. Did you go to a private sleep clinic or a university sleep clinic?

I had a sleep study 9 years ago and the doctor, though he had excellent credentials, didn't seem to care that I couldn't tolerate CPAP nor would he speak with my psychiatrist at the time(in Maryland) who is a renowned researcher with the NIMH. He was a prick. Some doctors don't like a challenge. If they can't figure it out, they lose interest.

I tried Cpap and I lasted maybe a week.... Maybe I need to see a neurologist....