Talk Cancer

Question:

Hi Ernie, Thank you for the feedback. I will check into this too. Best regards, Mel – Hide quoted text — Show quoted text – Hi, These effects are not established as great or very significant. In fact the data is usually very small effects in a statistically small group. Statistics based on too small a group can be misleading and especially when the data is old. Sometimes other factors such as age or conditions that are related can be enough to upset a study when this is the case. I would suggest talking to my favorite endocrinologist that has been treating men with TRT for decades in Augusta GA. Dr. R. Don Gambrell has a web site and will take questions. http://www.members.aol.com/gambr999/ ernestnolan Hi Joe, Thank you so much for the time and effort you went to to help answer my question. Sorry I took so long to respond, I’ve been out of town. I am going to talk to my doctors about what you have to say and hopefully they will respond and help me get off the testosterone. Recently I read a post on this NG where a fellow said his doctor may take him off testosterone replacement. I thought you couldn’t do that. I have been on Androgel for about two years and would like to stop using it. Will my body adjust and start producing its own testosterone again? The reason I want to stop is that I read in some rare cases it can cause your cholesterol to go too low, which mine has. I found out recently that too low cholesterol can cause as many problems as too high. Thanks for any information you can give. Quick answer: in many cases you can regain your pre-TRT natural production (whatever that was). To expedite and ease the restart process, there’s a protocol involving hCG and in some cases Clomid. If I remember right Clomid will help get my FSH to rise. If that is the case I don’t know if it will help me because before I started TRT it was twice the normal level. I had a lot of radiation around my gonads when I had rectal cancer, so I may never get the FSH up there again. If you’re otherwise happy on TRT, except for cholesterol, I’d examine that further. I just recently heard of a supplement that is supposed to help bring up the level of cholesterol. I may give it a try and  if it works then I may stay on TRT. But I may not be able to stay on due to cut backs in Medicaid and if they do stop helping me I can’t afford the TRT. Some studies show TRT will reduce HDL (good cholesterol), which you don’t want. However  other studies don’t show that. Make sure you’ve had a complete lipids profile, including total cholesterol, HDL, LDL, and triglycerides. You should also have a complete blood count (CBC) to check your hematocrit and other values, and a PSA test if you haven’t had one. I had a blood work up just recently and my cholesterol has come up a bit to HDL of 32, Chol/HDL Ratio of 3.0, and my LDL-Direct of 57. If it keeps going up I may be okay. I have been eating a lot of eggs and dairy lately to try to help get it to a higher level. The testosterone molecules in Androgel are identical to what your body naturally makes. In theory there should be no difference, assuming your dosage is properly adjusted. Have your free T and estradiol levels been checked to ensure proper dosage? I just had my estradiol tested and it was normal at 43. When I first started TRT I was getting too much and it went way up, so I cut back. A funny thing I didn’t expect is that when I have higher doses of Testosterone my sex drive goes way down and when I cut back on the dose it goes back up some. That is how I have been regulating my dosage. In most cases it is possible to stop TRT after two years, according to a couple of endocrinologists I asked. This assumes you took it properly at normal replacement levels, not at the very high levels some bodybuilders take. The best case is you’ll revert to your pre-TRT production level, which presumably was deficient else you wouldn’t have taken TRT. There’s a protocol for coming off TRT that involves taking hCG for 1-2 months while you take TRT (ramping down T dosage toward the end), then stopping both. Unfortunately there’s no published data on this I can find. Bodybuilders have a lot of empirical experience with this since they cycle on and off steroids and face the same problem. In addition to hCG they often take Clomid (Clomiphene Citrate) for a few weeks after the hCG phase. The reasoning is Clomid helps restart the hypothalamus pituitary production of LH. The reason for taking hCG is to force restart of testicular production. After being I just hope my doctors go for the HCG. I hope they do because what you have shared with me make good sense. on TRT for an extended period there’s some atrophy, not just physically but also regarding production capacity. The restart interval seems to be very roughly 4 – 8 weeks, but I can’t find good data on this. Of course you could just quit TRT, but you’d face a harsh several months while your hypothalamus-pituitary-gonadal axis restarts. There are two restart considerations: testicular restart and hypothalamus-pituitary restart. The limited data I’ve seen indicates testicular restart is the dominate component time-wise, thus the hCG. There was one study on this, but I can’t find it. However bodybuilders often take Clomid for a couple of weeks beginning about a week after the hCG phase. Since estrogen acts as negative feedback reducing pituitary LH production, and Clomid blocks estrogen receptors, this supposedly expedites the hypothalamus-pituitary portion of the restart. If you want to stop TRT first make sure your reasons and concerns are valid. Next review what your pre-TRT testosterone level was. E.g, if this was 250 ng/dl, there’s little reason in even trying to stop TRT.  Then discuss with your Dr the restart protocol. At a minimum this should involve hCG injections, probably 5000 to 7000 units per week for 4 to 8 weeks. Following this it may also involve Clomid or some other anti-estrogen drug, but some go without this. — Joe D. Thanks again Joe. Best regards, Mel

