New to TRT -> On Clomid

23 days after a 125 mg test , total test 270, LH 4,6, estradiol 32
it can go up a few points in the next days, but this only proves that his method inhibit even more…

well, i guess there is a 3rd way that could work aswell…
1/2 or 1 mg anastrazole a week could do the trick …so i have 3 different routes:

  • Tamoxifen 5 mg EOD
  • Clomid 125 mg EOD
  • Anastrazole 1/2 everyweek

Effects of aromatase inhibition in elderly men with low or borderline-low serum testosterone levels.

BZ Leder, JL Rohrer, SD Rubin, J Gallo and C Longcope, The Journal of clinical endocrinology and metabolism, Mar 2004

As men age, serum testosterone levels decrease, a factor that may contribute to some aspects of age-related physiological deterioration. Although androgen replacement has been shown to have beneficial effects in frankly hypogonadal men, its use in elderly men with borderline hypogonadism is controversial. Furthermore, current testosterone replacement methods have important limitations. We investigated the ability of the orally administered aromatase inhibitor, anastrozole, to increase endogenous testosterone production in 37 elderly men (aged 62-74 yr) with screening serum testosterone levels less than 350 ng/dl. Subjects were randomized in a double-blind fashion to the following 12-wk oral regimens: group 1: anastrozole 1 mg daily (n = 12); group 2: anastrozole 1 mg twice weekly (n = 11); and group 3: placebo daily (n = 14). Hormone levels, quality of life (MOS Short-Form Health Survey), sexual function (International Index of Erectile Function), benign prostate hyperplasia severity (American Urological Association Symptom Index Score), prostate-specific antigen, and measures of safety were compared among groups. Mean +/- SD bioavailable testosterone increased from 99 +/- 31 to 207 +/- 65 ng/dl in group 1 and from 115 +/- 37 to 178 +/- 55 ng/dl in group 2 (P < 0.001 vs. placebo for both groups and P = 0.054 group 1 vs. group 2). Total testosterone levels increased from 343 +/- 61 to 572 +/- 139 ng/dl in group 1 and from 397 +/- 106 to 520 +/- 91 ng/dl in group 2 (P < 0.001 vs. placebo for both groups and P = 0.012 group 1 vs. group 2). Serum estradiol levels decreased from 26 +/- 8 to 17 +/- 6 pg/ml in group 1 and from 27 +/- 8 to 17 +/- 5 pg/ml in group 2 (P < 0.001 vs. placebo for both groups and P = NS group 1 vs. group 2). Serum LH levels increased from 5.1 +/- 4.8 to 7.9 +/- 6.5 U/liter and from 4.1 +/- 1.6 to 7.2 +/- 2.8 U/liter in groups 1 and 2, respectively (P = 0.007 group 1 vs. placebo, P = 0.003 group 2 vs. placebo, and P = NS group 1 vs. group 2). Scores for hematocrit, MOS Short-Form Health Survey, International Index of Erectile Function, and American Urological Association Symptom Index Score did not change. Serum prostate-specific antigen levels increased in group 2 only (1.7 +/- 1.0 to 2.2 +/- 1.5 ng/ml, P = 0.031, compared with placebo). These data demonstrate that aromatase inhibition increases serum bioavailable and total testosterone levels to the youthful normal range in older men with mild hypogonadism. Serum estradiol levels decrease modestly but remain within the normal male range. The physiological consequences of these changes remain to be determined.

Those stats mean nothing, all that matters is you, and your lab responses.

Your biggest problem is that insane doctor who thinks that shutting you down every month is going to fix your HPTA when in fact, doing that to a normal guy might damage a working HPTA.

Yes!!! As you said. It was a total disaster .
But it’s finished !
Now, for a long term Therapy, with which should I start ? Clomid or tamoxifen …
I am thinking about tamoxifen 10 mg a day
Then reduce to 5 mg then 5 mg eod and live with that dose …ill use ai if necessary to control estrogen into 20-25 bucket

I have high urinary cortisol. But I’ve not cushing. Basal is ok.
Have you ever found this pattern ? Low test and high urinary cortisol.

