Why does TRT make some people worse (even while raising testosterone levels)?

[Megazoid]

I am aware of most of the mechanisims involved here but i would really like to discuss this a little further as i couldn't really find any other indepth threads regarding the subject.

I have noticed allot of people trying to restart after failing TRT, the big question is - why is this? Why do people describe a roller-coaster ride when referring to testosterone levels? Could adrenals be causing the mood swings, poor mood, etc?

When i did injections the last time (125mg weekly), i ended up feeling worse in the libido/ED/Shrinkage department than before. I felt a little stronger, maybe a little sharper mentally and didn't have as many muscles aches and pains. In most aspects i did see "some" improvements but nothing outrageous. However the ED was absolutely terrible, allot worse than before and i had times where i simply couldn't get erections. Even now they are hard to get, but some times allot better than others.

I am aware that testosterone does the following:

1) Can raise total testosterone too high resulting in excess Estridol due to armotization.

2) If a person is low on thyroid hormone and high E2 is introduced, this will further down-regulate the effects of thyroid hormone due to recepter competition.

3) Testosterone will supress cortisol production (adrenal glands), so if cortisol is already low it will be made lower resulting in low cortisol having negative effects on thyroid hormone (and other hormones). This also explains why guy's doing TRT get very tired for example, unlike what they were like previosuly.

4) Supressing adrenals (ATCH/LH) will down-regulate DHEA and Progesterone production.

Does this mean everyone doing TRT should be doing full HRT? Should everyone be treating themself with Melrom/HC and thyroid?

Are perfect responders to TRT people with no outstanding adrenal fatigue and hypothyroidism?

[jaydee]

Wow...thats a big question. I have no idea. I suspect there is some kind of hidden estrogen dominence happening that we havnt found yet. 5AR could have somthing to do with it, not just with finasterided guys.

Who knows? Why does some weed make you more horny? Ive got no idea....

The only other thing i could think of is a receptor problem of some kind or a gene problem.....gene expressions changing.

Its a good question and will be interesting to see what everyone comes up with.

[zkt]

Not sure I agree that 2&3 are true. Got proof other than heresay?

[HeadDoc]

Originally Posted by zkt

Not sure I agree that 2&3 are true. Got proof other than heresay?

yeah! the whole proposition rests upon someone starting TRT without assessment. That assessment usually includes thyroid, cortisol, etc. I did the initial work/up twice and the nurse commented that it looked like it was in for a blood donation!

[gregxy]

Based on my own experience and what I have read here and else where TRT only helps
if you are truly hypogonadal, that is T levels < 300. The medical establishment has it right.

Sure you can take injections and push you levels up and feel good for a few weeks but then the receptors down regulate, homostasis is restored and you feel the same as before.

Why does TRT make some men feel worse? It could be some complex mechanism with estrogen cortosol etc etc. However there is a much simpler explanation, its in your head.
You took all this fancy medicine and it didn't help, now what are you going to do? The magic
pill didn't help and you are running out of options and that prospect is depressing.

[jaydee]

Originally Posted by gregxy

Why does TRT make some men feel worse? It could be some complex mechanism with estrogen cortosol etc etc. However there is a much simpler explanation, its in your head.
You took all this fancy medicine and it didn't help, now what are you going to do? The magic
pill didn't help and you are running out of options and that prospect is depressing.

If its not testosterone that is the problem, then what is it?

Im not sure I agree with your last paragraph.

[love_en]

I have issues with this position as well. I tested at 388 total T before making the decision to put myself on TRT 2 years ago. Now I am on replacement cortisol and testosterone. I must be an exception to the rule of not being hypogonadal and therefore nonresponsive to TRT because it has benefitted me more than anything doctors were willing to prescribe. I am also on what is considered a high dose for T replacement, 200mg per week of enanthate. The difference between 100mg and 200mg is on 100mg I do not have muscle, bone and joint pain. However, my libido and virility leave much to be desired at 100mg.

Regarding the question about perfect responders to TRT, I am also of the belief that their thyroid, adrenals and pituitary(GH production) are adequate or better than average. I surmise those people do not get as sick as I do if their T is low. I doubt they even notice until they drop way below the reference range. The mythical healthy person with a total T of 300 probably is not dealing with fried adrenals and thyroid. Not everyone needs to replace all of the hormones. That is why it is important to get adrenals and thyroid tested at the same time as sex hormones. You be the judge of what is a healthy and adequate level. Most doctors only look at reference ranges and do not comprehend the relation between all of the hormnes. They could give a shit as long as you pass the reference range.

[Matt Muscle]

Originally Posted by gregxy

Based on my own experience and what I have read here and else where TRT only helps
if you are truly hypogonadal, that is T levels < 300. The medical establishment has it right.

Sure you can take injections and push you levels up and feel good for a few weeks but then the receptors down regulate, homostasis is restored and you feel the same as before.

Why does TRT make some men feel worse? It could be some complex mechanism with estrogen cortosol etc etc. However there is a much simpler explanation, its in your head.
You took all this fancy medicine and it didn't help, now what are you going to do? The magic
pill didn't help and you are running out of options and that prospect is depressing.

