Hey guys, would I qualify for TRT based on my labs?

[CFGT]

The forum won't let me post photos of the labs. It says file type isn't valid when I try to upload.

 

[johndoesmith]

The forum won't let me post photos of the labs. It says file type isn't valid when I try to upload.

www.imgur.com

 

[1Draw]

39 years old
Labcorp
total T 588
Free T 13
Estradiol 23
LH 3.0
Hematocrit 47
Hemoglobin 15

Lacking energy/libido/motivation and mood in the last 6-12 months. Big drop in athletic performance over that time and lack of motivation to train.

Depends on what time of day labs were taken IMO. If done early am, T levels normally are at their peak. Also, your Free T of 13 is well short of Life Extensions recommended optimal levels of free T of 20-25 pg/ml. Don't think your SHBG is high because your Free T of 13 is 2.2% of total T. If it were high, you would be somewhere around 8 or 9.

I like what a Doctor told me one time that he doesn't treat numbers he treats symptoms. You are having all the symptoms of Low T and problem now is to find a doctor that will treat you. Dr Saya and his staff at Defy would be a good place to start.

Good luck!

 

[CFGT]

Ok, spoke with Dr. Saya. He believes my testes are responsive with production but due to a lower LH level perhaps my pituitary isn't signaling properly. He prescribed clomid along with anastazole and some herbal supplements for liver detox and DHEA-S. I have follow up labs in 6 weeks. Will see if I can get back to a "natural" 1,000-,1200. Will keep y'all posted.

 

[eli]

don't man, TRT is a pain in the ass

 

[CFGT]

Why do you say that, Eli?

 

[user_joe]

Matter of opinion. I don't think it's a big deal.

Your case is is pretty interesting imo for a couple of reasons. One you are shooting for a natural TT that is top of the range. Odds are against that being achievable. The other deal is people report there is a 3x rule. You need to triple your levels to get the full therapeutic effects. That's just what people say. Hope you get it worked out.

 

[CFGT]

Thanks Joe. I start the Clomid restart in a few days and labs in 6 weeks. Will keep you all updated on results.

 

[eli]

Brows forums online, people have a really hard time finding that sweet spot. For one person that feels great on trt there are 4 complaining about not feeling anything. Try the clomid therapy.... Do 12mg ed or eod, let trt be your last option

 

[CFGT]

Yes, he prescribed the 12.5 ED with a low dose anastrazole.

 

[CoastWatcher]

Yes, he prescribed the 12.5 ED with a low dose anastrazole.

Curious where your estradiol was sitting? On the sensitive test?

 

[CFGT]

Curious where your estradiol was sitting? On the sensitive test?

around 24.

 

[Dr Justin Saya MD]

around 24.

It's imperative to keep VERY tight control of E2 while on Clomid due to the zuclomiphene effect. E2 levels that might have otherwise not necessitated an AI (for example with straight TRT patients) typically will require an AI with Clomid monotherapy. It's one of those pearls learned through vast experience treating with Clomid. Otherwise the treatment is often doomed to failure unfortunately...even with the added precautions, as we all know, success of treatment is certainly far from guaranteed.

 

[CFGT]

It's imperative to keep VERY tight control of E2 while on Clomid due to the zuclomiphene effect. E2 levels that might have otherwise not necessitated an AI (for example with straight TRT patients) typically will require an AI with Clomid monotherapy. It's one of those pearls learned through vast experience treating with Clomid. Otherwise the treatment is often doomed to failure unfortunately...even with the added precautions, as we all know, success of treatment is certainly far from guaranteed.

Dr. Saya, you put 0.08mg Anastrozole in my Clomid. I presume that is the purpose, to control E2?

 

[Dr Justin Saya MD]

Dr. Saya, you put 0.08mg Anastrozole in my Clomid. I presume that is the purpose, to control E2?

Precisely.

 

[CFGT]

Awesome. I should have the meds tomorrow according to Fedex.

 

[CFGT]

Another quick question. How long after starting Clomid is typical to "feel" any improvement in strength, energy, mood, libido, etc?

 

[Dr Justin Saya MD]

Another quick question. How long after starting Clomid is typical to "feel" any improvement in strength, energy, mood, libido, etc?

As with TRT it takes time. Patience is a virtue. Generally at LEAST several weeks (3-4) is a realistic expectation for STARTING to notice changes for both TRT/Clomid. Some may vary, but this is a general guideline.

 

[CFGT]

Thanks, doc. Have a wonderful evening.

 

[johndoesmith]

It's imperative to keep VERY tight control of E2 while on Clomid due to the zuclomiphene effect. E2 levels that might have otherwise not necessitated an AI (for example with straight TRT patients) typically will require an AI with Clomid monotherapy. It's one of those pearls learned through vast experience treating with Clomid. Otherwise the treatment is often doomed to failure unfortunately...even with the added precautions, as we all know, success of treatment is certainly far from guaranteed.

Is zuclomiphene an identical agonist as E2 is? Not just in terms of Ki but EC50 and possibly even other more complicated measurements of end target response.

In other words, there are ERa and ERb receptors, does zuclomiphene bind identically to these as does E2?

I wonder if zuclomiphene has a bit of a different response from the receptor than E2 does and possibly explaining the poor response most men report.

I've even thought that clomid's estrogen antagonist effects were responsible for the poor response, but the symptoms these men report sound more high E2 than low, but not always.