Seeking advice TRT Vs. Clomid

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BigO42

New Member
Seeking advice.

I am 37 years old. I've been on this journey for 5-6 years after significant chronic fatigue and anxiety symptoms sought to me start doing the thorough medical work up my family doctor refused to do. Prior to any intervention my Total T levels were usually between 390-530 and free T was in the mid teens.

Prior to clomid I probably always tended towards overtraining in the gym. Heavy lifting, and marathon history also. Shift work has also had me with an abnormal sleep routine and schedule since I was about 24.

I started clomid via Defy in April of 2018 and had a solid response. I took a custom compounded 15mg clomid tablet once every 3rd day and a .08mg tablet of anastrozole once every 4 or 5 days. Within 30 days my Total T was between 750-800 and Free T was around 20. I noticed significant improvement in sleep and anxiety within the first week. I was also able to recover from workouts again like I could when I was early 20's. My lab draws stayed pretty much right there with this regimen and I felt really really solid for a couple years. In 2020 I began to cut the clomid frequency to every 4th day and continued to feel good. Anastrozole continued at about every 5th day. My lab values dipped a little bit but felt solid through 2021. 2021 was extremely stressful for various reasons but I weathered it well. In early 2022 I began having sudden and severe anxiety, insomnia and wild mood swings. I had labs drawn and my T levels were almost down to pre clomid levels. I cut clomid to every 5th day wondering if maybe I was finally experiencing the zuclomiphene isomer mood side effects. I saw slight improvement and my total T values returned to mid 600's. I cut anastrozole to every 6th day and suspected during this time that perhaps anastrozole and estrogen levels were more the problem than anything. Anxiety continued to increase until august when I experienced panic attack type episodes for the first time and had to cut clomid entirely. I have been off clomid for 90 days and have seen some improvement in the anxiety. Panic attacks stopped within 2 weeks of stopping clomid. Anxiety is still present but not as intense and I've been working on the many stressful lifestyle components as well.

Thoughts: I think estrogen and anastrozole played as much of a role as anything when it actually came to mood and anxiety. Whenever I had labs drawn any my estradiol sensitive was near 30 or slightly above, I felt great. Anything 20 or below and I usually felt not so good. This year it was usually lower and I probably should've tried stopping only the anastrozole.

Family DOC- thinks clomid was a major contributing factor and should stay off of it and not do anything to address hormones and just take an SSRI (I think this is a bad plan).

Defy thinks clomid might've become an issue and I should switch to full TRT for the T levels and symptom relief I had initially with clomid

I did consult a psychiatrist who thinks that I might have a tendency towards anxiety but thinks this highly due to circumstances and its ok to resume clomid in moderation if I felt very good for nearly 4 years on it.

I am tempted to go back to clomid 12.5 mg or 15 mg every 3rd day like I was doing for the first 2 years when I felt the best. Long term, I do have concerns about ongoing estrogen receptor manipulation with clomid, but at 37 Im hesitant go full TRT when my total T can range 400-550 unassisted. I just don't feel great there and estradiol tends low.

All other labs drawn during my clomid experienced were in healthy ranges, always. LH was nearly always mid range- consistent with secondary hypogonadism.

Any adivce? Anyone here on enclomiphene or know where I can get it perscribed? Defy states they no longer do it. I don't know why, but I am reluctant to go full TRT/HCG protocol.
 
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bixt

Well-Known Member
am tempted to go back to clomid 12.5 mg or 15 mg every 3rd day

I fully support this view.

But make sure this time the clomid is pure clomid and not laced with the AI.

12.5mg (quarter of a 50mg tablet) twice a week is the lowest possible dose and a good starting point. Can be increased to 12.5mg EOD if needed. Best to use smaller more frequent doses.

Don't stress about enclomphene (or rather, the lack of it). It was hyped and we all had so much hope for it. In the real world though, it was no better than good old clomid. Certainly not the magic bullet we all hoped for.
 

Guided_by_Voices

Well-Known Member
I also did clomid for a few years before going on TRT although I never had the anxiety issues. I have also come off of TRT and gone to clomid as well, so I think I have a pretty good sense of how they compare. I do "ok" on Clomid, but TRT, even with similar T levels, is somewhat better. After 90 days, the clomid should be pretty much out of your system so your plan of restarting makes sense. Going to TRT without exhausting other options will leave a question in your mind as to whether you could have done something else. HCG monotherapy is also a possible step to try. All that said, I would not fear TRT. It gives a lot of freedom and consistency. Also note that 30 years or so ago your T levels would have been considered low range, and what's important is the level that makes you feel best, not what a blood test says.
 

bixt

Well-Known Member
I must mention its extremely important to measure SHBG and FT before and during clomid.

It's all and well to say your TT increased, but with the predicted large upswing of SHBG, your FT may well remain not much improved.
 

Systemlord

Member
I noticed significant improvement in sleep and anxiety within the first week. I was also able to recover from workouts again like I could when I was early 20's.

free T was in the mid teens.
This doesn’t surprise me at all, mid range Free T or even lower is suggested to be perfectly normal on these TRT boards, I would hope that certain members assimilate this info and stop clinging to old outdated ideas.
I am 37 years old.
I find it strange you’re willing to go on a frankenstein drug without hesitation, but when it comes to a natural hormone, you hesitate. Testosterone declines as we age, so it can only go lower and you’ll NEVER have the testosterone you had in your 20’s. Quality of life is all that matters.

So option one, decline and age gracefully, holding on, or option two, feel young again and elevate your quality of life and watch all your peers stuggle with muscle loss, fat gain and poorer health.
 
Last edited:

bixt

Well-Known Member
This doesn’t surprise me at all, mid range Free T or even lower is suggested to be perfectly normal on these TRT boards, I would hope that certain members assimilate this info and stop clinging to old outdated ideas.

Just want to clarify with you, you mean that the old outdated ideas you refer to are that "the higher the T, the better" and that you are now in preference to mid range FT (which I what I gather is the current view, also my own).

Just so we on the same page.
 

Systemlord

Member
Just want to clarify with you, you mean that the old outdated ideas you refer to are that "the higher the T, the better" and that you are now in preference to mid range FT (which I what I gather is the current view, also my own).
No, that in range equals normal because everyone has their own normal range.
 

BigO42

New Member
I must mention its extremely important to measure SHBG and FT before and during clomid.

It's all and well to say your TT increased, but with the predicted large upswing of SHBG, your FT may well remain not much improved.
I don't have values at hand but pre clomid my shbg was always on the low end. This is why defy said I was a good clomid candidate. It crept up a little on clomid but never beyond mid range.

My theory is that given my extremely low dose of clomid my mood sides were more related to low estradiol and still using an AI, albeit minimal.
 

Guided_by_Voices

Well-Known Member
Clomid is apparently pro-estrogenic in some tissues and anti-estrogenic in others, which further complicates things. I would stay away from an AI. Why were you on it in the first place?
 

BigO42

New Member
Clomid is apparently pro-estrogenic in some tissues and anti-estrogenic in others, which further complicates things. I would stay away from an AI. Why were you on it in the first place?
Defy advised due to the pro estrogenic sides it's vital with clomid to keep estradiol well controlled. But my estradiol was always low end of mid even with the AI so maybe I'd be okay without it.
I'm just thinking as infrequently as I was taking clomid, I'm wondering if mood/ anxiety resulted from clomid at all.
 
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