Clomid Restart w/Defy

TheyCallMeTrinity · Feb 21, 2017

JakeH said:
I could be misinformed, but I did not think one could manipulate total testosterone that much via lifestyle when ON testosterone shots, due to the levels be more influenced by amount injected.

Well, I am on hCG also, so my testicles are producing - that gave me a bump right away when I started that.

My Dr. was surprised also, but I was able to reproduce this twice (I have very detailed bloodwork) over my 2+ years on HRT (testosterone and hCG only). I track EVERY faced of my lifestyle daily and it paid off. My T lowered to ~700-800 range several times when went off that lifestyle protocol. Who knows, maybe I can zone in even better if I try more things out, we'll see.

I know for sure I will adhere to that protocol for sure if go off HRT like you are trying.

That's why I gave so detailed a description of what I did in hopes that protocol could help others.

Your mileage may vary!!

johndoesmith · Feb 21, 2017

JakeH said:
Day 19 Clomid

The unicorns have returned to the barn for now. That is to say, I am not feeling good mentally, as my anxiety level is increasing still, though that could be function of not enough sleep, overtraining, etc., etc. I have to say that I am looking forward to getting to day 30, so I can see how I am responding objectively, because the subjective assessments are not bright so far.

Hey man, sorry to hear you're not feeling well, but it could be just recovering from a cold? Did you take any medicine for it? I know pseudoephedrine can cause anxiety.

Personally I think you're expecting too much too fast. Hormones work slower the faster you want them to work, it's just how it is.

Everyday isn't going to be a change, much like how the sun sets later in the day this time of year, you don't notice the minutes added each day, rather you notice it suddenly that it's now not dark until 6pm.

Hormones move at arctic glacier speeds.

You're also on clomid, a rather difficult drug to titrate, but I have full faith that your providers are the best and will help you get where you need to be.

Dr Justin Saya MD · Feb 21, 2017

Hang in there Jake, there's a major transition occurring in the body. I'll be curious to see your first round of labs as well. Was it you or Paco that was having an early set of labs drawn? I'll be interested to see your estradiol level to see if you and Melissa will need to adjust anastrozole dosing. Soon enough we shall know.

JakeH · Feb 21, 2017

Dr Justin Saya said:
Hang in there Jake, there's a major transition occurring in the body. I'll be curious to see your first round of labs as well. Was it you or Paco that was having an early set of labs drawn? I'll be interested to see your estradiol level to see if you and Melissa will need to adjust anastrozole dosing. Soon enough we shall know.

Thanks, Dr Saya. Yes, I got the early blood work at day 14. It may arrive to your office tomorrow. I, too, look forward to seeing where I am objectively.

I will hang-in. I just wanted to note the highs and lows to make the restart journal more accurate.

Dr Justin Saya MD · Feb 21, 2017

JakeH said:
Thanks, Dr Saya. Yes, I got the early blood work at day 14. It may arrive to your office tomorrow. I, too, look forward to seeing where I am objectively.

I will hang-in. I just wanted to note the highs and lows to make the restart journal more accurate.

Coincidentally Melissa just contacted me about an hour ago to review your most recent results which just came in. You should receive a copy soon. I discussed recommendations for adjustments with her and it was my understanding that she would be in contact with you relatively soon to discuss.

JakeH · Feb 22, 2017

johndoesmith said:
Hey man, sorry to hear you're not feeling well, but it could be just recovering from a cold? Did you take any medicine for it? I know pseudoephedrine can cause anxiety.

Personally I think you're expecting too much too fast. Hormones work slower the faster you want them to work, it's just how it is.

Everyday isn't going to be a change, much like how the sun sets later in the day this time of year, you don't notice the minutes added each day, rather you notice it suddenly that it's now not dark until 6pm.

Hormones move at arctic glacier speeds.

You're also on clomid, a rather difficult drug to titrate, but I have full faith that your providers are the best and will help you get where you need to be.

Thanks for the reply, johndoesmith. I did take pseudoephedrine from Sunday through Wednesday of last week, then stopped because I was worried that was affecting erections.

I am not expecting the world to move quickly, but I am trying to capture the "mood of the day" in this journal, as it is more honest than only the high or low points. The unicron comment was more tongue-in-cheek, but without knowing me that would be difficult to discern.

