SERMs often cause high T–>E2 inside the testes from high LH/FSH. Many need 12.5mg EOD or less. Sometimes you cannot have higher T and lower E2 with any dose.
Aromatase inhibitors do not work inside the testes, anastrozole cannot fix that. Herbals may fail. AI drugs do not do anything to lower existing E2, only modulate T–>E2 production. Serum E2 is a balance of production and liver clearance.
SERM’s typically increase E2 levels, while hiding E2 from selected tissues. Your liver still sees high estrogens and typically then creates more SHBG to scavenge sex hormones.
Many on T+hCG+AI do not have any problems getting pregnant. When trying for a pregnancy, one can switch to T+SERM+AI or do that occasionally for a fertility tune-up.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.
Clinical research has been done with males+SERMs and males+AIs to understand how the HPTA responds. From a functional medicine point of view, FDA approval is not a major factor. But insurance may reject.
Anastrozole is a lot less expensive at 1mg/week than “herbals”.
Clomid simply does not provide an effective TRT result for many guys for several reasons. Clomid and other SERMs are drugs. T is a natural human hormone.