TRT advice (Just saw an endo today)

[jtmartin18]

What's up guys,

I just had an appointment with an endocrinologist today and was looking to hear your thoughts. I had my primary care order bloodwork because I didn't feel like I recovered (anxiety has been through the roof, chronic fatigue, very low libido) after my last cycle and was right. 30 days of clomid has always done the trick for me, but unfortunately this time it didn't.

My last cycle:
Weeks 1-12 - 200mg test
Weeks 3-10 - 400mg primo
Weeks 7-12 - 40mg var
Weeks 15-18 50mg clomid
And its been 3 more weeks since I finished the clomid. Not a very heavy cycle in my opinion..

My bloodwork from two days ago:

Test & Bioavailable test - still waiting for results, but endo confirmed my thoughts that with my estrogen levels this will likely be very low.

Estradiol

<5.00 pg/mL

See Comment pg/mL

FOLLICLE STIMULATING HORMONE

1.1 mIU/mL

1.0 - 12.0 mIU/mL

LUTEINIZING HORMONE

2.0 mIU/mL

0.6 - 12.1 mIU/mL

My bloodwork from my last pct before this one (taken in January 2020):

TESTOSTERONE, TOTAL	477 ng/dL	160 - 726 ng/dL
SEX HORMONE BINDING GLOB	34 nmol/L	10 - 57 nmol/L
TESTOSTERONE, BIOAVAIL MALE>17	221 ng/dL	48 - 317 ng/dL
TESTOSTERONE, FREE CALCULATED	103 pg/mL	20 - 135 pg/mL
TESTOSTERONE, FREE PERCENT	2.1 %	1.5 - 3.2 %

FOLLICLE STIMULATING HORMONE

1.2 mIU/mL

1.0 - 12.0 mIU/mL

LUTEINIZING HORMONE

5.0 mIU/mL

0.6 - 12.1 mIU/mL

Estradiol

26.90 pg/mL

See Comment pg/mL

So my endo put in an order for 50mg clomid and said to wait until she gets my bioavailable testosterone results to start taking it. The plan is to take 50mg for 4 weeks and retest to find out if my pituitary is reacting to the clomid or not. If it's not then I would need to freeze sperm in case I'm unable to restart things with HCG when I want to have kids. If it does react, then she would slowly taper down the clomid over a few months and hope that I'm able to keep producing enough after I stop taking it.

What are your thoughts on this? Does anyone think I have a good chance of recovering with more clomid? I've never not recovered before and obviously I knew this was always the risk, and I'm okay with that, I'm just wondering how likely it is that I just needed another month of clomid? I'm not too optimistic about more clomid doing the trick.

 

[Whisky]

So your only 3 weeks post pct??

I wouldn’t be even slightly concerned till 3 months plus bro. Yeah not the heaviest cycle for sure but the cycles add up and slow recovery over the years (as will your increasing age etc).

i probably wouldn’t even take the additional clomid till the 3 month mark to get a clearer view on where I was at.

presumably your endo knows about your cycle history?

 

[jtmartin18]

So your only 3 weeks post pct??

I wouldn’t be even slightly concerned till 3 months plus bro. Yeah not the heaviest cycle for sure but the cycles add up and slow recovery over the years (as will your increasing age etc).

i probably wouldn’t even take the additional clomid till the 3 month mark to get a clearer view on where I was at.

presumably your endo knows about your cycle history?

Yeah 9 weeks since last injection 3 since I finished pct. I’ll have a better understanding once the rest of my bloodwork posts but I’m assuming with an undetected amount of e2 it will not be good. I’m concerned because I can tell that I’m progressively not recovering like I use to, which I knew would happen eventually, and am wondering if it’s gotten to that time.

Yeah she does know.

Edit: I guess I’m not so much concerned as just curious if I’m at that point where I wont recover.

 

[Hyde]

Because you’re doing it with a doctor, I’d follow her medical lead.

If it was me all on my own seeing these bloods I’d ordered myself, I would blast HCG for about 10 days with some exemestane and then move onto 40mg Tamoxifen for 6 weeks... then test 6 weeks after that.

