I have been on TRT for over a year and don’t feel the benefits that I used to when I started. Do I need to increase the dosage?
Leading hormone optimization expert, Dr. Mark Gordon conveyed on an episode of the LLA podcast many years ago that if you only get on testosterone replacement therapy (TRT) over time you will down-regulate important upstream sex hormones such as DHEA and Pregnenolone. If you deplete these crucial hormones you will likely notice a drop in libido and mood so it makes sense to supplement with both if you’re going to use TRT. At the very least check your DHEA and Pregnenolone levels to see where they are at. If they are on the low end of the scale, bringing both back into the optimal range may be the solution you’re seeking. Be sure to check your estradiol levels as well to ensure you’re not converting too much testosterone to estrogen. On the other hand, if your Doctor has you on an aromatase inhibitor such as Arimidex make sure your estrogen levels are not too low. Estrogen levels have to be in a healthy range (not too high or low) to avoid a negative impact on mood, sex drive, and physique composition.
Next, we tend to become desensitized to anything we engage in for a prolonged period of time. For instance, the first time you had a cup of coffee you were probably bouncing off the walls from the caffeine kick. Yet, once you have a cup of coffee every day for a while you probably don’t even notice the caffeine and have to increase the amount to get the same effect. With TRT if your total testosterone levels went from 300 ng/dl to 900 ng/dl and more importantly your free testosterone from a low of 50 pg/ml to 200 pg/ml you’re likely going to notice a huge difference in mood, drive, and training performance. However, once you have been at this level for a year or so, your brain adapts and as a result, it may no longer have the perceived impact. While you can discuss increasing your dosage with your Doctor, I don’t think going higher is always the solution. The higher you take your testosterone levels the more likely you are to experience negative side effects so I think a more beneficial approach may be simply taking a break from time to time.
Dr. Gordon usually has his TRT clients take Clomiphene citrate (Clomid) at the same time. The fertility drug Clomid increases your own production of testosterone and acts as a backup plan in case you want to get off TRT or simply take a break. There may be some benefit from taking breaks periodically to avoid becoming desensitized or if you’re already desensitized increasing sensitivity by eliminating it for a while. This will require some experimentation as there isn’t any data that I am aware of to confirm this approach is valid. Nevertheless, one possible approach is to take a month off TRT every six months and just take Clomid or Aggressive Strength to ramp up your own production of testosterone. This approach won’t work for everyone on TRT of course as the reason most are on TRT is they no longer respond to natural production protocols. In such cases perhaps cycling the dosage of TRT may be a valid approach. Lower the dosage for a month for every six months on and then see if you notice a boost when you increase the dosage again.
Cycling to increase sensitivity is one of the reasons why I recommend my Aggressive Strength Testosterone Booster (ASTB) customers take a month off of ASTB every 12 weeks. In addition to avoiding becoming desensitized to the herbs in ASTB, you also avoid becoming desensitized to the higher testosterone levels you experience while on ASTB. Your levels won’t drop precipitously during the four weeks off but your body and brain will get a vacation from intensely augmenting your own production of testosterone.
We all need a break from time to time. Whether it is from work, intense training, or even social media, especially social media, taking breaks is beneficial. Perhaps we also need a break from TRT or any approach that augments testosterone to avoid becoming desensitized to the benefits.
