Quote Originally Posted by JoeP26 View Post
Well, a small fraction of guys are actually hypogonadal. I've seen enough labs of others to know for certain. The reason it happens in them is because of the rise in estrogens when 5ar type 2 is inhibited or methylated and no longer working. When this happens, testosterone starts preferring Aromatase conversion and estradiol rises, thus increasing all estrogens downstream of estradiol. Then the elevated estrogens get into the brain and signal the pituitary and hypothalamus to shutdown gonadatropin production which then shuts down testosterone production from the testes. It does happen.

I think the spookiness of TRT is because of two reasons.

1. If improperly used, it can permanently shutdown your natural testosterone production and even cause infertility. Essentially, you risk adding more problems to an existing problem.

2. Not everyone responds well to it while using it because you can feel a lot worse using it. Some have severe androgen receptor sensitivity while some are very deficient in brain Allopregnanolone. With the receptors, agonizing them further with more androgens is physically god awful. With the Allopregnanolone, it is made from progesterone which is made from pregnenolone and the brain's production of pregnenolone can be shutdown in many. Your brain is then "riding on fumes" of what little is passing through the blood brain barrier from serum and progesterone at serum is also produced from the testes. So, when you go on TRT, you obviously shut down your testes from producing testosterone but also progesterone. So the little progesterone your brain was getting is no longer there, thus causing further suppression of Allopregnanolone and GABA receptor signaling.

In short, they don't want you to feel way worse than you might or risk causing further issues.
Are there clear indicators of hypogonadism without getting labs?