Restart Update: Low Dose Clomid

[Dr Justin Saya MD]

Took 2g Taurine and cramps almost gone, much improved. Now to figure half life of arimidex 0.75mg that I took Wed night to reconcile labs today.

Good with the Taurine.

Half-life of arimidex is about 2 days (46-52 hours depending on source). Meaning after 2 days 50% remains in system, after 4 days 25% remains in system, after 6 days 12.5% remains, after 8 days 6.25% remains...if you were NOT on anastrozole already, then I would wait a solid week after taking it to allow the majority to exit your system before having your draw.

 

[Dr Justin Saya MD]

If you already had your draw...it's going to be very difficult to interpret your numbers having taken the 0.75mg arimidex 2 days ago (unless your levels are very high).

 

[skycop00]

Understood. I felt so bad I was impulsive.

 

[Dr Justin Saya MD]

I was impulsive.

That may indicate your T is up ;-)

 

[Weasel]

Understood. I felt so bad I was impulsive.

Most of us have been there to some extent or another...

 

[Xerxes]

As always thanks for lending your expertise to the board and to me as a patient. I totally get my options if teh Clomid does not work out for me.

I guess my wife and I are leery of TRT b/c I really wasn't doing well on it.


The question now is IF the Clomid doesn't work, what option do we choose (and I'm willing to be patient with the Clomid):


A: when Clomid experiment is over, cease any TRT and really focus on the mental health side of things (which deep down I think is the main culprit)


or


B: when Clomid experiment is over, do I try to get dialed in with Defy, which is famous for getting guys dialed in with different, innovative, and attentive protocols, WHILE also doing psych meds and therapy


C: some other treatment


Frankly I am willing to be very patient with the Clomid therapy (in conjunction with psych meds) and if it works, great, but if not Option A I think will be the answer. And maybe down the line TRT if all else fails again..

I just want to feel better.


To honest I am feeling better today than I was yesterday or the day before...a bit more energy. I only took 1/2 Kpin instead of a whole today, which is progress

 

[Dr Justin Saya MD]

As always thanks for lending your expertise to the board and to me as a patient. I totally get my options if teh Clomid does not work out for me.

I guess my wife and I are leery of TRT b/c I really wasn't doing well on it.


The question now is IF the Clomid doesn't work, what option do we choose (and I'm willing to be patient with the Clomid):


A: when Clomid experiment is over, cease any TRT and really focus on the mental health side of things (which deep down I think is the main culprit)


or


B: when Clomid experiment is over, do I try to get dialed in with Defy, which is famous for getting guys dialed in with different, innovative, and attentive protocols, WHILE also doing psych meds and therapy


C: some other treatment


Frankly I am willing to be very patient with the Clomid therapy (in conjunction with psych meds) and if it works, great, but if not Option A I think will be the answer. And maybe down the line TRT if all else fails again..

I just want to feel better.


To honest I am feeling better today than I was yesterday or the day before...a bit more energy. I only took 1/2 Kpin instead of a whole today, which is progress

Agree Xerxes.

If it turns out that Clomid doesn't work for you (the next round of labs with the dosage change will offer some great insight), and your aversion to TRT remains, then I agree option A would likely be best.

Indeed, having ANY underlying psychiatric diagnosis (assuming the diagnosis ISN'T from hormonal abnormalities to begin with, but other causes) that is symptomatic, untreated, or under-treated will almost universally complicate any treatment regimen you partake in.

 

[GeauxBears]

Xerxes, I too started with Defy after a poorly managed TRT protocol. At 30 years old, we replaced my previous regimen with LD clomid similar to you because it's a good first option for low T in guys who want kids. After about a year, 60 days ago we stopped clomid and went TRT+HCG because while my numbers responded well, I never saw much subjective improvement on clomid. The results on TRT have been phenomenal so far, although it took a month or so to see real improvement.

I want to encourage you to consider a WELL MANAGED TRT protocol, which Defy will do for you, prior to giving up and going a different route.

I too have struggled with depression and anxiety most of my life. Sometimes it's hard to know whether low T/depression is cart vs. horse, but I can say on TRT has virtually eliminated these issues.

Obviously consult with Dr. Saya on next steps, but I just want to give you this note of encouragement as someone who has been in similar shoes.

 

[Xerxes]

Just a little update on my journey. Have been on 25Mg clomid every day for two weeks. Up from 12.5 Mg every day for about 6 weeks).

To be honest, the first half week on increased dose was rough, but then I started to feel really good again. My libido was up erections were good, energy was pretty good.

Then at the end of last week starting on Friday May 20, I started to feel that drain again, sleep issues.

Yesterday (Sunday) had a nice day in the city with my daughters and wife, saw a show, got lunch, had a few beers.

When we get home my wife is really feeling the beers and wants to give me a BJ (not uncommon for us). Starts off well, but then I lost the erection in mid act. And I had taken some cialis earlier in the weekend and even that day.

She was okay with it and it wasn't a big deal to her, but I have a hard time dealing with it...and it's just making me feel awful emotionally. I really just want to feel better and get back a normal life. I hate that my issues are affecting my wife and family.

