T Nation

From Clomid to TRT?

Hi all,

I’m 39, 5’ 8” 172lbs, in the gym 4-5 days/week since high school. Super late bloomer. Noticed typical issues about 10 years ago and tested in the low 400s for total T. Been working with Dr. Shippen since 2011 and have been on Clomid and Anastrozole since. For the past couple of years I’m dosing Clomid 35mg 3x/week and Anastrolzole 0.1mg 1x/week. Over responded in the past so lowered to once a week. SHBG has crept up from 35 to 67 over the years. Still feeling mostly good, libido is there. No erection issues with sex. But ejaculate volume at times is minuscule with some anomalies that seem normal. Morning wood is infrequent and transient. Shippen has retired so moving to Defy to see what they think from here. Fathered 3 kids on the above regimen and am done there. Scheduling appointment with Defy on Monday and their lab results are attached. Thanks for any opinions!!!

I should have added that I accidentally missed my weekly dose of Anastrozole one week before this draw (2 weeks since the previous dose) - which landed me at 22. Subsequently, I also had great morning wood all week following making me wonder if I’m really sensitive to even my 0.1mg weekly dose.

Good choice going with defy.
Here’s my best guess at what your protocol will be from your bloods.
T cyp. 150mg/wk, 800-1500HCG/wk they will also give you anastrozole in .125mg pills to take as needed.
Your IGF-1 is low IMO and they will suggest either Sermorelin and or Ipamorelin. At your age you should be over 200 this is important for injury recovery and muscle repair since you workout.

My suggestions (defy patient over 4 years) your body is going to flip out over the T cyp. Water weigh, nipples on fire, if you are carrying some bodyfat lots of extra E2(emotions) to deal with. Your dick will quit working and libido will drop off. The list goes on. Just know this is all temporary and things will get way better once you stabilize. It took me a year because I did not do what I am suggesting to you.

Keep your script at 150 but only take 100mg/wk for 3 to 6 months. This will give your body a chance to adjust itsself.
The first year can be a real hell and the higher your dose the worse that year can be.

It is known that a big slug of T once a week will bring SHGB down over time so that will be something to think about in the future. You need your SHGB in range or you will have to take loads of T just to get your Free T midrange. Big T doses all year long have some bad side effects like over range HCT requiring blood donations.
Right now you just need to get your bodys endocrine system use to all that extra T.

hope that helps.

Thanks for all of the insight and transparency. Slightly scary but sounds like it’s all temporary. That said, wife and I have a trip planned in July that we’re planning on it being pretty sex-filled. Wondering if I should hold off and start later…

No one will know how you are going to respond to TRT . Everyone is different. If your libido and tools of the trade are working fine right now I would not risk this special vacation you have planned with the wife. TRT is for the rest of your life thats a long ass time. Its a marathon not a sprint. Best of luck.

Would defy potentially keep me going on my Clomid regimen? Maybe they can just optimize me a bit before I dive in. That SHBG though…

You can get anastrozole 0.050 from Defy/Hallandale pharmacy.

I’d hold off on trt . If it’s working stay with it. My erections were easier to get before trt, now my labido is better, I see sexy in woman more often . It’s weird how I’m changing.

I had days where it didn’t work even though I was damn horny and middle of night erectjons. also It does seem less sensitive, and modern powerfull like the hulk. Rawr.:: Almost every night I have rediculously hard erevtjons to where my nether region hurts at times. Most of the time I wake up and it’s not even close to the same strength. it’s hit and miss. Actually during the day it’s never been the same as night ones… maybe when I was 20? Lollll sorry I rambled but you can see it’s totally unreliable. Don’t piss the wife off. Or bring a dildo and disguise it … get used to acting? Happy wife is a happy life…

You are 40 and that’s my age. I went straight to trt and I see no reason to do anything else at this age.

You need to talk this over with them. Tell them your concerns and what you would like to do.
I have never gotten a NO when I ask for something that is reasonable. That is why we like them and so many recommend them.

Will do and thanks again. Shippen worked with a compounding pharmacy to adjust my Clomid and Anastrozole dosing so hopefully they can do the same and see if there’s anything I can do to optimize what I’m doing. Making appointment tomorrow.


Seems like the defy speciality

So you’re saying exactly what here about defys protocol?

Yeah I may keep spreading them out a bit to see what happens

Im not saying anything about defys protocol. I am just suggesting what I would do to reduce all the hell one goes thru when they start TRT.

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I had no idea it’s typically such a rough start

Had my initial consult with Dr. Calkins this morning. Very impressed. We talked options but agreed that I’m probably reaching the end of expected benefits from Clomid with my SHBG so high. So he’s got me starting:

  • 80mg test twice per week
  • 500iu HCG twice per week
  • 0.1mg Anastrozole twice per week
  • 25mg DHEA nightly

I mentioned my hesitancy with my summer vacation with the wife and he was super understanding and suggested a 2 month follow up rather than 3 months so we have more time to dial things in before the trip. Great experience so far and now my journey begins…

I like it. 160/wk should knock that SHGB down in no time.
If you start feeling weird I’d drop the DHEA first. Some have real issues with it. It gave me a coffee buzz so I could only take in morning. I finely just stopped taking it.

Prepare for water weight gain(I gain 30# in 3 weeks) and sore nipples (had to wear bandaids). Don’t panic stay the course.

Good to know. I was worried about overdoing it with going from .1mg Anastrozole once per week to twice but maybe not per your point!

The water weight, sore nipples, passed or needed to be corrected?

Definitely a good starting place considering high SHBG, down the road further tweaking is usually needed to dial everything in.