Beginner , TRT with Anastrozole and Enclomiphene

[kopanov]

Hello guys, first thanks in advance to whoever takes time to read and answer this, I really appreciate it!

30 years old, 150lb, lean, fit, T levels 430 and free T at 7, E2 15.

I tried many things to raise my levels but felt unmotivated, bad libido and sex drive.

Researched a lot and decided to start TRT, even though my doctor said can't prescribe it to me on those levels. I went with a private clinic and was prescribed 100mg T injection twice a week, Anastrozole twice a week at .5mg a week and Enclomiphene 50mg a week.

I am not taking the Anastrozole yet, I want to wait and see if there are side effects and then I'll start with it if I need it. Now about the Enclomiphene, I want to have kids in near future, but it might be a year, maybe two years.

Initially I was going to use the T injections and couple months before we decide to have a kid, I would just include HCG in the mix, but the doc at the clinic said its better to use the Enclo all the time so the balls never shut down basically.

How do you include fertility drug in your therapy?

Do you have experience with being on TRT for years and then including HCG when you decided to have a kid, if yes how did it go?

Do you have experience with being on TRT for years and using enclomiphine all the time and then decided to have a kid, if yes how did it go?

 

[Systemlord]

Do you have experience with being on TRT for years and using enclomiphine all the time

This isn’t a common occurrence, it’s questionable whether clomid will do anything while on TRT, because TRT has a strong suppressive effect on your HPTA.

Your protocol is terrible with regards to the aromatase inhibitor, 1 mg AI per week when you had low estrogen pre-treatment, is a recipe for disaster. A lot of men run higher on the estrogen on TRT and not everyone is going to have a problem.

So prescribing an AI right away before they are problems is just plain wrong.

The clomid has synthetic estrogen that competes for the same receptor as estrogen, even particularly blocking the effects of estrogen. Clomid has a bad side effects profile and may prevent you from experiencing symptom relief on TRT.

Normally when guys on TRT want kids, TRT is stopped and clomid is started, or hCG and FSH are added to the TRT protocol. This is how it’s been done for decades.

This TRT clinic is just trying to increase profits by prescribing these drugs alongside TRT.

 

[kopanov]

This isn’t a common occurrence, it’s questionable whether clomid will do anything while on TRT, because TRT has a strong suppressive effect on your HPTA.

Your protocol is terrible with regards to the aromatase inhibitor, 1 mg AI per week when you had low estrogen pre-treatment, is a recipe for disaster. A lot of men run higher on the estrogen on TRT and not everyone is going to have a problem.

The clomid has synthetic estrogen that competes for the same receptor as estrogen, even particularly blocking the effects of estrogen. Clomid has a bad side effects profile and may prevent you from experiencing symptom relief on TRT.

A lot of these TRT clinics and doctors in general have no clue how to manage male hormones.

I read a lot about the AI, that's why I decided not to take it as of now and wait to see if any side effects.

Thank you @Systemlord.

 

[madman]

Hello guys, first thanks in advance to whoever takes time to read and answer this, I really appreciate it!

30 years old, 150lb, lean, fit, T levels 430 and free T at 7, E2 15.

I tried many things to raise my levels but felt unmotivated, bad libido and sex drive.

Researched a lot and decided to start TRT, even though my doctor said can't prescribe it to me on those levels. I went with a private clinic and was prescribed 100mg T injection twice a week, Anastrozole twice a week at .5mg a week and Enclomiphene 50mg a week.

I am not taking the Anastrozole yet, I want to wait and see if there are side effects and then I'll start with it if I need it. Now about the Enclomiphene, I want to have kids in near future, but it might be a year, maybe two years.

Initially I was going to use the T injections and couple months before we decide to have a kid, I would just include HCG in the mix, but the doc at the clinic said its better to use the Enclo all the time so the balls never shut down basically.

How do you include fertility drug in your therapy?

Do you have experience with being on TRT for years and then including HCG when you decided to have a kid, if yes how did it go?

Do you have experience with being on TRT for years and using enclomiphine all the time and then decided to have a kid, if yes how did it go?

Your starting protocol is horrible.

Need to abort and rethink this one through!

