Natesto + Clomid

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BigBeard411

New Member
I have been on Natesto for about a year...it works ok and worked far better the first month or two. My natural levels are in the 400s, and natesto doesn't seem to boost it much (unless the timing after blood draw is not optimal). I did get stronger over the year and built additional muscle (been lifting over 10 years). I am 36 and haven't had children yet so i am reluctant to do injections.

Lately I've been getting fluctuations in mood/energy, but more importantly, i have low libido. I haven't had morning wood for months.

I mentioned this to my doctor and she wants to add 50mg clomid 3x a week to my current Natesto regimen and then check my blood in 6 weeks.

Does this seem like a good idea?

My last blood work showed:
DHEA 522 ug/dL...i think natesto raised this.
Prolactin 8.3 ng/mL
Testosterone 420ng/dL
Free test calculated 72.21% (24 to 110 range)
SHBG 20nmol/L
E2 16.2 pg/mL
LH 2.6 mIU/mL

From what I've read, clomid will raise shbg and e2. Should i bother messing with this? Generaly, libido would get worse? She said some people respond well to clomid. My issue always was my LH was not that high.

Is it with trying for a month? My concern is that shbg and e2 will go too high. How long will it take for those to drop if the numbers after 6 weeks are not favorable and i continue only with natesto? I wanna avoid taking more medicine, like an AI.
 
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Cataceous

Super Moderator
With Natesto, testosterone should be measured about an hour after taking a dose. Your number is a bit lower than average, but free testosterone is still ok. It could be interesting to experiment with a SERM, but I would start with lower doses of clomiphene, e.g. 12.5 mg 3x a week. If it's estrogenic action you're lacking then clomiphene will boost it. But if you don't need it or like the results then you'll be stuck with it for a while, because the zuclomiphene isomer has a very long half-life, sometimes given as a month or so. Your SHBG is on the low side, so no harm in getting a boost there; contrary to popular belief, rising SHBG does not lower free testosterone in normal circumstances.

If you want to try the experiment without the boost in estrogenic activity then you would need to find a source for enclomiphene. Rumor has it that Empower is still selling it. If not then it may not be possible to obtain a pharmaceutical grade product.
 

Fortunate

Well-Known Member
@BigBeard411, as one of the only other consistent Natesto users around, I’ve been wondering how you were doing. My experience is similar to yours in that I get little to no side effects. I feel decent on it, but often feel myself lacking some thing. It’s hard to pinpoint what it is. I also sometimes wonder if I’m getting a consistent dose from one application to the next. I have even suspected that some tubes are not as potent as other tubes. For these reasons, I have wandered off of it many times and tried something else. I then tend to get side effects, wind back up on it for a while, only to feel like I’m lacking something again. For what it’s worth, my peak levels are around yours. Maybe a touch higher when I measured an hour after my dose in the morning.

In the past, I used hCG with Natesto. It seemed to work well. I suspect the hCG provided me a baseline of testosterone production and the Natesto supplemented it. I went off hCG a while ago, and every time I’ve tried to get that magic back, I get really anxious on hCG so I haven’t been able to replicate this protocol.

You might consider hCG instead of clomiphene. The potential for visual disturbance that some have reported with clomiphene is a nonstarter for me.
 

BigBeard411

New Member
@Fortunate @Cataceous Yeah, Natesto is great for 0 side effects. I did take blood about 45 minutes after administration, but maybe my nose absorbs it at a different rate. I do think it does work, just obviously not as well as injections. Strength/muscle size has increased - considering I have been working out so many years, it is impressive. However, this is due to simply having more energy than prior to Natesto treatment, resulting in better results in the gym. Considering HcG worked well for you, Clomid might work well for me too. The doctor started someone else on a similar protocol recently. I have been to a few doctors and generally, none of them seem to concerned about the vision side effects of Clomid, but do mention mood/breast tenderness.

What dose of hCG did you take? You got it from Empower (what did it cost you monthly)? You only went off of it due to anxiety?

This doctor claims 50mg 3x per week gives good results with minimal side effects, and she advised I keep taking Natesto. I took my first pill last night and have been going back and forth about my decision. The rare visual side effects are concerning. However, there have been people on it for years without issue. I am also concerned about returning estrogen/shbg to baseline after cessation, which takes about a month as you say? I have a conference to attend in a couple of months and don't want to feel horrible during it due to hormone issues.

