HRT Exit Strategy...

[IZZOT]

Cash,
Good luck with your study bro. I too, sold my business and know very well about exit strategies. Prior to going with Maximus I had been on Hormone Replacement Therapy (HRT) with a local doc without the use of Human Chorionic Gonadotropin (HCG). I was worried about testicular atrophy becoming a problem if I ever was forced to come off the program. So before starting with Maximus I started a 30 day post cycle therapy (pct) with HCG/Clomiphene/Anastrozole for 15 days followed by Tamoxifen/Anastrozole for an additional 15 days. I completed a full panel blood work 1 day after finishing post cycle therapy (pct) and found ALL my levels were within the normal range except Total Test being 155. I continued off Hormone Replacement Therapy (HRT) for 30 more days and retested the full Blood work panel and found again all markers were normal and my Total test was 355. This was still low but my initial Test level before starting any Hormone Replacement Therapy (HRT) was around 315. So my conclusion was that if I followed my 30 day post cycle therapy (pct) I could get back to my pre-existing condition.
Again, I understand exactly why you are doing this and wish you the best.

 

[cashout]

Cashout

I don't really understand your response I have 3 kids and I am 45 and don't want any more kids. So would taken Human Chorionic Gonadotropin (HCG) just be a waste for some one on testosterone replacement therapy (TRT) if they don't want to have kids. Would just taking Test be all someone would need and maybe an AI?

HCG mimics the input signal of LH in the Lydig cells and that in turn cues the testis to, among other things, produce sperm.

Without a sufficent LH-like signal to the Lydig cells, the testis will atrophy. The atrophy will result in a decrease in sperm production. In about 65% of white males, with 200 mg of test a week the atrophy results in azoospermia.

So, depending on one's situation, Human Chorionic Gonadotropin (HCG) would not be a requirement for HRT.

 

[cashout]

Cash,
Good luck with your study bro. I too, sold my business and know very well about exit strategies. Prior to going with Maximus I had been on Hormone Replacement Therapy (HRT) with a local doc without the use of Human Chorionic Gonadotropin (HCG). I was worried about testicular atrophy becoming a problem if I ever was forced to come off the program. So before starting with Maximus I started a 30 day post cycle therapy (pct) with HCG/Clomiphene/Anastrozole for 15 days followed by Tamoxifen/Anastrozole for an additional 15 days. I completed a full panel blood work 1 day after finishing post cycle therapy (pct) and found ALL my levels were within the normal range except Total Test being 155. I continued off Hormone Replacement Therapy (HRT) for 30 more days and retested the full Blood work panel and found again all markers were normal and my Total test was 355. This was still low but my initial Test level before starting any Hormone Replacement Therapy (HRT) was around 315. So my conclusion was that if I followed my 30 day post cycle therapy (pct) I could get back to my pre-existing condition.
Again, I understand exactly why you are doing this and wish you the best.

IZZOT,

Thanks for the input and support.

You did the one thing I did not do before I started my Hormone Replacement Therapy (HRT) program. That was a very smart move on your part. Kudos to you for having the foresight to do what you described. That is what I'm going to do for my own peace of mind now.

Long story short, at the time, 2 years ago, all my markers (LH, FSH, TSH, ect) were in an acceptable range but my test had slowly slipped from 900+ to 700 and final to 579 when I opted for HRT.

So, I didn't run a restart at that time. I didn't try any of the Human Chorionic Gonadotropin (HCG) only programs, Aromatase inhibitor (AI) only programs, or the like.

From what I had experience over the few years leading up to my choice for Hormone Replacement Therapy (HRT), I just didn't feel that the non-test Hormone Replacement Therapy (HRT) options would produce the desired effect.

For what it is worth, I really feel I'll be able to return my natural test levels to near pre-HRT levels.

 

[transcend2007]

Cashout, like your other brother here on ology have stated this is an interesting concept and like many others I will be watching closely.

Have you considered the adverse affects of this test? I understand you are consulting with doc's, however, I think we'd all agree there is limited information available about coming off a therapy that is designed for lifelong usage.

I would think it may be better to research other people's experiences who were forced off of their Hormone Replacement Therapy (HRT) in order to better create your own written but not personally implemented exit strategy. This way you have it just in case if the need ever arises.

The one downside that comes to my mind is just the process of making these changes to your HTPA system (coming off of your Hormone Replacement Therapy (HRT) program) just to shut them down again in a short period of time seems like an unnecessary risk. There could be other less obvious but still detrimental consequences to this really academic exercise.