200 mg T/week let alone split twice weekly with an AI thrown into the boot is ridiculous.

Run-of-the-mill T clinic cookie-cutter protocol.

Start low and go slow on T only as we want to see how your body reacts to testosterone let alone see where said protocol (dose T/injection frequency) will have trough TT, FT, estradiol, and other important blood markers such as RBCs, hemoglobin, and hematocrit

100 mg T split (50mg T every 3.5 days) is a good starting point.

Most men are injecting 100-200 mg T/week whether once weekly or split into more frequent injections such as twice-weekly (every 3.5 days), M/W/F, EOD, or daily.

Even then most men can easily achieve a healthy let alone high FT using 100-150mg T/week especially when split into more frequent injections.

Far from common anyone would need the higher-end dose (200 mg T) to achieve such.

Are there outliers sure but they would be far and few!

Forget the enclomiphene while using exogenous T.

If anything T + hCG will help preserve fertility and minimize/prevent testicular atrophy.

 

[madman]

Hello guys, first thanks in advance to whoever takes time to read and answer this, I really appreciate it!

30 years old, 150lb, lean, fit, T levels 430 and free T at 7, E2 15.

I tried many things to raise my levels but felt unmotivated, bad libido and sex drive.

Researched a lot and decided to start TRT, even though my doctor said can't prescribe it to me on those levels. I went with a private clinic and was prescribed 100mg T injection twice a week, Anastrozole twice a week at .5mg a week and Enclomiphene 50mg a week.

I am not taking the Anastrozole yet, I want to wait and see if there are side effects and then I'll start with it if I need it. Now about the Enclomiphene, I want to have kids in near future, but it might be a year, maybe two years.

Initially I was going to use the T injections and couple months before we decide to have a kid, I would just include HCG in the mix, but the doc at the clinic said its better to use the Enclo all the time so the balls never shut down basically.

How do you include fertility drug in your therapy?

Do you have experience with being on TRT for years and then including HCG when you decided to have a kid, if yes how did it go?

Do you have experience with being on TRT for years and using enclomiphine all the time and then decided to have a kid, if yes how did it go?

What method was used to test your FT?

Where did your SHBG sit?

TT 430 ng/dL would not be considered unhealthy if you have low SHBG.

 

[kopanov]

Your starting protocol is horrible.

Need to abort and rethink this on through!

200 mg T/week let alone split twice weekly with an AI thrown into the boot is ridiculous.

Run-of-the-mill T clinic cookie-cutter protocol.

Start low and go slow on T only as we want to see how your body reacts to testosterone let alone see where said protocol (dose T/injection frequency) will have trough TT, FT, estradiol, and other important blood markers such as RBCs, hemoglobin, and hematocrit

Most men are injecting 100-200 mg T/week whether once weekly or split into more frequent injections such as twice-weekly (every 3.5 days), M/W/F, EOD, or daily.

Even then most men can easily achieve a healthy let alone high FT using 100-150mg T/week especially when split into more frequent injections.

Far from common anyone would need the higher-end dose to achieve such.

Are there outliers sure but they would be far and few!

Forget the enclomiphene while using exogenous T.

If anything T + hCG will help preserve fertility and minimize/prevent testicular atrophy.

Thank you @madman!

It's just a bit confusing after watching a lot of youtube and reading forums for a while.
But I would say a lot of people are leaning towards that T+hCG.

 

[kopanov]

What method was used to test your FT?

Where did your SHBG sit?

TT 430 ng/dL would not be considered unhealthy if you have low SHBG.

I don't know what you really mean about method, but this is what it says on the lab test
FT 7.7 pg/ml (8.7-25.2)
SHBG 46.3 nmol/L (16.5-55.9)

edited

 

[madman]

I don't know what you really mean about method, but this is what it says on the lab test
FT 7.7 pg/ml
SHBG 46.3 nmol/L

The testing method used for FT (calculated, direct immunoassay, Equilibrium Dialysis, and Equilibrium Ultrafiltration).

Always post the testing method/reference range.

 

[kopanov]

The testing method used for FT (calculated, direct immunoassay, Equilibrium Dialysis, and Equilibrium Ultrafiltration).

