anyone with experience using mesterolone (proviron) to combat SHBG rise from clomid?

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Aki

Member
Hi all,

Condensed "TL;DR" version of my question: has anyone who has been on clomid to treat secondary hypogonadism tried a low dose of mesterolone (proviron) to reduce the SHBG increase ensuing from using clomid? If so, can you tell me about your experience?

Context/long version: I have secondary hypogonadism (low LH and FSH and consequently low T), something I've known for over 10 years now (although I believe symptomatically it started much earlier than that). I'm almost 43 now.

I've been on a low dose of clomid for years (except for a couple of long-ish breaks), currently using the Indian version called enclofert which apparently is enclomiphene isomer. (btw I happen to be from India but I live in the middle east.)

Clomid was originally suggested to me by the late Dr. Crisler through one of his online advice-only consultations who confirmed based on labs that it appeared I had secondary hypo. Overall, clomid has worked reasonably well for me.

Last time I was off the clomid my total test was <200. My SHBG also tends to be low naturally - in the teens (which I see is a good thing because the free-T is not as low as it otherwise would've been).
50mg/week enclo + [email protected] a day stabilises my total T at around 500-600+ and SHBG in the 40-50s.

Subjectively I actually feel "decent" at this level. (I use NOW brand boron btw but am considering trying a different brand if it makes any difference. Currently I also take Tongkat Ali, fadogia and stinging root nettle.)

The thing is, i have felt "pretty good" (noticeably better than "decent") at that same total T if my SHBG is in check (in the 20s), such as when I restart clomid after a break - until eventually the SHBG creeps back up.

Basically I'm looking for a way to lower my SHBG a bit that ideally doesn't cause too much suppression or sides.

I managed to acquire a good supply of mesterolone (Provironum brand) a while ago that has just been laying around. I'm wondering if there's a low enough dose I can take along with the clomid that can modestly improve how I feel subjectively without causing suppression or inducing too many side effects, so if anyone has been in the same boat as me and have tried proviron, I'd like to hear about it.

As a sidenote, I'll mention that several years ago I tried adding a low dose of danazol (25mg/day IIRC) on top of clomid which initially worked great; my understanding (and correct me if I'm wrong) is the drop in SHBG caused by it caused an influx of free-T into my system, so for around a month and a half I felt better than I could remember, however by the end of that period I had tanked my SHBG, and the suppression caused by proviron dominated, so I quickly went from feeling awesome to feeling terrible. So that's not an experience I wish to repeat.

Before anyone suggests it, TRT is not a viable option for me right now (for multiple reasons).

Thanks for reading!
 
Defy Medical TRT clinic doctor

JmarkH

Active Member
I've been on a low dose of clomid for years (except for a couple of long-ish breaks), currently using the Indian version called enclofert which apparently is enclomiphene isomer. (btw I happen to be from India but I live in the middle east.)
Just FYI, enclofert, even though it says enclomiphene on the cover, says clomiphene on the back under ingredients. So 50mg enclomiphene equivalent is more like 75mg clomid.

If you feel good, why are you trying to lower shbg?
 

Aki

Member
@Mastodont

I tried taking a very low dose of proviron for a couple of weeks (I think it was one 25 mg pill weekly divided into two doses). Initially I felt some improvement but later on I started feeling what I describe as my low-estrogen symptoms (the main one being my body temperature feels off) so I gave it up.

I have since experienced a substantial improvement though by switching over to Nootropic Depot's brand of 10% Tongkat Ali. I have also increased my boron dosage, and I'm also taking stinging nettle root. (I feel the main factor responsible for the improvement is the tongkat ali though.. I actually felt the improvement from day one, unlike the last two brands I tried where I couldn't even tell the difference between taking it or not.) I'm also still taking my weekly dose of enclo, not to mention several other supplements.

The feeling isn't totally consistent though, as on some days I still feel the low-estrogen symptoms. I'm still trying to find the right dosage of tongkat ali (right now I'm doing 5 days on and 2 off). I've read that tongkat ali reduces T->E aromatisation (I've also read that about proviron) so if true that might account for it.

But right now - even on the days I'm feeling slightly off - I feel better than before I made the changes I mentioned, so I'm reasonably satisfied.


@JmarkH
I said I was feeling "fairly decent" (at the time I wrote the post) which for me is of noticeably inferior quality than "pretty good".

Usually what happens if I take an extended break from clomid (which I've done a couple of times) is both my testosterone and shbg drop back to low (i.e. below reference range) values, and when I restart clomid, I feel pretty good initially (due to the quick rise of T) but over time there is a regression in the feeling of well-being and energy levels, which I've always correlated with the eventual rise of shbg causing free T levels to reduce.

