26, UK, Just Prescribed Clomiphene - Opinions?

So after a long and frustrating wait I finally decided to bite the bullet and paid to go private. My protocol has now changed to:

  • Sustanon 250 125mg E7D
  • 500mg HCG E4D
  • Anastrazole 0.5mg E4D

Previous meds were 25mg Clomid and 1mg AI EOD. Last dose was Tuesday and started the new protocol Thursday. Just wanted to get some opinions on the new meds?

Haven’t noticed any immediate effects yet but I know it’s early days.

I’m worried I may have driven my E2 too low though - I had a date Friday and she came back to mine, despite taking 20mg Cialis as a precaution I still struggled to get and maintain an erection which is worrying considering I’ve used this in the past and and I could diamonds with it!

Also hear of people that take the same dose of HCG as me but only 1 week in 4 - is this something I should consider?

@jwal90

Congrats on getting where you were trying to get to in the first place after a heap of shitty waiting.

I don’t know much about the clinical side of things but as for the HCG I know most people take 250ui every 2 days so not sure if that’s something you would want to change.

Just out of curiousity because most people here are in the US and pay prices all over the shop, what were the prices and prescriptions as we would be looking at paying the same anyway If I were to consider private which is looking this way! Also how much was it for the consultation with the private endo?

Keep pushing.

250iu hCG SC EOD is a good LH replacement dose.

If hCG is mixed to 1000iu/ml, 0.1ml is 100iu for 700iu per week VS 875. So that is not bad. hCG does have a decent half-life and EOD injections are quite effective and more typical.

Here is a statement made on another post about HCG if that helps,

We can make a working assumption that you are, like most in UK, iodine deficient. UK never made iodized table salt compulsory and they depend on the fact that the cattle and dairy industry started to add iodine to feed to prevent a host of problems in the animals, so you get iodine second hand. But if you do not consume sea food and dairy, you are in trouble. Please read thyroid basics sticky re iodine. Selenium is critical as well, do not ignore.

Iodized salt is compulsory in Canada, Switzerland and ???
In USA, not and while there is always iodized salt on the shelf in the stores, generally no one has a clue about it. Many Common Wealth counties are lax, following the UK’s bad habits. The people who could change this will not because then they look stupid for not doing this in 1922, probably because not invented here…

So it’s been a while since I posted here and thought I’d share my latest blood results to see what you guys make of it. I have been on the following protocol for the last 6 weeks:

300iu HCG EOD
0.25mg Anastrozole EOD
125mg Sustanon 250 E7D

Testosterone: 32.8 nmol/L (8 - 26.1)
SHGB: 26.6 nmol/L (14.6 - 94.6)
Calc Free Test 0.817 nmol/L (0.174 - 0.729)
Oestradiol 156 pmol/L (0 - 145)
25-OH Vitamin D 84 nmol/L (75 - 200)

Red blood cell count top end of the range. Test was taken just before my next sust jab and a day after HCG/AI dose.

So my test levels are pretty much there (if a little high) but E2 still too high - think I read somewhere I’m aiming for the 70 pmol/L range? Vitamin D also low end of the range but I started supplementing last week along with Zinc+Copper, ZMA, Maca Root and Pine Pollen.

What do you guys make of this?

My main concern is my libido, it’s at rock bottom and has been for a while, especially considering that max dose Cialis isn’t even getting me hard anymore.

If you’ve only been on TRT for 6 weeks and expecting a robust sex drive and erection all the time forget about it, you’re still too early in treatment to experience that. It’s going to take several months to “start” to feel your old self again. Cialis will only work if your libido is functioning, don’t see how you could have a libido with your pituitary gland shut down. Everything will eventually start functioning again, it will take time though.

I’ve been on Sust+AI+HCG for around 3 months now and experimenting with dosage, I have been on the protocol I mentioned earlier for 6 weeks.

First bloods - Test High, E2 High
Second Bloods - Test High, E2 Low
Third Bloods - Test High, E2 High

Haven’t felt my libido since I first went on Clomid around 8 months ago and that didn’t last more than 2 days, since then I have had no sexual desire. Most people report a rise in their sexual desire within weeks of the first injection.

I’m hoping by slightly lowering my sust dose and raising my AI I should be able to get E2 within range and see how I feel then.

My other concern is that at the very beginning of treatment the doctor noticed I had low Zinc levels but it didn’t really concern him. I have since read a lot of information regarding the link between zinc and testosterone and wish I had at least tried to address this before going on TRT, at least Cialis used to work for me back then.