I agree.
I do not think that testsoterone replacement can ever replicate what our HPTA does so intricately. Most of us expect that we should feel as good as when our bodies were producing adequate levels of T, that our sex drive should also function the same way when in essence we are shutting down our reproductive system! How can you expect sex drive to be unaffected by such a side effect.

We are crudely putting testoterone into our bodies in comparison to the timely and accurate bursts of LH and the feed back mechanism. To duplicate this so that out libidos and other systems work in the same way seems to me to be very difficult. We can approximate it, but it will never be quite the same IMO. Just the fact that we supress LH and FSH permanently must have deleterious effects which cannot be fixed with hCG. hCG is not identical with LH and has side effects of its own.

Certainly, guys with very low testosterone will benefit with T replacement, there is no doubt about that. however many with low normal levels may not get quite the same improvements as the trade off's become greater. The way hormone replacement affects each of us must be individual. Some seem to respond better than others. Our bodies are constantly trying to maintain homeostasis even when we throw a bunch of testosterone at it in the form of an injection or slather it on our skin. In no way can this be as fine tuned as what evolution has taken millions of years to design.
We all give the endos such a hard time on this board, when in fact perhaps some of them are quite aware of these facts and will only prescibe testosterone as an absolute last resort.

[JanSz]

Originally Posted by love_en

I have issues with this position as well. I tested at 388 total T before making the decision to put myself on TRT 2 years ago. Now I am on replacement cortisol and testosterone. I must be an exception to the rule of not being hypogonadal and therefore nonresponsive to TRT because it has benefitted me more than anything doctors were willing to prescribe. I am also on what is considered a high dose for T replacement, 200mg per week of enanthate. The difference between 100mg and 200mg is on 100mg I do not have muscle, bone and joint pain. However, my libido and virility leave much to be desired at 100mg.

Regarding the question about perfect responders to TRT, I am also of the belief that their thyroid, adrenals and pituitary(GH production) are adequate or better than average. I surmise those people do not get as sick as I do if their T is low. I doubt they even notice until they drop way below the reference range. The mythical healthy person with a total T of 300 probably is not dealing with fried adrenals and thyroid. Not everyone needs to replace all of the hormones. That is why it is important to get adrenals and thyroid tested at the same time as sex hormones. You be the judge of what is a healthy and adequate level. Most doctors only look at reference ranges and do not comprehend the relation between all of the hormnes. They could give a shit as long as you pass the reference range.

How to adjust Aldosterone


Guest Lecturer II: Sexual Healing by Dr. Nick Delgado - Page 6

Originally Posted by DrDelgado

I will also suggest that aging is going to include a decline of hormones,
within genetic differences, expect to augment back Testosterone,
I keep mime and my clients under doctors monitoring,
around 1000 to 1,200 ng/ml Total T,
and Free T at upper range of 200 to 300 (or 20 to 40 pg/mldepending on the nomenclature)
Aldosterone is best at 10 to 40 ug/24 hr,
IGF-1 around 250 to 400 ng/ml.
DHT 60 to 70 ng/dl,
DHEA 300 ug/dl,
insulin under 5,
SHBG 10 to 30 nmol/l,
Estradiol 35 pg/ml,
with about 20 (2OHE) to 1 -16aOHE..

[jaydee]

Originally Posted by love_en

I have issues with this position as well. I tested at 388 total T before making the decision to put myself on TRT 2 years ago. Now I am on replacement cortisol and testosterone. I must be an exception to the rule of not being hypogonadal and therefore nonresponsive to TRT because it has benefitted me more than anything doctors were willing to prescribe. I am also on what is considered a high dose for T replacement, 200mg per week of enanthate. The difference between 100mg and 200mg is on 100mg I do not have muscle, bone and joint pain. However, my libido and virility leave much to be desired at 100mg.

Luv_en....I see on your signature about the proscar. Did you take it and is that why you have T problems, and if so did you recover? Its a good signature BTW.

[love_en]

Sorry jaydee, I wish my problems were from Proscar. I was born hypothyroid, adrenal insufficient and went through my teen years secondary hypogonadal. Recovery is not something I am going to dwell on. I am very happy that TRT and replacement cortisol are allowing me to live a good life after being sick since age 3. It would also be interesting if doctors also had their thyroids nuked and they were put on a course of mitotane. I keep on reading about how badly doctors treat patients who have thyroid and adrenal problems. What really hurts me is many of these people they see fit to abuse are our wives, mothers, sisters,daughters and grandmothers. Men are not protected either. It seems that many of us on this forum are also adrenal insufficient and hypothyroid. We have either gone through too many doctors or in my case treat ourselves illegaly because of stubborness and blindness of the doctors.

Originally Posted by Matt Muscle

We all give the endos such a hard time on this board, when in fact perhaps some of them are quite aware of these facts and will only prescibe testosterone as an absolute last resort.

They will get a very hard time from me because of their refusal to prescribe anything at all. I can understand a doctor's personal problem with TRT because it involves an anabolic steroid. But for heaven's sake treat my adrenals and thyroid. The medications needed are not restricted by the DEA and I might feel well enough to not need testosterone. Also reference ranges are not the final word. Endos are notorious for stubbornly dismissing symptoms just because of the reference range.

