Severe Sides After Ceasing 25mg Clomid + 1mg Anastrozole

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Firstly, wanted to say thank you to everyone here as I've gotten a lot out of searching this forum while dealing with all of this, and also found Defy Medical here who has been very helpful.

Back in August 2021 I had a lab done showing Total T at 346 with Free T at 43.7 pg/mL. My primary doc suggested I consider treatment and to find someone that specializes in it. I found an MD that was highly credentialed and started talking about options.

On January 6th he started me on 25mg Clomid ED and 1mg Anastrozole twice a week which I continued through March 28th. After searching these forums, I learned this is a recipe for disaster. About the sixth week in to treatment I started having panic attacks and anxiety, which I had never experienced before in my life. On the 28th of March, I quit everything cold turkey. I wanted advice from my doctor on how to get off gradually but he insisted I wait for another blood test at these full doses before changing anything and I simply could not.

After ceasing, the anxiety + crazy emotions were especially bad for a week, then slightly less bad for a week, etc. Unfortunately, thanks to the new anxiety the high blood pressure I have lived with for years suddenly became a real issue, and I was taken to the ER for a BP of 193/121. I'm now medicated for that (propranolol due to its anti-anxiety properties) which brings it down a bit and we're adding valsartan to that as well.

April 25th will be four weeks since my last dose of Clomid. It feels as though the high estrogen effects are mostly gone, however now it seems like the low T effects are creeping in, so I have anxiety and depression/lack of hope going, etc. Does that hypothesis sound correct? I've had no libido whatsoever for 3 weeks which obviously is related as well, so is it safe to assume that my body will at least take me back to my previous baseline T now that the majority of Clomid is out of my system?

I'm sure this question is asked all the time, but I just have to ask it again anyway... Should I expect things to return to my previous normal? I talked to Defy on April 22nd and they said I should start feeling better over the next two weeks, but any of you that have gone through this know that feeling this way can make it hard to believe you'll ever be back to being you. I realize I'm only going to feel so great at 346/43.7 but I would gladly take that over what I have experienced over the past month.
 
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From what I've read, there are a few things this doc did wrong:

1. Prescribed Clomid instead of Enclomiphine
2. Started at 25mg ED out of the gate; seems like 12.5mg is a better place to start, and possibly not even every day.
3. Two 1mg doses of Anastrozole per week is extremely high. He also did not take baseline estrodial levels to determine what my "normal" was before treatment.

While I don't have any labs to back it up, yes, my hunch is that the high dose Anastrozole was crashing e2, leading to the panic attacks and anxiety. While my T numbers were up along with strength and recovery, my mood was not great on treatment. I think this is because we were crashing e2 twice a week, rather than managing it to a healthy level. I say this because I took it upon myself to ditch the Anastrozole for a week after doing some research, then tried a half dose (0.5mg, still too high) and promptly had the best day of my entire treatment period. Confidence, quick thinking, good libido, strength, recovery; everything. That was how I expected TRT to feel, it was just never dialed in correctly.
 
I'd just like to strongly warn anyone against taking regular Clomid for HRT purposes. I'm almost 5 weeks out since my last dose and am still nowhere near myself. My life has basically been put on hold for over a month as I have no way to know when I'm going to be "triggered" and freak out about nothing. I've been prescribed Lorazepam (as needed) to cope which helps but taking it scares me.

I am better than I had been early on but far from 100%. I'm hopeful 6 weeks will be the magic number but starting to prepare myself for 8 or even 12 weeks after seeing articles like this one.

I can't speak to enclomephine and have to assume it is much, much better to get off of. All I can say is be very cautious before starting Clomid. Make sure your life is stress free and easy. Mine was not, which was by design, actually. I could handle it just fine in a normal state but I have been far from normal during this experience so it absolutely increases these extremely unpleasant anxiety episodes.

Buyer beware.
 
I blame the anastrozole for your bad experience and not the clomid.

You have taken two things simultaneously but seem to bash the clomid and you are "warning" people to "exercise caution" with clomid.

Sure, 25mg ED is a little high, you can get away with that same dose EOD instead.

 
I blame the anastrozole for your bad experience and not the clomid.
So, I actually agree with this while I was still taking both. But do you think the fact that I'm still having wild anxiety episodes 5 weeks later could be attributed to the anastrozole despite the much shorter half life than zuclomiphine? Honest question, I'm new to this...
 
So, I actually agree with this while I was still taking both. But do you think the fact that I'm still having wild anxiety episodes 5 weeks later could be attributed to the anastrozole despite the much shorter half life than zuclomiphine? Honest question, I'm new to this...

You probably have crashed your estrogen, which can take (as someone said yesterday on this forum) "up to a year to correct".

I am saying this by interpreting your symptoms. Severe anxiety, panic attacks = low E2. Rage, moodiness, PMS behavior, bloating, water retention are typical clomid symptoms, and you don't seem to have these.

One does NOT start any protocol by taking 1mg anastrozole a week.
 
One does NOT start any protocol by taking 1mg anastrozole a week.
And if you're sensitive to medications, half or even a quarter of 1 mg anastrozole may send your E2 spiraling down into the single digits or worse.

To complicate matters, anastrozole is being prescribed off label for men and all the dosing recommendations are for women for which the drug was originally intended for the treatment of breast cancer.

1 mg anastrozole is way too much for most guys.
 
Yeah, after bixt's reply to my post I researched further. I think crashed E2 hasn't been showing up on labs due to my multivitamin having 1,367% of the daily recommendation of Biotin.

Would crashed E2 present as low estrodial on the sensitive test or is there a separate test for E2?

I'm reaching back out to Defy for new labs without the Biotin, but is there any way to speed up recovery here? Can I like supplement with very low dose estrodial or something?