I would hate to disrupt how I feel now since I feel decent, other than libido issues. It takes a lot of work to get it up and as i said, no random erections and sex is not on my mind. Sensitivity greatly decrease too. I think this may be due to a drop in E2 and increase in Test, prior to starting Natesto a year ago.

Before I began Natesto, my Test was at 290 and my E2 was at 25. I had very strong sex drive with those numbers. I would have sex multiple times a day and have random erections/sexual thoughts. Now i feel like I don't need to have sex at all. Very strange. It is strange my E2 also fell after Natesto.
 

Fortunate

Well-Known Member
@Fortunate @Cataceous Yeah, Natesto is great for 0 side effects. I did take blood about 45 minutes after administration, but maybe my nose absorbs it at a different rate. I do think it does work, just obviously not as well as injections. Strength/muscle size has increased - considering I have been working out so many years, it is impressive. However, this is due to simply having more energy than prior to Natesto treatment, resulting in better results in the gym. Considering HcG worked well for you, Clomid might work well for me too. The doctor started someone else on a similar protocol recently. I have been to a few doctors and generally, none of them seem to concerned about the vision side effects of Clomid, but do mention mood/breast tenderness.

What dose of hCG did you take? You got it from Empower (what did it cost you monthly)? You only went off of it due to anxiety?

This doctor claims 50mg 3x per week gives good results with minimal side effects, and she advised I keep taking Natesto. I took my first pill last night and have been going back and forth about my decision. The rare visual side effects are concerning. However, there have been people on it for years without issue. I am also concerned about returning estrogen/shbg to baseline after cessation, which takes about a month as you say? I have a conference to attend in a couple of months and don't want to feel horrible during it due to hormone issues.

I would hate to disrupt how I feel now since I feel decent, other than libido issues. It takes a lot of work to get it up and as i said, no random erections and sex is not on my mind. Sensitivity greatly decrease too. I think this may be due to a drop in E2 and increase in Test, prior to starting Natesto a year ago.

Before I began Natesto, my Test was at 290 and my E2 was at 25. I had very strong sex drive with those numbers. I would have sex multiple times a day and have random erections/sexual thoughts. Now i feel like I don't need to have sex at all. Very strange. It is strange my E2 also fell after Natesto.
I actually did not go off of hCG for anxiety. I went off of it because I got tired of the daily injections, and now that I try to go back on it, it produces anxiety. When I was taking it out on 100 IU per day.
 

Fortunate

Well-Known Member
Sorry, forgot to answer your other question. I was on Pregnyl, which I got from a local, small pharmacy. No problems filling it with a prescription from my local doctor. It is kind of expensive. I want to say around $120-150 for a 10cc vial. That said, you can use that vial until it is no longer potent, which is probably 2 to 3 months.
 

Fortunate

Well-Known Member
@BigBeard411, I don't want to hijack your thread, but it's a good opportunity to compare notes. The last time I checked T levels on Natesto, I drew labs 45 minutes after my AM dose. Total T was 497 (not terrible) and free T was 67.5 (46-224). BUT, I was also only two weeks out of using a 50mg injection of enanthate and two weeks after stopping regular hCG use.

On another note, have you ever suspected a tube was less potent than it should be? Sometimes I have felt great on Natesto, other times not. I have had a few times when I felt like I was not getting any treatment at all. One possible explanation is an issue with the actual medicine (the tube).

Another possible issue is whether or not you absorb it consistently. I try to clear the nasal passages with a Kleenex and periodically, saline rinse. Even so, I doubt I get the exact same dose with every application. I also wonder about nose hair. I know - it sounds gross. But, is that something you have to think about? Is it necessary to trim nose hair to maximize absorption? Curious if you've considered these things, and if so, what your thoughts are?
 

Willyt

Well-Known Member
I would hate to disrupt how I feel now since I feel decent, other than libido issues. It takes a lot of work to get it up and as i said, no random erections and sex is not on my mind. Sensitivity greatly decrease too. I think this may be due to a drop in E2 and increase in Test, prior to starting Natesto a year ago.

Before I began Natesto, my Test was at 290 and my E2 was at 25. I had very strong sex drive with those numbers. I would have sex multiple times a day and have random erections/sexual thoughts. Now i feel like I don't need to have sex at all. Very strange. It is strange my E2 also fell after Natesto.
If you had strong libido at your natural T levels, why are you taking Natesto? Is the modest gym bump worth losing your natural libido?