I'm aware that the enclofert box says clomiphene on the back.. however, I've been informed by someone in the know that it is actually enclomiphene, but for regulatory reasons has been listed as clomiphene. (Unfortunately, I have no means of verifying this information except trusting this person; all I can say about him is he's knowledgeable and has links to pharma representatives/chemists, and his advice has helped me in the past.)
 

Mastodont

Active Member
@Mastodont

I tried taking a very low dose of proviron for a couple of weeks (I think it was one 25 mg pill weekly divided into two doses). Initially I felt some improvement but later on I started feeling what I describe as my low-estrogen symptoms (the main one being my body temperature feels off) so I gave it up.

I have since experienced a substantial improvement though by switching over to Nootropic Depot's brand of 10% Tongkat Ali. I have also increased my boron dosage, and I'm also taking stinging nettle root. (I feel the main factor responsible for the improvement is the tongkat ali though.. I actually felt the improvement from day one, unlike the last two brands I tried where I couldn't even tell the difference between taking it or not.) I'm also still taking my weekly dose of enclo, not to mention several other supplements.

The feeling isn't totally consistent though, as on some days I still feel the low-estrogen symptoms. I'm still trying to find the right dosage of tongkat ali (right now I'm doing 5 days on and 2 off). I've read that tongkat ali reduces T->E aromatisation (I've also read that about proviron) so if true that might account for it.

But right now - even on the days I'm feeling slightly off - I feel better than before I made the changes I mentioned, so I'm reasonably satisfied.


@JmarkH
I said I was feeling "fairly decent" (at the time I wrote the post) which for me is of noticeably inferior quality than "pretty good".

Usually what happens if I take an extended break from clomid (which I've done a couple of times) is both my testosterone and shbg drop back to low (i.e. below reference range) values, and when I restart clomid, I feel pretty good initially (due to the quick rise of T) but over time there is a regression in the feeling of well-being and energy levels, which I've always correlated with the eventual rise of shbg causing free T levels to reduce.

I'm aware that the enclofert box says clomiphene on the back.. however, I've been informed by someone in the know that it is actually enclomiphene, but for regulatory reasons has been listed as clomiphene. (Unfortunately, I have no means of verifying this information except trusting this person; all I can say about him is he's knowledgeable and has links to pharma representatives/chemists, and his advice has helped me in the past.)
What is your current protocol on the enclomiphene?
 

Mastodont

Active Member
50 mg/week taken over two consecutive days. (25 mg first day in the evening, 12.5 mg twice the next day)
May i ask the reasoning behind this, or you just feel good doing it like this? I was thinking of doing a twice weekly 25mg trial when i get off trt.
 

Aki

Member
May i ask the reasoning behind this, or you just feel good doing it like this? I was thinking of doing a twice weekly 25mg trial when i get off trt.
It was recommended to me by the guy who I was taking advice from. I think he gave a reason but I can't recall at the moment. Anyway, initially (as is always the case with me and clomid) I felt good so there didn't seem to be any reason to not go along with it.

I also remember reading about a once/week 50mg protocol on (the late) Dr. Crisler's forums.

However, now that I think back to a few years ago:I did 12.5mg/day for a significant amount of time, and one thing I remember is that my SHBG did not rise as much, even though I wasn't taking anything specific (like boron) to reduce it. I'd have to check my records but I also think that with the 12.5mg/day dose my T levels didn't rise to the same levels as they do with the current protocol either (meaning the free T was probably in the same range then and now).

Subjectively I remember that even with that protocol, I felt "fairly decent" (my go-to phrase to mean I'm able to function satisfactorily but there is definite room for improvement in energy and mood.) The desire to feel better is what prompted me to try danazol back then (as I talked about in my first post).
 

Cataceous

Super Moderator
Bear in mind that newer thinking says that modestly elevated SHBG is benign; it does not have a significant impact on free testosterone. That misunderstanding came about because people were thinking of total testosterone as being directly controlled by natural production or TRT dose rate. However, it's free testosterone that is driven proportionately to the rate of testosterone entering our systems. Total testosterone just follows along, also varying as a function of SHBG and albumin.
 

readalot

Member
Bear in mind that newer thinking says that modestly elevated SHBG is benign; it does not have a significant impact on free testosterone. That misunderstanding came about because people were thinking of total testosterone as being directly controlled by natural production or TRT dose rate. However, it's free testosterone that is driven proportionately to the rate of testosterone entering our systems. Total testosterone just follows along, also varying as a function of SHBG and albumin.
Cataceous should be sainted.

Saint Cataceous. Has a great ring to it.


