Still having problems, should I stop TRT??

[focus]

Hi everybody, been a long time lurker but finally decided to join and get some input from all of the experienced members on here. Sorry in advance for the long post, just trying to give a good history along with blood work. So here goes:

I have always felt tired and could sleep at any time of the day. I have been working out since high school and very seriously since I was 20. Started to notice that around age 24 it was hard to add muscle without fat and when dieting down I always lost a ton of size and strength without getting as lean as I wanted. Got random blood work done while in graduate school at age 27 (can’t find original labs) and my total testosterone was 248 ng/dl. I will post all labs at the end of my post. So I went to a wellness center to get blood work again and my test levels came back lower than they should for a 27 year old but within limits. The doc wanted me to try taking armour because my reverse T3 was high and he said that could be causing my low test levels. I decided not to take any medication and attributed my tiredness to stress from graduate school and some other life events.

A short while after this I got a divorce. I then started dating a girl who I was friends with and things were great and we loved each other very much. Only problem was I started to have slight ED (erection was softer than I thought it should be), so I self medicated with cialis and things were great. Fast forward to graduation and I was planning on moving to be with my girl and marry her. She left a little before me to get things ready and when I was on my way to join her I found out she was murdered and was devastated.

So, 5 months later I went to a wellness clinic with the afore mentioned symptoms and got new blood work. He said same thing as previous docs, test levels lower than should be but within range. We decided to begin TRT with 120 mg cyp split into 60 mg twice a week with 250 IU’s HCG twice a week and .25 mg adex twice a week. I felt great and had spectacular results in gym. I was finally as lean as I always wanted and had good size (205lbs at 12%BF at 6ft) and better energy. I accomplished this with a 40/40/20 diet at 2300 cals/ day with one re-feed day a week of 3000cals.

After about 3 months of this I meet my current girlfriend and was nervous because of past ED so started with cialis from day one with her. Things were ok but still had ED sometimes, even with TRT. I think most of it was mental but not sure. I stopped TRT after 7 months because I thought maybe my test levels did not require the lifelong decision of TRT. Did 8 weeks of PCT recommended by swifto with tamox/torm. Got blood work 3 weeks post PCT (prob too soon, so #’s might be higher) and things looked ok, but still felt crappy. Gained fat, lost muscle and ED worse than ever even with cialis.
So after being off TRT 7 months started up TRT again (been 8wks now) and feel great in gym, gained size back and lean again. But ED is still there if I don’t use cialis. So maybe TRT is not the answer. I understand that it could be mental (still dealing with my ex’s murder, moving , in between jobs so money is tight, ect) but I have taken cialis for so long that I can barely function without it even on TRT. I’m only 31 years old. Any help would be much appreciated!!

One more thing, when I was 19-23 I abused prohormones without proper PCT thinking it was not needed since they were not the real thing (young and stupid). So not sure what to do: stop PCT again and get new BW 6 wks after PCT and then see an endo, look into thyroid or who knows what??

[focus]

5/12/09

Test Name In Range Out of Range Reference Range Lab
IRON AND TOTAL IRON
BINDING CAPACITY MI
IRON, TOTAL 89 45-175 mcg/dL
IRON BINDING CAPACITY 267 250-425 mcg/dL
% SATURATION 33 20-50 % (calc)
COMPREHENSIVE METABOLIC
PANEL W/EGFR MI
GLUCOSE 83 65-99 mg/dL
FASTING REFERENCE INTERVAL
UREA NITROGEN (BUN) 25 7-25 mg/dL
CREATININE 1.17 0.80-1.30 mg/dL
eGFR NON-AFR. AMERICAN >60 > OR = 60 mL/min/1.73m2
eGFR AFRICAN AMERICAN >60 > OR = 60 mL/min/1.73m2
BUN/CREATININE RATIO NOT APPLICABLE 6-22 (calc)
BUN/CREATININE RATIO IS NOT REPORTED WHEN THE BUN
AND CREATININE VALUES ARE WITHIN NORMAL LIMITS.
SODIUM 140 135-146 mmol/L
POTASSIUM 4.6 3.5-5.3 mmol/L
CHLORIDE 106 98-110 mmol/L
CARBON DIOXIDE 27 21-33 mmol/L
CALCIUM 9.4 8.6-10.2 mg/dL
PROTEIN, TOTAL 7.3 6.2-8.3 g/dL
ALBUMIN 4.9 3.6-5.1 g/dL
GLOBULIN 2.4 2.1-3.7 g/dL (calc)
ALBUMIN/GLOBULIN RATIO 2.0 1.0-2.1 (calc)
BILIRUBIN, TOTAL 0.5 0.2-1.2 mg/dL
ALKALINE PHOSPHATASE 73 40-115 U/L
AST 22 10-40 U/L
ALT 23 9-60 U/L
MAGNESIUM, RBC 4.3 4.0-6.4 mg/dL AMD