Or you could just get on TRT if you are truly ready, but aspiring to have kids I would hold off - how old are you and when are you looking to have kids? She ain’t getting any younger you know

 

[Whisky]

Yeah 9 weeks since last injection 3 since I finished pct. I’ll have a better understanding once the rest of my bloodwork posts but I’m assuming with an undetected amount of e2 it will not be good. I’m concerned because I can tell that I’m progressively not recovering like I use to, which I knew would happen eventually, and am wondering if it’s gotten to that time.

Yeah she does know.

Edit: I guess I’m not so much concerned as just curious if I’m at that point where I wont recover.

yeah if you’ve got a professional advising you then for sure the smart play is her advice over some random internet bro

it can take a long time (like over a year) for natural levels to return from years of b and c but they do sometimes do just that (return to normal). One of the mind pump guys took around 15 months i recall.

i guess there’s not really a right or wrong answer. More clomid is a middle of the ground option imo, safe and kicks the can down the road a bit.

a proper restart protocol normally involves something like what Hyde is suggesting. I’d do that coming off a couple of years plus b and c personally.

my suggestion was more based on waiting to see genuinely whether it’s just too early after the cycle or whether you do need to take action.

no right or wrong here but do what your endo says. Seems like you’ve found a good one

 

[jtmartin18]

Because you’re doing it with a doctor, I’d follow her medical lead.

If it was me all on my own seeing these bloods I’d ordered myself, I would blast HCG for about 10 days with some exemestane and then move onto 40mg Tamoxifen for 6 weeks... then test 6 weeks after that.

Or you could just get on TRT if you are truly ready, but aspiring to have kids I would hold off - how old are you and when are you looking to have kids? She ain’t getting any younger you know

I'm 26 and would like to have kids around 30-34, but I don't necessarily have control over when it actually happens. Hahahaha that is very true, too bad she doesn't exist yet

 

[jtmartin18]

yeah if you’ve got a professional advising you then for sure the smart play is her advice over some random internet bro

it can take a long time (like over a year) for natural levels to return from years of b and c but they do sometimes do just that (return to normal). One of the mind pump guys took around 15 months i recall.

i guess there’s not really a right or wrong answer. More clomid is a middle of the ground option imo, safe and kicks the can down the road a bit.

a proper restart protocol normally involves something like what Hyde is suggesting. I’d do that coming off a couple of years plus b and c personally.

my suggestion was more based on waiting to see genuinely whether it’s just too early after the cycle or whether you do need to take action.

no right or wrong here but do what your endo says. Seems like you’ve found a good one

Yeah definitely gonna follow her lead, just wanted to hear others thoughts. Sounds like its completely possible to still recover so that's encouraging!

Thank you both, appreciate it!

 

[Hyde]

I'm 26 and would like to have kids around 30-34, but I don't necessarily have control over when it actually happens. Hahahaha that is very true, too bad she doesn't exist yet

Oh bro no way are you ready for TRT then; I mean yes if you can’t get recovered in another year that would be telling you it might be time to face the music; but I would not be going that route so young unless you have really taken time to try everything at your disposal (you’ve only tried one SERM for a few weeks).

Most people don’t realize that Clomid at 25mg ed/eod works for many doing shorter milder cycles, but the studies have shown mg for mg Tamoxifen is WAY more potent, and you can take basically the same mg range (20-45mg is common for PCT). And Toremifene is about on par with Clomid per mg increase in LH, but you can run 120mg with less sides than 50mg Clomid. And we haven’t even looked at kicking your nuts with some Toco9 and HCG.

So know there will be options if needed. And you haven’t even tried that 50mg pharm Clomid - you might be doing great 6 weeks from now with that alone - give it a go because the odds are in your favor here to eventually recover.

 

[bad rad]

The extremely low E2 is your answer to why you haven't recovered your endogenous testosterone levels. E2 production in men is almost entirely from aromatase conversion directly in the testes. Your LH/FSH are low but the real issue is your testes aren't responding. When dormant for that long they need a bigger hit than LH/FSH can provide so this is where hCG comes into play. I'd suggest 500iu EOD or E3D for a total dosage of 5000iu. Too much can actually shut you back down from over stimulation and driving E2 way up.