Response:

Thanks Joe! That is very helpful information. I will check it out and talk with my doctors. Best regards, Mel – Hide quoted text — Show quoted text – Hi Joe, Thank you so much for the time and effort you went to to help answer my question. Sorry I took so long to respond, I’ve been out of town. I am going to talk to my doctors about what you have to say and hopefully they will respond and help me get off the testosterone.  The limited data I’ve seen indicates testicular restart is the dominate component time-wise, thus the hCG. There was one study on this, but I can’t find it. OK I found the study I mentioned. It’s listed below. In general it shows that after long term TRT, the dominate component governing endogenous restart is testicular production. IOW almost immediately after quitting TRT, the hypothalamus realizes this and signals the pituitary via GnRH. The pituitary almost immediately reacts and produces LH and FSH. However the testicles are very sluggish and it takes at least 4 weeks to get any response at all, and 6-8 weeks to get a decent response, and 12 weeks (3 months) to reach pre-TRT levels. Without other treatment, you’d be feeling pretty bad during most of this time. The purpose of hCG treatment in coming of TRT is to force testicular restart over a 4-6 week period, while you continue taking TRT. In theory this avoids the prolonged months-long crash of stopping TRT. In addition to hCG, some bodybuilders take Clomid to further kick start the hypothalamic-pituitary axis, but the below study implies this probably isn’t vital. Without any medication, the hypothalamus and pituitary are very quick to respond. It is possible hCG might increase estradiol, so possibly a very limited dose of Clomid, Arimidex, etc. could ensure estradiol is low, avoiding negative feedback to the hypothalamus. However that’s somewhat speculative. The key is hCG. Here’s a web page that discusses this: http://www.mindandmuscle.net/magazine/i7postcycle.html — Joe D. Effect of long-term testosterone oenanthate administration on male reproductive function: clinical evaluation, serum FSH, LH, testosterone, and seminal fluid analyses in normal men. Mauss J, Borsch G, Bormacher K, Richter E, Leyendecker G, Nocke W. Acta Endocrinol (Copenh). 1975 Feb;78(2):373-84.

Response:

Recently I read a post on this NG where a fellow said his doctor may take him off testosterone replacement. I thought you couldn’t do that. I have been on Androgel for about two years and would like to stop using it. Will my body adjust and start producing its own testosterone again? The reason I want to stop is that I read in some rare cases it can cause your cholesterol to go too low, which mine has. I found out recently that too low cholesterol can cause as many problems as too high. Thanks for any information you can give. Mel

Response:

Recently I read a post on this NG where a fellow said his doctor may take him off testosterone replacement. I thought you couldn’t do that. I have been on Androgel for about two years and would like to stop using it. Will my body adjust and start producing its own testosterone again? The reason I want to stop is that I read in some rare cases it can cause your cholesterol to go too low, which mine has. I found out recently that too low cholesterol can cause as many problems as too high. Thanks for any information you can give.