Many of us jump onto TRT train in hope of regaining lost libido. But unfortunately, TRT is no miracle cure for that
 

BigBeard411

New Member
@BigBeard411, I don't want to hijack your thread, but it's a good opportunity to compare notes. The last time I checked T levels on Natesto, I drew labs 45 minutes after my AM dose. Total T was 497 (not terrible) and free T was 67.5 (46-224). BUT, I was also only two weeks out of using a 50mg injection of enanthate and two weeks after stopping regular hCG use.

On another note, have you ever suspected a tube was less potent than it should be? Sometimes I have felt great on Natesto, other times not. I have had a few times when I felt like I was not getting any treatment at all. One possible explanation is an issue with the actual medicine (the tube).

Another possible issue is whether or not you absorb it consistently. I try to clear the nasal passages with a Kleenex and periodically, saline rinse. Even so, I doubt I get the exact same dose with every application. I also wonder about nose hair. I know - it sounds gross. But, is that something you have to think about? Is it necessary to trim nose hair to maximize absorption? Curious if you've considered these things, and if so, what your thoughts are?
Fortunate, I spent a lot of time thinking about this. I read all the research papers I could find (I am a researcher by trade) on Natesto. I came to the conclusion that anatomical differences in a person's nose will greatly, and obviously, impact Total T after dosing (45min post administration). Placement of gel also impacts absorption in terms of speed. However, it seems like the recommend applying it to the soft tissue (basically interior lateral side of nostrils) where there is less vasculature. I think this may slow the absorption rate and allow for a broader spike and decline, as opposed to applying deeper inside (think about how people snort drugs) which prob causes a very quick and high peak that will also drop quickly. We need more sustained levels to feel better.

Sure, mucus can certainly affect absorption if it lines your nose. I think the brochure does advise to blow your nose prior to application. Hair may impact it, as some gel can cling to your hair as opposed to the wall of the nose. If you have a forest in there, then sure, use a nose trimmer.

And yes, i do notice variability in tubes. Not sure about dosage, but early on I did notice the amount coming out was not consistent. I complained a few times about this, but lately, things have been perfect with the tubes.

I did notice on natesto that my free T is higher than prior to Natesto usage, and it keep increasing every few months when I get blood work.

I took my 4th dose of clomid yesterday, (50mg 3x per week) and so far I have been feeling pretty great. Too soon to tell if this will persist. If you read below, you will see prior to TRT my test and LH fluctuates to below normal levels persistently, which resulted in many years of fluctuations energy/mood/focus.

If you had strong libido at your natural T levels, why are you taking Natesto? Is the modest gym bump worth losing your natural libido?

Many of us jump onto TRT train in hope of regaining lost libido. But unfortunately, TRT is no miracle cure for that
Well libido is not the only thing. Over the past few years, my body has been feeling more and more run down. Worst symptom was probably severe brain fog and lack of energy/motivation. I work in a field that requires a lot of focus and mental clarity. My work progress greatly stagnated because of how bad I felt. I became very irritable too; this strained my relationships.

I had day to day fluctuations - sometimes I felt great and other times I felt absolutely horrible. It was the dips into feeling "horrible" that made me consider TRT for a long time - something I thought about for years.

After multiple test I found my testosterone fluctuates quite a bit - from low 200s to mid 400s. I think when I feel bad, it is when the test is low. Once I began Natesto, I no longer experienced any of the symptoms above for some months. It did work great, but it does not boost your T anywhere near TRT levels and symptom relief varies on absorption and current levels. I think this is my issue since my levels fluctuate a lot. Some days i would literally feel like a mental zombie all day.

The only thing I had going for me was the mental libido - it was always great.

I know my balls still work, but something was wrong. I did find out I had high prolactin, which now normalized, and it is not from a tumor. So it could be something wrong with my brain, and not my balls. My LH and FSH levels are the same as they were one year ago prior to treatment (on the low end). This is why I also opted for a therapy that does not shut you down - Natesto.
 

BigBeard411

New Member
Hello, some updates since trying clomid + natesto.

I was on this protocol for 6 weeks and then tested. I felt very high energy levels but i began reading too much about negative sides, mainly eye issues. I always had minor floaters but i think paranoia made my hypersensitive to them now, so i decided to stop until i can get some enclomiphene from somewhere.

One thing to note is my igf-1 went from 180 to 100 after clomid...is this enough reason to quit? However, I also began intermittent fasting and calorie restriction, so maybe that has some effect?

