I’ve been on Clomid exclusively for 3 years

[FeelingLost]

Adding up all of the costs it appears to cost way more than I anticipated. 2180$ for first year and 2040$ a yr after. Looking at DefyMedical I think my insurance will cover labs and it will end up costing significantly less.. at 100$ a monthish with a 10% discount first responder. That's more doable!

Calling Defy and getting your system clean is a great start. i am looking forward to hearing about your progress.
Looking at your most recent blood numbers the T sucks but that is fixable The good thing is your SHGB. 50. Range 10-50 at least you won't have to deal with the low SHGB issues.

 

[Bcliff3027]

I spoke with them and they sent all relevant paperwork and cost break downs. Looks like first year with labs if I cannot get my insurance to help it will be around 2k. Year 2 and so on will be around 1400$ a year because of less labs and seeing the nurse as opposed to the Dr. Intake lady was super nice and patient with my questions.
Now, convincing the wife to allow me to spend that much money is the next hurtle. Going to be difficult when she’s used to things being covered by insurance and meds only being 20$ a month. The good news is at her request I called the Endocrinologist’s office I was referred to and the nurse really aggravated me. Actually bad enough I slammed them on Google... and to no surprise they had terrible reviews from previous patients.

My review.
I was referred to the Office. I called asking about the Dr. standard protocol for my issues and the nurse rudely kept repeating she would not answer any medical questions without me being a patient. I said, mam I am only asking what was typical for the Dr. when managing testosterone replacement therapy. She said, I cannot answer any medical questions. I asked if they had my chart and she continued having a snappy/rude tone and said you are not a patient here so we have no records. My previous Dr said they were sending them almost 2 weeks ago. She said we don’t have any of your records. All I wanted to know was if his protocols were just Test shots with no other hormone management such as estrogen.. I wanted a Dr that would be interested in managing the whole picture not just one end of the spectrum. I don’t think that is too much to ask. I will go without and feel terrible before stepping foot in there and spending my money. Just for the record, I was speaking with Dr. Barbers nurse.

 

[FeelingLost]

Your experience is no different than the three I delt with in Denver.
Endos and Uro's are slammed with treating cancer.
They have no time for TRT there just is no money in it compared to what they can charge major medical for cancer treatments.

You and your wife are going to have to decide how important this is to you both. Get a second job, sell the boat , haha you got to do what you got to do.

 

[Bcliff3027]

So higher SHBG is a good thing? I was reading this from the definitive trt manual about it.. wondering your thoughts.. my free test was low.. and SHGB was high..

In a healthy young male, 60% of testosterone
is attached to Sex Hormone-Binding Globulin
(SHBG).103 SHBG is produced mainly by the liver
and then released into the bloodstream. Hormones
bound to SHBG can’t be used by the body and
lose their anabolic effect. As men age, SHBG
levels rise and bind strongly to the testosterone
molecule lowering the body’s absorption of free
testosterone and its many benefits.104 Hence, we
want to have as much FREE (usable) testosterone available as possible.
SHBG is an important marker of insulin resistance and studies have shown
it an independent predictor of metabolic syndrome and type 2 diabetes105.
In aging men, the rise in SHBG and associated maintenance of total
testosterone values may mask low levels of free testosterone. SHBG is a
critical component of proper TRT evaluation. It is imperative your doctor is
vigilant to your SHBG and free testosterone levels while on TRT.



he suggests using stinging nettleroot to help control SHBG and also prevent conversion from free t to DHT.

 

[FeelingLost]

So higher SHBG is a good thing? I was reading this from the definitive trt manual about it.. wondering your thoughts.. my free test was low.. and SHGB was high..