I was just thinking about pros on cons. If you come off and you are able to stabilize naturally through your advance PCT regimen then you just proved implementing your exist strategy was not needed. If you come off and something negative happens while you proved the reason for needing an exit strategy but youre still screwed because you have to deal with the negative consequence now, when it really was not necessary to take risk in the first place.

You add a lot of value to this board I respect your input. I am just hoping that you carefully weigh the benefits vs potential risk.

 

[cashout]

Transend -

You bring up some very valid points and ones that I have considered in more than one dimension.

The funny thing about this is when I told my urologist what I wanted to do his initial response was "This is the damn reason I don't like to do Hormone Replacement Therapy (HRT) with people like you."

His response was in regard to the fact that went I first when to him he told me I was to young and health to consider HRT.

It wasn't until we started to go over my 20
+ years of labs that I've collected that he saw my point and agreed to work with me.

So, in short, yes this plan has not been well received by all parties to whom I've presented it on my medical support team.

My urologist immediately suggested we involve an endocrinologist to which I whole-heatedly agree.

In discussing this plan with the endocrinologist, we all come to the conclusion that through proper monitoring it would be possible to prepare ourselves for any consequences. Furthermore, my endocrinologist has a belief that it may even be possible to engage my HTPA function to pre-decline levels (circia 2006 when my natural test levels were around 900 ng/dl). I don't expect that to be the case. I do think we can return my HPTA to a functional level of pre-HRT (579 ng/dl w/ appropriate levels of other hormones).

So while there is some trepidation, I know that I am doing this with the full consultative support of a good team and by my own choice.

 

[zoofus]

From my perspective I view a potential forced exit from Hormone Replacement Therapy (HRT) the same way (except the conservative side of me wants 5 years of meds and 3 complete tested restart cycles in a locked safe...I know I have problems).

I really appreciate your exercise and willingness to document for the community. Thank you and very much appreciate your efforts. Good luck!

 

[CHIP WADOWSKI]

transend -

you bring up some very valid points and ones that i have considered in more than one dimension.

The funny thing about this is when i told my urologist what i wanted to do his initial response was "this is the damn reason i don't like to do Hormone Replacement Therapy (HRT) with people like you."

his response was in regard to the fact that went i first when to him he told me i was to young and health to consider hrt.

It wasn't until we started to go over my 20
+ years of labs that i've collected that he saw my point and agreed to work with me.

So, in short, yes this plan has not been well received by all parties to whom i've presented it on my medical support team.

My urologist immediately suggested we involve an endocrinologist to which i whole-heatedly agree.

In discussing this plan with the endocrinologist, we all come to the conclusion that through proper monitoring it would be possible to prepare ourselves for any consequences. Furthermore, my endocrinologist has a belief that it may even be possible to engage my htpa function to pre-decline levels (circia 2006 when my natural test levels were around 900 ng/dl). I don't expect that to be the case. I do think we can return my hpta to a functional level of pre-hrt (579 ng/dl w/ appropriate levels of other hormones).

So while there is some trepidation, i know that i am doing this with the full consultative support of a good team and by my own choice.

hey cashout,
my only real problem with your experiment is that it seems like you have really been "dialed in" perfectly for quite some time now, and like i tell all of my clients, "if it aint broke, lets not fix it". I'm sure that part of this experiment is triggered by the scientist in you. I'm just concerned that you will proceed with your plans, than after you document your findings, how are we to know if you will ever be able to get dialed in again, in the future, as well as you are now? Just a thought...

Hope it works out for you andi'm sure that if there is someone educated enough to do this, that it would be you. Best of luck with it, bro.

 

[cashout]

hey cashout,
my only real problem with your experiment is that it seems like you have really been "dialed in" perfectly for quite some time now, and like i tell all of my clients, "if it aint broke, lets not fix it". I'm sure that part of this experiment is triggered by the scientist in you. I'm just concerned that you will proceed with your plans, than after you document your findings, how are we to know if you will ever be able to get dialed in again, in the future, as well as you are now? Just a thought...

Hope it works out for you andi'm sure that if there is someone educated enough to do this, that it would be you. Best of luck with it, bro.

Chip, you certainly hit on one of my big concerns with this exercise.

I've really had great success with my Hormone Replacement Therapy (HRT) regarding what I hoped to accomplish when I started.

But you are very much correct. I always tell my students "when you have a good thing going, don't screw it up." So, I'm not taking my own advice.

I'm concerned that I may have some difficulty getting dialed in again afterwards.

I do think that as I've gone through the past 2 years of Hormone Replacement Therapy (HRT), I've learned a lot about my body and how it responds. I will have to lean on that to get back afterwards.