Quick answer: in many cases you can regain your pre-TRT natural production (whatever that was). To expedite and ease the restart process, there’s a protocol involving hCG and in some cases Clomid. If you’re otherwise happy on TRT, except for cholesterol, I’d examine that further. Some studies show TRT will reduce HDL (good cholesterol), which you don’t want. However  other studies don’t show that. Make sure you’ve had a complete lipids profile, including total cholesterol, HDL, LDL, and triglycerides. You should also have a complete blood count (CBC) to check your hematocrit and other values, and a PSA test if you haven’t had one. The testosterone molecules in Androgel are identical to what your body naturally makes. In theory there should be no difference, assuming your dosage is properly adjusted. Have your free T and estradiol levels been checked to ensure proper dosage? In most cases it is possible to stop TRT after two years, according to a couple of endocrinologists I asked. This assumes you took it properly at normal replacement levels, not at the very high levels some bodybuilders take. The best case is you’ll revert to your pre-TRT production level, which presumably was deficient else you wouldn’t have taken TRT. There’s a protocol for coming off TRT that involves taking hCG for 1-2 months while you take TRT (ramping down T dosage toward the end), then stopping both. Unfortunately there’s no published data on this I can find. Bodybuilders have a lot of empirical experience with this since they cycle on and off steroids and face the same problem. In addition to hCG they often take Clomid (Clomiphene Citrate) for a few weeks after the hCG phase. The reasoning is Clomid helps restart the hypothalamus pituitary production of LH. The reason for taking hCG is to force restart of testicular production. After being on TRT for an extended period there’s some atrophy, not just physically but also regarding production capacity. The restart interval seems to be very roughly 4 – 8 weeks, but I can’t find good data on this. Of course you could just quit TRT, but you’d face a harsh several months while your hypothalamus-pituitary-gonadal axis restarts. There are two restart considerations: testicular restart and hypothalamus-pituitary restart. The limited data I’ve seen indicates testicular restart is the dominate component time-wise, thus the hCG. There was one study on this, but I can’t find it. However bodybuilders often take Clomid for a couple of weeks beginning about a week after the hCG phase. Since estrogen acts as negative feedback reducing pituitary LH production, and Clomid blocks estrogen receptors, this supposedly expedites the hypothalamus-pituitary portion of the restart. If you want to stop TRT first make sure your reasons and concerns are valid. Next review what your pre-TRT testosterone level was. E.g, if this was 250 ng/dl, there’s little reason in even trying to stop TRT.  Then discuss with your Dr the restart protocol. At a minimum this should involve hCG injections, probably 5000 to 7000 units per week for 4 to 8 weeks. Following this it may also involve Clomid or some other anti-estrogen drug, but some go without this. — Joe D.

Response:

Hey, i used clomid for 21 days and raised my T level from 1.3 to 4.2 and it seems to have stuck. i would suggest tamoxifen instead of clomid as it has fewer side effects. 10 to 20 mg per day. but for someone on T replacement it may need a lot of hcg treatment first. – Hide quoted text — Show quoted text – Recently I read a post on this NG where a fellow said his doctor may take him off testosterone replacement. I thought you couldn’t do that. I have been on Androgel for about two years and would like to stop using it. Will my body adjust and start producing its own testosterone again? The reason I want to stop is that I read in some rare cases it can cause your cholesterol to go too low, which mine has. I found out recently that too low cholesterol can cause as many problems as too high. Thanks for any information you can give. Mel

Response:

Hi Joe, Thank you so much for the time and effort you went to to help answer my question. Sorry I took so long to respond, I’ve been out of town. I am going to talk to my doctors about what you have to say and hopefully they will respond and help me get off the testosterone. – Hide quoted text — Show quoted text – Recently I read a post on this NG where a fellow said his doctor may take him off testosterone replacement. I thought you couldn’t do that. I have been on Androgel for about two years and would like to stop using it. Will my body adjust and start producing its own testosterone again? The reason I want to stop is that I read in some rare cases it can cause your cholesterol to go too low, which mine has. I found out recently that too low cholesterol can cause as many problems as too high. Thanks for any information you can give. Quick answer: in many cases you can regain your pre-TRT natural production (whatever that was). To expedite and ease the restart process, there’s a protocol involving hCG and in some cases Clomid.