Libido is a vague term, for me I noticed I started staring at attractive women within the first couple of months and erections has been lagging behind. I have sexual fantasies all day long, my erections are still not consistent, sometimes they’re easy to get and other times not so easy. It seems like it’s becoming more consistent as more time passes, sometimes I go to put my pants on for work and find it difficult to do so with the spontaneous erection that comes out of nowhere. Venous leakage repair take at very least 1 year or more, it follows the time it take one to build muscle since there are muscles in the penus that must be rebuilt. High E2 stalls recovery and prevents testosterone’s effects on tissue regeneration, so if you spend most of your time in high E2 land recovery may never happen until you spend at least a year with all your hormones in range. This why why a lot of guys do not recover and claim TRT doesn’t work and give up, it doesn’t help that most doctors don’t know what their doing.

TRT was not what I expected it to be. I had “T Tunnel Vision”, I saw the symptoms and rushed straight into thinking it would solve all my problems, it hasn’t. Since I started I’ve actually seen a worsening of some symptoms: depression, no libido, insomnia, anxiety etc

I’m reaching out to you guys for advice because I’ve reached a crossroad and have two options:

  1. Stay on TRT and keep adjusting dosage until my numbers are right, see how I feel

or

  1. Come off TRT, hopefully get my levels back to baseline and attempt to correct all possible natural causes. If it fails, restart TRT

I wish I had attempted to correct any underlying issues before going on the juice. I was over-training (5+ days/week intense), not eating enough, not getting enough sleep and doing a stressful job, I suspect adrenal fatigue was the cause of all my symptoms. I also had low zinc levels which are linked to low T/high E.

So I’m reaching out, what do you think I should do?

I’d like to be off the TRT altogether. I’ve still got Clomid, Anastrazole and HCG so do I attempt PCT? Or go cold-turkey (I’ve only been on sust 3 months)? Should I just stay the course and accept I will be on TRT for the rest of my life?

I’m just getting tired of the up/down symptoms and need some help, would really appreciate it.

It’s going to take longer than 3 months to get dialed in, a lot of guys don’t have the patience required for TRT. These guys end up on a never ending cycle stopping and starting TRT and never really get a chance to enjoy the benefits. I’ve been on TRT for almost 8 months and I still get days where I’m feeling a little off, but as time goes on I’m am feeling better overall. Muscles are really starting to get harder, erections are also improving lately. You see it takes time, it’s not like the instant high you get from medication. You get your hormones in the correct ranges and months later you start to notice changes. It taken me 7 months to reach a point where improvements are more noticeable.

Imagine had I quit at month 6!

I understand what you’re saying but from all the research I’ve done over this year the vast majority of evidence I’ve seen, both anecdotal and scientific, people on TRT see improvements within months, if not weeks of starting. I haven’t noticed any improvement aside from better sleep, all other symptoms have in some cases worsened, especially with regards to libido.

It does seem a vast majority of my symptoms stem from high E2 and my bloods back this.

I’m just concerned about a life-long commitment to TRT when it’s possible my symptoms could be rectified with diet and lifestyle changes. I’m also thinking the longer I leave it the longer it will take to recover. On the other hand I’m getting close to being “in range” with FT, TT and E2 so do I just stick it out until I’m there and see how I feel?

Interestingly, took my body temp this morning and came in at 96.8F which seems a bit low? Have been supplementing with Iodine for the past month as per KSman’s advice.

To anyone considering TRT, this rabbit-hole is deep, give it some serious consideration before getting in and make sure you’ve done everything you can to correct your levels naturally first.

Results in:

Testosterone 12.3 mnolI/L (8.4 - 28.7)
Oestrdiol <70 pmol/L (0-145)

Protocol for last 3 weeks:
150iu hcg ed
0.5mg 3x pw

Not sure how I feel about this. T levels are not ideal but E2 is spot on. I have felt better in my mood, sleep is good but no real drive and no libido. Appointment with the doc this afternoon but he won’t give any advice without the specialist approval. Got the clomid prescription. So my options are:

  1. Stay on my current protocol

  2. Accept that for whatever reason I do not produce enough natural T and go sustanon+AI, get my levels right then add hcg and adjust.

  3. Use the clomid for PCT and try to get myself to my true baseline

Completely torn here. If my current levels are indicative of what I’m going to produce naturally then I’m not happy with that. But then there’s a chance once off HCG my pituitary may produce more LH>More T.

I think the fastest route to feeling how I should is sustanon but my one day I want kids and don’t want to shut down my testes.

Evening all, it’s been a while since I posted so thought I’d give y’all an update.

After a lot of careful consideration I decided to stay on TRT. Restarted my treatment on the 1st of January with the following protocol:

  • 150iu HCG ED
  • 50mg Sustanon 250 E3.5D
  • Anastrazole 0.5mg M W F

Happy to report within the first week I noticed an immediate improvement in my sleep and depression. Morning wood made a comeback somewhere within the 3rd week but I have had no improvement in my libido yet. Muscles look more defined and I have dropped BF (I do a heavy, manual job). So overall I’m pretty pleased with the results so far.

