Anastrazole and Enclomiphene During TRT

So I just started TRT last week
Pre labs:
Test: 398
Free test: 9
E2: 26
Normal hematocrit and TP
SHBG: 26.4

They started me on test cyp 150mg/week, anastrazole 1.0mg, and enclomiphene 25mg twice a week. I feel good so far but I’ve read soo much about not doing anastrazole unless it’s needed. Especially a whole miligram. Does anyone have any thoughts?

Thanks

Understanding from the BB world is that if you take a SERM while still having exogenous test or AAS in your system then they won’t work to restart your LH/FSH production. Adding a SERM to TRT is like trying to run a PCT while still taking AAS. But I see almost everyone doing this now. Did something change that I missed out on? Some new research suggesting EnClo will raise or maintain LH/FSH while on testosterone?

The enclomiphene doesn’t make much sense right now unless you are wanting kids really soon. Even if that was the case, I’d go down the route of using HCG over it.

1 mg of adex would be too much for me. I’d bet my E2 would be undetectable within a month. However, we are all different, and some need it. I doubt many need that much though on 150 mg/wk. I am fine with 0 Adex at that dose.

I don’t know much else about you. Did the Dr. have reasoning behind the protocol for you? If someone were to ask me what is a good starting TRT protocol for most people, I’d say start with 100-150 mg/wk injected twice a week with nothing else, and adjust several months later if needed.

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Per the doc, for testicular shrinkage, continued test production and fertility. I am a newbie on all this so…

They said they wanted to start low and increase if needed after labs from there. For the past six months, I have been super depressed to the point of being suicidal, low sex drive, not performing well in the gym (frankly no motivation to work out), and shitty erections. I am 35 6’3" 260lb. I feel better after the first week, but I am just nervous to take meds that aren’t needed and I don’t want a “cookie cutter” routine. I have had more motivation to work out since then too.

Do you care about those things? Just asking because you may or may not. I still think HCG is a better option for most guys.

150 mg/wk isn’t really starting low. I don’t think it is a bad starting place, but a majority will have an average TT and FT that are top or above range on that dose. You may be in range (especially if you inject once a week), but that is trough level, not average.

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Oh yeah, I know why they offer it, I’m just saying it doesn’t do those things, and BBers have known that for years running cycles and then going on PCT. So I was curious if there had been like new research or something special about EnClo that doesn’t act like a traditional SERM and would overcome the testosterone shutdown. I just think it’s odd.

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Yeah it’s once a week injections. That’s good info to know.

Yeah I don’t want them to shrink and am thinking about having kids so I opted to say yes to the enclomiphene.

I’m not sure of any new research but there could be some out there. I solely went by their recommendation.

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This looks like another cookie cutter protocol for everyone, no individualized treatment protocols, and no clue how to manage male hormones. An aromatase inhibitor was prescribed before any high estrogen symptoms were experienced, and a high dosage that is too much for a lot of men.

The clomid may block some of the effects of estrogen, half the benefits of TRT. Also clomid can have some nasty side effects.

I expect clomid to provide little to no benefit for its intended purpose and take away benefit of TRT.

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Dr. Saya, the medical director of Defy Medical, one of the more popular hormone clinics has found no measurable pituitary functionality in men on TRT while also using clomid.

Since hCG was banned by the FDA from being compounded, clomid seems to be the go to replacement and nothing comes close to the effectiveness of hCG for reversing testicular shrinkage of men on TRT.

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Do you mean cut my benefits from TRT in half? This is very helpful info and I appreciate it. I was going to talk to them about only using adex as needed. So the enclomiphene should only be used as PCT?

For men on TRT, Clomid is used for fertility or when coming off TRT. Usually if using it for fertility, TRT is ceased for a time.

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Careful with using as needed. Lots of guys screw it up on their own. If you do so, start with like 0.25 mg a week total. Preferable to wait until blood work to assess your response to T. Then with a low dose of Adex get more blood work to see your response to that.

I’d also put the enclomiphene in the drawer for now.

It isn’t a bad idea to have a bit of stock of both of these items for the future.

I don’t think HCG is banned if Rx’d from a Dr. for fertility. I’d ask if they will script it. You may have to fill it at a regular pharmacy. I’d still start with only Test, then add in HCG at like the 3 or 6 month mark.

Best to keep things simple and add complexity over time using data (blood work) and how you feel. Some keep a journal with protocol changes and how they feel, what their blood work looked like. Probably a good idea (I don’t do it though).

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So do you mean, start with 0.25mg adex and go from there? Or continue the current dose of adex now(1.0mg) and get bw done after four weeks?

First I agree with above posters. Cookie cutter poor protocol. Second, I don’t like not following the docs protocol. So IMO tell your doc that you feel trying solo T is the best way to go and see if he lets your try until your next follow up. If he doesn’t, I’d find a new clinic that’s not just a pill mill.

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Good info, thanks man I appreciate it

I think it is too high of a starting dose unless some sort of evidence exists that an individual needs it.

Most won’t need an AI on 150 mg/wk, so I think starting with 0 is best. If needed, I think the initial dose should be like a total of 0.25 mg/wk (preferably in two doses). If you then have high E2 symptoms, and that is backed up with blood work on the AI, then bumping it up makes sense. You can repeat that process until you are dialed in.

Speaking for myself, not second hand info from other clinics, it seems counterintuitive to use clomid with testosterone. However, I have a handful of guys who choose to do so. I have seen increases in FSH. It is slight, but measurable. However, if fertility is the goal, we stop test with clomid. If they want to continue testosterone, hCG works well.

This is inaccurate. We have no problem prescribing hCG through compounders. It is readily available. Some pharmacies discontinued making it when the FDA made it more difficult for them (regulations changed, it was not banned), and we may have had about three weeks before we were able to find sources. It is easy to get it.

I like this idea.

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My goal was to prevent testicular shrinkage and maintain the ability to be fertile with the enclomiphene. Just like you mentioned, I’ve read that it can stimulate FSH so I’m optimistic about it. All the while considering my own individual variation; the drug may not do that for me. I’m not completely sold on it. I go in for another injection tomorrow and was going to talk to them about not doing the anastrazole or enclomiphene.

The goal of TRT was to just feel better overall, better sex life, and hopefully put on more muscle. I want to gain as much muscle as I can (as we all do lol).