Changes to my TRT/ Any advice?

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drew16669

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Hello, I am 27, 6'2 250lbs 17-20% bf, exercise 4-5 times per week, diet is acceptable (low carb with 1 cheat meal per week)
In November of last year, after suffering with ED, Moodiness, Lethargy, Lack of confidence, and inability to conceive(my wife and I had been trying for a year which is what pushed me to the Dr in the first place). I went to a local Dr. Office, that had "Low T" therapy on their website, I had bloodwork done to check my total test and free test, which came back at 287ng/dl total, and 5.0 free. The Dr. prescribed me 200mg biweekly, or 100mg weekly(was told to try both). After months of a rollercoaster ride, I had found 50mg 2x weekly was keeping me more stable, however I was not feeling very well still. I went back to the Dr. for a 3 month checkup and after talking to them, they didn't want to change anything and weren't going to look into any of my other hormones(I had felt my E2 was really high due to puffy/sensitive nipples, and bloat).

I immediately went looking for a new Dr. and found one local that was way more up to date with TRT protocols. After discussing the problems I was having Pre and currently with TRT, my Dr. decided to do a semen analysis, which came back with zero sperm present. My total test came back at 579ng/dl, E2 came back at 57, prolactin 11, fsh <0.1, and H+H at 18.5/52%. After discussing options we decided to try a Clomid restart at 50mg EoD, to see what my body was capable of producing endogenously. I was also placed on .5mg anastrozole 2x week, and 5mg Cialis daily.

I started the new treatment 3 weeks ago, on 4-6-17(1 week after last test injection). For the first week, I felt amazing- the boys came back full force, daily morning erections, full of energy, great libido and great overall sense of well being. The 2nd week I noticed a slight decline in the morning erections, energy levels and sense of well being, however much improved over baseline feelings. Currently ending week 3 has been a steady decline, no morning erections for the last 4 days, energy level is in the crapper, sense of well being is poor, my moods are all over the place, and my libido is virtually non existent.

I have a follow up with the Dr. on 5-18, after 6 weeks of treatment. I have a suspicion that either the clomid has failed to bring me up past my baseline levels pre TRT, or possibly that my estrogen has crashed. Is there any merit to this conclusions, or is the clomid simply not peaked at this point? I was on test cyp- so I can understand the injection didn't clear my system until sometime around week 2- which could have aided the first weeks of clomid right? Also- I noticed that after starting clomid the boys came back online almost immediately- any merit to trying Test and Clomid together?
 
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I'm guessing with that much anastrozole you have crashed your estrogen. Also do you know if you had the sensitive E2 test? When starting anastrozole it is best to start at a very low dose maybe .125mg twice a week and adjust from there. That is only based on the E2 from sensitive test (LC\MS)....On a side note that is a pretty high dose of clomid....Also clomid seems to be a 50\50 in terms of people feeling well on it. No do not use clomid and testosterone together.
 
It was a sensitive E2 test. I thought so on the Clomid as well but that's what the Dr. ordered lol, which I wanted to atleast try their recommendations. I have seen many mixed reviews on clomid, was hoping it would get the boys making some sperm, but the moodiness and loss of libido is not going to help that problem even if they are making sperm. Also, my wife has fertility issues aswell and has PCOS, so the Dr. felt this was the best chance of getting me fertile. However, we have talked about trying Test+HCG if the clomid doesn't go well. Should I try skipping the next dose or two of anastrozole and see if that helps? or continue path until my bloodwork?
 
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Ok, thank you for the advice. I will try skipping the AI for a week see if that will help, unfortunately I don't have the means to test on my own at this time, even though it is fairly cheap. Nothing about this process has been cheap up to this point.
 
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