T Nation

4 Weeks on TRT, No Improvement as of Yet

What’s up guys, been on trt 200mg cyp once a week plus .25mg of clomiphene twice a week. Starting total before 549ng/dl and free 6.8pg/ML. Have had symptoms of what seems to be low T. No libido, poor erections, fat accumulation like a woman, loss of muscle mass etc. Problem is the only effects I’ve really noticed so far is after my 4th injection had a lot of anxiety and restlessness a couple days after, insomnia for the past few nights. I was hoping by now at least my libido would be increasing and possibly easier erections. Last week had a few days where I thought I was on my way, more feeling in penis and such. Any thoughts? Should I ask my doc about splitting dose or slightly lower dose? Any help would be appreciated, don’t want to have to be on trt if it’s not the issue
Thanks Guys

Why are you taking clomid?

And what were all of your labs before starting?

Most people don’t feel great on clomid. And they don’t feel great on TRT until 6-8 weeks in. So right now both of those are working against you. Your original total T wasn’t horrendous so I’m wondering if T levels are really the problem or not to be honest.

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How old are you? How is your sleep? How are your stress levels?

41 but been dealing with this for more than a decade now, total test is normal but free is on the low end so I’m hoping boosting that will help resolve a lot of these issues.

If T aren’t the issue, what could be? I’m having the same numbers and issue as this gentleman.

How long you been on trt?

It takes 6 weeks for testosterone levels become stable after starting TRT and dosing changes, longer to experience maximum benefits. Your protocol is unusual and not at all common, clomid is notorious for mental side effects and for not improving symptoms of low-T.

Your dosage might too much and together with the clomid you stand little chances of feeling symptom relief. You need to find someone who is better able to direct your treatment.

As for your testosterone labs they more than likely indicate elevated SHBG which lowers your Free T and elevates the Total T. I always recommend guys start out closer to 100mg and work their way up to dial in on TRT rather than starting out on the higher end and experiencing negative symptoms right away.

My shbg was 66 nmol/L range (14-95 nmol/L)
Should I opt for hcg instead of the clomid?

Clomid increases SHBG, your doc is working against you. TRT will decrease your SHBG, increase the Total and Free T which is what you want, but the clomid works against you in many ways.

You need to find out what your doc’s intentions are.

He said it’s for keeping testicle mass and help prevent atrophy

Clomid might very well achieve that, but forget about symptoms relief of low-T because the symptoms are more than likely going to continue and possibly worsen. HCG is normally used for testicular atrophy while on TRT.

HCG will stimulate the leydig cells in the tetsicles and even produce a small amount of testosterone. HCG response is so individual, some men feel great on it and some feel worse.

I had some sleep problems and restlessness early on. There is a lot of flux during the first 2-3 months. I wouldn’t pay too much attention to how you feel for another several weeks at least.

This doesn’t happen until later for a lot of guys. Cialis helps in the meantime.

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I hope I figure it out because this shit sucks!

Cialis does nothing for my libido. I wake every morning with an erection so there is no problem there. I added daily Cialis just to try it because so many people rave about it. Erections are definitely harder but still doesn’t do anything for libido. Even before I started TRT when my total T was 254 I would wake most mornings with an erection. Main reason I got check was because of libido. Been on TRT for 11 months and libido still sucks.

I would drop the Clomid. Take T only for now, nothing else, give it 2 months, see if you’re moving in the right direction. You can always add HCG later if you need it for the atrophy benefits.