Always post the testing method/reference range.

FT 7.7 pg/ml (8.7-25.2)
SHBG 46.3 nmol/L (16.5-55.9)

edited

 

[madman]

FT 7.7 pg/ml (8.7-25.2)
SHBG 46.3 nmol/L (16.5-55.9)

edited

If you used Labcorp the reference range for the direct immunoassay is

30 to 39 (y)

8.7−25.1 pg/mL

144980: Testosterone, Free, Direct | Labcorp

Labcorp test details for Testosterone, Free, Direct

www.labcorp.com

Then the testing method used would be known to be inaccurate direct analog enzyme immunoassay (EIA).

Would not trust this testing method for FT, especially in cases of altered SHBG.

Your FT should be tested using an accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Depending on which country one resides in if they do not have access to such then you would need to use/rely on the calculated linear law-of-mass action cFTV.

In your case luckily your FT level when using the cFTV is also dismal.

With a TT 430 ng/dL and high-end SHBG 46.3 nmol/L, your FT level would be shitty.

 

[kopanov]

If you used Labcorp the reference range for the direct immunoassay is

30 to 39 (y)

8.7−25.1 pg/mL

144980: Testosterone, Free, Direct | Labcorp

Labcorp test details for Testosterone, Free, Direct

www.labcorp.com

Then the testing method used would be known to be inaccurate direct analog enzyme immunoassay (EIA).

Would not trust this testing method for FT, especially in cases of altered SHBG.

Your FT should be tested using an accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Depending on which country one resides in if you do not have access to such than you would need to use/rely on the calculated linear law-of-mass action cFTV.

I guess I need to do more research on that.

Do you sugest that I keep running just the T, and check my sperm count after a while to see how it affects me and then see what kind of dose I start with hCG?

Is there any dose range that I would take if I let's say I am on 150mg T per week, or depends, I have to try and see what works best?

 

[madman]

I guess I need to do more research on that.

Do you sugest that I keep running just the T, and check my sperm count after a while to see how it affects me and then see what kind of dose I start with hCG?

Is there any dose range that I would take if I let's say I am on 150mg T per week, or depends, I have to try and see what works best?

Best to start on a T-only protocol at least for the first 6 weeks so you can see where said protocol (dose T/injection frequency) has your trough TT, FT, and estradiol let alone other important blood markers.

When using TC/TE hormones will be in flux during the weeks leading up until blood levels have stabilized (4-6 weeks).

Once blood levels have stabilized you will have your lab work done and we want to test at the true trough.

You can eventually add in the hCG (250-500 IU) 2-3 times weekly.

 

[kopanov]

Best to start on a T-only protocol at least for the first 6 weeks so you can see where said protocol (dose T/injection frequency) has your trough TT, FT, and estradiol let alone other important blood markers.

When using TC/TE hormones will be in flux during the weeks leading up until blood levels have stabilized (4-6 weeks).

Once blood levels have stabilized you will have your lab work done and we want to test st the true trough.

You can eventually add in the hCG (250-500 IU) 2-3 times weekly.

I will look further into it, but will run only T for now while I research.

@madman thank you I appreciate your time!!!

 

[Fortunate]

Hello guys, first thanks in advance to whoever takes time to read and answer this, I really appreciate it!

30 years old, 150lb, lean, fit, T levels 430 and free T at 7, E2 15.

I tried many things to raise my levels but felt unmotivated, bad libido and sex drive.

Researched a lot and decided to start TRT, even though my doctor said can't prescribe it to me on those levels. I went with a private clinic and was prescribed 100mg T injection twice a week, Anastrozole twice a week at .5mg a week and Enclomiphene 50mg a week.

I am not taking the Anastrozole yet, I want to wait and see if there are side effects and then I'll start with it if I need it. Now about the Enclomiphene, I want to have kids in near future, but it might be a year, maybe two years.

Initially I was going to use the T injections and couple months before we decide to have a kid, I would just include HCG in the mix, but the doc at the clinic said its better to use the Enclo all the time so the balls never shut down basically.

How do you include fertility drug in your therapy?

Do you have experience with being on TRT for years and then including HCG when you decided to have a kid, if yes how did it go?