 

Aki

Member
Bear in mind that newer thinking says that modestly elevated SHBG is benign; it does not have a significant impact on free testosterone. That misunderstanding came about because people were thinking of total testosterone as being directly controlled by natural production or TRT dose rate. However, it's free testosterone that is driven proportionately to the rate of testosterone entering our systems. Total testosterone just follows along, also varying as a function of SHBG and albumin.
I'm not sure I totally follow. But just to "think out loud" here:

If you mean (with me trying to phrase it in a drastically simplified way) that the body tries to maintain a certain level of free-T (said level being determined by genetics, environment, health, lifestyle, etc. and thus sometimes not optimal for one's needs) and other sex hormones like SHBG and total T get regulated in order to maintain that, then that does sound reasonable. With this notion in mind, two possible ways of increasing free-T are: "hijacking the HPTA" (i.e. TRT) and "tricking the body into producing more free-T" (something like clomiphene that blocks estrogen receptors). Personally, I'm only interested in the latter, as TRT is not something I consider an option right now. The problem is to make the body reach a more "acceptable" value of free-T, whether that be best achieved by lowering SHBG, or decreasing the rate of aromatisation, using an LH mimic, etc.

I think the challenge is that the body appears to "resist" such changes and manipulating some hormones will cause fluctuations in others to try to undo our attempts, until some uneasy equilibrium is reached.

Anyway, I've really run with this line of thinking, so forgive me for blathering on. :)

I should mention that my SHBG values are really "out of the range" high at the moment, not just modestly elevated - assuming the lab ranges are meaningful.
 

Cataceous

Super Moderator
...
If you mean (with me trying to phrase it in a drastically simplified way) that the body tries to maintain a certain level of free-T (said level being determined by genetics, environment, health, lifestyle, etc. and thus sometimes not optimal for one's needs) and other sex hormones like SHBG and total T get regulated in order to maintain that, then that does sound reasonable. ...
The body is basically regulating for its desired level of free testosterone. Sometimes this "set point" is off by enough to cause problems—secondary hypogonadism being a very common example. When this occurs there is no other compensatory mechanism. The HPTA is responsible for the regulation; if it thinks there's enough free testosterone then additional production is suppressed. My point above is that SHBG—not a sex hormone—does not have a significant interaction with this regulatory process. You could halve your SHBG and find that free testosterone has not changed at the new equilibrium. Conventional wisdom says that free testosterone should increase. But this would apply only if you could force total testosterone to be constant. In reality free testosterone is maintained and total testosterone is reduced. So to reiterate: lowering SHBG in isolation does not improve free testosterone.

As an aside, while SHBG doesn't drive the free hormones, the free hormones do drive SHBG. Androgens tend to reduce SHBG production, while estrogens tend to increase it.

In my opinion the safest option for increasing free testosterone is with short acting products, such as testosterone nasal gel or troches. With this "TRT-lite" the HPTA can continue to function—unlike with TRT— and you're not exposed to the possible risks in long-term tampering with estrogenic activity, which you have with SERMs and AIs.
 

sammmy

Well-Known Member
Usually what happens if I take an extended break from clomid (which I've done a couple of times) is both my testosterone and shbg drop back to low (i.e. below reference range) values, and when I restart clomid, I feel pretty good initially (due to the quick rise of T) but over time there is a regression in the feeling of well-being and energy levels, which I've always correlated with the eventual rise of shbg causing free T levels to reduce.

What you are describing sounds like chasing the so called "honeymoon period" in TRT. Every time you start a treatment that increases T, you are getting a testosterone "high" because your brain neuro-receptors are not used to such high levels. The moment the brain detects the high T levels, it downregulates the receptors and you feel "not as good" as in the beginning.

Nobody has found a way to stay in the "honeymoon" on the same dose of treatment. I've seen reports that the "honeymoon" reappears when the TRT dose is changed which again is explained by the neuro-receptor adjustment theory. Note that in TRT, you can reach any high level of free testosterone by increasing your dose and yet the brain doesn't respond because it downregulates the receptors further. So the real problem is not the SHBG or estrogen or the free testosterone but the body reaction to it.

Similarly, you cannot be constantly high on the same dose of a stimulant. Sooner or later tolerance sets in, i.e. receptors downregulate and the response is decreased. It is the natural way of the body to protect itself from too high levels of anything.
 

sammmy

Well-Known Member
If you want to get a stimulant like effect from rising T levels, you could try pulses of injectable HCG. People are complaining that as an addon to TRT or an enclomiphene-only regimen, HCG makes them feel good but interferes with sleep, which suggests a transitory testosterone high stimulant effect.

Read post #2 here:

 
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