Clomid and HCG Treatment Results and Free Test Question/Concern

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jtreentx

New Member
Back in October I saw a TRT/hormone specialist in my area. I brought him the results of my labs I had taken back in April this year for reference too. After looking them over and ordering a few more labs, he decided to put me on a Clomid and HCG Protocol. For about six weeks, I've been taking 500 iu of HCG 3x/week (M,W,F) and 25 mg of Clomid 2x/week (M,F).

So my check up was this last Tuesday and he emailed me that everything looked better on paper. My total Test had jumped from 272 ng/dl (4/27/17) to 633 ng/dl (11/28/17). Never mentioned anything about my free T. Estradiol was 32.1 pg/ml (Roche ELCIA). He also noted a big improvement in my cotisol level from (8.9; 11:30 AM) to (19.8; 10:30 AM).

I have a labcorp patient account setup to where I can view any and all labwork I have performed. I received an email this evening saying my results from last week were able to be viewed. I had been waiting to see the actual labs because I was interested in my Free T. Well I log on and to my amazement my free T is 34.7 pg/ml which is noted as high. I'm confused as to why it would be so high. That puts me at almost 5.5% of my Total T! Previously I was right around 2% at 7.8 of 272 total...which seems to be the norm. Should I be concerned about this? Any explanation as to why my free T is so high? The doctor didn't mention a word about it. I'll list below all of my tests I've had this year for before and after reference. Thanks beforehand for any and all replies.

Labs from 4-27-17
Total T - 272 ng/dL (438 - 1197)
Free T - 7.8 pg/mL (8.7 - 25.1)
DHEA Sulfate - 302 ug/dL (138.5 - 475.2)
TSH - .470 uIU/mL (.450 - 4.500)
Estradiol (Roche ECLIA methodology) - 22.5 pg/mL (7.6 - 42.6)
PSA - .8 ng/mL (0.0 - 4.0)
Vitamin D, 25-hydroxy - 31.2 ng/mL (30.0 - 100.0)
Triiodothyronine, Free, Serum - 3.6 pg/mL (2.0 - 4.4)
CBC with Differential/Platelet - All within normal ranges.

Labs from 10-10-17 with new doctor. Only ordered a few tests and not everything due to having the labs from April of this year.
Vitamin B12 - 908 pg/mL (211-946)
Folate (Folic Acid) - 15.3 ng/mL ( >3.0)
LH - 8.4 mIU/mL (1.7 - 8.6)
FSH - 8.9 mIU/mL (1.5 - 12.4)
Cotisol (taken at 11:30 am) - 8.9 ug/dL (AM 6.2 - 19.4; PM 2.3 - 11.9)
Prolactin - 8.8 ng/mL (4.0 - 15.2)

Labs from 11-28-17 after being on Clomid and HCG protocol for six weeks.
Cortisol - 19.8; 10:30 AM
Estradiol - 32.1 pg/mL; Roche ELCIA methodology
LH - 7.3 mlU/mL
FSH - 2.8 mlU/mL
Total Test - 633 ng/dL
Free T - 34.7 pg/mL


 
Defy Medical TRT clinic doctor

CoastWatcher

Moderator
Labs from 10-10-17 with new doctor. Only ordered a few tests and not everything due to having the labs from April of this year.
Vitamin B12 - 908 pg/mL (211-946)
Folate (Folic Acid) - 15.3 ng/mL ( >3.0)
LH - 8.4 mIU/mL (1.7 - 8.6)
FSH - 8.9 mIU/mL (1.5 - 12.4)
Cotisol (taken at 11:30 am) - 8.9 ug/dL (AM 6.2 - 19.4; PM 2.3 - 11.9)
Prolactin - 8.8 ng/mL (4.0 - 15.2)

Labs from 11-28-17 after being on Clomid and HCG protocol for six weeks.
Cortisol - 19.8; 10:30 AM
Estradiol - 32.1 pg/mL; Roche ELCIA methodology
LH - 7.3 mlU/mL
FSH - 2.8 mlU/mL
Total Test - 633 ng/dL
Free T - 34.7 pg/mL
Was SHBG never run? The estradiol test was incorrect one for a man to use. You want the LC, MS/MS methodology, the so-called Sensitive lab test. What you ran is - far more often than not - inaccurate when assessing a man's e2 level. How are you feeling? A lot of discussion about lab values, which is necessary...but the proof is in your subjective response.
 

