9mnths on trt can I restart naturally without drugs if I stop TRT

[angrydad]

Just giving it a cheeky bump!

 

[angrydad]

What dose of T4 &/or T3 are you being prescribed?

What is the TSH while on this dose?

Do you have an E2 while on TRT? If you went off TRT, why?

What are the current concerns?

Since you have empty sella syndrome, the likelihood is for multiple hormone needs.

Hi Dr Scally,

Would you mind having a look over the post please when you get a moment.

Thankyou

 

[Michael Scally MD]

Hi Dr Scally,

Would you mind having a look over the post please when you get a moment.

Thankyou

I would seek to optimize the T4 replacement first aiming for a TSH<2. Of course, being aware of side effects, although I anticipate few. I would easily bump up the dose to 100 mcg and move forward in 50 mcg increments. Again, watching for side effects. This can be done in a matter of weeks, not months. The hope is this will decrease the PRL ...

 

[angrydad]

Thanks for your reply dr scally, I am already on Cabergoline and it's got my PRL down half way into the normal range.

As you say I think I still need to get my TSH down which I'm in the process of now.

My real concern/question is that are my lh, fsh and T figures looking ok to you after 10days without testogel or anything else?

Please let me know what you think

Thankyou

 

[Michael Scally MD]

Thanks for your reply dr scally, I am already on Cabergoline and it's got my PRL down half way into the normal range.

As you say I think I still need to get my TSH down which I'm in the process of now.

My real concern/question is that are my lh, fsh and T figures looking ok to you after 10days without testogel or anything else?

Please let me know what you think

Thankyou

What are the values?

 

[angrydad]

Ok here we go! Got my blood results back.(given over the phone). Here are the results from last week.. 10 days after stopping TRT completely with no PCT.
The only drugs I am now taking are cabergoline and levothyroxine.
latest results from 9th Feb 12 (ranges given where known- UK) all over the phone!
9th Feb 12
Total Testosterone 6.3 range 11-36 nmol/L
Prolactin 274 range 0-500mu/L
LH 2.6 U/L
FSH 6.0 U/L
Estradiol 64 pmol/L
TSH 3.39 (range<6)
Free T4 11.8 Range 9-24
----------------------------------------------------------------------------------------
Results from 07/Nov/2011
Before being prescribed Cabergoline and Thyroxine BUT using Testogel 75mg (1.5 sachets per day)
Total Testosterone 9.2 range 11-36 nmol/L
Prolactin 1785 range 0-500mu/L
LH <0.5 U/L (shutdown from TRT) No HCG Used at any point
FSH <0.5 U/L (shutdown from TRT) No HCG USed at any point
Estradiol 165 pmol/L
TSH 6.78 (range<6)
Free T4 11.1 Range 9-24
---------------------------------------------------------------

BASELINES Taken before diagnosis BUT after I started feeling Unwell.
NO Medications or Diagnosis or ANY previous medical issues at this point.
Date 08/Feb/11
Total Testosterone 7.0 range 11-36 nmol/L
Prolactin 1200 range 0-500mu/L
LH 2.4 U/L
FSH 2.8 U/L
Estradiol 90 pmol/L
TSH 5.93 (range<6)
Free T4 12.8 Range 9-24

The above in RED are the latest results. I hope to have more bloods done in the next weeks or so to see how I am 4-5 weeks after stopping TRT.

Thankyou

 

[angrydad]

Any updates pls dr scally

Thanks

 

[Michael Scally MD]

Any updates pls dr scally

Thanks

I would increase the T4 dose. If this is on 50 mcg, I would increase to 100 mcg. I would also begin TRT. What was the IGF-1. Did you have a GH stimulation test?

 

[angrydad]

Thanks for your reply doc, I'm now on 100mcg. I have not had a GH stim test and apparently my IGF1 is at normal levels.

It's been 6 weeks for me off T now and will be getting some more blood results soon.

Dr Scally, why do you suggest I start TRT?

I have just stopped trt going to restart my hpta (hoping that now my thyroid & high PRL have/are being seen to) my own body might start making it's own T again..

I'm hoping that within the next month or so my lh fsh and T will all start to rise to more normal levels.

I could be wrong with what I'm trying to do here. But I really need to see if it's the PRL or thyroid issues causing my low T or whether it's just idiopathic..

How long should I give my body a chance to restart?

What is a sensible time? 3,6,12 months? If this fails should I try hcg/pct etc..

Would appreciate your advice please.

Kind regards

 

[angrydad]

Regarding my last post I would still appreciate feedback when you get a chance please Dr Scally.

I AM in a FANTASTIC MOOD right now guys.. It's not alot I know, early days and all that but I got my T results back after 5 weeks of having stopped TRT. I think I may be on my way back to recovery??

My latest blood test for Total T (This is the only blood test that was done unfortunately) is

5 weeks after stopping TRT.
5th MAR 12 Total T = 13.4 (range- 11 to 36)

my previous bloods 10 days after stopping TRT were.
9th FEB 12 Total T = 6.3 (range 11 to 36)

NOW before I hear anyone saying but it's still LOW.. I know it is. BUT, this is the highest my T has been for at least a year, I was even Low on TRT because the protocol was rubbish (sustanon 1 shot every 3 weeks) then Testogel didn't work well for me.

I am hoping that my reading will keep on going up with time. I still feel Low T obviously, sore joints etc. But I put down this T increase due to my thyroid issues being addressed (I'm on 100mcg Levothyroxine a day) also taking cabergoline to keep my Prolactin down.. (I have empty sella syndrome).

Perhaps I am setting myself up for a fall here, BUT I just wanted to thank all you guys here for your advice (some good and some not so good ;-) )

I guess my point is no matter how down or low you feel, If you have a hunch that it's not just 'ideopathic' and that something else may be causing your low T.. Thyroid etc.. Keep pushing your GP.

Would be interested what you guys think about my news?

IT's good isn't it and heading the right way..?

 

[hardasnails1973]

Correcting other factors (thyroid,ect) may actually be correcting your testosterone levels.

 

[angrydad]

H.a.N I couldn't agree with you more! Especially as my own G.P was adamant that I didn't have a thyroid problem with a TSH over 6!

 

[knucklehead]

H.a.N I couldn't agree with you more! Especially as my own G.P was adamant that I didn't have a thyroid problem with a TSH over 6!

How are you doing now angry dad?

 

[avacado]

Yes would be really interested to hear an update on this, especially as a UK guy also considering T4 treatment to boost baseline test