Had set of bloods done last Wednesday, frustrating experience. Doctor did not want to hear what I had to say - I wanted several blood tests but the doctor would only let me pick 5 of them. He then told me he was happy for me to play around with my AI dosage as well. To add to the frustration he has only given me a test for TT so not FT.

TT 37.8 nmol/L (8 - 26.1)
E2 112 pmol/L (0- 145)
Progesterone 2.7 nmol/L (no range)
Selenium 1.23 umol/L (0.89 - 1.65)
Red Blood Count 5.29 10(12)/L (4.5 - 5.6)
DHT is currently pending

The tests I had to ommit:

Prolactin
IGF-1
Zinc
Vit D
Vit B12
Magnesium
Ferratin
Cortisol
Thyroid Panel
Pregnenalone
DHEA

Slight concern - I missed my AI dose on Friday as I thought I was suffering low E2 sides then continued again Monday and Wednesday before the test - I’m worried this may have affected the true results of my E2 and I’m reluctant to raise AI dosage - considering staying on 0.5mg MWF until my next bloods in (hopefully) 4 weeks?

Would love to get to the bottom of why I aromatize so heavily. The Friday I missed my AI dose was also my Sust dose - within hours of my pin I had a surge in libido and an erection which wouldn’t subside for an hour! Then after that I noticed my mood drop and I had overwhelming fatigue - this has happened to me before when I took T without any AI and still happens to some degree now. Could high E2 be the cause of this fatigue?

My other concern is that body temps never get about 96.8F - I had thyroid tests done at the beginning of treatment and they came back normal.

96.8F mid afternoon is a severe problem.
Have you not been using iodized salt? Explain history of…
It is imperative that you get 200mg selenium every day when adding iodine to your diet. Not optional. Lab results may not be a reason to avoid.

See below re oral body temperatures and thyroid function.

E2=80 pmol/L is optimal.


Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

How can thyroid be normal when your body temperature isn’t normal, fT3 thyroid hormone directly correlates to body temperatures. To a doctor normal could mean suboptimal or optimal. You will have to fight your doctor for these tests or pay for it yourself.

My body temp before getting out of bed is 97.8 and 98.7 12 noon, that’s optimal. It’s recommended 200mg selenium and adding iodine to your diet as you’re iodine deficient.

I purchased Iodoral as per your recommendation in August 17’ but will admit I have not been supplementing religiously. No selenium. Last thyroid lab was Aug 16’:

TSH - 2.3mu/L (0.35 - 5.0)

Did not have thermometer this am, took temp now (current UK time 17:30) - 96.8f - will check again tomorrow and post results.

Researched hypothyroidism symptoms - I have:

  • Extreme Fatigue
  • Hair Loss (not to eyebrows)
  • Cold hands/feet
  • Poor memmory
  • Constipation
  • No libido
  • Insomnia
  • Occasional vision problems
  • Slow resting pulse (doctor attributes to my running)
  • Desire to be solitary
  • Depression
  • More

TRT improved symptoms somewhat but still troublesome, looks suspect. Next docs 15/02 will insist on not only the bloods missed last time but also:

  • TSH
  • FT4
  • FT3
  • TPO (Thyroid Peroxidase)
  • TgAb (Thyroglobulin)

Common prescription in the UK is Levothyroxine but prefer the idea of natural Armour Thyroid which is also available.

Booked blood donation Monday to lower RBC/save the world.

As always any advice much appreciated.

Ok temps taken yesterday:

06:00 - 96.4F
10:00 - 95.9F
14:00 - 96.8F

Had bad insomnia last night and had a girl stay over, when she layed on my chest she said I was burning “like a furnace” but I felt cold - think this may be normal for me.

What are your thoughts @KSman ?

@KSman Could you give me your thoughts on the above 2 responses?

@KSman ?

You can now do more thyroid labs, which could include thyroid antibodies.

Your low thyroid function slows down ever cell, tissue and organ system in your body. Most of the symptoms of low thyroid function are the same as low-T. You cannot feel right on TRT when thyroid is holding you back. Read the thyroid basics sticky, all of it.

There is a real risk of creating or worsening a thyroid autoimmune problem by introducing iodine with a lack of selenium.

With E2=156pmol and a target of E2=80pmol/L you need to increase anastrozole by a factor of 156/80

Managing E2 requires steady T levels and steady AI dosing. Injecting twice a week and taking AI at the time usually works well. Steady blood levels also reduce lab changes driven by changes in lab timing. Changes to T dose make everything a new game.

Libido was an E2 issue.