Quote:
|
Originally Posted by hoochyman1 I had the same question awhile back, but haven't attracted any response.
The reason I had asked about this is that so many people who have used testosterone experience shut-down of the HPTA, sometimes for a long time. I gather that this is mostly younger men who have taken much higher dosages than you would ordinarily use for TRT (I'm injecting 100 mg test E every 5 days). Since I'm older (67) I wondered whether my age might make me more susceptible to HPTA shut-down, even at this relatively low dose, should I ever have to stop TRT (e.g., because of polycythemia, etc.) I wondered whether periodic respites might restart my HPTA, and avoid extended or permanent shut-down in the event I have to stop TRT some day.
My serum testosterone before TRT wasn't 'officially' hypogonadal (it was around 450) but I had strong signs of androlpause anyway. The TRT has been extremely effective. I also wonder, though, whether I'm not driving my serum T up too high (over 800 ng/DL 5 days after injection, range is 200-1000). Free test also high, outside 'normal' range), around 50. Am I taking too high a dosage? I don't aromatize all that much, estradiol is 30 ( a good number, optimal thought to be 20-30).
Thanks for following up on this question. |
1. What were the signs of andropause? The question I would have is whether nor not the signs of andropause were caused by other hormonal problems than testosterone.
2. The Hypothalamic-Pituitary-Testicular axis will always be suppressed with testosterone replacement therapy (including
HCG therapy). In order to raise testosterone level over the baseline enough testosterone has to be added to overcome the reduction LH production from the pituitary from testosterone replacement. The testes will atrophy stop testosterone production from the loss of LH production - unless
HCG - an LH analog - is used to prevent testicular atrophy. Whether or not the HPT axis can bounce back to full activity will depend on many factors including one's age. Past the age of 60 or even younger ages, for example, the testes may not respond to LH or HCG. Past the age of 50 or even at younger ages, the pituitary of many men is too old to preduce enough LH to drive testosterone production.
3. One does not have to completely stop
TRT due to polycythemia. The dose can be reduced or blood can be donated or removed, etc. to reduce the risk of polycythemia.
4. Free Testosterone is determined primarily by the level of Sex Hormone Binding Globulin (SHBG) because albumin production is fairly stable - unless dehydration or dietary protein insufficiency is present. SHBG is increased by thyroid hormone, estradiol, and progesterone. SHBG is reduced by testosterone, DHEA, insulin, growth hormone, Dihydrotestosterone, and other androgens.
5. A high free testosterone with high-physiologic total testosterone implies there are other hormone problems besides testosterone. Common problems include hypothyroidism, insulin-resistance (which causes high insulin levels), adrenal fatigue, etc. Testosterone treatment alone may not fully correct these problems in many men. One is lucky if it does since it can in some men.
6. Due to age-related changes which can be irreversible, I do not think the HPT axis can be fully restored in older men (e.g. those over 40). Thus periodic withdrawal of
TRT may be an exercise in exposing a person to problems caused by low testosterone.
7. Early treatment with
growth hormone might slow down the deterioration in the HPT axis. Growth hormone drops quickly after the age of 30.
8. Optimal treatment of hypothyroidism and insulin resistance may help restore some of the testosterone production lost due to these problems - to thus see what one's true capacity to produce testosterone is before embarking on
TRT as a solution.