T Nation

Clomid to Prevent Testicular Shrinkage?


#1

Hi all and thanks for this forum...it is a great learning tool.

I am 48 years old and started TRT at the start of the year. My Pre-TRT baseline was through LifeExtension using Labcore (many more results are available but these seem to be the ones most are interested in...strangely my baseline did not include LH and FSH):
T: 576 (348-1197)
Free T: 11.5 (6.8-21.5)
DHT: 48 (30-85)
DHEA: 180 (71.6-375.4)
E2: 26.9 (7.6-42.6)
Hematocrit: 43.4 (37.5-51)

My doctor started me with 100mg/week of Test-cyp. Injection just once per week. I was concerned with testicular shrinkage...just due to cosmetic reasons since there are no plans to have additional children. Thus, he also prescribed 50mg per day of Clomid. No AI was prescribed and he would rather not use any if control can be maintained without. Thus, this has been my regiment since Jan 3rd, 2014.

I just had my first set of blood tests taken since starting. Unfortunately, I am on work assignment in China and only get back to the US around Christmas time. I had a very difficult time finding a hospital in China to do the testing and once I found one, the male panel of tests were very limited and not very useful. However, since this is all I have available I hope it can be of some use.

China test results (March 7): (These results were 36 hours after my weekly injection, thus should be close to the high.)
T: Just reported as >1000
Free T: They could not test for this
DHT: They could not test for this
E2: 43 (7.6-42.6)
Hematocrit: 49.8 (37.5-51)

I know it is not ideal information. However, based on this my doctor's advise is to continue the program unchanged. He rightfully says it is hard to know if the T was actually 1200 or 2000 since neither it nor Free T could be determined. However, he says that since my E2 is not sky high and my Hematocrit die not increase significantly, then this indicates that nothing major needs to be adjusted. Note: He firmly believes that E2 should always be at the very high side of the range because he believes there is little downside and also some studies that show this is better for stroke and heart disease long term. I know many on this board may disagree with this, but this is his beliefs.

Sorry for the long background. My real question is: How much clomid is really needed to prevent testicular shrinkage? I would prefer for my E2 to come down a bit and am wondering if it would be beneficial to reducing clomid to 50mg EOD? I suppose it could also be helpful to change the 100mg/week into 50mg E3.5D. I am open to this but do not relish the thought of more injections and also have a bit of a concern if I have a full year's worth of needles since this was not the original plan...I would have to see. Perhaps it is possible to get gear in China, but I don't know how easy it would be and I don't want to draw any more attention than necessary.

Thanks for taking time to read, and for all of the great advice that is given on this forum.


#2

I have taken both Clomid and T-E together and separate from 1 another…
IMO you don’t need anywhere near 50 MG clomid per day…
I currently take 25 EOD and my boys are as full as ever…
I needed this after stopping the TRT though… And have not been for bloodwork since I started the clomid…

That’s another story though


#3

It’s not that they couldn’t test for free-T, it’s that the test doesn’t exist. It’s simply a calculation of total T/albumin/SHBG. I think it’s a waste of time since it’s entirely possible that individuals have a wide variety of testosterone binding transport proteins. It’s also completely inaccurate.


#4

Why on earth did you go on T? Your pre-treatment numbers did not look that bad. Getting DHEA-s to the top of the range probably would have given you even better T levels. If not, you could have tried just the clomid, maybe an AI if needed.


#5

Sorry, I don’t have any valuable input on this subject. I am wondering if I am the only guy on earth that considers a bit of testicular shrinkage a benefit? Mine are a much more manageable size. No worries about sitting on them or smashing them together between my legs anymore. It might just save me from ever having to change an ass clay filled diaper again.


#6

Ridiculous that an MD would prescribe you testosterone for numbers like that. You’re baseline is higher than my numbers WITH testosterone.

It isn’t strange that LH and FSH weren’t tested. The level of testosterone and fertility is a better indicator of LH and FSH since these values fluctuate all day long. LH and FSH are useful for seeing if the HPTA has been shut down, if there are functional or non-functional tumors, for fertility troubleshooting, and HPTA restarts.


#7

Thanks all for the feedback. While many of you seem to think it was bad advice to jump into TRT because my pre numbers were higher than yours, I would just say that not everyone is the same. Personally, I could clearly tell my levels were down significantly from when I was younger…perhaps I am a lucky one with normal levels above 1000 but I never had a baseline test when I was in my 20’s and 30’s.

I have been very cautious to not fall into the mental placebo effect and am 100% sure that the past 3 months of treatments has resolved all of the original symptoms I was seeing…constant fatigue, lack of strength, low libido, zero morning erections, etc. Thus, regardless of what many have said, it seems to be the right direction for me and I feel blessed since I read about so many people that do get on TRT and still feel bad…in my case it has worked well.

Thus, my question was not whether or not I should have begun TRT, my question was how much clomid is needed to prevent testicular shrinkage. Some seem to think that clomid will have no effect while on Testosterone. If you understand the mechanism that makes clomid effective then you will also understand that it does work regardless of your testosterone levels.

However, I am not trying to convince people of this so let me rephrase the question a different way. If you are only on Test (and not HCG or clomid, etc)…how long would it be to start noticing testicular shrinkage? Thus if my clomid is not preventing shrinkage due to the testosterone, then when should I start seeing shrinkage?..I have not seen any after 3 months but I have no idea if it would take 1 month, 1 year, or ???

Thanks.


#8

I’m glad your symptoms are improved. I think that with your numbers it would have been prudent for the Dr to find other possible causes of your symptoms before commiting you to life-long treatment.

I experienced complete shrinkage to soft grapes on 50mg/wk in only 6months. I will be looking to start hCG at my next visit to get some size back as I’ve heard to many negatives about Clomiphene.


#9

Your E2 is really high, isn`t that affecting you negatively? No emotional issues, higher bodyfat, etc?

I`m interested in hearing about that!


#10

Just wanted to give a 2.5 year update. I have stayed on the program my MD prescribed. I have blood work done every 4 months and have not seen any problems. After 2.5 years on Clomid, I still cannot notice any atrophy of my testes…they seem the same size as before I started.

For me Clomid has not yet demonstrated the negative side effects that many have noticed. When I discussed all of the negative reactions on this board with my Dr., he once again explained to me how it worked and it made sense (of course I can’t remember it all now.) More than that, he said let the results speak for themselves. He was trained by the Cenegenics organization and says that prescribing Clomid to prevent testicular shrinkage with men taking testosterone is not that uncommon. Although HCG is more common, it is also much more expensive and is a bit more inconvenient then taking a pill. Anyway, not trying to start any trouble, just reporting my results.


#11

Clomid works well for manyh?most guys. Some feel horrible on clomid and Nolvadex does not have those negative effects.

The stickies now are found here: About the T Replacement Category

You should be considering E2=22pg/ml as a therapeutic target. You can ask to try that then go on how you feel to determine what is right for you.

With a SERM [clomid], you can do these labs:
TT
FT
E2
LH/FSH

Can you post your labs with ranges?

LH/FSH will show what the SERM is forcing the pituitary to do. You do not want high LH as this can create a high rate of T–>E2 inside the testes; and anastrozole cannot control T–>E2 inside the testes.

I am glad that T+clomid is working for you, hCG does not travel well.

Injected T brings up your T levels. Dose of hCG or SERM should be small, as we are not looking for the testes to make much T and we need to avoid the effects of LH receptor over stimulation.