I just just seen a video of Nelson discussing how a recent study showed that Clomid was effective in maintaining LH and FSH somewhat while on TRT. I am definitely going to add Clomid or Enclomiphene to TRT to see if this is maintained.
Do you have the link? Dr. Saya has stated that in rare cases he sees a little LH/FSH activity with the TRT/Clomid combination. But for most the HPTA shutdown is complete. The reason is that TRT causes strong negative feedback, both at the pituitary from estradiol, and at the hypothalamus from testosterone and estradiol.
Vince
Super Moderator
I’ve always thought of trying Enclomiphene, along with my trt protocol. Just to see what results I would get.
Do you have the link? Dr. Saya has stated that in rare cases he sees a little LH/FSH activity with the TRT/Clomid combination. But for most the HPTA shutdown is complete. The reason is that TRT causes strong negative feedback, both at the pituitary from estradiol, and at the hypothalamus from testosterone and estradiol.
Seems to be misstated. The study cited is: Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study
The three arms are 50 mg clomiphene daily, 5000 IU hCG twice weekly, or both. They find little difference between the three arms:
So there's still no rigorous evidence showing HPTA activation when clomiphene is used with TRT. It would be expected when the TRT dosing is low enough, but most men dose well on the high side of normal.
The three arms are 50 mg clomiphene daily, 5000 IU hCG twice weekly, or both. They find little difference between the three arms:
In conclusion, CC alone may be an option for men with hypogonadism when maintenance of fertility is desired. Published data show that CC is a safe and efficacious drug to use as an alternative to exogenous testosterone and our data suggest it is as effective in this patient group as either hCG alone or a combination of hCG and CC.
So there's still no rigorous evidence showing HPTA activation when clomiphene is used with TRT. It would be expected when the TRT dosing is low enough, but most men dose well on the high side of normal.
Vince
Super Moderator
There has been a very limited study published on the use of Clomid with TRT:
Clinical Practice Guidance for the use of Clomiphene Citrate in Male Hormone Replacement Therapy (HRT)
Clinical Practice Guidance for the use of Clomiphene Citrate in Male Hormone Replacement Therapy (HRT)
Limited indeed. It is a case study of one guy.
For what it is worth, I have been using .125 testosterone cypionate, and 2000 IU HcG x 3 each week.
Also 25mg of Clomiphine daily.
Only issue I have had high Hemoglobin/Hematocrit.
So I reduced to .1 testosterone 2 x week and those numbers are reducing.
One GREAT benefit is that, it took a couple years, but testicular hypertrophy has occured and almost back to my 18 yr old size at 71.
Also 25mg of Clomiphine daily.
Only issue I have had high Hemoglobin/Hematocrit.
So I reduced to .1 testosterone 2 x week and those numbers are reducing.
One GREAT benefit is that, it took a couple years, but testicular hypertrophy has occured and almost back to my 18 yr old size at 71.
bullseye55
New Member
I have some experience with both clomiphene and enclomiphene along with HCG and 1 gram of topical TRT 2% (bit of DMSO added to enhance absorption). Before starting the clomiphene and then enclomiphene my LH and FSH were both <0.2 at the time I was using the TRT and HCG. I dropped the TRT for a month and started clomiphene 25mg/day and anastrozole 0.125mg every 3 days with the HCG. After following this new regimen my LH was 1.2 and FSH 2.6 after a month. The total T and free T were lower without the TRT but the levels were higher than just HCG alone. I reduced the clomiphene to 12.mg and after another 30 days LH was 3.4, FSH 4.4. The lower dose of clomiphene dropped the T levels but bumped the LH and FSH. Enclomiphene 25mg gave similar results to clomiphene 25mg. I did stop the anastrozole for a bit and E sensitive came back as 39 so I went back on at a 0.1mg every 3 days. Enclomiphene 25mg seemed to give me a bit of climax issues so I backed off to 12.5 and added back in the 1gm of TRT since the 12.5 dosages were not as impactful on the T levels. The latest lab day which reflects the TRT/HCG/Enclomiphene/Anastrozole had LH 2.2 FSH 6.4. So TRT with enclomiphene or clomiphene can raise LH/FSH. My biggest objection to either is my SHBG almost doubled from 42 to around 80. Dosage adjustments in the enclomiphene or clomiphene didn't change the increase in SHBG. Boron has been ineffective too. The result of the higher SHBG has been my free T is more in the mid-range vs higher upper end. Not sure if this is a good trade-off. I would say enclomiphene/clomiphene might be one of those situations where less is more. I am trying to figure out if any of this contributed to a DVT diagnosis. i have been on hormone replacement (either T or T/HCG for almost 5 years) with no issues and this was my first experience with clomiphene/enclomiphene. So I might drop it as a precaution, see my SHBG go down and free T back up. I have noticed my testicles hang a lot lower with the enclomiphene/clomiphene. I can't really detect any size change from just the HCG alone vs adding one of these other two agents.
@bullseye55, my guess is you're maintaining HPTA activity due to the relatively low amount of exogenous testosterone. If absorption is the typical 10% for topical applications then you're getting 2 mg. Maybe the DMSO bumps it up a bit. You've reduced negative feedback from estradiol with the SERM and AI.
bullseye55
New Member
I have found with the DMSO I get similar blood levels of T with just 1 gram of the 2% vs the 5 grams I would apply before. I have read that absorption can approach 100% or about 10 times the average 10%. In my experience I would say 5x. It sure cuts the cost plus the area of application is much smaller. One benefit that I can't confirm is that with DMSO it is in the body faster so the transfer potential to other persons is reduced to a smaller window. I might drop the EC for a month, get some labs and see if the SHBG goes back in the low 40s and free T comes up. If that happens I will probably stop the EC permanently. I am trying to maintain T around 800 and free T in the upper 25% of the range. I seem to get the benefits in that range and it doesn't jack up the hemoglobin/hematocrit quite as dramatically or quickly. I appreciate your input. Maintaining some HPTA activity even without fertility concerns is probably a good thing. Just wish SHBG was not driving down free T.
Nelson Vergel
Founder, ExcelMale.com
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