Switched from TRT to Enclomiphene...surprising results

[DaveK2204]

So I was on TRT recently for the last 2.5 years and decided to do a re-start and try Enclomiphene. I have been on & off TRT about 4x over past 15 years so and I did clomid when not on TRT...rather no get into all that though as it's a complicated story.

So after 6 weeks of doing Enclomiphene 25mg EOD, I got my lab work back. It came in in stages so I got LH first, then TT & FT followed days later. Defy Med initially suggested 25mg daily but I wanted to see how EOD worked first. Here are my labs:

Testosterone, Total​	182 ​	250 - 1100​
Testosterone, Free​	26.2​	46 - 224​
SHBG​	30​	22-77 nmol/L​
DHEA​	147​	32-279 mcg/dL
LH​	4.8​	1.5-9.3 mIU/m​
Estradiol​	12​	< or = 29​

So when I initially saw my LH was in mid range (before I knew my TT), I thought my TT & FT could be also near the mid point too. To my shock, not even close...it's the lowest ever.

What I am wondering now is if my testicles have some atrophy from the 2.5 yrs on TRT. I did do HCG the entire time on TRT so I was hoping to minimize any atrophy best I could. Is it possible my Leydig cells just need more time to fully recover? It seems my pituitary is reacting fairly good to even just the low dose Enc. but maybe it's still not enough.

While waiting now for my followup with Defy, I am starting 25mg daily which may have been the correct protocol from the start. I did read that Enclomiphene has a much shorter half life compared to Clomid so mybe EOD is just not ideal.

If anyone has any insights on this, feel free to share.

 

[Vince]

So I was on TRT recently for the last 2.5 years and decided to do a re-start and try Enclomiphene. I have been on & off TRT about 4x over past 15 years so and I did clomid when not on TRT...rather no get into all that though as it's a complicated story.

So after 6 weeks of doing Enclomiphene 25mg EOD, I got my lab work back. It came in in stages so I got LH first, then TT & FT followed days later. Defy Med initially suggested 25mg daily but I wanted to see how EOD worked first. Here are my labs:

Testosterone, Total​	182 ​	250 - 1100​
Testosterone, Free​	26.2​	46 - 224​
SHBG​	30​	22-77 nmol/L​
DHEA​	147​	32-279 mcg/dL
LH​	4.8​	1.5-9.3 mIU/m​
Estradiol​	12​	< or = 29​

So when I initially saw my LH was in mid range (before I knew my TT), I thought my TT & FT could be also near the mid point too. To my shock, not even close...it's the lowest ever.

What I am wondering now is if my testicles have some atrophy from the 2.5 yrs on TRT. I did do HCG the entire time on TRT so I was hoping to minimize any atrophy best I could. Is it possible my Leydig cells just need more time to fully recover? It seems my pituitary is reacting fairly good to even just the low dose Enc. but maybe it's still not enough.

While waiting now for my followup with Defy, I am starting 25mg daily which may have been the correct protocol from the start. I did read that Enclomiphene has a much shorter half life compared to Clomid so mybe EOD is just not ideal.

If anyone has any insights on this, feel free to share.

Do you know if you were primary or secondary hypogonardism.

Primary hypogonadism is when the testicles themselves don't work correctly and fail to produce enough testosterone.

 

[DaveK2204]

Do you know if you were primary or secondary hypogonardism.

Primary hypogonadism is when the testicles themselves don't work correctly and fail to produce enough testosterone.

All indications over the years is that I was secondary based on labs.... either clomid mono or HCG mono would bump my TT up fairly good apparently indicating good testicle response. However, those protocols also drove E2 up too high.

My gut says I will just need to see what labs look like after 6 weeks on my new protocol of Enclomiphene daily. If my TT is still tanked, then I know it's a "primary" issue.