I should have results today, as they are in preliminary at Defy, so I am just waiting on someone to contact me, so I can then contact them, to have Defy send the results. For some reason the discoutlabs.com results go to my Labcorp Beacon account, but Defy's do not.

JakeH · Feb 22, 2017

Day 20 Clomid
I received the LH test results this morning, but the Total/Free/E2 portion is still either pending or at Defy. Defy says they have them, but are not finalized. Labcorp says they have not been released, so I haven't a clue as to their disposition.

It seems Clomid is doing its job and fooling my brain into sending the proper signal, so that is positive. Fingers crossed my testes are making it happen, but the below results seem to say no.

Mentally a shade better than yesterday, though sleep evaded me most of the night, marked by sweats, chills and waking every hour. Penis still feels like it is made of rubber and libido is down. I assume the latter is driven by the former.

Day 14 of Clomid Blood Results:
Total Test-- 544 ng/dL 348 - 1197
Free-- 9.4 pg/mL 8.7 - 25.1
E2 Sensitive--Pending pg/mL 8.0 - 35.0
LH 8.7 miU/ml HIGH REF: 1.7 to 8.6

Dr Justin Saya MD · Feb 22, 2017

JakeH said:
Day 20 Clomid
I received the LH test results this morning, but the Total/Free/E2 portion is still either pending or at Defy. Defy says they have them, but are not finalized. Labcorp says they have not been released, so I haven't a clue as to their disposition. I assume Dr. Saya knew my real name when he said above that my results were in. It seems Clomid is doing its job and fooling my brain into sending the proper signal, so that is exciting. Fingers crossed my testes are making it happen.

Mentally a shade better than yesterday, though sleep evaded me most of the night, marked by sweats, chills and waking every hour. Penis still feels like it is made of rubber and libido is down. I assume the latter is driven by the former.

Day 14 of Clomid Blood Results:
Total Pending
Free Pending
E2 Pending
LH 8.7 miU/ml HIGH REF: 1.7 to 8.6

Based on that LH level, it appears the patient Melissa contacted me about last night was actually not you, JakeH, as the LH level she reviewed with me was quite different. My previous comment still stands, however, that I'll be interested to see where your estradiol stands and if a dosage adjustment is warranted.

JakeH · Feb 22, 2017

Dr Justin Saya said:
Based on that LH level, it appears the patient Melissa contacted me about last night was actually not you, JakeH, as the LH level she reviewed with me was quite different. My previous comment still stands, however, that I'll be interested to see where your estradiol stands and if a dosage adjustment is warranted.

I suspected that was the case, due to the confusion this morning when I called Labcorp and then Defy. It seems the E2 is holding the train.

Melissa did call to clarify, and we discussed some options based on bloodwork below, as the free T is still very low, which would explain the symptoms. She is a wonderful asset to have on this mission.

Bloodwork update:
Day 14 of Clomid Blood Results:
Total Test-- 544 ng/dL 348 - 1197
Free-- 9.4 pg/mL 8.7 - 25.1
E2 Sensitive--Pending pg/mL 8.0 - 35.0
LH 8.7 miU/ml HIGH REF: 1.7 to 8.6

Dr Justin Saya MD · Feb 22, 2017

JakeH said:
I suspected that was the case, due to the confusion this morning when I called Labcorp and then Defy. It seems the E2 is holding the train.

Melissa did call to clarify, and we discussed some options based on bloodwork below, as the free T is still very low, which would explain the symptoms. She is a wonderful asset to have on this mission.

Bloodwork update:
Day 14 of Clomid Blood Results:
Total Test-- 544 ng/dL 348 - 1197
Free-- 9.4 pg/mL 8.7 - 25.1
E2 Sensitive--Pending pg/mL 8.0 - 35.0
LH 8.7 miU/ml HIGH REF: 1.7 to 8.6

Indeed she is.

Based on those results, which are not very robust, it appears that your "ceiling" for endogenous testosterone production is likely mid-500's.

Your upper HPTA (hypothalamus-pituitary) has responded and "awakened" well as evidenced by increase in LH to 8.7. Unfortunately, the testes are not demonstrating impressive response/capability at this point.

JakeH · Feb 23, 2017

Dr Justin Saya said:
Indeed she is.

Based on those results, which are not very robust, it appears that your "ceiling" for endogenous testosterone production is likely mid-500's.