If I remember right Clomid will help get my FSH to rise. If that is the case I don’t know if it will help me because before I started TRT it was twice the normal level. I had a lot of radiation around my gonads when I had rectal cancer, so I may never get the FSH up there again. If you’re otherwise happy on TRT, except for cholesterol, I’d examine that further.

I just recently heard of a supplement that is supposed to help bring up the level of cholesterol. I may give it a try and  if it works then I may stay on TRT. But I may not be able to stay on due to cut backs in Medicaid and if they do stop helping me I can’t afford the TRT. Some studies show TRT will reduce HDL (good cholesterol), which you don’t want. However  other studies don’t show that. Make sure you’ve had a complete lipids profile, including total cholesterol, HDL, LDL, and triglycerides. You should also have a complete blood count (CBC) to check your hematocrit and other values, and a PSA test if you haven’t had one.

I had a blood work up just recently and my cholesterol has come up a bit to HDL of 32, Chol/HDL Ratio of 3.0, and my LDL-Direct of 57. If it keeps going up I may be okay. I have been eating a lot of eggs and dairy lately to try to help get it to a higher level. The testosterone molecules in Androgel are identical to what your body naturally makes. In theory there should be no difference, assuming your dosage is properly adjusted. Have your free T and estradiol levels been checked to ensure proper dosage?

I just had my estradiol tested and it was normal at 43. When I first started TRT I was getting too much and it went way up, so I cut back. A funny thing I didn’t expect is that when I have higher doses of Testosterone my sex drive goes way down and when I cut back on the dose it goes back up some. That is how I have been regulating my dosage. – Hide quoted text — Show quoted text – In most cases it is possible to stop TRT after two years, according to a couple of endocrinologists I asked. This assumes you took it properly at normal replacement levels, not at the very high levels some bodybuilders take. The best case is you’ll revert to your pre-TRT production level, which presumably was deficient else you wouldn’t have taken TRT. There’s a protocol for coming off TRT that involves taking hCG for 1-2 months while you take TRT (ramping down T dosage toward the end), then stopping both. Unfortunately there’s no published data on this I can find. Bodybuilders have a lot of empirical experience with this since they cycle on and off steroids and face the same problem. In addition to hCG they often take Clomid (Clomiphene Citrate) for a few weeks after the hCG phase. The reasoning is Clomid helps restart the hypothalamus pituitary production of LH. The reason for taking hCG is to force restart of testicular production. After being

I just hope my doctors go for the HCG. I hope they do because what you have shared with me make good sense. – Hide quoted text — Show quoted text – on TRT for an extended period there’s some atrophy, not just physically but also regarding production capacity. The restart interval seems to be very roughly 4 – 8 weeks, but I can’t find good data on this. Of course you could just quit TRT, but you’d face a harsh several months while your hypothalamus-pituitary-gonadal axis restarts. There are two restart considerations: testicular restart and hypothalamus-pituitary restart. The limited data I’ve seen indicates testicular restart is the dominate component time-wise, thus the hCG. There was one study on this, but I can’t find it. However bodybuilders often take Clomid for a couple of weeks beginning about a week after the hCG phase. Since estrogen acts as negative feedback reducing pituitary LH production, and Clomid blocks estrogen receptors, this supposedly expedites the hypothalamus-pituitary portion of the restart. If you want to stop TRT first make sure your reasons and concerns are valid. Next review what your pre-TRT testosterone level was. E.g, if this was 250 ng/dl, there’s little reason in even trying to stop TRT.  Then discuss with your Dr the restart protocol. At a minimum this should involve hCG injections, probably 5000 to 7000 units per week for 4 to 8 weeks. Following this it may also involve Clomid or some other anti-estrogen drug, but some go without this. — Joe D.

