Why is it that so many endos put patients immediately on testosterone without thinking of other means?
Case in point: the topic here is low LH. How do you treat low LH? Well, you typically treat that with Clomid or Nolvadex.
BUT, before that, there really should be a check of the testes. A shot of HCG and subsequent bloodwork will determine if that portion of T-production is bad.
If it’s good, and if LH is low, and IF there is no pituitary tumor, then treatment with Clomid should be tried. In my opinion, all this should be exhausted before going on good ol Testosterone.
From a pragmatic point of view, TRT may be the cheapest and most practical therapy, certainly for injectables. You do not need LH and FSH to feel well etc. But HCG does have some value and is also quite inexpensive… but the recombinant type is more costly.
If T is low and E is not abnormally high, then I don’t expect that suppressing E or its effect on receptors would raise T to high-normal levels that are the objective for many progressive doctors.
As for real problems and getting therapy covered by insurance, TRT is gaining acceptance and other alternatives might not be covered for reason of cost or ignorance.
But if there are other concerns… I am always wanting to learn more.[/quote]
Personally, I don’t think the decision to potentially bypass the body’s natural production system by adding the end ingredient is a very good way to go. This is a LIFE-long decision. You start, you basically stay on for the duration.
With respect to low T and average E; clomid will act like a less estrogenic compound than typical circulating estrodiol. Therefore, the brain will sense a low level of T and E and will pump out more LH to try and stimulate the testes. That’s the theory. I have many friends, acquantances, and enemies who have gone the proper route as I have mentioned and have checked the testes first via HCG, then went on clomid therapy and have great testosterone numbers.
I understand that some might have to make a financial decision, and that going the straight T-injection or T-gel route is more cost effective. However, if one can afford it, I believe the PCT used by many steroid users over the decades can have tremendous benefits for the aging or low T crowd.
If your testes are fine that is! If not, then straight T is the way to go.