T Nation

4 Months of Clomid, Now on TRT (high SHBG)

Hello all,

I’m 29, 5’11” and 175lb.

I went to my doc in December and got a blood test done. They only tested total T (stupid, i know now) and it was 512.

I know it’s not super low, but I’ve struggled with sleep, anxiety, and fatigue.

They prescribed clomid and after 4 months, total T was up to 991, but SHGB was at 52 and e2 at 44. And a subsequent blood test (after 4.5 months) showed SHGB all the way up to 72!

I felt 0 benefits, if anything I was recovering worse from training (lost more strength on this cut that usual).

Anyway, I’ve been off the clomid for a week. Also started 200mg test (weekly, 2 injections so far), 500iu hcg (weekly) and 1 anastrozole (twice weekly).

  1. Will the SHGB get back down now that I’ve stopped clomid and started trt?

  2. Any other feedback? I realize I might have rushed into the clomid and also TRT and I feel like my doc is clueless about everything which kind of misled me.

Thanks in advance guys :muscle:t3:

If seeking a doctor in the sick care system, be prepared to seek a deer in highlights because most are clueless. You need a private specialists who specializes in this area of medicine. It seems only Total T was test, the bound hormone and no one was interested in the free portion of testosterone circulating in the blood.

No thyroid testing either, low thyroid hormones share all the common symptoms of low testosterone. TSH, Free T3 and Reverse T3 should be tested together, if your numbers are suspect you may need to test antibodies.

In any case 512 ng/dL is low given your age, sick care doctors do not care about being below averages, doctors only care about if insurance will cover treatment.

Your protocol is at the upper end for weekly dosing, most men cannot handle this much testosterone. Most men are closer to 100-160mg weekly split up more frequently when SHBG is lower.

Thanks man! Appreciate the assistance

Given my SHBG, would you expect it to lower now that clomid has stopped?

Would you advise asking doc to reduce to 150 test/weekly? I honestly feel like she will do whatever i want at this point :man_facepalming:t3:

I would advise 60mg twice weekly and retest in 6 weeks, this protocol will see higher trough levels than weekly dosing.

Unfortunately I’m at a men’s clinic where they personally administer the injections once per week, waiting on an appointment with a urologist my friend sees who I’m sure will prescribe the T. But for the next month or two, I think I’m stuck with the weekly injections

The weekly office visits are for the benefit of the clinic while inconveniencing the patient for profit often degrading TRT benefits. There is someone who administers the injection, it’s how they make a living but that isn’t your problem and you should not be treated like an invalid.

Children are taught to inject insulin at home, so why can’t an adult inject T at home…

I agree with you man, that’s why I’m looking for a new doctor

You know how to beast bro, just sayin.

It was good to know LH, FSH and SHBG before clomid, it seems to me that your testies dosent respond very well to clomid, the increase in total testosterone was very proportional to SHBG increasement, wich is just SHBG “invading” your total testosterone and showing a false high testosterone result.

As for your curent regimen i can t help you too much, but the 200 mg/week seems too much for starting, start low dose and see how it goes, then adjust if needed. 50 mgs twice a week it’s a usual starting dosage.

As for hcg i am pretty sure you want to preserve fertility, but for some folks hcg seems to negatively affect how they are feeling on the theraphy, try to use the minimun effective dosage and as frequent as possible to avoid estrogen problems, too muh hcg means too much testicles stimulation wich turns into high aromatization inside testicles where arimidex can’t work.

Finally, on the arimidex, i suggest you to wait and see if you really need it, and then start administrating. Be aware of crashing estradiol cause it can feel like shit, and many have problems with him and also controling your estradiol it’s very important to feel the fully benefits of trt.

You need to educate yourself and see what and what not works for you.

Sorry for the bad language skill.

Thank you brother!

Any idea anyone if the SHBG will come down now that I’m off the clomid?

SHBG should decline after stopping clomid.

Okay that’s good to hear. I’ve read on here (from you, I believe) that SHGB doesn’t come down much after it goes up, but I’m guessing with clomid it’s different.

Will the once weekly injections (200 or maybe lower to 150 test / 500 hcg) kill me for 2 months? Seems to be the soonest I can get an appointment with a legit doc that comes recommended from a friend on TRT.

It depends how your body reapond, but basically you will experience fluctuations cause of the short half life of test, if i am not wrong half life of cypionate is like 8 days, and by the end of the week youre levels will be half as much and the body can’t reach homeostasis.

The more frequent injections means stable levels wich you shold aim for to not experience ups and downs.

Isn’t going to kill you, if you want to start sooner give it a try, but it’s possible that you’re not going to feel good and that can change you perception about trt.

Also keep in mind that trt needs some time to feel it’s fully efects, but that also depends on how you’re body will respond, you’re thyroid health, you’re adrenal health, etc.

500 hcg at once can potentially create some estrogen aromatization problems inside the testicles and as i sayd anastrozole may not be able to work out there.

Check estradiol after 7-10 days and see how it goes, you might need some anastrozole.

Bigger injection less often are actually better for high SHBG, they help to lower it. Once a week is probably a better place to be for you than multiple shots right now.

Thanks man.

I think I’m stuck with the weekly injections for now, anyhow.

I’ll try and get doc to prescribe HCG next week so at least I can do smaller doses of that. What is recommended for starting? 250 EOD?

Twice a week or EOD, depends on the person.

Thank man, I’ll start with 250 twice a week. What markers should I look for with my bloodwork to evaluate HCG dose?

Also, with the 200 test/week, would you start with 1mg or 0.5mg anastrozole (twice weekly for each), keep in mind my e2 was 44 after the clomid.

(I started on 1mg x2 for 2 weeks now)

I would actually start with none and see what happens. Clomid is known for increasing E2, more so than you would see from aromatisation.

Okay I’ll definitely decrease to 0.5 in that case and do some blood work sooner than 6 weeks to see where my levels are. Thank you for all the help man.