Thanks again Joe. Best regards, Mel

Response:

Thanks Sevenofnine! I will see what my doctors have to say and see if I can try the tamoxifen, plus HCG. Thanks again. Best regards, Mel – Hide quoted text — Show quoted text – Hey, i used clomid for 21 days and raised my T level from 1.3 to 4.2 and it seems to have stuck. i would suggest tamoxifen instead of clomid as it has fewer side effects. 10 to 20 mg per day. but for someone on T replacement it may need a lot of hcg treatment first. Recently I read a post on this NG where a fellow said his doctor may take him off testosterone replacement. I thought you couldn’t do that. I have been on Androgel for about two years and would like to stop using it. Will my body adjust and start producing its own testosterone again? The reason I want to stop is that I read in some rare cases it can cause your cholesterol to go too low, which mine has. I found out recently that too low cholesterol can cause as many problems as too high. Thanks for any information you can give. Mel

Response:

Hi Joe, Thank you so much for the time and effort you went to to help answer my question. Sorry I took so long to respond, I’ve been out of town. I am going to talk to my doctors about what you have to say and hopefully they will respond and help me get off the testosterone.  The limited data I’ve seen indicates testicular restart is the dominate component time-wise, thus the hCG. There was one study on this, but I can’t find it.

OK I found the study I mentioned. It’s listed below. In general it shows that after long term TRT, the dominate component governing endogenous restart is testicular production. IOW almost immediately after quitting TRT, the hypothalamus realizes this and signals the pituitary via GnRH. The pituitary almost immediately reacts and produces LH and FSH. However the testicles are very sluggish and it takes at least 4 weeks to get any response at all, and 6-8 weeks to get a decent response, and 12 weeks (3 months) to reach pre-TRT levels. Without other treatment, you’d be feeling pretty bad during most of this time. The purpose of hCG treatment in coming of TRT is to force testicular restart over a 4-6 week period, while you continue taking TRT. In theory this avoids the prolonged months-long crash of stopping TRT. In addition to hCG, some bodybuilders take Clomid to further kick start the hypothalamic-pituitary axis, but the below study implies this probably isn’t vital. Without any medication, the hypothalamus and pituitary are very quick to respond. It is possible hCG might increase estradiol, so possibly a very limited dose of Clomid, Arimidex, etc. could ensure estradiol is low, avoiding negative feedback to the hypothalamus. However that’s somewhat speculative. The key is hCG. Here’s a web page that discusses this: http://www.mindandmuscle.net/magazine/i7postcycle.html — Joe D. Effect of long-term testosterone oenanthate administration on male reproductive function: clinical evaluation, serum FSH, LH, testosterone, and seminal fluid analyses in normal men. Mauss J, Borsch G, Bormacher K, Richter E, Leyendecker G, Nocke W. Acta Endocrinol (Copenh). 1975 Feb;78(2):373-84.

Response:

Hi, These effects are not established as great or very significant. In fact the data is usually very small effects in a statistically small group. Statistics based on too small a group can be misleading and especially when the data is old. Sometimes other factors such as age or conditions that are related can be enough to upset a study when this is the case. I would suggest talking to my favorite endocrinologist that has been treating men with TRT for decades in Augusta GA. Dr. R. Don Gambrell has a web site and will take questions. http://www.members.aol.com/gambr999/ ernestnolan

Hi Joe, Thank you so much for the time and effort you went to to help answer my question. Sorry I took so long to respond, I’ve been out of town. I am going to talk to my doctors about what you have to say and hopefully they will respond and help me get off the testosterone.