The graph below is from a study that pretty much represents your same experience.

 

[jtmartin18]

Oh bro no way are you ready for TRT then; I mean yes if you can’t get recovered in another year that would be telling you it might be time to face the music; but I would not be going that route so young unless you have really taken time to try everything at your disposal (you’ve only tried one SERM for a few weeks).

Most people don’t realize that Clomid at 25mg ed/eod works for many doing shorter milder cycles, but the studies have shown mg for mg Tamoxifen is WAY more potent, and you can take basically the same mg range (20-45mg is common for PCT). And Toremifene is about on par with Clomid per mg increase in LH, but you can run 120mg with less sides than 50mg Clomid. And we haven’t even looked at kicking your nuts with some Toco9 and HCG.

So know there will be options if needed. And you haven’t even tried that 50mg pharm Clomid - you might be doing great 6 weeks from now with that alone - give it a go because the odds are in your favor here to eventually recover.

This is exactly what I needed to hear brotha. Hopefully the pharma clomid will hit me completely different.

 

[jtmartin18]

Also I got the rest of my bloodwork back and threw it in a spreadsheet. The 8-17 pcp ordered and 8-18 endo ordered. Interesting that the second round was lower and taken AM while the first was taken PM.

Now that I look at the dates I don’t think I took as much time off between cycles as I should have this time

 

[jtmartin18]

The extremely low E2 is your answer to why you haven't recovered your endogenous testosterone levels. E2 production in men is almost entirely from aromatase conversion directly in the testes. Your LH/FSH are low but the real issue is your testes aren't responding. When dormant for that long they need a bigger hit than LH/FSH can provide so this is where hCG comes into play. I'd suggest 500iu EOD or E3D for a total dosage of 5000iu. Too much can actually shut you back down from over stimulation and driving E2 way up.

The graph below is from a study that pretty much represents your same experience.

Good info, thanks man! Much appreciated

 

[jtmartin18]

Update: just got bloods two days ago. After 3 weeks of pharma clomid...huge difference. Doc wants me to drop to 25mg of clomid for the next 3 months. Sounds absolutely miserable but hey at least I Don’t need trt yet

 

[bad rad]

Too much Clomid will cause other issues with your HPTA. Some get by with 12.5mg 3x weekly. 25mg daily is still a big dose.

 

[Hyde]

Too much Clomid will cause other issues with your HPTA. Some get by with 12.5mg 3x weekly. 25mg daily is still a big dose.

Yeah I would go with the doc but if you are feeling bleh I would just skip a day here and there, down to eod dosing. 25mg eod at this point will definitely keep levels going

 

[prestoner]

Cycles are cheap compared to fertility. 20k for IVF, freeze them if you're going to continue with the AAS. Fertility clinics see this scenario all the time. Loads of 18 year olds took took tons of superdrol, M1T, M1A, over the counter for years. Now they wonder why they cant have kids.

 

[Hyde]

Cycles are cheap compared to fertility. 20k for IVF, freeze them if you're going to continue with the AAS. Fertility clinics see this scenario all the time. Loads of 18 year olds took took tons of superdrol, M1T, M1A, over the counter for years. Now they wonder why they cant have kids.

While I don’t necessarily disagree with the idea of freezing backups if it’s not a financial strain, I think you might be misconstruing his low test scenario with an infertility scenario.

You can take a few grams of test and some proviron and the increase in FSH can actually improve fertility by a significant margin - this is how Justin Harris had his daughters and how Ben Chow did recently as well. Or of course push a bunch of HCG & HMG while trying.

Being largely shut down, by no means, guarantees infertility. You just will likely need other drug protocols when the time comes to try. Live by the sword, die by the sword, as they say.

 

[prestoner]

No doubt low t and fertility are way different subjects. May have gone off the subject a bit but it’s advice I wish someone would have given me at 26.

 

[jtmartin18]

Doesn’t FSH in the middle of the range mean you are fertile? I may be mistaking correlation for a definitive answer...

