T Nation

Going from Clomid Mono Therapy Back to TRT


#1

My guy had me on Clomid and I have fired him because he refused to listen to my concerns about it's side effects for me personally. I've had horrible fluid retention, no sex drive, joint and lower back pain. I've lost muscle mass and gained 10 lbs. I literally told him ( and showed him) I was on the last hole on my belt. His response was your TSH is to high, we'll adjust your thyroid meds and you'll be OK. That was 3 weeks ago, it's still not better.

Long story short I'm going to go back to T injections with HCG. Any advice on how I should make the transition would be helpful. I've been taking alternating 25mg with 50mg of clomid EOD. I haven't been taking anastrozol because I over respond to it.

Should I come off the clomid for a period of time then start injections?
Should I front load the T injections?
Will coming off the clomid cause any E issues I need to deal with?

Last bloodwork 12/29: ranges
TT = 543 ng/Dl 348-1197
FT = 17 pg/ml 6.8-21.5
E = 36.2 pg/ml 7.6-42.6
total Estrogens 180 pg/ml 40-115
LH = 12.7 miu/ml 1.7-8.6
FSH = 13.1 miu/ml 1.5-12.4
TSH = 1.820 uiu/ml .450-4.5

I'm waiting on some bloodwork from Monday of this week.


#2

Your E2 was too high. Perhaps because clomid dose was too high and LH/FSH also suggests that. 50mg clomid EOD does seem too high. High LH might have desensitized LH receptors. With those LH levels, TT and FT seem too low - or you already had a degree of primary hypogonadism. With your ~50mg injected T per week, that could have created most of your TT and FT.

Nolvadex does not have the estrogenic side effects that some get with clomid.

Any observations about size and firmness changes to your testes?

Before TRT, what were your LH/FSH numbers?

What was your anastrozole dosing that did not work? Many over-responders do OK with 1/4mg per week in divided doses.
What were your E2 labs on anastrozole?

Have you read these stickies?
- advice for new guys <<<< good technical foundation
- thyroid basics
- protocol for injections
- finding a TRT doc

Transition:
- stop clomid
- 24 hours later
- inject 28mg T cyp/eth EOD
- 48 hours later
- start 250iu hCG EOD at time of injections
- you can try 2 drops of a liquid anastrozole product, 1mg/ml

Thyroid:
Please post labs.
Were you iodine deficient? Always used iodized salt?
Check body temperatures as per the thyroid basics sticky. This can be a guide to your thyroid Rx med dosing.

Thyroid labs of interest:
TSH
fT3
fT4 [please not T3, T4]


#3

KSMAN
For clarity while taking clomid I as not injecting T. The clomid was 25mg EOD taking 50mg on the alternate days. Really I can't see a reason to continue it as I won't be having any more kids.

He wasn't pulling the thyroid labs you're asking for. That along with failure to pull the senstive E makes me think he really is clueless. I only staid with him because he would write the Rx's I need without a lot of hassle. Once he insisted on Clomid it was time to part ways.

My testes before TRT were normal to smaller size on clomid they got huge and hard. I learned that sitting on your balls hurts.

Before TRT Range
LH = 2.4 miu/ml 1.7-8.6
FSH = 4.8 miu/ml 1.5-12.4

Read all the stickies but the thyroid one. I'll fix that

The anastrozol started out at .5 mg 2x's per week while on T Cyp 60mg 2x's per week. I lowered the anastrozol to .25 2x's per week and then once per week and it would drop my E into the low teens single digits. All this while my T was 900-1000. So what I did was reduce my TCyp to 50mg's every 4 days. While on that protocol my T was 769 and E was at 33.5 but I felt great and was not exhibiting any high E symptoms.


#4

When on anastrozole and you get an in-range number, lets say 12 and your target is E2=22, your new dose is old_dose x 12/22. Its that simple. So 1/4mg per week is probably going to be close. You need a liquid product to dispense by the drop. You can also dissolve anastrozole tabs in vodka, shake and dispense by the drop.