I've been on TRT on and off since 2023 for clinical hypogonadism. So far it's been all good for me.

But my endocrine system has been a mess for years due to an autoimmune disorder, and possibly related to head injuries (boxing, lots of falls and crashes in other sports, and hit by cars twice). I've been on thyroid supplement for decades and had thyroid cancer, removed by surgery several years ago, no chemo or radiation, no recurrence.

Without TRT I was making good progress in my fitness from 2015 when I resumed cycling at age 57 after a 30 year hiatus, through 2021 when I was snagging a few local Strava top tens in my early 60s, against some younger, stronger riders who had better stamina. I was just the right size for certain climbs and could expend full steam for 5-10 minutes on climbs. But I never had the stamina for longer challenges, even in my youth (lung scarring from TB as a kid, many bouts with pneumonia and bronchitis). I was more of a full gas, short duration guy, including in amateur boxing with three 3-minute rounds. I'd never have made it as a pro with my crappy endurance.

But in late 2022 I felt like I hit a wall and never got any better. I had to cut back on cycling and my running slowed to jogging, then walking 3-5 miles a day, and even walking was difficult some days.

Doc said it might have been long-term effects of COVID, might have been one of half a dozen other respiratory viruses floating around at that time. Might have been the autoimmune disorder worsening. No way of knowing without specialized testing (which the VA wouldn't do), but I never recovered. By late 2023 I asked my civilian PCP about TRT (my VA doc refused to consider it for anyone other than men with full orchiectomy or Total Testosterone below 200). A friend had suggested it several years ago but I was skeptical for the same reasons other folks in this thread have mentioned -- although some of those concerns were based on faulty studies and conclusions, since superseded by more accurate data and studies.

There's also evidence TRT can improve bone density. I had already developed osteopenia and osteoporosis runs in the family -- my mom's was so severe her femur snapped spontaneously just standing in the kitchen one night. Her doc described her bones as cheese filled pretzels.

My PCP authorized it with close supervision and regular blood tests to check results, especially PSA. I wasn't expecting much. The usual dose of 1 ml, 200 mg testosterone cypionate is pretty minimal, far below the PED level used by some athletes to gain an edge.

TRT has been a game changer for me. My energy rebounded, my hematocrit returned to normal. My bone density is close to normal (takes longer for that to recover, compared with anemia and other factors which respond fairly quickly).

Total T doesn't tell us much, so even when my total T was 250-300, my other factors were very low -- free T, bioavailable T, etc.

I was also borderline anemic (37-38 before, 47 after TRT). And I had chronic low grade inflammation with elevated monocytes and related issues -- that also improved with TRT.

I can't say I noticed any significant performance enhancing effects. My fitness remains well below where I was before getting sick in 2022. But I'm also older now at 67 and can feel my clock winding down quicker now. I can't ride a bike or run like I used to, mostly due to chronic neck pain from injuries (my C1-C2 are permanently damaged and I'm not a candidate for surgery). So I've needed to switch to no/low impact cardio. It's hard to compare the indoor spin bike with outdoor rides. The few times I have ridden a bike outdoors the past year (maybe three or four times) my average speed is the same on my usual favorite 15-25 mile route on roller coaster terrain.

I've switched to more strength training in the gym and have put on upper body muscle, but nothing dramatic. Probably nothing different than without TRT. Bodybuilders and weight lifters generally use a cocktail of far more anabolics. And a younger guy would get more dramatic results from 200 mg of test cyp than I would.

Mostly it's helped stabilize joints that were suffering from the onset of arthritis, another family curse. My thumb joints are gradually deteriorating, same as my granddad's. But strength training helps stabilize the joints and my thumbs don't pop out of joint as easily now.

I wouldn't recommend TRT lightly, but if your condition warrants it and your doc agrees, it's worth a try.

Regarding the long-term effects, I don't see any evidence of permanent negative effects from discontinuing TRT. I stopped taking test cyp voluntarily in late 2024 for a few reasons:

• After a year on TRT (2023-2024), while the benefits were noticeable it wasn't dramatic. But it was definitely noticeable and measurable, while I got zero perceived or measurable benefits from any non-prescription supplements that claimed to boost testosterone. In my limited experience, nothing boosts testosterone other than TRT.
• My right testicle shrank to about half normal size. The left remained the same.
• My PSA stayed around 5 ng/mL. But even before TRT it varied between 3 and 5.

So I was curious to see how I felt after discontinuing TRT. I figured if the decline was noticeable I'd resume TRT and stay with it. My doc agreed.

It was a pretty miserable year. My energy was in the toilet. I was in bed 12-16 hours some days. Arthritis pain was much worse and didn't respond to other treatments. My crit dropped back to 38-40. Bone density loss worsened again. And my PSA still fluctuated between 3-5 ng/mL.

On the other hand, my right testicle size returned to normal during the months I discontinued TRT. But it didn't improve my testosterone levels.

So I've been back on TRT since July and plan to continue until or unless complications arise.

That's my story, your mileage may vary, not available in some states of mind, etc.