T Nation

Clomid, Danazol and Arimidex Tri-therapy as TRT/SHBG

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.

Clomid is not recommended for those with high SHBG, clomid will increase SHBG so there is no point because Free T will be suppressed into oblivion and you will feel like death!

As far as managing high SHBG, TRT is really the only way to lower SHBG enough to make a difference. You can always add HCG and FSH injections to a TRT protocol when wanting kids or you can stop TRT and do a restart.

You want the impossible, optimal Free T levels, decreased SHBG while remaining fertile and this is not in the cards.

Run trt with hcg. My shbg went down on this regimen. Similar issues as you

Doc - who is pretty progressive and informed - advises he’s had success with the SHGB using Danazol (akin to Proviron’s intended action, though not identical of course). In theory the SHBG gets managed that way while Clomid works the T up, thus resulting in more free T. All in theory of course.

The T + HCG is interesting, though I don’t have much perspective on its efficacy relative to fertility.

And yes, I want it all, lol.

What did your protocol look like, if you don’t mind?

No doubt clomid ups the T, but the side effects can be unbearable for the majority of men. I guess I prefer a hormone to a drug, a chemical that is not natural to the body. It’s like drugs are preferred over hormones and one can make an educated guess as to why, profit on patented drugs.

It’s the reason why there are some doctors still prescribing viagra or cialis instead of TRT when the cause of ED is low testosterone. Arimidex is another area of profit, not a drug you want to be on if you really care about your health, are you alright with low bone density?

I see three different drugs here, three different areas to profit, TRT well there is no profit for your doctor prescribing TRT.

Doctors prefer to prescribe patented drugs, not low cost, low profit hormones.

Great points.

I need shift the paradigm and see it as such. Hard to break the lifelong habit of deferring to the medical institution.

Just go to a different doctor. I prefer less is better if it’s working. My regimen was 175mg ethanate a week, 500iu hcg, still trying to get away from arimidex by injecting 3 times a week instead of 2. Hoping to get rid of arimidex. This regimen has taken shbg to normal levels and free test to top of level.

Thanks. You’re doing the 500 IU HCG once weekly?

250iu twice weekly

The is one legit reason a doc would prefer clomid or cialis over testosterone - they are not suppressing and can be stopped at any time and nobody can argue that

He’s made that case with me, though the Danazol seems counter to that benefit based on the likelihood of its suppression effects.

I imagine that proviron would be better than danazol as far as benefits/sides ratios go. But that’s just an educated guess.

I’ve thought the same - given the similar SHBG binding affinity. I have an Rx for Danazol, though pharma grade Proviron doesn’t seem to challenging to get.

I also think so. In USA Proviron is illegal to prescribe. He should ask the doctor about this

My SHBG was higher than yours, at around 120 at the time I think. TRT doc tried Danazol (100mg a day) and Sustanon 150mg E7D. I managed to get my SHBG down to 25 at one point but it would always creep up when I came off Danazol. Interestingly, I noticed no positive effects when I reduced my SHBG.

Since then, I decided to come off Danazol and control my free test by putting myself on a higher sustanon dose of 250mg E7D which has now been approved by the doctor. My SHBG is back up to 45 at the moment but I feel much better for it. Free test is way up (0.88 I think) so seems to be working.

45 SHBG is still ok, even better than 25 because you can take more rare shots