Although this has always been a though in my mind from the start, there have been a couple of things in the past month that have brought me to consider this now.

I guess the biggest one, as I mentioned elsewhere, is that I have watched an associate have to come off Hormone Replacement Therapy (HRT) due to an illness. Against my recommendations and suggestions, he just "cold turkey-ed" it and it has been a struggle for him.

Chip, thanks for the support and thanks to all the rest of you as well. I DO appreciate it.

I will continue to keep everyone informed as I proceed. I hope that I not only learn from this but everyone of us finds value in the exercise.

 

[grilla_b]

Cashout - Thanks for taking the time to share this with everyone. I think it's a smart idea for everyone to think about this.

There are a lot of scenarios where one would have to stop Hormone Replacement Therapy (HRT) and I think it's a great idea to be prepared for it ahead of time.

Do you plan to always have these compounds on hand in case you ever need them?

 

[cashout]

Cashout - Thanks for taking the time to share this with everyone. I think it's a smart idea for everyone to think about this.

There are a lot of scenarios where one would have to stop Hormone Replacement Therapy (HRT) and I think it's a great idea to be prepared for it ahead of time.

Do you plan to always have these compounds on hand in case you ever need them?

No need to keep them on hand. They are very common drugs. If they are needed, I'll get a script for them and take it to my local Walgreens.

 

[freethebeast]

Thank you so much for doing this. This is my greatest fear for starting TRT.

Not only for all the curveballs life can throw at you, but just from an economic and societal standpoint, the uncertainty is greater than perhaps any time in modern history.

And really I just can't decide if trying to fix low T is worth the risk of someday having to walk around with no T...

 

[abearsfan]

There appears to be lots of interest in Cashout's planned, if not only temporary, exit from HRT. I too am interested in how this will play out but am more amazed that there aren't many other examples of others who have had to stop Hormone Replacement Therapy (HRT) for one reason or another. Where are their stories? What protocol did they run when they had to stop and were they successful? I can't imagine starting therapy (speaking *only* for myself) without knowing what my chances of success would be with an exit strategy if one were needed for whatever reason.

Keep us posted Cashout

 

[dfeaton]

Bump

Any update Cashout?

 

[MoparMuscle]

Quality thread Cash.

Thanks.

 

[old mechanic]

I can think of several conditions that could possible preclude one's use of exogenous androgen.

My vet was diagnosed three weeks ago with Hashimoto's and he was immediately told to discontinue his HRT. So, yes, this has been on my mind as a result.While I certainly don't anticipate anything like that in my future, I would like to know that if I have to cease and desist I have a plan for that already prepared.

It is just that simple.

Why??

the reason i ask is i tryed Hormone Replacement Therapy (HRT) and i had to give it up after a while because i felt VERY tired. I have low thyroid (Hashimoto's) and am on synthroid .212 per day.

thanks

 

[cashout]

Why??

the reason i ask is i tryed Hormone Replacement Therapy (HRT) and i had to give it up after a while because i felt VERY tired. I have low thyroid (Hashimoto's) and am on synthroid .212 per day.

thanks

Hashimoto is the initial condition that was diagnosed.

Subsequently, their has been concern about an abnormal cell cluster beneath the thyroid. They are not certain, as far as I know today, whether it is a lymphoma of the thyroid gland.

From what he shared with me, they are trying to baseline him so that they can work thought his issues.

To do that they requested he discontinue HRT.

 

[old mechanic]

Ok so they are trying to get a base line. There is not a problem with low throid when on testosterone replacement therapy (TRT), correct??

thanks

 

[cashout]

Ok so they are trying to get a base line. There is not a problem with low throid when on testosterone replacement therapy (TRT), correct??

thanks

I wouldn't know of the specifics of Hormone Replacement Therapy (HRT) and Hashimoto.

I think, from our last conversation before the holiday week, that the concern was the cell mass beneath the thyroid. They had not yet determine what type of tissue mass it was or if it was affecting the thyroid function itself.

 

[MoparMuscle]

Hashimoto is the initial condition that was diagnosed.

Subsequently, their has been concern about an abnormal cell cluster beneath the thyroid. They are not certain, as far as I know today, whether it is a lymphoma of the thyroid gland.

From what he shared with me, they are trying to baseline him so that they can work thought his issues.

To do that they requested he discontinue HRT.

Sucks I know 2 people thathad thyroid cancer one caught it early and was ok with just removing it the other caught it too late. A mass of cell growth is never good. Hope he's ok.

 

[cashout]

Update

All blood work completed. Should have labs back on Wednesday or Thursday.

On course to begin exit on Monday Dec 5th - next week.