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These things affect us all differently to some degree. I also was freaked out about AIs after all my reading, video watching and podcast listening prior to starting treatment. I have tried to take as little AI as possible, in fact I started out trying to take none. BUT as it turns out I've had...

Defy and most of the doctors who are really knowledgeable in this field do not take insurance. You really can't tell what your fertility situation is without getting a semen analysis done. But Clomid will increase your sperm count, unlike TRT which will reduce it.

Blood thickening or erythrocytosis doesn't happen with all guys on TRT and for those where it becomes an issue it is easily managed by donating blood. Cardiovascular issues? This doc is ill-informed... going from low T to mid/high range T increases heart health. That being said if you want to...

Your LH is pretty low so it's no wonder your T is low, which indicates secondary hypogonadism. That with your age means most docs would want you to try clomiphene first before TRT. It's worth a try and it doesn't have the same kind of long-term implications that TRT does. I hated it, but it does...

And stop overtraining! lol You don't want to be overtraining nor undertraining, you want a good level of training, like Goldilocks, not too little, not too much ... that yields optimal gains.

You don't have to be medicated... you could go back to feeling like shit. Totally up to you. Frame your choice in those terms and it's kind of a no-brainer, to me anyhow. (Assuming you feel better on treatment than off.)

If all your low-T symptoms are gone after 8 weeks on Clomid, that's a pretty rare thing... I wouldn't go messing with it trying to get back that honeymoon period feeling. As far as labs, I suppose it's good to always monitor things and your doc probably requires periodic testing, but really no...

Look into metformin... many benefits. https://www.excelmale.com/forum/showthread.php?12305&p=84830#post84830

I would find it highly doubtful that Empower would have given you the wrong drug by mistake

Your lipids don't look too good, despite you having a pretty good diet / activity level. Improving T levels should help there. Looks to me like possible secondary hypogonadism... your LH is quite low. Your testicles aren't making enough T because the pituitary signal for them to make some (LH)...

Aging will raise it, as would Clomid treatment... hard to know by how much though.

Yes I think we both use LabCorp and the range I'm given for SHBG is 16.5 - 55.9. I last tested at 35.7, which is 49% of the range, but my provider said I was a bit on the high side.

My primary care doc didn't even want to place an order for a semen analysis until 12 mos of unsuccessful trying for a pregnancy. She said most insurance won't reimburse for it otherwise. But maybe if the reason for the test is framed differently... maybe if they say it's for hypogonadism versus...

Semen analysis is about $200 through Discounted Labs and probably about the same through Defy. Healthman I think you got lucky your insurance covered it... I think in general, insurance will only cover a semen analysis for fertility reasons if you have been trying to get your lady pregnant...

The half-life of HCG is 2 days. https://www.excelmale.com/forum/showthread.php?10305-Half-lives-of-medications-Most-underrated-aspect-of-TRT

Been about a week since I discontinued the clomiphene and the DHEA. I've taken 0.875mg anastrozole over the week. Definitely feels a lot better... almost back to normal. I think moving forward I'm going to have to keep anastrozole at the ready and take at the first sign of any worsening of these...

Ok well apparently I did some pec flies with my left arm while I was asleep last night, because today the left pec is sore. The right pec/breast definitely feels swollen and I think I can feel a little pea-sized nodule or ball or something just lateral to my right nipple, which I cannot feel...

Doesn't look like this one is available through Discounted Labs, but... https://www.labcorp.com/test-menu/28431/human-chorionic-gonadotropin-hcg-%CE%B2-subunit-quantitative I don't know that there is info out there though on what serum levels are effective, it's usually talked about as what...

I'd like to believe that but I don't think so man. Only similar thing I've felt like this before would be a spider bite, but that's not the case here

That's what I thought at first as I was half-awake but then I realized no I just woke up, couldn't have done this while sleeping.

I'm not sure about the free T increase, how much to expect there... it's more complicated than total T because SHBG and other factors are at play. But the total T increase does not seem suprising to me. As far as it being contraindicated... I think there are probably some guys who need that...

I see a number of threads about the enlargement, itching, sensitivity, etc. of the nipple / breast area but not too many about pain. I don't have any of the above issues except recently, pain. Woke up yesterday and my right nipple had a burning pain to it. I went straight to the anastrozole...

Well in order to keep your E2 at pre-treatment levels you'd probably have to be on an AI indefinitely, right? Which is something most people would rather avoid. I started with a SHBG of 36 and an E2 of 14. Now E2 is around 30 and it definitely feels too high. Although I've been on Clomid not...

Yeah in fact it seems like once per week injections are one of the least common protocols... most guys inject at least twice a week.

You're taking what is usually considered the maximum TRT dose, 200mg per week.

From reading, it seems like the longer guys are on TRT they seem to move to more frequent injections at lower doses to prevent side effects and feel good... I could be wrong but that seems like a pattern I've noticed. Now this may be from TRT lowering their SHBG, which wouldn't really apply to...

Lower SHBG like yours usually means more frequent injections at smaller doses. Higher SHBG, less frequent injections at higher doses.

That's right because you're not making your own T (endogenous), it's all coming via the needle or cream (exogenous).

I'm guessing your SHBG is mid/low range? Yeah good luck keep us updated

Why do you feel worse... is this lowering the dose without increasing injection frequency? So I'm guessing the lower levels of testosterone in your blood make you feel worse, until you adjust to your "new normal"?

I don't know but Defy offers a lot of tests related to individualized nutrition, so they must have someone on staff who is knowledgeable in this area to discuss with patients, you might give them a call or email.