I am still trying to get a psychiatrist appointment so I can try to start some meds (again...maybe different nmeds? mood stabilizer as oppossed to SSRIs and/or wellbutrin which I tried...but I am willing to give SRRIs a chance again). The Klonopin helps a bit with the anxiety and sometimes gets me through a bad day, but benzos can't be the long term answer.

I don't know if my issues are hormonal or brain chemistry or what...

Sorry for the rant. It's just so crazy that I feel good for a week or two and then the bottom falls out...It's kind of how it was when I was on TRT.

I cycle through highs/normal and lows pretty quickly (every few weeks or so)...hopefully I can keep on being patient with the clomid and then titrate down and just deal with the brain chemistry stuff...

If that doesn't work maybe I consider a well thought out and monitored TRT regimine...

Although my and my wife's preference is to avoid TRT b/c it reallt didn't help me when I was on it for 8 months or so...

 

[ERO]

FWIW - There is a huge difference between run of the mill TRT and WELL MANAGED TRT like you would get with Defy. I would not write it off without giving it a fair shot.

 

[Xerxes]

So I think I might try to titrate down (and off) the Clomid with the supervision of Dr. Saya and Defy, of course. When I bumped up to 25 mg/day about two weeks ago, after a few days I felt a bit better, but now I am feeling very low and depressed with ZERO libido. My usual problem mentally was always anxiety, and not too often this depression.

I think my wife and I are planning on ceasing all TRT, including Clomid), safely and trying to work with a new psychiatrist and my therapist to see if I can get myself better.

If all else fails, I can always go back to TRT, but I've never had any prolonged success or symptom relief. My wife and I are very leery of going back to TRT b/c of this.

There could be some other underlying cause that no endo or uro had found yet. I mean my test went from 900s to 400s from October to January with absolutely NO protocol change (120mg/week split MWF)...and no one was able to explain why. It was the exact same appointment and draw day (9am on Monday before first shot of the week).

I am so tired and feeling awful and mentally drained.

 

[Vince]

Xerxes, It must be nice to have a wife that's so understanding, I guess TRT isn't for everyone. Anxiety is tough, some has had success with yoga and meditation.

 

[Xerxes]

Thanks for the encouragement...so Dr. Saya got back to me (so incredibly attentive and caring!). I can stop the Clomis cold turkey b/c of the long half life.

I will keep you updated about how the mental health side goes.

Dr. Saya did also say that if all else fails Defy could provoide proper TRT if necessary...\

 

[PAUL-E]

I hope things go well for you but also consider TRT can have its own health benefits besides mental you might end up needing a combination of things GOOD LUCK!

 

[CoastWatcher]

I wish you all the best.

 

[Xerxes]

Hey Fellas,
Just wanted to give you an update: I just started some SSRI treatment (Lexapro 10 mg daily) and kolonopin as needed for my mental health issues. (had tried Wellbutrin and Zoloft and xanax before my TRT journey) So far, so good, but I feel pretty lethargic and my libido is pretty low, but my anxiety and depression seem a bit better. I am two weeks in to this treatment and I know it could take up to 6 weeks for full effects, so I am being patient. I am sure my T numbers are dropping as the Clomid works its way out of my system, which might explain some of the lethargy (but is also a potential side effects of the lexapro..

I was wondering about a few things:
1) Should I reorder some of the pregnenelone/Dhea caps that I had been taking when attempting my restart with the Clomid?
2) When my mental health issues are squared away I was wondering if I might give the Clomid another chance.
3) Is HcG monotherapy an option once I get my mental health stuff squared away? I felt great when I was on HcG for two weeks before starting Clomid.
4) If all else fails maybe I might be back to a well-managed TRT protocol with Defy with psychiatric treatment s well.

Thanks for any advice or support...

 

[ERO]

Did you ever get to a high enough Total T on Clomid? By high enough, I mean high enough to really feel it? if not, I'd recommend going on a TRT protocol with Defy.

Also, most guys test low for DHEA/Preg so it makes sense to keep supplementing them.

 

[Xerxes]

I only ever got to the high 380s for total T on clomid. But even when my T was in the 700s and 800s, I never felt consistently good on TRT.

I am being patient with my psychiatric treatment and then I'll wrestle with the hormone stuff if I am still symptomatic.

I think I will reorder the DHEA/preg caps, though...

 

[trt4me]

Aniexty and or depression can wreck you on ways that trt can't totally overcome.
I would include saya in your quest for resolving that with meds because he will know the history of them as to what should be avoided and how much especially when it comes to libido.
Almost everyone that has aniexty or depression, when having a good libido day will coincidencedently have neither at that time.

 

[Vitamin_C]

Hormones are only part of the equation. Diet, lifestyle, gut health, liver health etc are all key factors. Have you tried a liver detox with NAC? gut health? other prescription medications? heavy antibiotic use? I've seen people come out of depression running NAC and cleaning the liver and the gut. MTHFR gene mutation???