Why doesn't testosterone replacement therapy (TRT) work in the long run?

If your levels are going down than that means you have a methylation cycle problem. You need to do a urinalysis the same day you do lab draw and compare what was secreted throughout the day VS what was in your blood.

This could simply be related to aging.

The methylation cycle is essential for mental and physical health. It is critical to the metabolism of catecholamines in the synapse via an enzyme (COMT) as well as the synthesis of depression-relevant' compounds such as melatonin, myelin basic protein, carnitine, CoQ10, etc. Methylation is required to inactivate histamine.

Basic nutrients necessary for normal function of the methylation cycle include B12, glycine, serine, activated B6, selenium, cysteine, methionine and folic acid.

The proper functioning of the methylation cycle is essential for a number of critical reactions in the body. Consequences of genetic weaknesses (mutations) in this pathway are increased risk factors leading to a number of serious health conditions. A central pathway in the body that is particularly amenable to bio-molecular genetic weaknesses is the methionine/folate pathway.

There are several sites in this pathway where blocks can occur as a result of genetic differences. In general, single biomarkers are identified as indicators for specific disease states. However, it is possible that for a number of health conditions, including autism and other severe neurological syndromes, it may be necessary to look at the entire methylation pathway as a biomarker for underlying genetic susceptibility for a disease state. It may require expanding the view of a biomarker beyond the restriction of a mutation in a single gene to a mutation somewhere in an entire pathway of interconnected function.

The Methylation Cycle - Blog - Testosterone replacement & general men's health articles
 
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