Anyways, my results show my T total and free is sky high, and my LH is not insanely elevated. If only my body could produce these levels of LH without clomid.

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Fortunate

Well-Known Member
Hello, some updates since trying clomid + natesto.

I was on this protocol for 6 weeks and then tested. I felt very high energy levels but i began reading too much about negative sides, mainly eye issues. I always had minor floaters but i think paranoia made my hypersensitive to them now, so i decided to stop until i can get some enclomiphene from somewhere.

One thing to note is my igf-1 went from 180 to 100 after clomid...is this enough reason to quit? However, I also began intermittent fasting and calorie restriction, so maybe that has some effect?

Anyways, my results show my T total and free is sky high, and my LH is not insanely elevated. If only my body could produce these levels of LH without clomid.

View attachment 32762
Did you feel better than on Natesto alone? How long after your Natesto dose was this blood draw?
 

BigBeard411

New Member
Did you feel better than on Natesto alone? How long after your Natesto dose was this blood draw?
yes i had a lot more energy than natesto alone. never felt run-down. could workout 6-7 days per week without issue. this was 1 hour after natesto dosing. keep in mind, my levels were 400-450 with natesto 1 hour after dosing before clomid.

i thought my LH would be higher with clomid; would this suggest my pituitary doesn't pump out too much LH? i thought clomid would raise levels to high end of normal or above.

i also got diagnosed with mild sleep apnea (~15 events per hour) and have an appointment in a couple of weeks to get a mouth guard made. God-willing my hormones will rebalance and I can be free from taking medicine.
 

MegaMan NT

New Member
yes i had a lot more energy than natesto alone. never felt run-down. could workout 6-7 days per week without issue. this was 1 hour after natesto dosing. keep in mind, my levels were 400-450 with natesto 1 hour after dosing before clomid.

i thought my LH would be higher with clomid; would this suggest my pituitary doesn't pump out too much LH? i thought clomid would raise levels to high end of normal or above.

i also got diagnosed with mild sleep apnea (~15 events per hour) and have an appointment in a couple of weeks to get a mouth guard made. God-willing my hormones will rebalance and I can be free from taking medicine.
Heyy how are you feeling. My Urologist also prescribed me Clomid and prescribed me Natesto but not to use them in conjunction as it can cause blood clots. Idk if its true but ive only been taking 25 mg of clomid EOD and my test showed 600 levels (pre-clomid 200). I have a few months supply of Natesto unopened.
 

BigBeard411

New Member
Heyy how are you feeling. My Urologist also prescribed me Clomid and prescribed me Natesto but not to use them in conjunction as it can cause blood clots. Idk if its true but ive only been taking 25 mg of clomid EOD and my test showed 600 levels (pre-clomid 200). I have a few months supply of Natesto unopened.
Hi; I no longer use clomid because I began getting a lot of floaters. It did dramatically increase my testosterone levels, and my trough from last dose resulted in testosterone levels of 1000ng/dL. I felt great at first but honestly after i had so much energy I felt slightly manic.

I also no longer use Natesto. I have been feeling like quite well lately with good gym recovery and strength gains without exogenous test. I will make a doctors appointment in a month or so to check my new baseline levels. I think initially my levels plummeted due to the covid vaccine I was forced to take - maybe my levels are slowly recovering.

I think Natesto will only work for you if you have extremely low levels to make you feel normal. I know a couple of people on a trt injectable regiment and I see their dramatic improvement in muscle and leanness. I don't think anything can come close to injectables as you will be at peak physiological range. IT is something I will consider once I am done having children.
 

MegaMan NT

New Member
Hi; I no longer use clomid because I began getting a lot of floaters. It did dramatically increase my testosterone levels, and my trough from last dose resulted in testosterone levels of 1000ng/dL. I felt great at first but honestly after i had so much energy I felt slightly manic.

I also no longer use Natesto. I have been feeling like quite well lately with good gym recovery and strength gains without exogenous test. I will make a doctors appointment in a month or so to check my new baseline levels. I think initially my levels plummeted due to the covid vaccine I was forced to take - maybe my levels are slowly recovering.

I think Natesto will only work for you if you have extremely low levels to make you feel normal. I know a couple of people on a trt injectable regiment and I see their dramatic improvement in muscle and leanness. I don't think anything can come close to injectables as you will be at peak physiological range. IT is something I will consider once I am done having children.
Thank you for your response. Keep me informed on your test levels then.
 
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