Test Name In Range Out of Range Reference Range Lab
T3, REVERSE 35 H 11-32 ng/dL AMD
This test was performed using a kit that has not
been cleared or approved by the FDA. The
analytical performance characteristics of this
test have been determined by Quest Diagnostics
Nichols Institute, Chantilly, VA. This test should
not be used for diagnosis without confirmation by
other medically established means.
CORTISOL, TOTAL, LC/MS/MS 26.9 H mcg/dL EZ
Adult Reference Ranges for Cortisol, Total, Serum:
Males and Females 8-10 AM 4.6-20.6 mcg/dL
4-6 PM 1.8-13.6 mcg/dL
Cortisol Response to ACTH
Adult Males and Females
Peak >20.0 mcg/dL
Peak >16.0 mcg/dL after IM injection
METHYLMALONIC ACID,
URINE EZ
METHYLMALONIC ACID, URINE 0.5 mmol/mol creati
Reference Range:
< OR = 2.7
CREATININE, RANDOM URINE 4.8 mmol/L
Reference Range:
2.38-26.55
CBC (INCLUDES DIFF/PLT) MI
WHITE BLOOD CELL COUNT 4.8 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 4.58 4.20-5.80 Million/uL
HEMOGLOBIN 15.6 13.2-17.1 g/dL
HEMATOCRIT 44.9 38.5-50.0 %
MCV 98.1 80.0-100.0 fL
MCH 34.1 H 27.0-33.0 pg
MCHC 34.7 32.0-36.0 g/dL
RDW 13.6 11.0-15.0 %
PLATELET COUNT 185 140-400 Thousand/uL
ABSOLUTE NEUTROPHILS 2774 1500-***0 cells/uL
ABSOLUTE LYMPHOCYTES 1622 850-3900 cells/uL
ABSOLUTE MONOCYTES 322 200-950 cells/uL
ABSOLUTE EOSINOPHILS 62 15-500 cells/uL
ABSOLUTE BASOPHILS 19 0-200 cells/uL
NEUTROPHILS 57.8 %
LYMPHOCYTES 33.8 %
MONOCYTES 6.7 %
EOSINOPHILS 1.3 %
BASOPHILS 0.4 %
Test Name In Range Out of Range Reference Range Lab
T4, FREE 1.3 0.8-1.8 ng/dL MI
TSH, 3RD GENERATION 2.93 0.40-4.50 mIU/L MI
ESTRADIOL 29 13-54 pg/mL MI
VITAMIN B12/FOLATE,
SERUM PANEL MI
VITAMIN B12 765 200-1100 pg/mL
FOLATE, SERUM 14.3 ng/mL
REFERENCE RANGE:
LOW: < 3.4
BORDERLINE: 3.4-5.4
NORMAL: > 5.4
T3, FREE 266 230-420 pg/dL MI
DHEA SULFATE 148 110-510 mcg/dL QDB
FERRITIN 209 20-345 ng/mL QDB
TESTOSTERONE, FREE AND
TOTAL, LC/MS/MS AMD
TESTOSTERONE, TOTAL 511 250-1100 ng/dL
TESTOSTERONE, FREE 1.85 1.50-2.20 %
PERCENT
FREE TESTOSTERONE 94.5 35.0-155.0 pg/mL

7/29/11
ESTRADIOL, SERUM
ESTRADIOL, SERUM 90 PG/ML DE
--------ESTRADIOL REFERENCE RANGES--------
FEMALE: (PG/ML)
FOLLICULAR <=212
MIDCYCLE <=480
LUTEAL <=247
POST MENOPAUSAL <=32
MALE: <=54
NO PEDIATRIC REFERENCE RANGE ESTABLISHED. FOR PATIENTS LESS THAN 18
YEARS OF AGE, THE NICHOLS' ESTRADIOL ASSAY
(EXTRACTION/CHROMOTOGRAPHY/RIA METHOD) IS RECOMMENDED (ORDER CODE:
17635-2).

