KSman is Here

You are missing some distinctions that make your post a bit fuzzy.

The lower dose SERMs that we use in TRT modulate E2 exposure to the hypothalamus. You cannot be using the term “blocked”.

The bad effects of clomid are only experienced by some guys, not a small fraction. This is showing that some are wired up differently via DNA or DNA expression that probably is via different variations in enzymes. Those who suffer with Clomid are good with Nolvadex.

  1. E2 only gets high if the dose is high enough for LH to be high enough to drive high T–>E2 inside the testes. You missed this distinction and make a bad conclusion. If E2 is high, SHBG can increase, lowering FT %, but this is then a dosing problem, not an absolute fact. I do not see a firm relation to cortisol, please link me to references.

  2. I know that anastrozole does not work to control E2 when testicular T–>E2 is high. Aromasin might work, but I have never seen an lab situation to support that premise. I cannot support your statement as fact. No AI can reduce existing E2 in the blood, only the liver is a major player in that. An AI can only modulate T–>E2 and anastrozole cannot do that inside the testes, aromasin perhaps might, but might not.

“At this point we stimulate hypothalamus, pituitary gland, and gonadal glands but we don’t stimulate androgen receptors because of low FT (not to mention libido and well-being).”

  • I can’t make any sense of that, FT is not low!
  1. yes to some extent, but we are needing to consider modulation not blocking, so T+SERM vs SERM will increase E2.

Thank you for your reply

Yes, you are absolutely right, bad simplification.

I’ve noted a lot of complains on a lot of forums about those side effects and no improvement in anything but lab results.

Yes to the first sentence (again - my simplification). So, according to you, SHBG is dependent on E2 in this case and not on (other) properties of clomiphene? I have doubts. Please read the following (also contains info on cortisol):

http://joe.endocrinology-journals.org/content/53/2/261

So: 1 [AI’s don’t work on aromatase conversion in testicles] or 2 [conversion in testicles happens via different enzyme]?

I meant - a lot of people claim that on Clomid their TT is high, E2 is high but FT is very low (and I know that some medical research papers say different). If FT is low then there is no improvement in for example libido. Also - there are some, that have less sensitive T receptors and for them FT is crucial.

I understand modulation. What did you mean by [T+SERM vs SERM will increase E2]? On T+SERM E2 will be higher than on SERM alone? If that’s the case - yes I think the same.

According to the summary, 3mg/kg/day, 225mg/day for a 75kg male [165 pounds]

This is a study to determine the effects of the drug. This is not a study of a therapeutic dose. This is 9 25mg doses per day.

E2 levels were probably getting insane and E2 would be driving the bus.

You need to learn how to read papers to distinguish between a research paper and clinical paper to not be led astray. Some papers are in-vitro, test tubes for example, and other in-vivo, a living organism. Some are in humans and others in rats etc.

The results are meaningless. They also talk about SHBG but do not report estrogen levels.

Please pretend you never found that article.

“I’ve noted a lot of complains on a lot of forums”

  • they are using stupid high doses for PCT, stacking SERMs and SERMs+hCG. If you do everything wrong, you find things to complain about.

Guys who are typically doing things very wrong do not have labs.
On high dose SERMs with high E2, the liver sees E2 loud and clear and will jack up SHBG.

In the testes, intratesticular testosterone can be 80-100 times higher than serum levels. Anastrozole is a competitive drug that simply is not going to work inside the testes unless you take 80 or 100mg per week which is insane. Aromasin binds to aromatase and might behave differently. But this is hyped so much. If that is so great, why are the doses so high when 1mg/week anastrozole works.

Proper dosing of SERMs does not create high E2. There are always a few/rare guys where things work differently.

Can you apply the above to your thinking. Let me know if you have remaining questions. But I am not hear to edit your summaries, but equipping you with knowledge to think things through.

So, could T + SERM + AI work? I know that it would depend on perfect doses (and frequent lab work), but does it make any sense to you? Do you think it might be better for fertility than T + HCG?

I really don’t want to bore anyone with my story. Docs are clueless in this matter, they know only Clomid monotherapy or T + HCG. I found few instances of T + HCG + Clomid + AI for 3 months before trying to conceive on TRT, but that is overkill in long term.

Hey Brother,
I’m new here and could use some help. Any chance you could take a look at my labs?

KSMan-

I updated my thread.

Thanks!

Just a quick question cause I don’t feel the need for a new topic . I have hypogonadism still untreated and I was wondering if suicidal thoughts was a known symptoms?

Couple of updates on my thread. Appreciate your insight. Thanks!

Updated details on Iodine supplementation.
Big thanks.

Yes, however with TRT lasting the rest of your life, hCG as a natural human hormone is not going to create issues and SERMs are not worry free. I sometimes suggest hCG with SERM holidays occasionally when there is a heightened concern re fertility. LH/FSH needs to be manged to avoid high levels just as high hCG doses need to be avoided.

Tucker, we see lots of guys here treated for depression when the underlying problem is a sex hormone imbalance. Mostly low T, but I need to stress that E2 needs to be in balance. Low thyroid function is a very common problem that robs energy and can create mood-depression problems by itself or compound any other cause/case of depression. In many cases the thyroid issues can be caused by iodine deficiency caused by not using iodized salt.

If your depression has deeper roots, hormone problems still need to be addressed as you peel back the onion.

Some SSRI’s can increase suicidal thoughts as the medication can give one the energy to attempt.

Please open a topic for your case and provide all available labs with lab ranges. I think that we can help a lot. Getting docs to do things right may take some work.

1 Like

hi can you please respond to me when you have a moment at my thread. @KSman

KSMan -

Replied to your comments

Thanks!

Hi.please get back to me. My test results been uploaded. Thanks

Thank you for the info.

Can you think of any reason for HCG effectiveness for testicular atrophy to be dependant on exogenous T level? Is there something like too much testosterone in blood stream for HCG to activate Leydig cells?

Can you think of any other reason for HCG (250 units E3D, pharmaceutical grade, properly stored) to not be able to prevent testicular atrophy during TRT (100 mg E3,5D, also pharmaceutical grade)?

K Sman,

I don’t have any questions. I just wanted to thank you for helping everyone. There are a lot of useless doctors out there, along with an inefficient medical system and legal structure, and you’re providing a selfless, invaluable service.

Thank you.

@KSman - Just wanted to let you know I posted a thread and could use someone like you taking a look at the calculations and labs to make sure I’m not totally hosing up my dosing. I think I’m on the right track but if you could take a minute to give some feedback, I’d greatly appreciate it. Thanks in advance!

CDMac’s Thread

The answer is propably in the stickies but I can’t seem to find it. I’m injecting 2 times a week (thursday morning and sunday evening). When should I get my blood drawn. ( to be the lowest cause i’m meeting with a new endo )

@KSman

I’m not @KSman but I did sleep at a Holiday Inn recently :smile:

The amount of testosterone in your body will be the lowest the further you are away from an injection.