do you use clomid with TRT?

gerardo

Member
Good morning everybody. After reading several posts I would like to take this discussion. To keep the HPG axis less suppressed with TRT does anyone have experience or use low doses of clomid or tamoxifen during TRT? Would it be an alternative to using HCG with TRT?
Thanks
 

Cataceous

Super Moderator
For most this will not work. Negative feedback from testosterone still disables the hypothalamus, keeping the axis inactive. Until there's a SARM that blocks androgens only at the hypothalamus the best one can do is bypass it by injecting GnRH or maybe kisspeptin. In this case a SERM is sufficient to keep the pituitary active and producing gonadotropins.
 

gerardo

Member
For most this will not work. Negative feedback from testosterone still disables the hypothalamus, keeping the axis inactive. Until there's a SARM that blocks androgens only at the hypothalamus the best one can do is bypass it by injecting GnRH or maybe kisspeptin. In this case a SERM is sufficient to keep the pituitary active and producing gonadotropins.
In the case of the hypothalamus and if you make single and daily applications of gnrh, can you not also suppress it since the release is pulsatile throughout the day?
In this case, would the serm maintain the pituitary gland and logically sperm production and prevent testicular atrophy, for example? What dose of clomid or tamoxifen would be needed for this? I don’t put enclomiphene because in my country it doesn’t have it.
 

Jon H

Member
I use low-dose tamoxifen (10mg every 2-3 days) with TRT, but not to keep the axis less suppressed. I'm very sensitive to any sort of elevated estrogen, so the primary reason is to suppress gynecomastia.
 

gerardo

Member
I use low-dose tamoxifen (10mg every 2-3 days) with TRT, but not to keep the axis less suppressed. I'm very sensitive to any sort of elevated estrogen, so the primary reason is to suppress gynecomastia.
Thanks Jon H. How long have you used tamoxifen in this way? Did you have side effects like loss of libido or increased serum estradiol? With that dose of tamoxifen, your testicle was less stunted? Thank you for your participation.
 

Jon H

Member
Gerardo - I'm not sure my use of tamoxifen would be relevant to your situation. I'm extremely primary hypogonadal, so I have to use a pretty high dose of HCG to keep my POS testicles from shrinking. If I use it, they stay average size. If I don't use it, they will literally shrink to the size of small raisins, to the point of feeling non-existent. Tamoxifen use has had no positive impact in that area, and I doubt it would for most men.

I've been using tamoxifen tablets for about two months. I was using topical tamoxifen thru Defy Medical, but found that oral tamoxifen (thru Defy as well) worked better for gynecomastia suppression. It's also allowed me to use a much smaller dose of anastrozole. My libido is always great on TRT, but I will say that tamoxifen has helped alleviate ED to some degree. Any elevation of estrogen always causes problems in that area.

Regarding elevated serum estradiol level: I'm scheduled for labs in June, so won't know until then what my estradiol levels are. If you search the forum I believe the use of Clomid and/or Tamoxifen with TRT, to minimize suppression of HPTA, has been discussed a few times. If I remember correctly there were some comments from at least one doctor that said it simply didn't work well to stop suppression of LH and FSH in the patients that tried it.
 

gerardo

Member
Gerardo - I'm not sure my use of tamoxifen would be relevant to your situation. I'm extremely primary hypogonadal, so I have to use a pretty high dose of HCG to keep my POS testicles from shrinking. If I use it, they stay average size. If I don't use it, they will literally shrink to the size of small raisins, to the point of feeling non-existent. Tamoxifen use has had no positive impact in that area, and I doubt it would for most men.

I've been using tamoxifen tablets for about two months. I was using topical tamoxifen thru Defy Medical, but found that oral tamoxifen (thru Defy as well) worked better for gynecomastia suppression. It's also allowed me to use a much smaller dose of anastrozole. My libido is always great on TRT, but I will say that tamoxifen has helped alleviate ED to some degree. Any elevation of estrogen always causes problems in that area.

