low T, clomid only?

[42HRT]

I finally went to a real doctor. Urologist. I have had one test total T of 230 laborp.
The urologist. seemed knowageable. And we are getting some more tests on Friday, before deciding how to proceed. She mentioned based on the tests, that running 25mcg of clomid daily, may provide a mild-moderate bump in testestrone. I prefer to try that before jumping on T at only 42. Has anybody had any good luck with clomid only? She mentioned HCG only as well, but said that the dose required to raise T levels, would be way more expensive, than just T.

 

[Systemlord]

Has anybody had any good luck with clomid only?

There are unicorns out there that respond favorably to clomid. My concern is how clomid works, by blocking some or all estrogen in the brain, liver, pancreas and heart.

It’s one of those unknowns what if anything will happen long term. Side effects can be quite severe for some men, severe mood disturbances, vision problems and more commonly, feeling no different even when hormone values are much higher than baseline.

TRT isn’t without it’s potential downsides, like suppressing many other hormones downstream of LH, which is almost fully suppressed on exogenous testosterone.

The vast majority of men don’t have problems on TRT beyond the initial optimization of their protocol.

As far as hCG, you’ll get estrogen from two different sources compared to only one source on TRT, the former has the potential to create more problems with estrogen dominance. I find the majority of men feel better on TRT than clomid or hCG.

A small minority of men need hCG with their TRT to make it work, hCG can fix ejaculation and penile sensitivity problems and improve wellbeing.

HCG is one of those compounds that men either respond very well, or not at all. A smaller number of men respond well to hCG, if only initiall, then things go downhill from there.

 

[aneuman]

What I'm going to mention is an anecdote of one person, but it may encourage you to try your doctor's approach. This is a 33 yo male that had total T levels of 125 ng/dL (280-1100 reference range) confirmed twice. He started enclomiphene citrate and was not able to get above 300 (which was a noticeable improvement. His doctor switched him to Clomid (I'm not sure if it's 25 or 50 mg daily) but he's now above 550 ng/dL which is a 440% above baseline. He claims he feels well and is willing to continue the treatment.

Your doctor seems knowledgeable. It is true that HCG would be more expensive and more inconvenient, given that it is an injection and requires refrigeration. Compared to one pill a day, Clomid wins hands down.

Now, neither Clomid nor hCG, or TRT for that matter works equally well for every man. The good thing is that if Clomid doesn't work for you, there's hCG, and ultimately TRT, so you have options.

I wish you good luck.

 

[aneuman]

My concern is how clomid works, by blocking some or all estrogen in the brain, liver, pancreas and heart.

Would you be so kind to provide reliable sources to backup this statement?

It’s one of those unknowns what if anything will happen long term. Side effects can be quite severe for some men, severe mood disturbances, vision problems and more commonly, feeling no different even when hormone values are much higher than baseline.

This is a valid concern. Doesn't happen to everyone, though, but it's known to happen.

TRT isn’t without it’s potential downsides

True.

Unfortunately, there's no way to tell which will end up working for the OP. So my advice would be, go with your doctor's advice, monitor symptoms, and above all, don't read too much on the internet or watch too many "low testosterone" videos on you tube. Give it time (3 to 6 months) if you see no improvements or benefits, discuss other options with your doctor. If something negative starts to occur (vision problems, dizziness, etc) visit your doctor immediately.

 

[Systemlord]

Would you be so kind to provide reliable sources to backup this statement?

I heard a very prominent doctor talking about how clomid binds to certain receptors in various organs throughout the body.

 

[aneuman]

I heard a very prominent doctor talking about how clomid binds to certain receptors in various organs throughout the body.

Thanks! I've also heard very prominent people (doctors, lawyers, presidents) say lot of things I have a hard time believing.

A prominent doctor once told me he did not check estrogen on men because that was a female hormone (in 2022, not the 18th century)

I also heard a prominent lawyer say that covid was created by Bill Gates... well, I won't get into this one...

