40 and Considering TRT

[Julio75]

I turned 40 last year. I have been borderline low for at least 3 years, maybe longer but that was the first time I had levels checked. Over these past 3 years my total T has been between 300 and 400, which usually prompted the physician to tell me I was normal. My body said otherwise though. I am very active and lift weights 3 times a week, but have made virtually no progress over the past few years. I am mostly going to the gym to hold onto what little muscle I have because if I miss much time in the gym the muscle starts fading pretty fast. My sex drive has continued to dwindle with occasional bouts of ED, and I have mostly relied on Viagra to have decent sex. Energy is okay because I eat well and stay active. I saw an Endo last November and she put me on Clomid to try a "restart". For the first few weeks I felt great. I was immediately seeing gains in the gym, waking up with morning wood like I was in high school, and felt kind of like a badass every morning when I would leave the house. My test showed a total T of 923 after week 3 and I thought I had found a miracle pill. About week 4 everything started to change as the estrogenic isomer of Clomid took over and I awoke one day with no wood and in a complete mental fog. I tried reducing dosage but it seemed this was just not the answer. So now it is out of my system, morning wood is scarce and only semi-rigid, and desire is gone. Gym gains are gone, and now my sleep is getting worse. So I go back in a few weeks to the Endo and I am considering TRT depending on what my next test shows. I would certainly like to live the way I felt those few weeks on Clomid before things went south. Is TRT the answer? Can I make enough lifestyle changes to get my 300-400 average up to 600 or higher? I want this decade of my life to be the best ever, but that is a difficult task with what I am currently dealing with. I appreciate any feedback from the group.

 

[Vince]

Clomid (clomiphene) Increases Testosterone and Sperm Count in Men


Unfortunately, this study says nothing about sex drive and erectile dysfunction. Many men taking Clomid (clomiphene) alone do not feel more sexual or have improvements in erection quality.

Oral Enclomiphene Citrate Stimulates the Endogenous Production of Testosterone and Sperm Counts in Men with Low Testosterone: Comparison with Testosterone Gel. The Journal of Sexual Medicine. http://onlinelibrary.wiley.com/doi/1...12116/abstract


Introduction - Clomiphene citrate is employed off-label in men who have low testosterone and for the restoration of sperm counts in men who have used exogenous testosterone. Clomiphene is a mixture of two diastereoisomers: zuclomiphene and enclomiphene. We evaluated enclomiphene citrate in men with secondary hypogonadism.


Aim - Our aim was to compare oral enclomiphene citrate as an alternative to topical testosterone.


Main Outcome Measures - Blood levels of total testosterone (TT), estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone binding globulin, thyroid stimulation hormone, prolactin, and insulin-like growth factor 1 IGF-1 were measured at certain times after treatment with each agent. Sperm parameters were determined at the same visits. Free testosterone (FT) was calculated.


Methods - This was a proof-of-principle, randomized, open-label, fixed dose, active-control, two-center phase IIB study in 12 men with secondary hypogonadism treated previously with topical testosterone.


Results - After discontinuation of topical testosterone, morning TT values averaged 165 ± 66 pg/dL. After 3 months, there was a significant rise in men receiving enclomiphene citrate and gel that was sustained for 3 months. At 6 months, TT levels were 545 ± 268 and 525 ± 256 pg/dL for groups receiving the gel and enclomiphene citrate, respectively. Only men in the enclomiphene citrate group demonstrated increased LH and FSH. TT decreased one month posttreatment to pretreatment values. Enclomiphene citrate elevated sperm counts in seven out of seven men at 3 months and six out of six men at 6 months with sperm concentrations in the 75–334 × 106/mL range. The gel was ineffective in raising sperm counts above 20 × 106/mL for all five men at 3 months and raised counts in only two or five men at 6 months. At follow-up, only enclomiphene citrate treatment was associated with elevated sperm counts.


Conclusions - Enclomiphene citrate increased testosterone and sperm counts. Concomitant changes in LH and FSH suggest normalization of endogenous testosterone production and restoration of sperm counts through the hypothalamic–pituitary–testicular axis. Clomid (clomiphene) Increases Testosterone and Sperm Count in Men

 

[Vince]

Are guys that do well on low dose clomid unicorns...or do they really exist? https://www.excelmale.com/forum/sho...-dose-clomid-unicorns-or-do-they-really-exist

 

[CoastWatcher]

Is your estradiol being monitored with the sensitive assay? If so, what level was reported?

 

[ERO]

My best advice is to go with a TRT expert like Defy Medical if you are in the USA. The track record for TRT success for run of the mill Endos on this forum is truly awful.

 

[Lancealot]

Hi and welcome,
I cant speak to the clomid, as I've no experience with it, but I can almost say without a doubt you wont be able to get your T levels up enough naturally to feel like you did 20yrs ago. I tried and it didn't happen. I'm turning 43 next week and couldn't be more pleased with my TRT results. As was said above, seeking proper medical treatment is probably the no.1 determining factor in your success with TRT. Best of luck and keep us posted.

 

[Julio75]

Thank you for all the responses. I am getting blood work drawn this week and have a follow up with my Endo next week to discuss the next step. The Clomid definitely was not for me. The blood work showed the desired rise in total and free T, but the other effects negated any benefit of that.

I have great insurance so I am going to stick with a traditional physician and clinic for any treatment rather than use a nation wide provider that is cash only. The Endo I see is young and very knowledgeable, and only agreed to the Clomid treatment because I specifically requested it. I was hoping I was one of the chosen few who did not experience the negative sides, but it was not to be.

I will share my labs from this week's test and also whatever treatment regimen my Endo prescribes. I appreciate any and all feedback!