In a healthy young male, 60% of testosterone
is attached to Sex Hormone-Binding Globulin
(SHBG).103 SHBG is produced mainly by the liver
and then released into the bloodstream. Hormones
bound to SHBG can't be used by the body and
lose their anabolic effect. As men age, SHBG
levels rise and bind strongly to the testosterone
molecule lowering the body's absorption of free
testosterone and its many benefits.104 Hence, we
want to have as much FREE (usable) testosterone available as possible.
SHBG is an important marker of insulin resistance and studies have shown
it an independent predictor of metabolic syndrome and type 2 diabetes105.
In aging men, the rise in SHBG and associated maintenance of total
testosterone values may mask low levels of free testosterone. SHBG is a
critical component of proper TRT evaluation. It is imperative your doctor is
vigilant to your SHBG and free testosterone levels while on TRT.

he suggests using stinging nettleroot to help control SHBG and also prevent conversion from free t to DHT.

I'm going to copy a post from one of this forums long term trusted members.

I have low SHBG (fluctuate between single digits and low teens) my main symptom is basically next to no response to TRT overall. I am on a state of the art protocol with a great doctor and yet I feel like I did with Low T. Low to no libido along with an inability to gain muscle or loose fat. I would also take a nap every day if not for having to work. -ERO

Here's the whole thread if interested. https://www.excelmale.com/forum/showthread.php?12417-Low-SHBG-guys

 

[Bcliff3027]

Wow... his symptoms are EXACTLY what mine are.. the heat intolerance and exercise intolerance. If I do any high intensity workouts like CrossFit, which I love but haven’t been able to do, I can’t breathe.. I’m breathing hard and still feel like I’m suffocating.. and then later I get like a 24 hr flu like symptoms after the workout. I literally have to go to bed because of the intense headache. I also recently got up to 255 lbs.. in my early 20s I was 180.. the weight gain has shot up in the last 4 years. I’m 32 now. I am down to 232 now through intermittent fasting which I love and will probably continue to do for the rest of my life. My wife finds it almost embarrassing how much I sweat in just normal warm weather.. face turns all red and you can literally feel salt crystals on my skin if I am out there long enough. I wonder if low and high behave the same??

Im a low SHBG guy (usually single digits).

Do you have muscle loss/weakness?
Fasciculations (muscle twitching)?
Raised triglycerides?
Heat intolerance?
Abdominal weight gain?
Shortness of Breath?
Exercise intolerance?

Any other symptoms?

 

[glintcranium]

Make sure you get tests to monitor your blood levels too. Clomid may have adverse reactions if taken too long.

 

[Bcliff3027]

Well, another twist in the road, my father in law recommended that I call a place that his friend goes to for TRT. He said his friend has been going there for years and loves them. So, I called them. I spoke with the nurse and she said.. we do trt anti estrogen and Hcg as part of our protocol.. and they accept my insurance and labs would be covered... she said if i would have came to them years ago with my levels they would have put me on Clomid too if we were wanting to have kids. Jeez I wouldn’t have had to fight with my Urologist years ago...

 

[dikow]

Enclomiphene actually has a half life of 10 hours. Zuclomiphene has a half life of 7 days!

I know where you come from with this data, but there is a study done on females that received clomid intravenously and the half-life found ranged from 2-12 days for the enclo part. Check this out:

http://www.peaktestosterone.com/Clomid_Half_Life.aspx
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379933/

I am personally confused because different studies give different info on this subject.

 

[Bcliff3027]

Welp, my first appointment ( post labs ) is on Tuesday. I cant wait because currently im wearing a bandaid on both nipples.. my shirt touching them is killing me. Guessing my levels have tanked.. mental clarity suffering too. Took 10 days without Clomid for my nipples to get ultra sensitive.

 

[FeelingLost]

Post Labs? do you have the labs now? If so what are your numbers?
I had very sensitive nipples about 6 months ago. My doc at that time said it was my prolactin.
Sure enough my blood test confirmed. My protocol was changed to ad an AI and HCG

Within 2 weeks I could remove the bandaids. NOTE to self shave nipples if you ever have to put bandaids on again, HaHa ouch!