DIHYDROTESTOSTERONE
DIHYDROTESTOSTERONE 31 ng/dL 25-75 CN
TESTOSTERONE,FREE/TOT,LC/MS/MS

TESTOSTERONE,TOTAL,LCMSMS 552 ng/dL 250-1100 CN
Total Testosterone was measured by LCMSMS. The LCMSMS method
correlates well with our extraction/RIA method.

TESTOSTERONE, FREE 102.8 pg/mL 35.0-155.0 CN

[focus]

BW 9/14/11 (on TRT, no adex yet):


Estradiol 77 pg/ml <54
Total Test 1079 ng/dl 300-1100
Free Test 310.9 pg/ml 35.0-155.0


BW 12/15/11 (on TRT)


Estradiol <32 pg/ml <54
Total Test 1028 ng/dl 300-1100
Free Test 275.4 pg/ml 35.0-155.0
DHT 85ng/DL 16-79


BW 3 weeks post PCT after stopping TRT the first time:


HS TSH 3.126 uIU/ml 0.350-5.500
Testosterone 607 ng/dl 300-1080
FR Testosterone 100 pg/ml 47-244
% FR Test 1.7% 1.6-2.9%
Sex Hormone Bnd 44nmol/L 11-80
Estradiol 32PG/ML 12-40
FSH 2IU/L 1-18IU/L
LH 3.1 IU/L 1.5-9.3

[focus]

Bump for kel, Gdevine or other experieneced members

[Brohim]

You might want to separate your story into paragraphs so it's easier to read.

[focus]

Edited post, thanks for the input

[TheSpoonyBard]

Woah, that is a ton of info to take in. Very thorough and complete. I'm sure GDevine, Kel, Vette, Hrtstudent, and a few others I'm forgetting will have a field day with all of the info displayed here. It sounds like you have a good doc that is willing to work with you and prescribe AI's and the like! So there's that as a positive. You've come to the right place, and you'll get the answers you need from at least one, if not all of the members I've mentioned. Welcome.

[bass]

man sorry for all the hardship you went through, to be honest as far as ED problem it sounds like you worry too much, however i still think you need to be on TRT due to your previous cycles and low test levels. no question about it you are shutdown. it seems that TRT worked great for you but i think your ED problem is mostly in your head. your BW all look good prior and while on TRT, the only area i see you may want to supplement with DHEA and maybe Vitamin D. i don't blame you for being stressed, heck anyone would be going through what you have gone through, you just need to move on and look forward and never look back.

[focus]

Bass
I was able to get my hormone levels to where they were pre TRT when I did a PCT. I have only been back on 8weeks. Do you think those levels are low enough to be on TRT? I prob do worry too much bout the ED, but I noticed that even when alone my errections are weak without cialis

[bass]

well if cialis helps then take it. not sure about you returning to your base line, but I'd do another BW 3 months after your PCT and see where you stand. when i did PCT my levels came back better than my base line, then three months later did BW and i was way below normal, so not sure how your PCT will hold up, but BW will determine that.

[focus]

If those post PCT levels did hold, would you suggest to hold off on the TRT? I still want to have kids in the next few years. Also, at 31 why would I need cialis along with TRT? Is it possible my body became dependant on it since I was using it for 2.5 years? If I quit taking it, will my body eventually not need it anymore since my hormones are optimized?

[bass]

if your PCT holds then by all means do not go back on TRT. not sure about cialis, i don't know much about it. hopefully Kel can give you some information on it.

[xcraider37]

If those post PCT levels did hold, would you suggest to hold off on the TRT? I still want to have kids in the next few years. Also, at 31 why would I need cialis along with TRT? Is it possible my body became dependant on it since I was using it for 2.5 years? If I quit taking it, will my body eventually not need it anymore since my hormones are optimized?

I don't think cialis is a drug that your body becomes dependant on, but like bass said some others will respond soon and maybe give a clear answer.

[bass]

from what Kel and others said cialis is not only good for ED but also good for cardiovascular system.

[Brohim]

from what Kel and others said cialis is not only good for ED but also good for cardiovascular system.

There are studies that show it increases your Testosterone as well

[xcraider37]

There are studies that show it increases your Testosterone as well

Thinking on trt this may not be true, but still cialis works awesome when all your hormones are in balance.