Recently I read a post on this NG where a fellow said his doctor may take him off testosterone replacement. I thought you couldn’t do that. I have been on Androgel for about two years and would like to stop using it. Will my body adjust and start producing its own testosterone again? The reason I want to stop is that I read in some rare cases it can cause your cholesterol to go too low, which mine has. I found out recently that too low cholesterol can cause as many problems as too high. Thanks for any information you can give. Quick answer: in many cases you can regain your pre-TRT natural

production (whatever – Hide quoted text — Show quoted text – that was). To expedite and ease the restart process, there’s a protocol involving hCG and in some cases Clomid. If I remember right Clomid will help get my FSH to rise. If that is the case I don’t know if it will help me because before I started TRT it was twice the normal level. I had a lot of radiation around my gonads when I had rectal cancer, so I may never get the FSH up there again. If you’re otherwise happy on TRT, except for cholesterol, I’d examine that further. I just recently heard of a supplement that is supposed to help bring up the level of cholesterol. I may give it a try and  if it works then I may stay on TRT. But I may not be able to stay on due to cut backs in Medicaid and if they do stop helping me I can’t afford the TRT. Some studies show TRT will reduce HDL (good cholesterol), which you don’t want. However  other studies don’t show that. Make sure you’ve had a complete lipids profile, including total cholesterol, HDL, LDL, and triglycerides. You should also have a complete blood count (CBC) to check your hematocrit and other values, and a PSA test if you haven’t had one. I had a blood work up just recently and my cholesterol has come up a bit to HDL of 32, Chol/HDL Ratio of 3.0, and my LDL-Direct of 57. If it keeps going up I may be okay. I have been eating a lot of eggs and dairy lately to try to help get it to a higher level. The testosterone molecules in Androgel are identical to what your body naturally makes. In theory there should be no difference, assuming your dosage is properly adjusted. Have your free T and estradiol levels been checked to ensure proper dosage? I just had my estradiol tested and it was normal at 43. When I first started TRT I was getting too much and it went way up, so I cut back. A funny thing I didn’t expect is that when I have higher doses of Testosterone my sex drive goes way down and when I cut back on the dose it goes back up some. That is how I have been regulating my dosage. In most cases it is possible to stop TRT after two years, according to a couple of endocrinologists I asked. This assumes you took it properly at normal replacement levels, not at the very high levels some bodybuilders take. The best case is you’ll revert to your pre-TRT production level, which presumably was deficient else you wouldn’t have taken TRT. There’s a protocol for coming off TRT that involves taking hCG for 1-2 months while you take TRT (ramping down T dosage toward the end), then stopping both. Unfortunately there’s no published data on this I can find. Bodybuilders have a lot of empirical experience with this since they cycle on and off steroids and face the same problem. In addition to hCG they often take Clomid

(Clomiphene Citrate) for a – Hide quoted text — Show quoted text – few weeks after the hCG phase. The reasoning is Clomid helps restart the hypothalamus pituitary production of LH. The reason for taking hCG is to force restart of testicular production. After being I just hope my doctors go for the HCG. I hope they do because what you have shared with me make good sense. on TRT for an extended period there’s some atrophy, not just physically but also regarding production capacity. The restart interval seems to be very roughly 4 – 8 weeks, but I can’t find good data on this. Of course you could just quit TRT, but you’d face a harsh several months while your

hypothalamus-pituitary-gonadal axis restarts. There are two restart considerations: testicular restart and

hypothalamus-pituitary – Hide quoted text — Show quoted text – restart. The limited data I’ve seen indicates testicular restart is the dominate component time-wise, thus the hCG. There was one study on this, but I can’t find it. However bodybuilders often take Clomid for a couple of weeks beginning about a week after the hCG phase. Since estrogen acts as negative feedback reducing pituitary LH production, and Clomid blocks estrogen receptors, this supposedly expedites the hypothalamus-pituitary portion of the restart. If you want to stop TRT first make sure your reasons and concerns are valid. Next review what your pre-TRT testosterone level was. E.g, if this was 250 ng/dl, there’s little reason in even trying to stop TRT.  Then discuss with your Dr the restart protocol. At a minimum this should involve hCG injections,

probably 5000 to 7000 – Hide quoted text — Show quoted text – units per week for 4 to 8 weeks. Following this it may also involve Clomid or some other anti-estrogen drug, but some go without this. — Joe D. Thanks again Joe. Best regards, Mel

Response: