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Old 09-09-2006, 12:42 PM
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Default Periodic interruptions of TRT as ASIH hedge

TRT is usually regarded as a continual therapy, sort of like blood pressure meds or thyroid meds. Yet a patient on TRT for an extended time might be forced later on to abandon it for various reasons, e.g., polycythemia. No doubt there are other examples. The patient typically finds that his HPTA is then severely depressed, and getting it going again can be a problem. This has been the subject of much discussion on ASIH, and protocols have been developed that usually (?) restart the HPTA, so that the patient is at least as good as before. But if the HPTA doesn't get going again, despite the sophisticated protocols that have been developed -- I assume this probably happens in some unlucky patients -- he is worse off than before starting TRT. This could especially be true when TRT is started in men who are not 'officially' hypogonadal, but rather have T levels in the low-normal neighborhood. He may now find himself completely at sea, no way to restore his T exogenously (because of the polycycthemia or whatever), and with no HPTA to make his own T. Would periodic interruptions of TRT, to let the HPTA recover before it becomes morbidly depressed, provide a hedge against the possibility of permanent suppression of the HPTA? Athletes usually employ such an approach when they cycle on and off AAS regimens, and this seems to protect them -- perhaps not perfectly -- from crippling dysfunctional HPTA.

Why is this technique not considered necessary or desirable for TRT?

This topic may have been covered long ago, and maybe all I need is to find out where to find it. I haven't been on this site very long. I'm a 67-year-old man with low-normal (400 ng/dl) total T, sub-optimal free T, normal estradial (28), 170# 5'11", non-athletic physique. Andropausal symptoms. I'm on T enanthate 100 mg/week IM, feeling great, just wondering whether I should 'cycle' like the athletes do, or commit to continual treatment as a diabetic or hypothyroid must. My TRT brings my levels into what are considered 'optimal' zones (e.g., 600-800 total T).

I would value the collective wisdom of this group.
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