[focus]

So would most people here attempt a restart with proper BW timing (at least 3 month post PCT) or just get the TRT dialed in and not look back? I know the the decision comes down to me, but I am just trying to make the most informed decision. Thanks so much to everyone that has already posted up!!

[bass]

for me there is no looking back, look back to what?! i got on TRT for a reason and that reason was feeling old and broken, so why would i look back or want to go back to that! having said that i am 52 so if i live another 30 years feeling great then that would be a great accomplishment. you on the other hand are much younger than me and no one knows what long term TRT can do for/to someone. so the question is would you like to go through life feeling the way you do right now or get quality life for the rest of your life, even if its only 30 years... its your call.

[APIs]

for me there is no looking back, look back to what?! i got on TRT for a reason and that reason was feeling old and broken, so why would i look back or want to go back to that! having said that i am 52 so if i live another 30 years feeling great then that would be a great accomplishment. you on the other hand are much younger than me and no one knows what long term TRT can do for/to someone. so the question is would you like to go through life feeling the way you do right now or get quality life for the rest of your life, even if its only 30 years... its your call.

^^x2. Initial BW results indicate a need for TRT. While I understand OP's desire for children at some point, it really comes down to a quality of life issue. IMO, quality of life is always #1. Children etc.; #2. Besides, there are many men that have children while on TRT & HCG. I personally know a few in my gym. As for the ED issue, it's bound to be worse if you're off TRT. Also, am I mistaken, but your E2 levels in the above BW appear elevated if I'm correct? This might be contributing to the ED issues if I'm correct?

[focus]

Bump. Any other opinions?? As far as the E2 levels, I got them lower but need more BW and E2 sensitive to get more dialed in.

[Renholder]

Sorry to hear about your girlfriend.

If discontinuing TRT and attempting a restart is even an alternative, I would at least wait until you got your life handled and your in a better place financially and has less stress in your life.

Good luck!

[JackG79]

Bump. Any other opinions?? As far as the E2 levels, I got them lower but need more BW and E2 sensitive to get more dialed in.

Focus,

Have you considered seeing a psychologist or a psychotherapist for your ED issues? A traumatic event such as you went through with a wife/gf/fiance' is not something that goes away easily. There could be underlying issues there that you aren't even aware of man.

I had a a couple of friends that were good people that got mixed up in using Heroine. His wife died of an overdose. He was experiencing ED issues when him and his wife were together. (Mostly due to his extended drug use)

He eventually re-married after about 4 years. He self medicated his ED behind his new wifes back for a few months before finally coming clean to her. She discussed things with him and his doctor... together, the couple made the decision to seek counciling for his ED. After a while it came out of his therapy that the reason for his ED was that he felt an underlying guilt for "Not Rising to the occasion" for his 1st wife who had passed away, so in the back of his mind, he would get himself worked up to where He would have ED when he was intimate with his new wife.

The brain, guilt, feelings. hormones, and the like are things that are far more complex than we will probably ever fully understand,

but through therapy, he was able to find, fix, and overcome this guilt that he had. His ED was completely cured after about a year of appointments. Occasionally his wife going with him.

Obviously this was a very private issue that he did not discuss EVERY little detail with me.. (nor did I want them all...LoLoL)

He has a new job now that he loves, and he has two children. His ED problems are gone,and he says that he functions as good as he did before he got in the heroin.

Luckily for him, he was able to get off the junk, and get his life back.

Maybe some kinda therapy is an option that you could seek??? As far as the HRT goes, if you are feeling better, i'd stick with it, but I am by no means an expert, KelKel, GDevine, and others are amazingly smart.

Good Luck to you man.

[HRTstudent]

A few things...

I would forget about the prohormone stuff from over 10 years ago.

Next, ED is incredibly complex. It CAN be totally mental. Having good hormones probably is only going to help, even if it is mental.

Lastly, if you feel better overall on TRT, and you can afford it, and you want to be on it, then I would say go for it. Like I said above, it's probably only going to help your ED situation or at worse have no effect.

When it comes to sexual issues, estradiol is immensely important. For me, it's more important than testosterone levels - high or low. Were those E2 tests you got the sensitive assay? If I were you and I went on TRT I would watch my e2 like a hawk to make sure it's not too high or too low. Both extremes will impact your sexual issues.

