TRT: Permanent?

Therapeutic Efforts Pharmaceutical
#1

I saw Dr. Jacobs a few week back for ongoing issues post-Fin. (Unlike some of you guys, sexual issues aren’t my primary concern. I did experience sexual issues for a few months after quitting Fin, but my overall sexual health has recovered to probably around 80 or 85 percent. Obviously, I’m still hoping for full recovery.) The main problem has and continues to be profuse sweating from my feet, from the area of my scrotum, and from my hands, though less so in that third area.

Anyway, he took bloods and everything seemed fine, except for my bioavailable testosterone, which seemed a little low. He recommended starting TRT, as low bioavailable testosterone could account for my sweating. I had always been under the impression, though, that undergoing TRT and thus adding synthetic testosterone into the body shuts down the testicles and the body’s ability to produce testosterone naturally. He said that wasn’t true and thought we could try to bump my levels up and see if they stick at a higher level.

So, to the question: Is he right about this? Can TRT in fact be used as a temporary means and not just as a permanent treatment? I’ve read horror stories from different guys who started on TRT thinking they would only be on it temporarily but instead were stuck on it for life when their testicles stopped producing testosterone, even after stopping treatment. Dr. Jacobs seems like a good doctor, but I’m concerned of going down the TRT route if there’s a chance of shutting down my testicles forever.

#2

I was also confused by this. Jacobs says you can restart your T production at pretty much any time. But, if you have PFS you arnt a “normal” person taking TRT. There seem to be more reports of people having no response or getting worse than of those of us seeing improvment on TRT. I sort of wonder the wisdom of TRT for our condition. If you are coping fairly well it seems a bit drastic for just sweaty feet, etc. Dr. Jacobs is a great doctor with incredible medical cred and I’m just another d-bag who took Fin for hair loss. So, keep that in mind. If you do decide to gon on TRT you may want to consider bioidentical over synthetic.

Did you check your levels of SHBG? Lowering that should raise your Free T. Makes me wonder if your e2 was high as well. I wonder if supplementing DHEA and/or Muira Puama would help lower your SHBG? There are some interesting discussions on this and other ideas to lowering or balancing your SHBG in some of the body building forums.

#3

The sweaty feet/scrotum has frankly stopped my life dead in its tracks for the last nearly five months. Any sort of movement is agonizingly uncomfortable, and my clothes are soaked through within five minutes of putting them on in the morning, all of which has basically left me no choice but to be a shut-in for this entire time. So the sweating is a big deal, but I agree that something like TRT nevertheless seems a bit drastic in my case. Especially confusing is the fact he seems to think natural testosterone production will simply switch back on once I get off TRT treament. (He compared TRT to birth control, in that testosterone production returns to normal once treatment is stopped, much in the same way estrogen production in women returns to normal once birth control is stopped. The more I read the more I question that analogy – but, really, compared to him, what do I know?)

Anyway, SHBH and E2 were in a healthy range given my testosterone levels, according to Dr. Jacobs. I haven’t seen the results yet, as Dr. Jacobs simply communicated his thoughts on them to me via phone, but once I receive a copy I’ll compare SHBH to what it was when I had it tested a few months back.

Boston, if you could humor me: What’s the wisdom of supplementing DHEA? Perhaps that my problem isn’t related to testicular hormones but instead to hormones produced by the adrenal glands?

#4

I have personally seen Dr. Jacobs for treatment and he prescribed 1 tube (5g) of Testim initially and subsequently bumped it up to 2 tubes. When I was on 2 tubes, my T and bioavailable T levels had actually dropped to lower levels than when I had stopped Propecia and was not on TRT. I have been off all forms of TRT and my levels returned to basically what they were pre-TRT but my T and free T are actually slightly higher.

Dr. Irwin Goldstein, the San Diego urologist, recommends trying clomiphene (clomid) over testosterone which I believe is in pill form. Clomiphene increases testosterone levels endogenously. He warns that testosterone may result in sertoli cell suppression with possible fertility issues.

#5

Ding ding

Right on the money.