Regarding elevated serum estradiol level: I'm scheduled for labs in June, so won't know until then what my estradiol levels are. If you search the forum I believe the use of Clomid and/or Tamoxifen with TRT, to minimize suppression of HPTA, has been discussed a few times. If I remember correctly there were some comments from at least one doctor that said it simply didn't work well to stop suppression of LH and FSH in the patients that tried it.
Got it, Jonh. Thanks. I read that serum estradiol increases with tamoxifen and libido decreases (more with clomid) but in low doses I couldn't find many studies. Let's wait for more people to experience it. I think this is a very important subject.
 

gerardo

Member
For most this will not work. Negative feedback from testosterone still disables the hypothalamus, keeping the axis inactive. Until there's a SARM that blocks androgens only at the hypothalamus the best one can do is bypass it by injecting GnRH or maybe kisspeptin. In this case a SERM is sufficient to keep the pituitary active and producing gonadotropins.
What would be the best solution to maintain testis size without using Hcg? Hcg definitely gives me a horrible headache.
 

gerardo

Member




 

Cataceous

Super Moderator
What would be the best solution to maintain testis size without using Hcg? Hcg definitely gives me a horrible headache.
Natesto instead of conventional TRT. But if you're on regular TRT then the alternatives to hCG are less practical. They include hMG or GnRH therapy.

Does anyone use clomid together with TRT?
In general it will not work. In those studies you cite, tamoxifen plus oral testosterone undecanoate works because oral testosterone undecanoate alone is not very suppressive:

By and large, administration of T undecanoate as a single treatment had no inhibitory effect on pituitary activity, and its combination with TAM did not change FSH secretion.[R]​

In contrast, our conventional TRT methods are highly suppressive, be they injections, transdermal products or pellets.
 

gerardo

Member
Natesto instead of conventional TRT. But if you're on regular TRT then the alternatives to hCG are less practical. They include hMG or GnRH therapy.


In general it will not work. In those studies you cite, tamoxifen plus oral testosterone undecanoate works because oral testosterone undecanoate alone is not very suppressive:

By and large, administration of T undecanoate as a single treatment had no inhibitory effect on pituitary activity, and its combination with TAM did not change FSH secretion.[R]​

In contrast, our conventional TRT methods are highly suppressive, be they injections, transdermal products or pellets.
Do you think that using Clomid or tamoxifen in small doses during TRT would not keep LH and FSH at normal levels and consequently the amount of sperm?
 

Cataceous

Super Moderator
He keeps citing the same study. Clearly oral testosterone undecanoate is a different animal. But it seems to have resisted widespread adoption, perhaps in part because it is not very effective. The limited anecdotal reports on the forums are generally negative.

...
Do you think that using Clomid or tamoxifen in small doses during TRT would not keep LH and FSH at normal levels and consequently the amount of sperm?
Repeating, for most men SERM's are ineffective at HPTA stimulation when used with conventional TRT. The androgenic suppression of the hypothalamus is unrelenting.
 

Cataceous

Super Moderator
How does natesto not have the HMG protocol here? Isn't the cost too high? Would Gnrh be gonaderoline?
Rephrase the first question; it's unclear. The cost of hMG is relatively high, which is why I said it's less practical. Also, frequent injections would give more natural results, which is also the case with GnRH/gonadorelin. This is another point against practicality for either treatment.
 

Trip McNeely

New Member
Natesto instead of conventional TRT. But if you're on regular TRT then the alternatives to hCG are less practical. They include hMG or GnRH therapy.


In general it will not work. In those studies you cite, tamoxifen plus oral testosterone undecanoate works because oral testosterone undecanoate alone is not very suppressive:

By and large, administration of T undecanoate as a single treatment had no inhibitory effect on pituitary activity, and its combination with TAM did not change FSH secretion.[R]​

In contrast, our conventional TRT methods are highly suppressive, be they injections, transdermal products or pellets.
Why would Natesto not cause testicular shutdown? It's just another form of exogenous testosterone, like injections or creams.
 

Cataceous

Super Moderator
Why would Natesto not cause testicular shutdown? It's just another form of exogenous testosterone, like injections or creams.
If you do a forum search for it you'll see that @madman has posted a lot of the research on it. What differentiates it from other forms of exogenous testosterone is its short half-life. It's dosed three times a day, each resulting in a fast rise in serum testosterone, which then drops to baseline within hours. The relatively short duration of the pulses and the time spent at baseline levels lead to reduced suppressive effects and continued functioning of the HPTA.
https://www.excelmale.com/forum/threads/acerus-pharmaceuticals-natesto®.23251/
 

gerardo

Member
Rephrase the first question; it's unclear. The cost of hMG is relatively high, which is why I said it's less practical. Also, frequent injections would give more natural results, which is also the case with GnRH/gonadorelin. This is another point against practicality for either treatment.
Here in Brazil we don't have Natesto. Would a solution be Hmg?
 

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