Perhaps most importantly, I would try to figure out the mental blocks you have - stress, anxiety, all sorts of mental games that will effect your ED. It's very powerful...

[Juced_porkchop]

A few things...

I would forget about the prohormone stuff from over 10 years ago.

Next, ED is incredibly complex. It CAN be totally mental. Having good hormones probably is only going to help, even if it is mental.

Lastly, if you feel better overall on TRT, and you can afford it, and you want to be on it, then I would say go for it. Like I said above, it's probably only going to help your ED situation or at worse have no effect.

When it comes to sexual issues, estradiol is immensely important. For me, it's more important than testosterone levels - high or low. Were those E2 tests you got the sensitive assay? If I were you and I went on TRT I would watch my e2 like a hawk to make sure it's not too high or too low. Both extremes will impact your sexual issues.

Perhaps most importantly, I would try to figure out the mental blocks you have - stress, anxiety, all sorts of mental games that will effect your ED. It's very powerful...

exactly what i was going to say!

and i rec to stay on hrt if you need it.
when come time for kids jump on hcg and Clomid. till then stay with hrt and maybe cognitive therapy.

[ZenFitness]

I asked my doc about Cialis and dependency, and there is no such thing. Cialis is neutral in that it stimulates blood flow but not libido and your body doesn't grow to need it. As a side note, I've been on daily Cialis 5 mg for a few months while I get my test levels under control. I did not take it yesterday and am trying out stopping to see if it is necessary anymore (I don't feel that it is as I think my test is stable at a good level now). Worse case scenario I just go back on it - no harm no foul.

[Juced_porkchop]

I asked my doc about Cialis and dependency, and there is no such thing. Cialis is neutral in that it stimulates blood flow but not libido and your body doesn't grow to need it. As a side note, I've been on daily Cialis 5 mg for a few months while I get my test levels under control. I did not take it yesterday and am trying out stopping to see if it is necessary anymore (I don't feel that it is as I think my test is stable at a good level now). Worse case scenario I just go back on it - no harm no foul.

but you could grow one mentally . eg if some one swapped your pills for sugar pills and you didnt know.... it may still have some effect if you think you took it and think your better off and less worried.

[focus]

Thanks so much for all of your replies!!! I think I am probably going to stay on TRT as I do feel much better on it and try to get my E2 better dialed in. As far as the ED issues I believe most of you are right and it probably is a psychological thing as I have been/am dealing with a lot of things...so I will try to find someone in that field that might be able to help.

[Juced_porkchop]

Thanks so much for all of your replies!!! I think I am probably going to stay on TRT as I do feel much better on it and try to get my E2 better dialed in. As far as the ED issues I believe most of you are right and it probably is a psychological thing as I have been/am dealing with a lot of things...so I will try to find someone in that field that might be able to help.

Good luck man!

shit its happend when i was hungry and a couple times when very stressed. alot can be mental.
you have to be feeling secure with the women and maybe even talk about ti before hand so your not as worried,, and if shes not cool then forget her sorry ass.

[focus]

Was also hoping kel and gdevine would chime in if you guys are seeing this

[focus]

Should have some E2 BW results soon.

[kelkel]

Ok, I want to focus on your pre-trt BW as afterward it's kind of a moot point.

E2 tests need to be a sensitive assay.

Cortisol is high. High cortisol (stress hormone) = equals adrenals producing absurd amounts of cortisol which can cause thyroid problems by inhibiting T4-T3 conversion which can elevate RT3 more. All this can lead to adrenal fatigue:

http://www.lef.org/magazine/mag2011/...ortisol_01.htm

TSH level is high, despite what the lab range says. Modern standard is .3 - 3.0. TSH is a weak indicator of thyroid function but couple that with the above thoughts and it may be indicators of subclinical hypothryoidism for which you'll need an astute doc.

DHEA is low. I'd begin supplementing with 25mg of micronized DHEA (not 50) and I emphasize micronized. Reason I say start low is that it can elevate estrogen levels slightly and you need to see where yours actually is with the proper test. It can raise T levels as well. DHEA is a precurser to T (Chol-preg-dhea-T-DHT.) It can also improve your lipids. This one supp made the best improvement in my lipids that I've ever seen and it actually raised my E a little as well, which I needed.

Add vit D to your protocol to help elevate your Free T level. It will lower your SHBG levels to accomplish this. Don't see that test above unless I missed it.

