Question on Testosterone suppresion / recovery after weaning off opioids

J

Jarf

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Apr 26, 2016
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Quick rundown ... chronic pain patient currently on day 6 of weaning off of buprenorphine (if curious, MUCH more detail in my intro thread here ... http://www.bluelight.org/vb/threads/791270-Hellos-amp-my-history).


  • Past 3 years started with 3 spinal surgeries and 1 major complication
  • Oxycodone 5mg 2-3x/day + 5mg diazepam @ night first year post-op
  • Levorphanol 2mg 1-2x/day + 5mg diazepam @ night second year
  • Buprenorphine 2mg 3-4x/day + 0.5mg clonazepam @ night past year (didn't actually switch to bupe with the intent to wean off, that decision came recently)

About 9 months ago I decided to have my hormone panel run and came back under 100 for Testosterone. Tried cypionate shots but they thickened my blood (ie, too much hemoglobin) too much. Switched to Androgel but between cost of refills (even with insurance, but deductibles) and slimey factor on busy days I haven't been as consistent with it as I should. However I did manage to get from 95 to 154 last blood check. Have been much more consistent with the last couple of months up until I decided (for reasons in that intro thread above) to get off my opioid pain pills.

The question I have is ... during withdrawals ... stay on the Androgel to keep things up or (as I've done for the last 5 days, mostly from being bed ridden during the withdrawals) go off of it in a last ditch hope that my body kicks it back in similar to it starting to produce endorphins again?

It won't kill me to just stay off of it for now in hopes of it kicking things back in. I went for a long time with low T to begin with and, if it doesn't kick back in, I've got no big problem with sticking with supplementation. Only 1 of my testes has ever produced properly due to an injury as a kid, so I'm likely limping along and might need supplementation even without the opioid suppression.

I just haven't had a lot of luck with it and my urologist, while a great uro and cardio, isn't super familiar with opioid suppression.

My gut feeling is that during withdrawals may be the worst time to supplement IF I want a shot at the body getting the signal that it is time to start up again. I definitely could tell that the Androgel suppressed what little natural production I had.

If anyone knows of medical research or personal experience with this, much appreciated.
 
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Just stay off it all until withdrawals are over. Most of the literature surrounding this topic suggests that the testosterone decrease is largely a factor of the drugs of being in your system, affecting the pathways which produce hormones and not just testosterone.

I could see why he'd script you supplementation if you had to stay on for pain management, but seeing as you have plans to come off then I would just chalk it. Get tested for your levels like a month after you're done being sick. You might be in for a pleasant surprise. I've read of about tons of junkies suddenly being able to get boners again after quitting.

I don't know what the extent of your injury is, but it's been well documented that even after an oncogenic crisis requiring orchiectomy, 1 testicle can manage to compensate for the other one in picking up the slack.

If you're still under 250ng/ml long after WD's, then I guess go back on the gel. The low test isn't a surprise. In my view, you're on a lot of opioids. The diazepam certainly has a negative effect too.
 
Once you have your testosterone levels down, I believe you need to either have an injection that works during 3-4 months and after this period is done you may need to check if your liver and cardio is okay as well as some other blood exams. Once you've start using Testosterone your body will tend to decrease its levels when you are off. But first I suppose you need to know if you need to use it and whether this is temporary or not.

Using the gel is good but it takes time for you to get to the average desired level. Perhaps, up to 3 full months.
Depending on your age and how your body is reacting it could be possible that you need to use it for a while.
Good levels of Testosterone makes you mood better, protects your body mass, bones and enhance your sexual life.
As far as I understand you can only know this after sometime measuring your levels and checking if everything else is okay.

Good luck!!
 
As the others have said, I would recommend waiting until the opioids are out of your system before supplementing with any anabolic/androgenic agents. Reason being is that you won't know what your true baseline testosterone levels are until the opioids are completely out of your system. Once you're finished with withdrawals get a blood panel and find out if you need supplementation. Also, in the event that you decide to go forward with testosterone supplementation I would recommend trying out testosterone undecanoate (Aveed) rather than the patches or weekly administration of testosterone cypionate. This way you will not have to deal with patches/constant injections. The recommended dosing schedule for testosterone undecanoate is 1 IM injection of 750 mg, another 750 mg IM injection 4 weeks after the first one, and then one 750 mg injection every 10 weeks thereafter. The undecanoate ester gives it an extremely long half-life so after the first two injections you'd only be required to use it once ever 3 and a half months.
 
Just to be clear, I was supplementing T prior to going off buprenorphine for a few months. I'd been chronically low for a long time by that point and actually ended up crashing lower once we found the cypionate caused the hemoglobin problem, the Androgel was just managing to get me 1/2way between my crash level and normal. So I'm currently actually going off of both bupe and T atm.

I put in a call in to both docs, 1 returned call and said "np, btw, come in and get the LDN" (I've been planning to try to switch to LDN for my spinal pains anyway, and various readings make it sound like I probably should have set that up before Day 9 hit but ... oh well). The uro doc office hasn't replied. But, like I said, he has little experience.

Oh and I can't do patches anyway. The solvent they use to keep the medicine in suspension for long-term release gives me significant chemical burns. Learned that a long way back with Butrans. Took 6+ months for those burns to subside.

For now I'm sticking with the plan to give the nads a few months to wake up post-opioid and get tested then, if they still aren't producing, investigate a long-term mechanism like the sub-dermal pellets.
 
And, thanks for the infos :) I'll post back later on once I know how things are looking. I hate threads that ask things then disappear when they got what they needed.
 
Erikmen said:
You are welcome and good luck Jarf!! :)
Click to expand...

No offense, but you didn't really contribute much of substance other than re-stating the basics that anybody on TRT already knows. In fact, you didn't even directly answer the question.
 
None taken. Just shared my own experience with Testosterone.
Good luck!
 
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Finally got a real opinion back from the uro today. 3 month followup after no T supplementation to see how things are looking once all of the opioid withdrawals (I hope) are finished.
 
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