Couldn't exactly tell from your PDF, but I'm guessing secondary hypogonadal, so discussing the options you have there with Clomid and/or Injections/topicals would be helpful.
You're on the higher end for SHBG so I'm assuming they'd recommend a higher dose than normal to push that down somewhat and elevate your Free T (if you go the injection route).
They might recommend DHEA but not sure.
E2 wasn't horrible but will increase with treatment but that doesn't mean you need to suppress it in anyway just yet.
Just pay attention to what your body does once treatment starts (monitor symptoms).
Good luck and keep us posted!
So my starting protocol seems pretty standard.
Test Cyp 200mg/l - .4ml twice weekly (180mg/week)
HCG - 500iu twice weekly
Anastrozole - .125 twice weekly
DHEA - 25mg nightly
Armour Thyroid - 1/2 grain every morning, can increase up to 1/2 grain every two weeks if no relief up to a max of 2 grains.
Have read a lot of horror stories about anastrozole so that’s the part of the protocol that worries me the most. My estradiol was 33 and shbg was 48 so what I’m told is that my estradiol is probably really around 20 since most of it is bound due to higher shbg.
Has anyone started anastrozole right away and had zero problems with it?
I'm an over-responder to AI's, so after I took 3 .125 anastrozole, estrogen was 12 pg/mL which isn't so terrible considering I'm a low SHBG guy as I have a ton of free estrogen floating around even at the lower numbers.
I'm planning of dosing 0.050 anastrozole and dissolving it in 5mls of vodka using graduated droppers and dosing .4mls twice weekly when E2 gets out of hand again. When testosterone is low and estrogen close to the top of the ranges, you can bet on estrogen being a problem once testosterone is sufficiently elevated.
Losing significant weight can reduce or eliminate the need for AI's.
I’m 37. We discussed my igf being on the low end but apparently it could get better with TRT so we’ll look at again at 3 month mark. The Dr. mentioned it is expensive and requires nightly shots for the igf and it can shoot up pretty quick so to me it sounded like too much to deal with in the beginning especially if it’s something that has to dialed in. My bmi is pretty high at around 35. I’m one of those guys that carry all my weight in the hips, ass, and thighs. I’ve gotten down to 185lbs before but I had to starve myself and run 5+ miles everyday. Needless to say I couldn’t maintain that weight. Probably has alot to do with my thyroid.
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