Stopping TRT

[Blankinator]

Been on TRT for nearly 3 years. I would call it a successful therapy experience. Was diagnosed with Primary Hypo back in 2013. My T was 258. my CFT was 6.1. LH 6, TSH, 1.66, FSH 4.1. Seemed to support primary so that's the assumption. But I digress.

The trigger for me going off TRT is working with my cardiologist toward determining whether to get a procedure or not and we want to take TRT out of the diagnostic equation.

I suspect I will be off TRT for several months - maybe 6 mos or more. I'm wondering if a PCT would be beneficial in getting me back to my "low normal" sooner than just stopping TRT cold turkey. My clinic T doc says, "Just stop. You feel like crap and have no exo T in your system 30 days from stopping. Expect to be lower than your original 258 though."

Being Primary Hypo, I'm not looking to get back to some magical outcome of "normal" T. Just looking to avoid crashing hard.

Thoughts on PCT or not?

[kelkel]

My question is what type of procedure, if you don't mind me asking, requires you to come off TRT? What your injecting or applying is bio-identical to what your body used to produce endogenously. So, if your values are normal I'm curious how your doctor thinks it can harm you, as it makes you much healthier than when living with low T.

[Blankinator]

Kelkel - Sure. About 5 months into TRT I developed PVCs (Premature Ventricular Contractions). They became consistent and chronic. Many tests later and the cardiologist (and crew) ruled out everything they could and suggested that I stop TRT just in case it was somehow a contributing factor. I chose to continue TRT and was prescribed a few meds to lessen the PVC symptoms. At first the meds did a great job, most recently that's not the case. My other option is to have an ablation procedure that kills part of the heart that may be responsible for the PVCs. Heart doc says there is a 60% chance of that procedure resolving the problem - which leaves a 40% chance the other way. Before I go through that, I'd like to completely rule out TRT having some kind of role in the PVC thing. What that might be? Who knows?

[Bonaparte]

Your doc's logic in this equation isn't too great, since he is viewing testosterone to be a superfluous perk, not as a necessity to a decent quality of life. Would you want to live with very low test for the rest of your life if it stops the PVC's? I would think not, so just get the ablation. Coming off HRT does more than "make you feel like crap", as you'll probably grow a pair of old man tits, lose muscle and get all flabby. If you were in the 200's before, I'd hate to see what your numbers will be after 3 years of HRT.

[Blankinator]

Ha! Not a fan of the picture you paint for me off of T.

Seriously though, I don't think my cardiologist is viewing the T as superfluous. I think he is genuinely interested in ruling out a trigger. And I'm not planning on going off T forever. Maybe I go off T and still have PVCs, then I'll know it's not the T. Maybe I go off T and the PVCs stop, then I can look into T levels, protocols, etc.

What I'm wondering is would a PCT be worth it in terms of my crash not being so hard and so low?

[Bonaparte]

Ehhh...hard to say.
Depends on whether you plan on coming off for a long time and try to regain some natural production (your prospects here are dismal), or just coming off long enough to rule out that the HRT is causing it. If the former applies, you'll want a good PCT.

I would just do the latter, then after a month (when nothing good happens) get the ablation.

Have you tried everything else first?
http://drjohnday.com/stop-pvcs/

It just doesn't make any sense that HRT (done properly) would cause it, since it only replaces what you're lacking. There is no way that your heart only wants to function properly when you're testosterone deficient. What is your dose and protocol?

[Richard Head]

Don't know if this will help but I had a similar situation but not chronic. Found a combination of sleep, stress and caffeine made mine worse. Worked on all three and it mostly stopped.

[Blankinator]

Thanks for the link Bonaparte. Good writeup. Hadn't heard the 20% threshold before now. My doc had it at >12%. Two times I wore the holter it was 16% and 17% total irregular beats per day.

Dose and protocol for me:

190 mg Test Cyp per week.
300 IU of HcG 2x per week at day 3 and 5 after T.
Only use AI based on how I feel. Generally speaking when i feel myself retaining water, I'll take half an anastrazole pill on day 2 after T for 2 weeks to get E2 under control. I usually go 4 weeks in between needing the AI.

