Is TRT right for me

I am trying to decide if making the jump to TRT is right for me and thought this forum might be able to steer me in the right direction.

Current I am 38 years old, 6'-0" tall and 225lbs. 4 years ago my wife and I started trying to have children with no luck, after about a year of trying we decided to see a local fertility specialist who is also an Endo. At that time I was a very fit 185lbs. First thing he tested me for was my T level which came back really low, can't remember the number but it was in the 300 range. He decided to put me on Clomid (25mg daily) because TRT would make conceiving even harder. The Clomid did get my T levels back up into more of a normal range but slowly I started to put on BF and gain weight. Even as an avid road cyclist and mountain biker I couldn't keep the weight off. After 3 years of Clomid I have gained about 40 lbs (mostly the bad kind) and now have little energy or interest in cycling and 2 very expensive bikes are just collecting dust in the basement.

On a positive note all this was not for nothing as my wife recently gave birth to a healthy baby girl who is the light of my life. As such I want to get my fat ass back into shape so I can be the kind of dad to her that my dad was for me. My wife and I have also decided that we will not be having anymore children and TRT is on the table if I so choose.

Before I make an appointment with my Endo I am trying to find out as much as possible on the topic.

1. Is weight gain a common side effect of Clomid?

2. Can you tailor the TRT treatments more towards fat loss and maintenance vs muscle gain? Getting back down to my pre Clomid weight as well as getting my stamina and flexibility back are much more important to me than muscle gain.

3. If i start TRT will I need to be on it the rest of my life?

Thanks in advance
Tim

1. Is weight gain a common side effect of Clomid?

I have heard of this problem before. Clomid can increase estradiol no matter what you read in other forums. Higher estradiol can aid in fat gain.

2. Can you tailor the TRT treatments more towards fat loss and maintenance vs muscle gain? Getting back down to my pre Clomid weight as well as getting my stamina and flexibility back are much more important to me than muscle gain.

If you get on TRT + HCG you can remain fertile and I bet it will help you lose that weight if used along with a clean diet and exercise. I would bet you will get some energy back. Of course, it has hard to predict.

3. If i start TRT will I need to be on it the rest of my life?

Yes. You can get off it but you will go back to your low T status.

However, you can also do an experiment now. See if by any lucky chance Clomid was able to reset your HPTA by stopping it and testing your testosterone 6 weeks later. You never said what your T level is on Clomid. Some young guys get lucky and remain with TT over 500 ng/dL after stopping Clomid after post cycle therapy. Only one way to find out.

I wish I could remember what my T levels were after I started the Clomid, it was just so long ago and low T wasn't really my main focus at the time.

I mean your T ON Clomid

It would be good to see your baseline numbers, not only for test serum, but free test (or SHBG can calculate it), E2, and LH & FSH, along with any others?

Clomid promotes endogenous LH & FSH, which thereafter signals the production of testosterone (LH) & sperm (FSH). As Nelson noted, this can be mimicked with HCG, which covers the LH analog, and for further measure hMG, which covers both LH & FSH analogs. You wouldn't need to administer Clomid or any other SERM for that matter if you and your physician elect to start on a Test Cyp/Enath w/HCG therapy. If sperm labs are not satisfactory, you could then discuss hMG as an additional option to invoke productivity with the Sertoli cells.

Nelson Vergel said:

I mean your T ON Clomid

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Before Clomid my T level was in the low 300's and after Clomid it was in the high 400's. I don't remember any of the specifics becuase at the time low T wasn't my focus, getting my sperm count and motility up and having a baby was all that mattered.

I guess my next step should be a visit with the Endo and get tested again and go from there.

You did not seem to have a strong response to Clomid. I am glad you got your wife pregnant, which is the goal you wanted, though.

Nelson Vergel said:

You did not seem to have a strong response to Clomid. I am glad you got your wife pregnant, which is the goal you wanted, though.

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Just got off the phone with my Dr (fertility & Endo) and he going to see me on 09/22 and he also wants me to have labs done next week prior to the appointment.

I had blood work done last week and saw my endo yesterday afternoon. When I first started seeing him for fertility issues several years ago my initial T level was 220 and he started me on a course of 25mg Cloimid Daily. After several months on the Clomid I was retested and my t level was 515. I remained on the Clomid for about 2 years but stopped after my wife and I conceived. Now it has been about 8 months since being off the Clomid and my current T level is 186. Below are all the test number he felt were relevant and shared with me:

T Level - 186
FSH - 3.3
PSA - 1.6
TSH - 1.8


We discussed treatment options and he didn’t even put Clomid on the table as that is a treatment he will only use for men trying to conceive. He also told me that in his opinion pills, gels & patches just don’t work and his preference for his patients is injections. He recommend either HCG injections 2 to 3 times per week, or a bi-weekly testosterone injection. Either of which I will be able to do myself at home. After some discussion I opted to go with the T injection and was given a Rx for Depo-Testosterone, 100mg every other week to start. After my 2nd injection he wants me to get blood labs done the following day and then see him later that week to review my numbers and make any adjustments needed. Even if the 100mg dosage is enough I may ask to take 50mg weekly instead of 100mg bi-weekly. I am also going to see how he feels about putting me on a slightly higher dosage cycle to help jump start some weight loss and then taper down to a lower maintenance dosage.

100mg bi weekly is a weird dose and a weird schedule. 50 mg per week is likely to leave you in a Low T status, which is why doctors almost always start folks off on 100mg per week. Going weekly as you already suggested is better than bi-weekly, but 50mg per week is unlikely to make you feel good.

ERO said:

100mg bi weekly is a weird dose and a weird schedule. 50 mg per week is likely to leave you in a Low T status, which is why doctors almost always start folks off on 100mg per week. Going weekly as you already suggested is better than bi-weekly, but 50mg per week is unlikely to make you feel good.

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I agree completely with this statement. Fifty milligrams per week is a dose that is likely to leave you feeling worse than you do now. What natural production your body is engaged in will shut down, but you'll have insufficient exogenous testosterone in your system to close the gap.