DHT is low IMO. DHT is what helps to make us men and is far stronger than T. Pretty much all T converts to DHT in our bodies everywhere except skeletal muscle. Better DHT levels will equal a better sex drive. It is also helps to control estrogen on 3 different physiological levels.

Total T and free T levels are not bad at all and could be improved with some of the above as well as probably some lifestyle changes such as diet, exercise and less stress! We all can improve there.

Do you have LH/FSH levels pre TRT anywhere or did I miss them?

So, those are my initial thoughts on your pre-trt BW. All issues should be examined prior to starting a man on TRT. It seems to be the "fix all" by so many docs these days and it is prescribed way to quickly IMO. Since your T and Free T levels were decent I'd assume you are pathology free and have no testicular issues as well and the issue is somewhere other than your actual T level.

Regarding Cialis. Good answers above regarding it. I'll only add that it's a healthy thing for a male to take. Improved blood flow, nitric oxide booster as well as being approved by the FDA for BPH. I take 5mg twice per day. When it comes to erectile quality you may look into low dose Doxazosin which is an alpha blocker and smooth muscle relaxer (think weener=smooth muscle + doxy = harder erection.) Several people here use it regularly and GD is a proponent of it as well.

Now, your choice is to continue TRT or come off with the help of an astute doc and proper pct and see where you land. It would really be great to NOT need TRT for another 20 years would it not?

Sorry I missed this earlier and hope my thoughts may help a little.

kel

[focus]

Thanks for your response kel! Now I have some new questions:

1) Do you or anyone else know of an “astute doc” in Southern California that could help diagnose the possibility of hypothyroidism? And if I was medicated for this, would that most likely help with the low energy, ED and difficult in losing bodyfat (before TRT I could always get to 4-6 pack, but after trt I was able to achieve a full 6 pack with no softness on the bottom abs)?
2) How much is it possible to elevate pre-TRT Test levels when thyroid hormones are optimized?
3) I could not find my old BW so I do not have old LH and FSH levels.
4) What would increase my DHT levels if I was not on TRT?
5) I am pretty happy with my current physique as I pretty much look the way I have always wanted on my current TRT protocol. If I address the thyroid issue and discontinue TRT, will I lose most of the progress I made? I understand it’s about quality of life and in the end that is what’s most important to me, but I would hate to lose the progress I made.
6) Do you think a restart could be successful with the amount of time I was on TRT?
7) If a restart was not successful and TRT is needed, should I still look into the thyroid conditions?

[kelkel]

Thanks for your response kel! Now I have some new questions:

1) Do you or anyone else know of an “astute doc” in Southern California that could help diagnose the possibility of hypothyroidism? And if I was medicated for this, would that most likely help with the low energy, ED and difficult in losing bodyfat (before TRT I could always get to 4-6 pack, but after trt I was able to achieve a full 6 pack with no softness on the bottom abs)?

I'm on the opposite coast so no, but try the search engines in the Finding a Doc Sticky or hit up google too

2) How much is it possible to elevate pre-TRT Test levels when thyroid hormones are optimized?

No one can put a number to it but hypothyroid can cause hypogonadism. Remember I'm thinking possibly sub-clinical hypo

3) I could not find my old BW so I do not have old LH and FSH levels.

Ok. Still think they're decent due to T levels presented

4) What would increase my DHT levels if I was not on TRT?

Hard exercise. Eat more meats, supplement with creatine: http://www.ncbi.nlm.nih.gov/pubmed/19741313

5) I am pretty happy with my current physique as I pretty much look the way I have always wanted on my current TRT protocol. If I address the thyroid issue and discontinue TRT, will I lose most of the progress I made? I understand it’s about quality of life and in the end that is what’s most important to me, but I would hate to lose the progress I made.

Totally understand. Sure, you can lose some, especially during pct and the effort to return to normal so I completely understand your hesitation. Really tightening up on your diet/exercise during this time can help

6) Do you think a restart could be successful with the amount of time I was on TRT?

Personally I don't put to much weight into the time on TRT stuff and being harder to restart. If I could read some studies on it I may be of a different opinion. I would always opt for no TRT if my levels could be restored, but they can't.

7) If a restart was not successful and TRT is needed, should I still look into the thyroid conditions?

I would investigate everything. Life is a long journey and your body constantly searches for homeostasis. If something is "off" inside of us it has a domino effect. Action=reaction

kel