T Nation

On Clomid, Change to HCG Mono?


#1

Long story short I have been on Clomid (12.5mg ED) for awhile now after a long battle with Low T. I am 29 years old, 200lbs. Here are my numbers on Clomid currently:

Total T: 657 (264-916)
Free T: 142 (52-280)
% Free T: 2.1 (1.5-3.2)
LH: 3.3 (1.7-8.6)
FSH: 2.2 (1.5-12.4)
Estradiol (sensitive): 31 (8-35)
Estrone: 95 (12-72)
SHGB: 41 (16.5-55.9)
TSH: 3.35 (getting more in depth bloodwork because of this, it’s usually 1.5/1.6. Can Clomid affect?)
Free T3: 3.3 (2-4.4)
Free T4: 1.12 (.82-1.77)
AM Cortisol: 22 (6.2-19.4)
Prolactin: 4.7 (4-15.2)
IGF-1: 171 (98-282)
DHEA Sulfate: 347 (138-475)
DHT: 52 (30-85)
B12: 779 (211-946)
Magnesium: 2.1 (1.6-2.3)
Insulin resistance score: 60 (<=45)

Doc is adding adex (1mg per week, .5 Monday, .5 Friday) to see if any numbers improve.

Can Clomid affect TSH? I’ve had lots of bloodwork and don’t ever remember it being that high. Doc ordered more thyroid bloodwork for more details.

Clomid seems to be working well so we will see what changes on the Adex. Another option he gave was 1500iu HCG 2x per week along with the Adex. Anybody think this would be better than Clomid+Adex?


#2

Good plan as you are in the danger zone as far as estrogen issues. E2 should be closer to 22

Yes it sure can, please see the attached link. Glad to hear your doctor is looking further into it.

The second option is crazy. 250IU of HCG every other day closely mimics the bodies natural LH production as far as quantity. 3000IU weekly would be six times the amount and you would likely find desensitization in the testes after 30-90 days (I can link the study if you like).


#3

Fair enough. IF 250iu EOD was an option with the HCG, would that along with Arimidex be a better option than Clomid and Arimidex?


#4

Given the side effect profile of clomid I would say so, but each person is different. The decision is personal, for me it was testosterone was the option as if I had to take shots it may as well be test. But for me fertility was not a concern.


#5

HCG would shut down my LH and FSH production correct? It mimics both of those?


#6

It is an LH analogue, it would shut down the natural production of LH and FSH. However, even though it is not and FSH analogue, you would not be sterile.


#7

Interesting. So no FSH isn’t a problem?


#8

I am reading HCG replaces FSH and LH.


#9

@KSman can you chime in on my labs and my docs suggestion of Adex at 1mg/week with e2=31? Is that too high of a dose? Estrone was high.

Would HCG mono be a better way? Would I then need to supplement with pregnolone, dhea, etc?

What E2 number should I be aiming for on the Labcorp Estradiol sensitive test with a range from 8-35?

Are my Total T and Free T numbers pretty good? Hopefully the AI will drop the SHBG a bit and raise them even more.


#10

LH: 3.3 (1.7-8.6)
FSH: 2.2 (1.5-12.4)
Estradiol (sensitive): 31 (8-35)

LH/FSH could be better, more clomid possible.
E2=31 is not too high, you can try 1/4mg anastrozole twice a week
Lower E2 in itself might improve LH/FSH a bit.

hCG has no advantage over clomid induced LH. However, hCG is a natural human hormone.
Do you feel OK with clomid? Mood problems?

TSH:
Have you been getting iodine from iodized salt?
Feeling colder lately?
Outer eyebrows sparse?
See “oral body temperatures” below.

What is insulin resistance score?
glucose?
A1C?


Please read the stickies found here: About the T Replacement Category

  • 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.


#11

1/4 tab Anastrozle twice per week is what I’m going to try. We will see what that does to the Free T and SHGB numbers. My TSH is never that night so we are going to check it again in six weeks along with the other normal stuff. I do use iodized salt. I don’t have any of the symptoms you mentioned.

I feel pretty good overall. Will report back when I get bloods again in 6 weeks.


#12

In general @KSman, would an individual tend to feel better on HCG mono-therapy rather than Clomid? One thing that isn’t great on Clomid is my libido.

Also, why don’t we see a lot of people having success with HCG by itself?


#13

hCG replaces lost LH receptor activation with hCG and many report a improvement in mood that is from hCG itself.

Clomid and SERMs in general get the pituitary, if able, to produce LH/FSH to activate LH receptors etc.

Both methods can fail if the pituitary or the testes are a weak link.

These can work better with younger males who are secondary as the testes are younger and more functional. So stories need to be filtered by age.

SERMs are cheap and oral meds but not natural human hormones.

Clomid can increase E2 and does not block all effects of E2 and might have its own estrogenic effects for you.


#14

@KSman my pituitary reacts to Clomid so does that mean HCG should work as well?


#15

Not related at all. Clomid acts on pituitary, hCG acts on the testes.


#16

@KSman got it. My total t is high 600’s even with LH at 3.3. so HCG should technically work well if my dose turns out to be something that corresponds to LH > 3.3. free t and shbg is killing me right now.


#17

SHBG not SHGB

Yes that is high. E2 was near top range …

If you increase FT/Bio-T and reduce E2, SHBG is expected to fall, but that can take time as it is a liver response.


#18

@KSman do you think it is worth me trying HCG mono? Not feeling too great on the Clomid (no motivation, no libido, etc.).


#19

@KSman

Alright, my doc will allow me to try TRT (Cyp, HCG, AI). 100mg per week 1x per week. My question is, what dose/timing of HCG is the most up-to-date protocol when doing a 1x per week injection of test? I’ve seen every other day, E3D, and also just both days before your next injection to try and prevent levels from dropping off before the next shot. Suggestions? Along with that, what dose/timing for Arimidex as well?

Thanks


#20

One inject per week with your SHBG level doesn’t make sense, inject T twice weekly using insulin syringes in shoulders or thighs and take AI at injection time. Inject HCG 2-3 times weekly.