Your upper HPTA (hypothalamus-pituitary) has responded and "awakened" well as evidenced by increase in LH to 8.7. Unfortunately, the testes are not demonstrating impressive response/capability at this point.

Thanks for the reply, Dr. Saya.

My generally elevated SHBG (avg. 44=50,43,39/3) and average albumin of 4.5 would produce a Free T in-line with these results (i.e., 9.4 [1.74%] at a total of 544). If my calculations are correct, I would have to get to 750 total T to produce a free T of 13.9 or 1.86%, all without a concomitant rise in SHBG, which clomid is apt to induce. I would need a total of 950 to get me close to 2% free (18.7), which would be difficult if my sleepy testicles might possibly max out at mid-500s.

As a comparison, my blood levels total and free @ 48 hours after my last shot (Test Cyp 160mg/500uiHCG) were 1350 and 29.4, respectively (SHBG 45, Albumin 4.4). (This test was conducted as part of my yearly physical, thus the 48-hour, not trough, draw.) If my body cannot get to 75% of this via Clomid stimulation, then I am not sanguine about my ability to do so naturally, especially when one considers the rapid return of symptoms.

Thanks again for the work you and your staff do.

Dr Justin Saya MD · Feb 23, 2017

JakeH said:
If my body cannot get to 75% of this via Clomid stimulation, then I am not sanguine about my ability to do so naturally, especially when one considers the rapid return of symptoms.

Thanks again for the work you and your staff do.

I agree with your assessment, JakeH.

Unfortunately, seems like your testes aren't going to "play ball" with the gonadotropin stimulation (LH/FSH) from the Clomid as well as we would have hoped.

I wish the labs that were briefly confused to be yours actually were...that guy made it to ~1150 for his T (though his LH shot above range).

JakeH · Feb 23, 2017

Bloodwork update for E2:
Day 14 of Clomid Blood Results: 25mg Clomid/0.22AI compounded

Total Test 544 ng/dL 348 - 1197
Free 9.4 pg/mL 8.7 - 25.1
E2 Sensitive 10.8 pg/mL 8.0 - 35.0
LH 8.7 miU/ml HIGH REF: 1.7 to 8.6

JakeH · Feb 24, 2017

Day 21 Clomid/Day 22 No Clomid

The last two days have been blue mentally, even with 7+ hours of sleep each night. My boss and coworkers have noticed the change in my output and demeanor, without knowing the whys.

Discussions with Defy have led to a go/no-go decision point of staying on Clomid, due to my testes not responding strongly with an LH at upper levels of the range, which does not bode well for going natural, thereby, in my estimation, relegating me to a form of life-long therapy (Clomid or HCG mono or TRT).

Physically, things are not going well from a workout/recovery standpoint, and my erections have required 20mg of Cialis to work. Also, it still feels like I am constantly wearing a condom, because penile sensitivity is reduced.

Just to take the what-if off the table for me, I got another blood draw today to see if any surprises pop-up, as the Test Cyp/HCG will not be here until next week anyway. However, even if my free T has bumped a couple of points, the symptoms have only worsened over the last 44 days, so that would sway me back toward TRT/HCG if I am going to be on an adjunct therapy for the next 40 years. I guess that is the danger of feeling what life is like at 1200-900 Total T and a Free T at 30-24, and then going back down to low "normal."

Worried · Feb 24, 2017

JakeH said:
Day 21 Clomid/Day 22 No Clomid

The last two days have been blue mentally, even with 7+ hours of sleep each night. My boss and coworkers have noticed the change in my output and demeanor, without knowing the whys.

Discussions with Defy have led to a go/no-go decision point of staying on Clomid, due to my testes not responding strongly with an LH at upper levels of the range, which does not bode well for going natural, thereby, in my estimation, relegating me to a form of life-long therapy (Clomid or HCG mono or TRT).

Physically, things are not going well from a workout/recovery standpoint, and my erections have required 20mg of Cialis to work. Also, it still feels like I am constantly wearing a condom, because penile sensitivity is reduced.

Just to take the what-if off the table for me, I got another blood draw today to see if any surprises pop-up, as the Test Cyp/HCG will not be here until next week anyway. However, even if my free T has bumped a couple of points, the symptoms have only worsened over the last 44 days, so that would sway me back toward TRT/HCG if I am going to be on an adjunct therapy for the next 40 years. I guess that is the danger of feeling what life is like at 1200-900 Total T and a Free T at 30-24, and then going back down to low "normal."

