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Blood Work on Clomid & 1 Month After Quitting, Next Steps?

Came off injections after 2 years because my urologist got in my head about long term health concerns and fertility concerns. I’m 28. Went onto clomid for 4 months, now I’ve been off for one month. I have labs below.

40mg twice weekly, 500iu HCG twice weekly and .25 arimidex
Total T: 1347
Free T: 23.9 (9-26)
E2: 22

Had my sperm analyzed as well, it was all fine and healthy levels. BUT i still decided to come off and give clomid a try…

Clomid after 4 months of 12.5 mg EOD:
Total T: 726 (264-916)
Free T: 11 (9.3-26.5) - low
E2 sensitive: 14.7 (8-35) - low
SHGB: 89.3 (16.5-55.9) - high
DHEA sulfate: 350 (138.5-475.2)

One month after quitting clomid:
Total T: 473 (264-916)
Free t: 6.9 (9.3-26.5)
E2: 14 (8-35)

My symptoms:
Low e2 symptoms like fatigue, verrrry bad joint pain ever since I came off of injections. Clomid never increase my e2 on paper and I have had joint probs ever since my e2 went below 20.

Depression/apathy is mild at this point. I’ve had clinical depression in the past and been treated with medication but can’t say it’s nearly as bad at the moment.

Decreased libido but erections are good, morning wood is hit or miss, maybe 50% of the time.

Should I wait another month and re test to see if my test levels stay within range or will they continue to decrease since I discontinued clomid. They were ~150 before injections. I’m hesitant to go back on clomid because of joint problems not being helped by it and I’m prone to SHBG.

Currently taking 10 mg DHEA at night to try and raise E2 as well as boron 3mg to maybe raise free T.

Any suggestions? Thyroid labs showed everything pretty good except my tsh was still a little elevated at 2.7 (.4-4.5). I had the comprehensive panel from discountedlabs done and everything else looked fine.

What long term health concerns is he referring to?

I assume you were feeling well and maintaining fertility with this protocol. After switching to clomid and then stopping, you have experienced significant symptoms. Correct?

What if they do stay in range? You will likely still feel bad, perhaps worse as time goes on.

Any chance you could return to your original program?

You are correct. Quit injections and onto Clomid , joint pain and brain fog began. Quit Clomid, fatigue and everything else began.

I can go back onto my old protocol whenever I want which is what I’ll likely do in January

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You’ll never have enough Free T naturally do to your sky high SHBG, inject FSH when you want a kid, no need to come off TRT.

What good is fertility if you feel like crap all the time?

Yeah I mean I had a sperm analysis just before I came off injections/hcg after 2 years and my numbers were actually really good.

So I figure I can prob maintain my fertility just using trt/hcg. I’ll worry about that when the time comes though.

My urologist specializes in fertility which is why I believe she was so against injections. She got into my head big time.

You know what, I know plenty of heavy AAS guys who have conceived without the use of hCG. I’m one of them. Twice.

Just curious, how long have you been on Test?

I’m 28. planning on having children in the next 3 -4 years or so. I will be opting for HCG when I do start back on testosterone.

Five years.

Any recommendations on what protocol to resume with injections?

40 mg twice weekly had my t level over 1300. I’m assuming I should maybe cut it down to like 60 mg once a week? Maybe that will help lower my SHBG?

Maybe lower ai dose to .125 and keep hcg at 500 mg twice a week?

I like your original protocol, with the reduced anastrozole.

Yeah I’m just hesitant to get back on a dose that had me over 1300 total t.

I think I’d be fine around 1000 or so. Also, shouldn’t I be doing once per week shots since my SHBG is so high at the moment?

Look at the free t. If on trt for life I personally would want to stay within range. At least mid range. Not over.

But your free test was fine. You’ll need more to keep free T up. I think once a week would be fine. As long as you feel good though, whatever works is good.

I’ll prob just resume my old protocol at twice weekly and go from there. Maybe lower the ai dose a little

My doc thinks I should continue to wait for hpta to restart because it takes 3-4 months after coming off Clomid… I guess she thinks my testosterone will rebound? Not sure exactly what she’s expecting.

Any thoughts @systemlord ?

Usually when the levels decreased, that’s a sign clomid didn’t work and you would then need TRT.

The odds of clomid restart working were slim to none anyway, we just don’t get too many sucess stories.

I was 25 when I first had my t levels checked and they came back at 159 (300-1200)

I just hope they don’t fall back to that number