Do you have experience with being on TRT for years and using enclomiphine all the time and then decided to have a kid, if yes how did it go?

My advice: figure out what symptoms you are trying to correct and look long and hard issues other than hypogonadism that might be causing them. Then, look at all the lifestyle changes you might be able to make to improve your natural production.

If you go down this road, consider the least disruptive way, such as Natesto. Short acting, so you can bail if it’s a bad experience and it’s out of your system quickly. Tends to work well in guys like you whose T levels are close to normal. Do you know your LH levels?

 

[kopanov]

My advice: figure out what symptoms you are trying to correct and look long and hard issues other than hypogonadism that might be causing them. Then, look at all the lifestyle changes you might be able to make to improve your natural production.

If you go down this road, consider the least disruptive way, such as Natesto. Short acting, so you can bail if it’s a bad experience and it’s out of your system quickly. Tends to work well in guys like you whose T levels are close to normal. Do you know your LH levels?

I work out consistently for years, 4 times gym 1 time run a week. I cant gain any more muscle, I just got lean. I eat good, I dont smoke, I drink very little.
I didn't mind that I can't gain muscle but since last year motivation is bad, sex drive, even erection sometimes is hard to get.
Overal I thought the same I have too high SGBG and low FT.

I dont have FSH or LH listed on the blood work.

 

[Systemlord]

I dont have FSH or LH listed on the blood work.

LH can be deceptive, the half-life is 20 minutes, and a lot of low-T men have good LH levels and lower testosterone values. The majority of men have mixed hypogonadism, a combination of secondary, primary failure but is still classified as secondary.

 

[CKO]

I agree with madman and systemlord. Your protocol is terrible. There is no need to introduce enclomiphene with 200 mg T a week. It's simply won't work. I'm going to give you an alternate suggestion and recommend you drop the T in only use enclomiphene for 6-12 weeks. See how your body responds. I'm not a doctor, so I can't prescribe a protocol. But based on my experience it should look something like 12.5 mg enclomiphene every other day. The ai should be zero to .125 twice a week.

 

[kopanov]

I agree with madman and systemlord. Your protocol is terrible. There is no need to introduce enclomiphene with 200 mg T a week. It's simply won't work. I'm going to give you an alternate suggestion and recommend you drop the T in only use enclomiphene for 6-12 weeks. See how your body responds. I'm not a doctor, so I can't prescribe a protocol. But based on my experience it should look something like 12.5 mg enclomiphene every other day. The ai should be zero to .125 twice a week.

Thank you for the response @CKO.

I thought about it, but I saw dosens of people saying enclomiphene improved their numbers but didn't improve any of the symptoms like low energy, libido etc.

Do you have experience with that protocol you mentioned?

 

[CKO]

Yes I tried it and had some level of success. It doesn't seem to be a great long-term solution for quite a few on here. However, it's a conservative and reasonable first step before going into full-blown TRT. Being on TRT itself is difficult to maintain homeostasis and leads to all sorts of challenges as well. Do a search of forum post related to quitting TRT or difficulty balancing, and you will see the challenges that come with it. Your pre-trt levels are not great, but may not be at the point where TRT is necessary, especially if you're considering fertility.

 

[kopanov]

Yes I tried it and had some level of success. It doesn't seem to be a great long-term solution for quite a few on here. However, it's a conservative and reasonable first step before going into full-blown TRT. Being on TRT itself is difficult to maintain homeostasis and leads to all sorts of challenges as well. Do a search of forum post related to quitting TRT or difficulty balancing, and you will see the challenges that come with it. Your pre-trt levels are not great, but may not be at the point where TRT is necessary, especially if you're considering fertility.

I certainly will.
I am looking for a long term solution though. Honestly I don't mind being on TRT until I die. I see myself working out in my 60s and 70s, fingers crossed. I've seen a lot of people that use T and then implement HCG and lower their T intake when they want to increase fertility, so that's one way I am leaning towards.
There are so many people and so many variables and outcomes, every organism responds differently to different substance and its just confusing overall which way to go.

I guess I have to try different things and see what works best for me, but my priority for sure is keeping my fertility.