SERMs block estrogen receptors, dose dependent, in some “Selected”" tissues, but not in others and estrogens interfere with T at T receptors to some extent as well. So SERMs are not the solution to elevated estrogens and an AI is still needed, as required, to achieve favorable E2 levels. You do seem to have that issue well understood.

As for urinary cortisol VS anything, that has never been considered here before.

re that paper, some men with low-T have low E2, so an AI cannot be used. Overweight men may have higher E2 levels needed to be lowered. In any case, all if that requires a basically functioning HPTA, with lower T and elevated E2 and not primary. Starts to be a nitch application. I always point out that the only thing that matters for an individual case is that case alone.

Hi @KSman
New labs today, 5 1/2 weeks after the last 125 injection.
A disaster as you predicted: … my baseline droped 100 points and it’s now on 290. Estrogen 32 LH 4,2.
Only odd pattern is that morning erections are very present.
Gyno surgery done! i am at 8th day post op.
I am starting today with Clomid and Anastrazole. Ill start with a 12.5 mg 3x times a week and 0,5 anastrazole a week ( 1/4 two times a week) . Do you think these doses are ok?

Ive got a question. Just to recap… My baseline was 560. After 6 weeks of a weak AAS without PCT it only recover to 370. With the same LH → 4,2.
After a couple of months i took tamoxifen 20 mg a week and my LH climbed to 9 and test value to 800. I dropped tamoxifen after 3 months and LH came back to 4,2 and test value to 370.
A endo suggested this stupid protocol (before descovering this site) of 4 monthly 125 injections. After the protocol LH is the same 4,2 as usual… but test is lower… only 290… What’s going on ??? I am dealing with a testicular failure? From my resume am i primary ? secondary o terciary? Everytime i cause a bit supression my values seem to go lower and lower … isnt it odd ? after 3rd injection it was 330 , afer 4th is 290… what do you think is going on ?

Do you think HCG would be usefull ?

Many thks

If testes are not responding to LH, there is no reason to expect that hCG acting on the same LH receptors will work any better.

I am suspicious of data where you always get LH=4.2 when it should change hour to hour. Are these real?

Because LH is pulsatile with a short half-life, LH and FSH should be tested together as FSH is typically a better indicator of LH status than LH itself. You have a doctor-lab problem.

On tamoxifen, you should have tested TT, FT, E2 LH/FSH. If E2 elevated and you dead stop, E2 will nail it.

Sorry for being imprecise… what i meant was that my T dropped twice (after AAS from 560 to 370, and after those 4 T shots 370 to 290) while LH is almost similar on the 4 to 5 range.
On tamoxifen LH went to 8 or 9 and T to 800.
What’s going on? Why are my tests producing less testosterone each time i supress endogeneous production for a while ( 6 weeks on the case of AS, a matter of 1 week in the case of the T shots) ?

I dismiss this endo…another one… because the other 3 told me repeatdly that with a T of 370 I was normal. it’s so frustrating!!!

Tomorrow ill go to another endo, to check what kind of TRT is posible where i live… Cause if i go to TRT I want to go as you recommend ( 2 shots week, with HCG and AI):
Meanwhile ill be logging my results with Clomid… I am afraid my values will not be as good as last tamoxifen trial and i am afraid i will not feel good with it… but i have to try …
I am not trying a restart … i am going for long term terapy… so … i rather perfer clomid… if it doesnt work ill go directly to shots… I am afraid of Tamoxifen long term side effects even at a low dosage of 5 mg EOD.
Ive got to solve this issue this month, cause my low T gave me a gyno condition, i did the surgery and i will not risk it to grow again

Quick update.
Gyno Surgery update day 14 → All is looking very good. No pain at all. In 13 days i’ll be back to the gym
Clomid → day 6 on 25 mg (+ .25 anastrozole 2x a week) → no sides … (may be an occasional testicular ache).
Sex drive seems ok and morning wood great (it’s been great on the last four weeks, even with a T of 270).
Tomorrow i’ll go for the labs .

So…
7 days on 25 mg Clomid and TT = 410, Estrogen = 37; LH = 7
TT was 290 one week ago…
@KSman do you think i will achieve values > 600 … I am staring to been less optimistic here…
Stupid endo with his T injection protocol ruined my balls!!!

did the test say estrogen or estradiol?