My core numbers in my most recent lab - taken 7 days after T shot - had me at 625 Total T, Free T at 16.8. E2 at 21.9 (not sensitive assay but 20-30 is where I've found I feel the best).

I've been going the clinic route and have considered switching so that I can self pin. I already self pin my HcG.

With the weekly protocol, I've been curious as to what my numbers are at peak - I would think on day 3. And, was wondering if maybe the peak is high enough that it might be a contributor for the PVCs. In other words, if I'm hitting >25 every week on Free T at peak, would that be something that my heart might not be on board with?

I suppose I could switch doctors, get to where I am in control of my protocol and see if less T and less of a peak might show some positive results on PVCs.

[Simon1972]

190 as a trt dose is too much.
Try dropping it first to 100-140 a week split into two doses. See if that works before you let any Dr touch your heart.

After all they want to try an ablimation so thought knowing what causes it. I had heart concerns too at a higher dose , if be adjusting yours first and see if that works.

This will take weeks, but don't rush into a procedure when the Dr has no idea of the actual cause with 100% certainty

[Blankinator]

190 as a trt dose is too much.
Try dropping it first to 100-140 a week split into two doses. See if that works before you let any Dr touch your heart.

After all they want to try an ablimation so thought knowing what causes it. I had heart concerns too at a higher dose , if be adjusting yours first and see if that works.

This will take weeks, but don't rush into a procedure when the Dr has no idea of the actual cause with 100% certainty

Simon,

Thank you for this feedback. This is the first time I've had any discussion where anyone admitted a higher dosage could affect the heart. The typical response, across the board has been "Nope. Can't happen."

I have no problem with being patient, been dealing with it for 3 years. Thanks.

[Simon1972]

Simon,

Thank you for this feedback. This is the first time I've had any discussion where anyone admitted a higher dosage could affect the heart. The typical response, across the board has been "Nope. Can't happen."

I have no problem with being patient, been dealing with it for 3 years. Thanks.

not saying its a fix- BUT.....
immediately try injecting every tuesday night before bed 60mg and again on saturday when you wake 60 mg of test.
that will bring you down to 120mg a week. This results in the conversion to Estrogen dropping as you dont have a huge spike in test, possibly eliminating your need for an AI- (keep an eye on it)
stick with your HCG - i have no experience in that so unless someone can give some input as to typical dosage levels- keep it going.

625 test levels at 7 days post injection is pretty good- BUT. imagine what it is 2 days after injecting - it could only be higher and possibly at superphysiological levels- not needed or helpful unless you are looking to bulk muscle gain.

Your E seems also on the upper range of normal- id imagine it would be higher earlier on in the week post injection-

again- DONT DO THE ABLAMATION- killing off part of your heart as an experiment is just plain stupid , and your drs have shown a lack of understanding and are clutching at straws.

PLEASE- keep this thread going and update it- im keen to see what results you get from this advice.

[APIs]

Good points above, especially trying a lower dose. Adding PCT would only introduce another pharmacological effect that I'm sure your Docs dont want in trying to figure out your condition. Good luck...

[joebailey1271]

190 as a trt dose is too much.
Try dropping it first to 100-140 a week split into two doses. See if that works before you let any Dr touch your heart.

After all they want to try an ablimation so thought knowing what causes it. I had heart concerns too at a higher dose , if be adjusting yours first and see if that works.

This will take weeks, but don't rush into a procedure when the Dr has no idea of the actual cause with 100% certainty

190 is not too much, not for everyone

[kelkel]

190 is not too much, not for everyone

You're correct, it may not be to much. For the overwhelming majority it is high end TRT which most don't need unless they're hyper-excreters.


The name calling is quite unnecessary. Please cease with it.

[Simon1972]

190 is not too much, not for everyone

my post was written specifically for blankinator and his heart issues and not for everybody, 190 may indeed not be too much, but I'm trying to rule out testosterone excess, as a cause or estrogen conversion as a root cause before he attempts messing with his heart, when adjusting trt dosage is so much easier.

Again this thread is to help blankinator, not you.