From enclomiphene to TRT cream - where do I stand?

mcs · Thursday at 4:53 PM

Hey all,

I’ve been on topical TRT compounded cream (100 mg/day) for 52d now. No prior exogenous T before this. 50mg twice daily (AM/PM), rotating between behind knees, deltoids, and inner thighs. Chose to avoid transscrotal application as I didn't want to spike DHT/E2.

I was on enclomiphene at 25 mg/day for the last 2y up until the last 10d. Although it did raise TT into the mid-600s, it didn't move the needle much on FT. Recently added TRT to push further anabolic support.

Current Stats:

• Age: 65

• Height: 5'7"

• Weight: 160 lbs

• 11-12% bf (DEXA)

• ~132 lbs lean mass

• Training 5–6x/week, eating high protein (~200g/day)

• BP stable at 120–125/70

Subjective effects:

• Noticeably more morning wood and some libido increase

• No signs of DHT-related issues

• No water retention or high E2 symptoms

• No mood issues or fatigue

Symptoms (may not be related?):
• Increased joint pain in prone sites of tendinopathy (shoulders, elbows)

Concerns / Questions:

• FSH/LH not fully suppressed — perhaps from enclomiphene alongside TRT?

• SHBG hasn’t dropped, even though I assumed it might on exogenous T

• HDL dropped — likely from TRT?

• Ferritin is higher than usual — may be related to diet (heme iron supps) but keeping an eye on it

• IL-6, hsCRP and cystatin C (eGFR) are elevated (separate issue I’m tracking — possible LPS exposure months back)

• Have been on peptide regimen (BPC-157/TB500/ipamorelin/frag//cjc/tesamorelin/AOD/IGF1-LR3; split dosing; cycle off 2d/week)

Attached are most recent labs for review — curious to hear your feedback, especially on:

• Whether my current dose is optimal or needs tweaking

• Any flags in hematocrit, lipids, or hormone feedback

• Any risk in discontinuing enclo + TRT combo long-term
(FT3 is elevated due to peak serum level from dosing 2h prior to draw)

Thanks in advance.

DixieWrecked · Friday at 10:12 AM

Are you saying that your joints hurt more since starting TRT?

Seagal · Friday at 1:10 PM

"Increased joint pain in prone sites of tendinopathy (shoulders, elbows)."

Did your strength and workload increase (faster) since adding TRT?

FunkOdyssey · Friday at 1:54 PM

mcs said:
Symptoms (may not be related?):
• Increased joint pain in prone sites of tendinopathy (shoulders, elbows)

Concerns / Questions:
• FSH/LH not fully suppressed — perhaps from enclomiphene alongside TRT?• SHBG hasn’t dropped, even though I assumed it might on exogenous T• HDL dropped — likely from TRT?• Ferritin is higher than usual — may be related to diet (heme iron supps) but keeping an eye on it• IL-6, hsCRP and cystatin C (eGFR) are elevated (separate issue I’m tracking — possible LPS exposure months back)

DHT / E2 ratio + enclomiphene ER antagonism is relevant for tendinopathy. You might experiment with removing enclomiphene and see if the tendons improve without the estrogen antagonism. Enclomiphene is also keeping your SHBG high, and yes, it is also the reason for the normal levels of LH / FSH.

hs-CRP changes quickly and wouldn't still be affected by a months-ago event. Elevated cystatin-C is scary.

What's going on with the hyperthyroid free T3? Are you doing something to cause that?

Also, you need to relax with the Vitamin D supplements. You are far beyond optimal levels, on the declining side of the inverted U. If you aren't also supplementing high levels of K2, these levels will be reducing your bone density while they calcify your arteries.

mcs · Saturday at 1:40 AM

DixieWrecked said:
Are you saying that your joints hurt more since starting TRT?

Yes, but these are long standing joint issues and could be coincidental.

mcs · Saturday at 1:41 AM

Seagal said:
"Increased joint pain in prone sites of tendinopathy (shoulders, elbows)."

Did your strength and workload increase (faster) since adding TRT?

Hard to tell with injuries slowing me down from peak performance due to nagging pain.

mcs · Saturday at 2:21 AM

FunkOdyssey said:
DHT / E2 ratio + enclomiphene ER antagonism is relevant for tendinopathy. You might experiment with removing enclomiphene and see if the tendons improve without the estrogen antagonism. Enclomiphene is also keeping your SHBG high, and yes, it is also the reason for the normal levels of LH / FSH.

hs-CRP changes quickly and wouldn't still be affected by a months-ago event. Elevated cystatin-C is scary.

What's going on with the hyperthyroid free T3? Are you doing something to cause that?

Also, you need to relax with the Vitamin D supplements. You are far beyond optimal levels, on the declining side of the inverted U. If you aren't also supplementing high levels of K2, these levels will be reducing your bone density while they calcify your arteries.

1) Already stopped enclo.10d ago.
2) Last cys-c test was high normal so hope it will continue down; eGFRs all normal; will repeat testing
3) Like I mentioned in my post, FT3 is elevated because of peak serum level from dosing 2h prior to draw
4) Taking 10kiu Vit D eod instead on ed - this level; is an anomaly for me - usually around 55-60; K2 complex daily! "When vitamin D levels are too high, the body may absorb too much calcium, which can accumulate in the joints and cause pain, stiffness, and inflammation." Come to think of it, an ultrasound showed calcific tendonitis in the afflicted elbow. Doc advised Tenex procedure to remove which I'm looking into.