I know this is going to sound oversimplistic. But the body has a powerful ability to recover. If I were feeling the way you are right now, I would move heavily into green low glycemic smoothies. The reason being you can put so many different vegetables and Low glycemic fruits in with huge massive amounts of micro nutrients that can only do good for you. You may never get back to where you may have been prior to ever doing any kind of therapy or testosterone, but you will recover and have a good quality life whether you do testosterone replacement therapy or not.

Also if you could somehow lessen your fixation on your sexual performance, I think it would do so much good for you mentally which is connected to how you feel physically.

There is life outside of sex. At least that's what my wife tells me. 😛

JakeH · Feb 24, 2017

Worried said:
I know this is going to sound oversimplistic. But the body has a powerful ability to recover. If I were feeling the way you are right now, I would move heavily into green low glycemic smoothies. The reason being you can put so many different vegetables and Low glycemic fruits in with huge massive amounts of micro nutrients that can only do good for you. You may never get back to where you may have been prior to ever doing any kind of therapy or testosterone, but you will recover and have a good quality life whether you do testosterone replacement therapy or not.

Also if you could somehow lessen your fixation on your sexual performance, I think it would do so much good for you mentally which is connected to how you feel physically. There is life outside of sex.

I already do loads of veggies and low sugar fruit, nuts and sardines, etc. Regarding the fixation on sex, I noted prior that I have started to see a therapist, because "just do not focus on it" doesn't work. There is an old saying in therapy that sex only makes up a fraction of your week (3 hours of 168=~1.79%), until it does not work, then it is 90%.

Worried · Feb 24, 2017

JakeH said:
I already do loads of veggies and low sugar fruit, nuts and sardines, etc. Regarding the fixation on sex, I noted prior that I have started to see a therapist, because "just do not focus on it" doesn't work. There is an old saying in therapy that sex only makes up a fraction of your week (3 hours of 168=~1.79%), until it does not work, then it is 90%.

I just went to the local high school track and did interval training, The sun is shining bright. Don't know if you're in an area where you can do something like that. But I'm certain it will at the very least raise your spirits. If you're already doing that please excuse me.

JakeH · Feb 27, 2017

Days 23-26 No Clomid

My last Clomid/AI dose was 5 days ago (Wednesday), and I oddly started feeling better yesterday (Sunday). My anxiety lessened by Saturday, and by Sunday I felt decent. Moreover, my libido improved, as did my penile sensitivity. I am not sure if it was the Clomid and AI clearing that drove that, but I will take it.

My Test Cyp, HCG, AI will arrive tomorrow, also. I was instructed to forgo the AI for a few weeks to allow my E2 to increase to a healthy level.

Perhaps I will wake tomorrow to fully functioning testes and a clear head and get to delay the return to TRT. A boy can dream.

Anyway, I should receive my last set of Clomid labs tomorrow, so it will be interesting from a numbers-monkey perspective where they stand. I will post them here as a data point for others who happen upon this thread.

johndoesmith · Feb 27, 2017

JakeH said:
Days 23-26 No Clomid

My last Clomid/AI dose was 5 days ago (Wednesday), and I oddly started feeling better yesterday (Sunday). My anxiety lessened by Saturday, and by Sunday I felt decent. Moreover, my libido improved, as did my penile sensitivity. I am not sure if it was the Clomid and AI clearing that drove that, but I will take it.

My Test Cyp, HCG, AI will arrive tomorrow, also. I was instructed to forgo the AI for a few weeks to allow my E2 to increase to a healthy level.

Perhaps I will wake tomorrow to fully functioning testes and a clear head and get to delay the return to TRT. A boy can dream.

Anyway, I should receive my last set of Clomid labs tomorrow, so it will be interesting from a numbers-monkey perspective where they stand. I will post them here as a data point for others who happen upon this thread.

Keep in mind that changes with TRT happen over weeks even months. I noticed nothing for 2 months. That's with a protocol that had my levels right where you want them on the first try.

JakeH · Feb 27, 2017

johndoesmith said:
Keep in mind that changes with TRT happen over weeks even months. I noticed nothing for 2 months. That's with a protocol that had my levels right where you want them on the first try.

I had the same experience when I was on TRT from Sept '16 to Jan '17. By month two my head felt really good, and my body started noticeably responding.

Clomid Restart w/Defy

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