 

[Bcliff3027]

No unfortunately I haven’t seen the labs.. had blood drawn on Thursday. I’ll be meeting the Dr and hopefully walking out with a good action plan.. I’ll keep you posted as soon as I get the plan and my labs.

 

[Bcliff3027]

Great news!!! So for labs..
Total test 249
Estrodiol 12.6
Thyroid everything else good. I didn’t see anywhere for LH or FSH.. anyways.
Dr prescribed
200MG test Cypionate weekly
250iu HCG 3 Times a week..
and she anticipates an AI but she’s going to wait for labs to indicate it’s needed. She said they will keep it under 40.
I did get approval to do 2 injections weekly to help with troughs and I’ll do HCG in those injections. She was super knowledgeable and I’m impressed. She wants me to come back next month for labs..

 

[CoastWatcher]

Great news!!! So for labs..
Total test 249
Estrodiol 12.6
Thyroid everything else good. I didn't see anywhere for LH or FSH.. anyways.
Dr prescribed
200MG test Cypionate weekly
250iu HCG 3 Times a week..
and she anticipates an AI but she's going to wait for labs to indicate it's needed. She said they will keep it under 40.
I did get approval to do 2 injections weekly to help with troughs and I'll do HCG in those injections. She was super knowledgeable and I'm impressed. She wants me to come back next month for labs..

What, may I ask, prompted you and your doctor to settle on 200mg of testosterone as your weekly dose? It's on the steep side of a TRT protocol, particularly if you're going to be injecting twice weekly.

 

[Bcliff3027]

Umm.. it’s just what she wanted to start me at.. she didn’t give any reasons.. I’m sure she will back it down should my levels be too high next month.

 

[JPB]

That's great news for you, and she does sound knowledgeable. But if I were doing that dose I would probably inject every other day to help avoid estrogen sides and peaks and troughs. And 200mg/week is still a lot. Usually on a frequent injection schedule target levels can be hit on lower dosages. Best to adjust and avoid the AI. Personally, I am not a fan of hcg it tends to contribute to the estrogen issues.

 

[Bcliff3027]

Before beginning Clomidiphene I was experiencing testicular atrophy and pretty strong constant dull pain in both testicles. Nothing helped sexually.. abstaining.. lightening the load.. nothing. My urologist said he believed it was from atrophy because it stopped when I began Clomid. HCG should keep them from atrophying again and hopefully save me some pain.

 

[Will Brink]

Great news!!! So for labs..
Total test 249
Estrodiol 12.6
Thyroid everything else good. I didn't see anywhere for LH or FSH.. anyways.
Dr prescribed
200MG test Cypionate weekly
250iu HCG 3 Times a week..
and she anticipates an AI but she's going to wait for labs to indicate it's needed. She said they will keep it under 40.
I did get approval to do 2 injections weekly to help with troughs and I'll do HCG in those injections. She was super knowledgeable and I'm impressed. She wants me to come back next month for labs..

Other then that, sounds like she's on the ball. It's usually the case the doc starts off on too low a dose, rare they start so high. But, see how it goes via labs and how you feel. Good luck.

 

[Bcliff3027]

You guys got me worried about the dosing so I just looked at the actual prescription and she actually prescribed 150MG weekly. I guess I misunderstood what she was saying but it’s clear on the prescription. That sound more reasonable?

 

[JPB]

Yes 150mg, that sounds about right. The strength is probably 200mg/ml but that does not mean 1ml weekly. Regarding the hcg, yeah that is what it suppose to do. For me, my balls felt worse and more atrophied on it, with TRT, over time. Although in the past way back in the day when I came off cycle and did some Pregnyl it certainly fattened them up nicely. But something about taking it concurrently with T, did not work for me. Also as I have elluded to, there are some posts here noting a big difference between pharma Pregnyl and compounded hcg. But you are heading in the right direction no doubt.