jtreentx

New Member
Labs from 10-10-17 with new doctor. Only ordered a few tests and not everything due to having the labs from April of this year.
Vitamin B12 - 908 pg/mL (211-946)
Folate (Folic Acid) - 15.3 ng/mL ( >3.0)
LH - 8.4 mIU/mL (1.7 - 8.6)
FSH - 8.9 mIU/mL (1.5 - 12.4)
Cotisol (taken at 11:30 am) - 8.9 ug/dL (AM 6.2 - 19.4; PM 2.3 - 11.9)
Prolactin - 8.8 ng/mL (4.0 - 15.2)

Labs from 11-28-17 after being on Clomid and HCG protocol for six weeks.
Cortisol - 19.8; 10:30 AM
Estradiol - 32.1 pg/mL; Roche ELCIA methodology
LH - 7.3 mlU/mL
FSH - 2.8 mlU/mL
Total Test - 633 ng/dL
Free T - 34.7 pg/mL
Was SHBG never run? The estradiol test was incorrect one for a man to use. You want the LC, MS/MS methodology, the so-called Sensitive lab test. What you ran is - far more often than not - inaccurate when assessing a man's e2 level. How are you feeling? A lot of discussion about lab values, which is necessary...but the proof is in your subjective response.

No SHBG has never been tested. I agree on e2 test. I mentioned this to my doctor but he disregarded and said that it is only used for women when trying to detect estrogen in the low levels. So its not necessary in my case. Completely contradicts everything I've read though. I didn't feel like arguing with him so I just said OK.

As to how I'm feeling, well the first week I felt much better. More engergy, clearer thinking, less brain fog. My biggest complaint has been extreme fatigue and brain fog/concentration issues. After the 1st week of treatment, I ended up coming down with a nasty viral upper respiratory infection that my daughter brought home from school. Been trying to kick it for the past 2-3 weeks so my fatigue has returned. I mentioned this to him and he agreed that the viral infection was a big contributing factor to how I've been feeling. I'm actually feeling a lot better this week though, but still feel like things could be quite a bit better. I'm going to stay on the current treatment until my wife gets pregnant (hopefully sometime this spring) then jump to t therapy. I mentioned this plan of action and doc was on board.

One other thing the doctor said that made me question his knowledge. He recommended I give t cream a shot in conjunction with my current protocol. I asked him "Well wouldn't that shut down my HPTA and possibly affect my fertility?" He responded something along the lines of "Well not so much with the cream since the cream doesn't create the spike in hormones that injections do. It's the spikes in the hormones that really shuts down your HPTA" While researching T therapy, I have never once read anything like that. Everything I've seen says once exogenous T is introduced, then your HPTA shuts down. I didn't argue with him on this either but I walked away thinking I might should get a second opinion. Thoughts?
 

ratbag

Member
Your already on HCG so you won't get shut down unless you stop HCG. But since part of his mandate assumably is for you to get your wife pregnant it's unlikely he'll stop HCG. You can add testosterone in any form now and it won't lower your sperm count. Just stay on HCG as well and you'll be ok.
 

jtreentx

New Member
Your already on HCG so you won't get shut down unless you stop HCG. But since part of his mandate assumably is for you to get your wife pregnant it's unlikely he'll stop HCG. You can add testosterone in any form now and it won't lower your sperm count. Just stay on HCG as well and you'll be ok.

No that is all me. My main thing right now is preserving fertility so we can have another child. As far as HCG and Test injections go, I've read the research pointing to men maintaining fertility while on T and HCG. But I've also read that it is still no guarantee, and the last thing I want to do right now is mess with my fertility. Just not a risk I'm wanting to take. I declined the cream for that reason. I'm 34 and wife is 33 so the window for more children is getting smaller.
 
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