Tried Clomid restart, doc has me on hCG mono now...

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46and2

New Member
Hi all. I am a 36 year old male, and my story started in the last 2-3 years. I have always been small, little facial hair, higher pitched voice, etc. I train Brazilian Jiu Jitsu 5-6 days a week and coach little kids 3 days a week. Over the last 2-3 years, I noticed a decrease in my sex drive, a sharp decrease in my enjoyment in everything except BJJ and family time, no motivation at work, depression, and some fat gain around my waist. I went to my PCP last year and he said I am too young for low T, exercise more. So I went to a Urologist that a friend recommended. My total T was 284 and free T was also low, but their scale was 175ng/dl - 780 for total T, so they said "you're low but normal, goodbye".

I contacted a clinic and tested again, this time at 399 total and a low but "in range" free T. The doctor recommended a Clomid restart. I did 50mg/day for 4 weeks, and my total T shot up to 1195, with free T at 33 ng/dl. My estradiol also went up into the 50's. They tapered me off VERY slowly, going to 50mg on weekdays and skipping weekends. My total went even higher to 1258, but E2 was in the 60's and I got 2 itchy nipples and a lump under my left one. The Dr. upped the adex to 1mg a week, which was not enough to reduce the itching and lump. This whole time my libido was improved somewhat, making gains in the gym, feeling good other than being kinda emotional and itchy. Financial issues arose, so I went on my own and tapered quickly off the Clomid and ran mucho adex. In April, total T was 828 and I was still feeling good. Fast forward to September, my total T was 446, free was 10.6 ng/dl, and my libido is gone, exhausted after training (so much that I cannot even lift weights). The depression is returning but I am working on that with a therapist and mediation.

I found a new doc on my insurance, and she has me trying 2,000IU of hCG E3D for a total of 10,000IU, which seems like a high dosage to me. She wants to do blood work 5 weeks after my 1st injection. This seems a bit off to me and I have asked for clarification. I did my 1st injection Friday, September 26th. So far I have not noticed any effects. My questions are, why would she run it so high for a short time? Wouldn't 500-750IU split 3x a week be better? If I just run for ~2 weeks, won't it be tough to see any subjective benefits on mood, libido, etc? I guess the biggest thing is I feel like I am "wasting time" trying to "restart" myself and I should just find a doc to go straight TRT. Does that sound ridiculous? I'd like to hear your thoughts. Thanks!
 
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Did you consider low dose clomid (i.e. 12.5 ED or EOD) Might not need an AI with this route.

I thought about that yes. I'm guessing the emotional sides I experienced on Clomid were due to the higher dosage I was on? If I saw that SPCA commercial with Sara McLaughlin I'd lose it lol.
 
Clomid was not good for me... T levels great but emotionally felt terrible... Still have not recovered....
 
Yes a lipoderm cream 150MG... A gram in morning and one at night... And because of this site I have my DR adding in HCG 125 units twice per week... For 4 years I was on this protocol minus the HCG and felt good... Dr went out of business and the Dr he referred me to put me on the Clomid (50MG Monday-Friday)... I still feel something is off... Went from having a huge sex drive to nothing... Loss of appetite... Loss of weight and lack of desire to work out.... Beginning to wonder if it is something else...
 
This study shows the discordant fact that increased T, LH and FSH caused by Clomid may not help sexual function. It does not explain why.

J Clin Endocrinol Metab. 1995 Dec;80(12):3546-52.

Effect of raising endogenous testosterone levels in impotent men with secondary hypogonadism: double blind placebo-controlled trial with clomiphene citrate.
Guay AT1, Bansal S, Heatley GJ.


Abstract

Secondary hypogonadism is not an infrequent abnormality in older patients presenting with the primary complaint of erectile dysfunction. Because of the role of testosterone in mediating sexual desire and erectile function in men, these patients are usually treated with exogenous testosterone, which, while elevating the circulating androgens, suppresses gonadotropins from the hypothalamic-pituitary axis. The response of this form of therapy, although extolled in the lay literature, has usually not been effective in restoring or even improving sexual function. This failure of response could be the result of suppression of gonadotropins or the lack of a cause and effect relationship between sexual function and circulating androgens in this group of patients. Further, because exogenous testosterone can potentially increase the risk of prostate disease, it is important to be sure of the benefit sought, i.e. an increase in sexual function. In an attempt to answer this question, we measured the hormone levels and studied the sexual function in 17 patients with erectile dysfunction who were found to have secondary hypogonadism. This double blind, placebo-controlled, cross-over study consisted of treatment with clomiphene citrate and a placebo for 2 months each. Similar to our previous observations, LH, FSH, and total and free testosterone levels showed a significant elevation in response to clomiphene citrate over the response to placebo. However, sexual function, as monitored by questionnaires and nocturnal penile tumescence and rigidity testing, did not improve except for some limited parameters in younger and healthier men. The results confirmed that there can be a functional secondary hypogonadism in men on an out-patient basis, but correlation of the hormonal status does not universally reverse the associated erectile dysfunction to normal, thus requiring closer scrutiny of claims of cause and effect relationships between hypogonadism and erectile dysfunction.
 