I’m very surprised at Jacobs being so quick to use TRT without trying other methods first. On that evidence i would be concerned about his ability to cure any PFS patient. Dr Crisler and Dr Shippin have various protocols they will look to trial first, one being Clomid starting at around 12.5mg ED. A much better first protocol.

As for TRT and fertility. It’s true. This is why many men use hCG or a SERM like tamoxifen or clomid alongside TRT to preserve fertility.

#6

Well, in general anabolic hormones (Testosterone,DHEA,DHT,Growth Hormone etc.) reduce SHBG while estrogen raises it. Kind of an over slimpification but in general. Dont use Stinging Nettle Root as it also inhibits 5AR2. Some of the guys on the bodybuilding forums claim transdermal Chrysin has lowered their SHBG.

#7

I’m sure Dr. Jacobs checked this, but excessive sweating is symptom of hyperthyroidism. Did your thryoid hormones look ok?

#8

Just curious, but how does LOW bio T account for increased sweating?

From my understanding, sweat and sebum production are generally controlled by androgens, and excessive sweating is generally due to elevated 5AR activity or androgen levels. It therefore seems counter intuitive to me to take TRT to increase androgens in order to reduce sweat production, especially considering TRT is generally a lifelong commitment.

However, I am not a doctor.

ncbi.nlm.nih.gov/pubmed/6454525

ncbi.nlm.nih.gov/pubmed/1613448

In 1996, Merck themselves filed a patent for the use of Finasteride to treat (reduce) sweat conditions:

google.ca/patents/download/5512555_Method_of_treating_sweat_related.pdf?id=G1cgAAAAEBAJ&output=pdf&sig=ACfU3U0SoH6iu6h6luwlw1BJCzXMFqRRKQ

Increased sweating after quitting Finasteride has been reported by a few members in the past, possibly due to “reflex hyperandrogenicity” (ie, androgen levels increase beyond what they should normally be):

hairlosshelp.com/hair_loss_research/hyperandrogenicity.cfm
viewtopic.php?t=825&highlight=reflex
viewtopic.php?f=25&t=3680&p=22096&hilit=reflex#p22096

#9

Let me preface, this might be a silly idea
I couldnt imagine this for the scrotum area, but have you looked into botox for your feet? I heard the rich peeps use it to reduce underarm sweat. I read it might help for up to 2 years.

hyperhidrosis-california.com/How_to_Stop_Sweaty_Feet_2309.htm

#10

as for my condition:
before Finasterid I sweated a lot at night.
after Finasterid I hardly sweat at all at night.
As it did not bother me, I did not pay much attention to it (ED, numbness etc. is much more of an issue for me). However, it seems that it is just another bad side effect of Finasterid.

#11

Im the same as you, Keepup

My feet used to sweat a lot, and now they dont sweat much at all

#12

My TSH level is almost identical to what it was about six years ago, long prior to my having any problems related to Fin. My maternal grandmother had an overactive thyroid, so hyperthyroidism was something I’ve brought up to doctors, but seeing as how my TSH seems fine and I’m not exhibiting any other symptoms of hyperthyroidism, there’s been no reason as of yet to pursue issues with the thyroid any further. I know there are other thyroid tests, though, which I may have to think about getting.

I’ve read stuff here and there how low testosterone contributing to issues with sweating. Here’s one link:
timesonline.co.uk/tol/comment/talking_point/article397870.ece
Dr. Jacobs mentioned he thought it might be a factor, but he wasn’t definitive about it. Given what I’ve read, it doesn’t seem impossible there’s a correlations, but, like you, I’m not a doctor.

Thanks for these links, Mew. This is interesting; I’d never heard of reflex hyperandrogenicity before. The only problem is, other than the sweating, I don’t show any other symptoms of this condition. My libido, for one, has not fully recovered to where it was.

On the other hand, after I got off Fin, the sexual problems started within a few days, but it wasn’t until about a week or ten days later that the sweating began. I wonder if in that time my body had “upregulated,” so to speak. I don’t know, but it might be something worth looking into. Do you know of any treatments – herbal, pharmacological, or otherwise – used to treat this?

#13

Never mind the last question in my previous post. Obviously, I had forgotten that androgen is a blanket term for testosterone and other hormones in males.