Thanks for all the replies, this is such a disaster and you guys are at least helping me make sense of it.
 
but is there any way to speed up recovery here? Can I like supplement with very low dose estrodial or something?

The quickest, fastest way by far for immediate relief is to take dbol. It aromatises heavily and will nuke "low E2 symptoms". This need only be taken for a couple days and is temporary, not part of your permanent protocol or anything like that.

You will have to get this from a bodybuilding steroid supplier.

I doubt any doctor or even anyone else on this forum would approve of such a fix, probably because they have not tried such a thing. On the other hand, this kind of thing is second nature to bodybuilders and routinely used.
 
Appreciate that reply. I searched the forum further and it looks like 6-8 weeks is a reasonable time for things to settle naturally. I'm only at 5 weeks and have been improving so I'm going to wait it out.
 
...
Would crashed E2 present as low estrodial on the sensitive test or is there a separate test for E2?
...
A sensitive estradiol test, e.g. one based on liquid chromatography-mass spectrometry, should not be influenced by excessive biotin.[R] It also seems as though biotin interference is more likely to make hormone levels appear lower than they actually are. If you haven't seen low estradiol on lab work then it may not actually be low. Therefore I wouldn't dismiss the possibility of lingering—estrogenic—zuclomiphene causing some problems. You've only recently gone beyond one half-life, at which point half the accumulated drug was still in your system.

...
After ceasing, the anxiety + crazy emotions were especially bad for a week ...
This could be interpreted as a rebound effect involving excessive aromatase. Anastrozole works through competitive inhibition, so once you stop taking it the aromatase is freed and added to unbound levels, which may have been elevated by a perceived deficiency.
 
A sensitive estradiol test, e.g. one based on liquid chromatography-mass spectrometry, should not be influenced by excessive biotin.[R] It also seems as though biotin interference is more likely to make hormone levels appear lower than they actually are. If you haven't seen low estradiol on lab work then it may not actually be low. Therefore I wouldn't dismiss the possibility of lingering—estrogenic—zuclomiphene causing some problems. You've only recently gone beyond one half-life, at which point half the accumulated drug was still in your system.


This could be interpreted as a rebound effect involving excessive aromatase. Anastrozole works through competitive inhibition, so once you stop taking it the aromatase is freed and added to unbound levels, which may have been elevated by a perceived deficiency.
Very interesting, thank you for this.
 
Therefore I wouldn't dismiss the possibility of lingering—estrogenic—zuclomiphene causing some problems. You've only recently gone beyond one half-life, at which point half the accumulated drug was still in your system.

It's been 5 weeks and you've said I'm only past one half-life; what is the generally understood half-life of the zuclomiphene isomer?
 
It's been 5 weeks and you've said I'm only past one half-life; what is the generally understood half-life of the zuclomiphene isomer?
It varies, depending on the study, but 30 days is commonly reported. E.g. Wikipedia:

Additionally, enclomifene has a halflife of just 10 hours, but zuclomifene has a halflife of 30 days—therefore if the goal is to boost testosterone, taking regular clomifene may produce far longer-lasting pro-estrogenic effects than pro-androgenic effects.
...
Due to its long halflife, zuclomifene can be detected in urine for at least 261 days after discontinuation[21]
 
Thanks. I'm going to get a fresh lab with no biotin interference to conclusively figure out my Free T/E2 ratio. With that I'll be able to either do something about crashed E2 or rule it out.
 
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Firstly, wanted to say thank you to everyone here as I've gotten a lot out of searching this forum while dealing with all of this, and also found Defy Medical here who has been very helpful.

Back in August 2021 I had a lab done showing Total T at 346 with Free T at 43.7 pg/mL. My primary doc suggested I consider treatment and to find someone that specializes in it. I found an MD that was highly credentialed and started talking about options.

On January 6th he started me on 25mg Clomid ED and 1mg Anastrozole twice a week which I continued through March 28th. After searching these forums, I learned this is a recipe for disaster. About the sixth week in to treatment I started having panic attacks and anxiety, which I had never experienced before in my life. On the 28th of March, I quit everything cold turkey. I wanted advice from my doctor on how to get off gradually but he insisted I wait for another blood test at these full doses before changing anything and I simply could not.

After ceasing, the anxiety + crazy emotions were especially bad for a week, then slightly less bad for a week, etc. Unfortunately, thanks to the new anxiety the high blood pressure I have lived with for years suddenly became a real issue, and I was taken to the ER for a BP of 193/121. I'm now medicated for that (propranolol due to its anti-anxiety properties) which brings it down a bit and we're adding valsartan to that as well.

April 25th will be four weeks since my last dose of Clomid. It feels as though the high estrogen effects are mostly gone, however now it seems like the low T effects are creeping in, so I have anxiety and depression/lack of hope going, etc. Does that hypothesis sound correct? I've had no libido whatsoever for 3 weeks which obviously is related as well, so is it safe to assume that my body will at least take me back to my previous baseline T now that the majority of Clomid is out of my system?

I'm sure this question is asked all the time, but I just have to ask it again anyway... Should I expect things to return to my previous normal? I talked to Defy on April 22nd and they said I should start feeling better over the next two weeks, but any of you that have gone through this know that feeling this way can make it hard to believe you'll ever be back to being you. I realize I'm only going to feel so great at 346/43.7 but I would gladly take that over what I have experienced over the past month.
WOW, I'm really sorry you went through all of this. How awful. I've experienced the same insane symptoms from something else I did a few years ago.. crippling anxiety, panic attacks, then fell into a dark clinical depression.... It was terrifying.

Anyway, just wanted to let you know you have a friend that can sympathize with your pain.

I do pray you get feeling better.
 
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