[jaydee]

Originally Posted by love_en

Sorry jaydee, I wish my problems were from Proscar. I was born hypothyroid, adrenal insufficient and went through my teen years secondary hypogonadal. Recovery is not something I am going to dwell on. I am very happy that TRT and replacement cortisol are allowing me to live a good life after being sick since age 3. It would also be interesting if doctors also had their thyroids nuked and they were put on a course of mitotane. I keep on reading about how badly doctors treat patients who have thyroid and adrenal problems. What really hurts me is many of these people they see fit to abuse are our wives, mothers, sisters,daughters and grandmothers. Men are not protected either. It seems that many of us on this forum are also adrenal insufficient and hypothyroid. We have either gone through too many doctors or in my case treat ourselves illegaly because of stubborness and blindness of the doctors.
They will get a very hard time from me because of their refusal to prescribe anything at all. I can understand a doctor's personal problem with TRT because it involves an anabolic steroid. But for heaven's sake treat my adrenals and thyroid. The medications needed are not restricted by the DEA and I might feel well enough to not need testosterone. Also reference ranges are not the final word. Endos are notorious for stubbornly dismissing symptoms just because of the reference range.

So youve never taken finasteride before?

Its clear that you have been put through the wringer with drs and believe me, I am familiar with your frustration. But I have come to the conclusion that for the most part, drs are just doing their job the best way they know how.

Keep in mind also that Drs have a VERY tight schedule. Theyve got insurance issues and paperwork to sort out so they dont get sued, and most probably genuinly dont have time to go to conferences and brush up on things. Most of the things we talk about on this forum are still classed as cutting edge medicine, even though it may seem simple to us. A lot of Drs wouldnt have a clue how adrenals, thyroid and testosterone work together. They say your ok with a T level of 300 because thats what they were tought to do.

Heres a question....Are drs MADE to go to some kind of seminar every now and then to find out how much medicine has changed since they graduated 40 odd years ago?

It sounds to me like you need to keep looking for a better dr....and im aware that you may have been doing that for the last 10 years....its not uncommon. Keep looking and you WILL find a dr that will help you and has the knowledge to give you a good chance.

Just my opinion FWIW.

[JanSz]

Originally Posted by love_en

Sorry jaydee, I wish my problems were from Proscar. I was born hypothyroid, adrenal insufficient and went through my teen years secondary hypogonadal. Recovery is not something I am going to dwell on. I am very happy that TRT and replacement cortisol are allowing me to live a good life after being sick since age 3. It would also be interesting if doctors also had their thyroids nuked and they were put on a course of mitotane. I keep on reading about how badly doctors treat patients who have thyroid and adrenal problems. What really hurts me is many of these people they see fit to abuse are our wives, mothers, sisters,daughters and grandmothers. Men are not protected either. It seems that many of us on this forum are also adrenal insufficient and hypothyroid. We have either gone through too many doctors or in my case treat ourselves illegaly because of stubborness and blindness of the doctors.
They will get a very hard time from me because of their refusal to prescribe anything at all. I can understand a doctor's personal problem with TRT because it involves an anabolic steroid. But for heaven's sake treat my adrenals and thyroid. The medications needed are not restricted by the DEA and I might feel well enough to not need testosterone. Also reference ranges are not the final word. Endos are notorious for stubbornly dismissing symptoms just because of the reference range.

It is even worst than that.
I have three women in my family that could use adremal treatment.
By now they are so brainwashed that they only listen to doctors (who are mis-treating them).

[love_en]

Originally Posted by JanSz

It is even worst than that.
I have three women in my family that could use adremal treatment.
By now they are so brainwashed that they only listen to doctors (who are mis-treating them).

Sounds like the women in my family. I also suspect my father has the same issues I do. But instead of doing something constructive about it, he has made the choice to drink himself to death.

[gregxy]

In my own case I had many of the symptoms that so many on here complain about, low sex
drive and problems with ED. My T levels were low enough (low 400s) that I could get a script for
testosterone. Well it worked for a while then it stopped, so I added arimidex and that worked for
a while too but it also stopped, so I added viagra, same story. Each of these things worked only
as long as I truely believed it would help me. Classic plecebo effect.

My real problem is marital difficulties and performance anxiety. Finding a "new partner" helped
more than all of the drugs...

Some of these cases DO have a medical origin but erections are controlled by the unconscious
mind and figuring that one out is more difficult than the hormones.

A bunch of guys relating there experiences is unscientific, half of those that do benefit from
TRT might do just as well on sugar water. The only way to find out if these treatments really
work is with double blind studies.

Regarding my wife, She has all the subclinical hypothyroid symptoms, dry skin, slow pulse, low
temperature etc, but hormone levels within the acceptable range so no one would
treat her. Finally she went to Dr M. He gave her armour which did raise her temperature
and pulse but did not help her primary problem which is a lack of energy and foggy thinking.
She has even been gaining weight on the stuff since, while it does raise the metabolism,
it also increases your appitite.