Now seriously, it's very possible that this is true, I'll go as far as to say that it is most like true that SERMs act on estrogen receptors in organs other than their targets, with unknown side effects. What I don't agree with is throwing this hypothesis without a caveat, as a statement of fact. I think it serves us all well if try to elevate the level of everyone in this field, by encouraging critical thinking, and at a minimum, evaluate risks and benefits with a more factual basis.

Thanks for your contribution, I've learned a lot from you, particularly on the ferritin topic which I did not know anything about. If you ever encounter a serious article talking about clomid/enclomiphene acting on receptors other than pituitary/hypothalamus and what effect it has on the body, I'd really appreciate you shared it with us. I've searched a lot about this topic but I can't find anything.

 

[TLR]

I finally went to a real doctor. Urologist. I have had one test total T of 230 laborp.
The urologist. seemed knowageable. And we are getting some more tests on Friday, before deciding how to proceed. She mentioned based on the tests, that running 25mcg of clomid daily, may provide a mild-moderate bump in testestrone. I prefer to try that before jumping on T at only 42. Has anybody had any good luck with clomid only? She mentioned HCG only as well, but said that the dose required to raise T levels, would be way more expensive, than just T.

The good thing about Clomid is if it doesn’t work you didn’t cause any shutdown to the HPTA….I like your docs approach….Clomid didn’t work for me at attempting to come off TRT, but I think age and the length my system was shutdown was the biggest barrier. Give it a shot.

 

[FunkOdyssey]

If you ever encounter a serious article talking about clomid/enclomiphene acting on receptors other than pituitary/hypothalamus and what effect it has on the body, I'd really appreciate you shared it with us. I've searched a lot about this topic but I can't find anything.

One documented anti-estrogenic effect of enclomiphene shows up in IGF-1 levels:

Testosterone Restoration by Enclomiphene Citrate in Men with Secondary Hypogonadism: Pharmacodynamics and Pharmacokinetics - PubMed

Enclomiphene citrate increased serum LH and TT; however, there was not a temporal association between the peak drug levels and the Cmax levels LH or TT. Enclomiphene citrate consistently increased serum TT into the normal range and increased LH and FSH above the normal range. The effects on LH...

pubmed.ncbi.nlm.nih.gov

In general, enclomiphene citrate had few changes in these hormones and markers, with the exception of IGF-1. IGF-1 is secreted by the liver and is regulated in part by hGH levels; however circulating levels also are dependent on the proteins that bind IGF-1 in the circulation. IGF-1 levels were decreased in the men in the enclomiphene citrate groups, but not in the transdermal testosterone group, but the levels remained within the normal physiological ranges. We are uncertain as to the significance of this observation. Testosterone treatment of men with testosterone deficiency usually increases serum estradiol levels, and may increase hGH and IGF-1 levels. Estrogen is known to potentiate secretion of hGH and IGF-1 levels. Enclomiphene citrate increases serum estradiol levels. We suspect that the anti-estrogen effects of enclomiphene citrate are working at either the hypothalamic-pituitary level or possibly on the liver to reduce IGF-1 levels. Unfortunately, technical issues prevented the measurement of hGH levels in the serum samples from these men. It would also be relevant to know if enclomiphene citrate treatment affects the IGF-binding proteins.

They aren't sure whether the estrogen-blocking is taking place in the liver or at the hypothalamic-pituitary level though.

 

[aneuman]

One documented anti-estrogenic effect of enclomiphene shows up in IGF-1 levels:

Thanks @FunkOdyssey. Thank you for sharing the article.

They aren't sure whether the estrogen-blocking is taking place in the liver or at the hypothalamic-pituitary level though.

That's precisely the problem. Just as @Systemlord, I suspect encomiphene acts on many ER receptors throughout the body, with different effects, but it seems that no one has been willing to put the time and money to find out. I was aware of the IGF-1 link, but most likely there are other sites as well.

Again, thanks fro taking the time to find and share the article.