Doc has suggested (in lieu of traditional TRT, reasons below) Clomid at 50 mg EOD, Danazol at 100 mg ED (troche not pills) and adex at 0.25 mg 2 x / week max or as needed based on subjective analysis and labs.
By way of background total test levels are “ok” - low of 400 high of 800 at intermittent testing over 5 years. Most recently 565 with E at 29. However SHBG high at 78, making free test about 6 (and thus associated symptoms).
Issue is that while TRT in the past was doable, want to have kids making that problematic.
Thoughts on this for the short, medium and long term?
Concerns include long term HPTA suppression via the Danazol, hepatic issues there too (though doc pronounces that being the rationale for the troche vs traditional oral), long-term Clomid therapy (and its reduction in efficacy over time) and transition back to TRT (whether continuing under the care of doc or self-directed with clinical intervals).
The goal is here to manage the high SHBG symptoms which are numerous, stay fertile and able to continue T therapy in the future.