Have you been on testosterone replacement therapy and wondering how to safely discontinue are you worried about high estrogen levels are you worried about whether or not your testosterone levels are going to come back into their normal range.  In this article, we will look at how to come off TRT (testosterone replacement therapy) safely.  We will address luteinizing hormone, estrogen, do you need to take things like HCG or Clomid, etc.  We will also look at some of the questions surrounding testosterone replacement therapy and shutting off the natural production of testosterone when you stop replacement therapy. How To Come Safely Come Off TRT?

Once you decide to stop TRT you may ask if it's safe to stop it abruptly or if there's something specific you need to do to reset your body.  Do you need to do something or to make sure everything is working the way it was prior to starting, for instance.  The main reason people ask this question is because of the feedback loops between the testes the pituitary and the hypothalamus.  These feedback loops can get interrupted when you are taking testosterone from some external source. This is true whether it is an injection, something you take by mouth, a pellet, or even a topical cream.  That outside source of testosterone will actually interrupt the feedback loops between your brain and your testes.  Sometimes it will just turn down or dampen that loop or it will shut it off completely and this is a dose dependent phenomenon.

First we want to look at the feedback loop itself, then we will look at what happens with testosterone replacement therapy.  Finally we will look at the things you can do to mitigate the interrupted feedback loop when you stopping TRT. 

Testosterone is produced from specific cells in the testes called the ledig cells.  Those cells are stimulated to produce the testosterone by hormone that comes from the pituitary gland in your brain called luteinizing hormone.  When your pituitary gland receives high levels or sufficient levels of testosterone (and to a lesser extent estrogen) it will decrease or dampen the amount of luteinizing hormone it produces.  So when the Ledig cells produce the testosterone, it feeds back and shuts off or decreases the amount of luteinizing hormone that's produced there.  In addition, there is a higher level in the brain called the hypothalamus that produces gonadotropin releasing hormone (GnRH).  This hormone stimulates the pituitary to produce luteinizing hormone.   The production of GnRH is partially influenced by the luteinizing hormone which feeds back to the hypothalamus to tell it there is enough.  This will then cause a decrease in the amount of gonadotropin releasing hormone that it produces.  The hypoothalamus also has an internal pulsatile stimulus of GnRH too.  So that there is not a constant stream of gonadotropin releasing hormone, it is done in a pulsatile manner.  When the the overall feedback loop is interrupted that pulsatile stimulation of gonadotropin releasing hormone is also interrupted. 

Pituitary Feedback Loop While On TRT
When you are taking an exogenous source of testosterone, the amount of luteinizing hormone goes down.  As that luteinizing hormone decreases, you will have less stimulation to the testes to produce that testosterone.  In this case it's okay given that you are taking it exogenously.  The moment you stop, it will take some time for your pituitary to reset and produce that luteinizing hormone again.  Keep in mind this is not a light switch it is more like a dimmer switch.  The more testosterone present in your body the less luteinizing hormone you will produce.  If you are doing injections, day one after the injection the luteinizing hormone production will be very low and stay low for several days after.  It may start to kick five days after or so depending on the dose you are taking.  The more saturated your body is with the testosterone, the less LH you will produce.    The same principal is true when you stop testosterone completely.   

Many people have commented to me that they don't want to go on testosterone replacement therapy because they don't want their testosterone production to completely shut off.  The signaling does not really work that way in my experience.  It's more of a dimmer switch and it does come back when you stop taking it.  There seems to be some suggestion that once you start testosterone therapy you have to continue taking it because it shuts off the internal production completely. This doesn't mean it won't happen but it seems to be more extreme cases.  I wouldn't know because i've never seen it.
How To Come Off TRT Safely