For one week, that might not be a bad response, no idea why you had it done so early. I wouldn’t bother testing before a month unless you start getting some side effects.

Estradiol I meant.
Well I am very obsessed in solving this issue and I need to know asap if I responded to clomid. I am so fucking furious about the outcome of the 4 injection proposed by the endo. He made me loose 100 points !!! So …it seems that I can t be supress whatever the reason or else my test will came lower with the same LH.
I’ll do labs again on 2 weeks
Does anybody has an explanation for my testosterone behavior after small Supression S ? Cause on real world neither friends neither docs understand what’s going on. If u add high cortisol to low t condition and it’s a perfect storm …

When you shutdown your HPTA, you create an opportunity for a failed restart or a bad restart/PCT attempt.

Doctors do stupid things. If they did not, would there be a need for this forum?

E2=39 pg/ml is too high. Increase anastrozole dose by a factor of 37/22 to get nearer to E2=22pg/ml. E2 37 can have a lot of negative effects while decreasing FT. If your E2 does not come down substantially, you have a lot of T–>E2 inside your testes where anastrozole cannot work.

Lower E2 will probably improve sexual function. But not all guys are wired the same.

TRT options where you live: Have you read the finding a TRT doc sticky?

Well, a 125 T shot reduced my test production for a while because LH and FSH were somekind supress (not total)… but after 15 days i should have obtain the same T value and gradually the external testosterone would have be replaced by my one.
In theory at day 28 after the shot i should be as equal as day 0 ( same baseline, same LH, same endogeneous T value). But this didnt happened. Doctor expected T would be greater (raison de etre of his protocol) , i was expecting at least the same , but what i was not expecting was to get a lower baseline.

Yes, I will increase Anastrazole dose to 0,25 EOD.

Can I had a bit of tamoxifen say 5 mg twice a week for one or two weeks so i can get higher values as soon as posible ?

What do you think of 410 after 1 week at the 25 mg dosage… I think it will not be enough to get into the 600.
Remember that with tamoxifen 20 mg/day i got into 800, but this was before my stupid endo.

Regarding TRT. Several hypoteses: Gel , Nebido , Sustanon Once every two week.
If it’s necessary i want to inject twice a week for Test and HCG and of course AI at the time of shots. We will see if Clomid can put on 550… If Clomid cant put me at leat 550 or if i get strange symptoms i’ll go for TRT. In a couple of weeks i’ll test my sperm to check if i am still fertile and freeze some swimmers, cause this story is telling me that once i go to TRT os AAS it’a a no way back

I’ve went to a lot of doctors (I am ashamed of the number) but I think i Found one that can help me…Endo focused on fertility issues…

KSMan, I am really apretiate all the guidance and support/advices you are giving to all of us . This forum is great. I am learning so much with you and from the other guys experiences…
Many many thanks

Hi,
Today i did labs, 14 days on clomid

Pre Clomid → T 290, E34, LH 4,2
Clomid 25 mg/ day + Anastrazole 0,25 mg E2D
Clomid → T 545, E21, LH 7,5

@KSMan, what do you think ?
I think it’s working and it can be a long term solution… new labs in 3 weeks.

Many thks

Decent labs. TT may improve with time. LH is high, better to test LH/FSH as FSH levels are steady and lab can catch LH peak or low as LH released in pulses with short half-life. E2=21 is perfect.

Testes may need more time as there are tissue changes taking place.
If you are feeling good, just sit back for a while. It take time for you brain to respond as well. Think 6-8 weeks from beginning for that.

Hi @KSMan,

6 weeks on clomid, T is 767 , free T is 21, E2 14 , LH 8,8
I ve been taking 25 mg Clomid a day and 0,75 anastrazole a week.
I’ll diminish both doses a bit, and try to mantainin T values and increase E2 a litle bit.

Sex drive is a bit low …
I cant see any changes on body composition yet… How long do you think it will be necessary, to lose body fat and gain some muscle ?
3 months ?

Many thks for your help

Nice numbers. If you want results, you need to lift.

I lift heavy and I am strong (except legs i guess that avoid as much as posible).
Lift 6x a week
Even so… i am not seeing significant changes for now …