Thx GB
Is someone goes on TRT, is the ususal protocol to include HCG also so as to avoid "atrophy"?
Is this standard or would I have to go to a special endo who is used to this procedure?
It is not usual to add HCG to TRT, It is something rarely seen anywhere outside of the US and something very often not seen even in the US.
But that does not make it wrong by any means.
One particular specialist has a highly advertised protocol that uses HCG to prevent testicular atrophy alongside TRT and his patients are supposed to be very happy with the results. His name is Dr John Crisler and he is recommended by a number of men I know, I can get you his contract details if you wish?
It must be remembered that HCG only helps if your testicles have at least SOME function. If they cannot produce any testosterone then you won’t get a response from HCG and in fact HCG would be inappropriate.
Dr Eugene Shippen is another forward thinking specialist who uses HCG in appropriate circumstances. In some men I believe he uses it instead of TRT on its own. Again I can get you his contact details if you wish?
Suppose I got off TRT after having been on it for years...would I have no endogenous test production again? Or would things just kind of ramp back up?
It depends upon a number of factors some of which are;
The cause of your deficiency,
The size/appropriateness of the dose of TRT
The form of TRT
Your response to the TRT
In most cases the HPTA is suppressed when guys are on TRT.
The HPTA has a negative feedback system. IF this feedback system works correctly or to some degree (it often doesn’t work in hypogonadotropic hypogonadism) and IF the testicles can produce some testosterone then IN TIME testosterone production will return.
The operative words above are IF and IN TIME.
What is typically seen is a return to that of pre treatment TRT levels or thereabouts (it is possible that it could be worse).
Because it takes time for the HPTA to kick back in and because it takes time to reach something approaching pre treatment/TRT levels and because even then we are talking about poor levels of testosterone (hence the diagnosis and TRT to start with) you have two problems.
A) A period of time exists when TRT is stopped and the HPTA has not got testosterone production up and running. During this time estrogen if not correctly medicated can go unopposed as it takes much longer to come down to lower levels and this can result in a short term problem of a very poor androgen to estrogen balance and the perfect conditions for the development of gynecomastia.
Men in this situation can see gynecomastia development within days!!!
B) Even when/if testosterone production returns to pre-treatment levels, it is still a poor testosterone level hence the diagnosis and prior treatment. If this is what caused the gynecomastia to develop in the first place, even with the limited production up and running then you are again in a situation when gynecomastia can return.
I have heard many men prior to going on TRT say things like I don’t want to go on it for life or is treatment for life?
As Dr John Crisler puts it;
No you can go back to feeling as ill as you did before treatment.
It is odd, but the fact is if your health improves and you feel better, why would you care if it is for life, I mean would you back out of becoming a millionaire because it could be for life? Lol
Points you should be aware of;
If you go on TRT fertility can be adversely affected if it isn’t already a problem. It is often stated that this can be got around if fertility is possible pre treatment (by having fertility therapy or by sperm banking pre treatment).
Fertility is less likely to be affected by HCG alone or Clomid therapy alone, although both are only options in clear cases of secondary/pituitary based hypogonadism or hypogonadotropuic hypogonadism as it is called where the testicles fully function and the latter of the two therapies is a little controversial/not everyone agrees with its use.
If you are on TRT and HCG then fertility may be affected a little less than on TRT alone (all presuming that fertility is possible pre treatment).
If you come off HCG alone or HCG in combination with TRT you still get the same suppression at the HPTA as you do with TRT alone because although HCG stimulates the HPTA, it actually replaces LH being an analogue that mimics LH. When HCG is removed then the HPTA and LH are at rock bottom.
This is not the case with Clomid, but a rebound effect can occur unless estradiol is correctly handled.
So………………
You can come off TRT and get something like if not your full inadequate testosterone production back…..but doing so whilst preventing gynecomastia development via mentioned mechanisms takes the help and good practice of a forward thinking specialist (PCT guesswork as employed by bodybuilders, doesn’t cut the mustard in these situations).
Topic: TRT question for hypo-is-here (Read 2315 times)
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