So far I have not noticed any subjective improvements after finishing the 10,000 IU of hCG. I did bloodwork this morning so hopefully the results will come quickly.
 
hCG mono was a failure.

Total T - 255 ng/dL, range 348-1197
Free T - 5.6 pg/mL, range 8.7-25.1

Guess it's on to TRT for me. Doctor's appointment is this week, wish me luck!
 
46and2


I am sorry to hear. Ask to be put on 50-75 mg of testosterone cypionate or enanthate plus 500 IU HCG twice per week. I bet that would work.

https://www.excelmale.com/?s=149-Ho...o-Preserve-Fertility-Libido-and-Testicle-Size

Thanks Nelson. That sounds like a solid regimen, 100-150mg per week in split doses along with hCG. Maybe by splitting it I won't need an AI. On the other hand, I have heard others say that once they add hCG they need an AI. We'll see what the doc says!
 
Quick update. Everything is kicking ass right now. I'm on 160mg a week, but just doing 1x IM injection. When I meet with Dr. Saya next time, I think I am going to ask to go to 1/2 the dosage 2x weekly. I am feeling a bit of a "peak and valley" with the 1x weekly injections. It's nothing serious, mainly lethargy and recovery in the 1-2 days before my injection. 500IU hCG 2x weekly is keeping the boys big enough, but there has been a bit of atrophy. 0.5mg adex 2x weekly has no itchy nipples or lumps like I experienced with Clomid.

Mood is wonderful. I laugh and joke with my wife, something I haven't done in several years. Speaking of the wife, she says she can barely handle the libido increase. We are looking into vasectomy as we are done with kids. My motivation in the gym is sky-high. I am doing Brazilian Jiu-Jitsu 5-6 days a week, lifting with Greyskull Linear Programming (GSLP) 3x a week, and doing conditioning 2x a week. I'm able to recover from this very well. Lifts are shooting up. Brain fog and memory issues are mostly gone, but I still make more typos at work than I used to. Only negative side effect I have seen is some swelling in my ankles and hands after consuming large amounts of sodium, something I do not recall seeing before TRT. After getting back on my regular diet I am back to normal though.

Overall things are going great and my wife and I couldn't be happier.
 
Quick update. Everything is kicking ass right now. I'm on 160mg a week, but just doing 1x IM injection. When I meet with Dr. Saya next time, I think I am going to ask to go to 1/2 the dosage 2x weekly. I am feeling a bit of a "peak and valley" with the 1x weekly injections. It's nothing serious, mainly lethargy and recovery in the 1-2 days before my injection. 500IU hCG 2x weekly is keeping the boys big enough, but there has been a bit of atrophy. 0.5mg adex 2x weekly has no itchy nipples or lumps like I experienced with Clomid.

Mood is wonderful. I laugh and joke with my wife, something I haven't done in several years. Speaking of the wife, she says she can barely handle the libido increase. We are looking into vasectomy as we are done with kids. My motivation in the gym is sky-high. I am doing Brazilian Jiu-Jitsu 5-6 days a week, lifting with Greyskull Linear Programming (GSLP) 3x a week, and doing conditioning 2x a week. I'm able to recover from this very well. Lifts are shooting up. Brain fog and memory issues are mostly gone, but I still make more typos at work than I used to. Only negative side effect I have seen is some swelling in my ankles and hands after consuming large amounts of sodium, something I do not recall seeing before TRT. After getting back on my regular diet I am back to normal though.

Overall things are going great and my wife and I couldn't be happier.

I am glad things are working out for you!
 
Beyond Testosterone Book by Nelson Vergel
Still getting the swelling/water retention on weekends. I limited my sodium intake but it seems to be tied to my injection. I do 160mg on Thursday morning and Friday/Saturday is when it occurs. By Saturday night or Sunday morning it is back to normal. This, coupled with a bit of "roller coaster" energy levels has me wanting to switch to 2x weekly injections of 80mg. I do not meet with Dr. Saya until January, so I am going to continue on this protocol until I speak with him. Everything else is going so smooth. My wife and I are happy, getting a vasectomy early next year. ;)
 
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