 

[Warbeast]

I ran into cycle recovery issues in the past myself. At the time my wife was eager to get pregnant and it wasn’t happening. I dropped into TRT and my levels were still pretty jammed up. Low LH/FSH was a problem. I blasted HCG for a week (5000iu) then hit myself with clomid for 3 weeks ( I believe 40 mg tapered down to 20mg). This was extremely successful and led to me getting my wife pregnant a few weeks after finishing clomid. Going forward I highly recommend running HCG through your whole cycle if you are taking any type of test (250-500iu per week depending on tolerance). I also recommend starting PCT with one week of increased HCG use. Some guys on these boards will give you similar or slightly different advice. While I am by no means an expert, My advice is based on trial and error and what works for me.

 

[jtmartin18]

I ran into cycle recovery issues in the past myself. At the time my wife was eager to get pregnant and it wasn’t happening. I dropped into TRT and my levels were still pretty jammed up. Low LH/FSH was a problem. I blasted HCG for a week (5000iu) then hit myself with clomid for 3 weeks ( I believe 40 mg tapered down to 20mg). This was extremely successful and led to me getting my wife pregnant a few weeks after finishing clomid. Going forward I highly recommend running HCG through your whole cycle if you are taking any type of test (250-500iu per week depending on tolerance). I also recommend starting PCT with one week of increased HCG use. Some guys on these boards will give you similar or slightly different advice. While I am by no means an expert, My advice is based on trial and error and what works for me.

Thanks for the input brotha. I’ve actually never run HCG before, but for my next cycle I’m definitely going to. Unfortunately my preferred source carries literally everything but HCG

 

[StarScream66]

You guys know way more about this stuff than me, so I applaud yall for all this information you're giving this dude. Very advanced stuff.

I'm 26 and would like to have kids around 30-34, but I don't necessarily have control over when it actually happens. Hahahaha that is very true, too bad she doesn't exist yet

Since you're only in your 20s, my guesstimation would be you probably have a pretty good likelyhood of recovering your natural test production without going wild with all kinds of fancy protocols and everything else. But these guys are giving you some solid advice. I would take all this information and ask your endo if you should add hCG on top of the Clomid. Or just go with what your doctor advises and wait and see if your natural test production comes back only using what your doc recommended. If it doesn't, then I would go down the road of trying all these experimental protocols.

I really like Anabolic Doc on YT. I think he gives out some pretty good information, although some people here think he's just trying to get you into his clinic. So, take this for what it's worth.

Also, here are a couple of really good articles by William Llewellyn, author of Anabolics 11th Edition and those series of books. They're basically like the steroid bible.

Understanding Post Cylce "T" Recovery

Understanding Post Cylce "T" Recovery O.K. You have been on an awesome 4-month cycle of Sustanon and Dianabol. You’ve gained a massive 20 lbs, and are extremely pleased with your results.

web.archive.org

Clomid, Nolvadex, and Testosterone Stimulation

Clomid, Nolvadex, and Testosterone Stimulation Editors Note: I am extremely pleased to have Bill Llewellyn contributing an article for us this week. For those who are unaware,

web.archive.org

You can take a few grams of test and some proviron and the increase in FSH can actually improve fertility by a significant margin - this is how Justin Harris had his daughters and how Ben Chow did recently as well. Or of course push a bunch of HCG & HMG while trying.

What's HMG? I've never even heard of this!

 

[bad rad]

Human Menopausal Gonadotropin. It's equal parts LH/FSH but various dosages.

 

[StarScream66]

Human Menopausal Gonadotropin. It's equal parts LH/FSH but various dosages.

Man, you guys have taken PCT to the next level. I've never even seen this on the black market or RC sites.

 

[Hyde]

Man, you guys have taken PCT to the next level. I've never even seen this on the black market or RC sites.

It’s not really for PCT - it’s pretty much just used as a fertility drug to my knowledge. I have never used it, only seen it in fertility protocols.

 

[jtmartin18]

Yes thanks again to everybody, great advice. I’m still on the 25mg clomid protocol but I’ve been doing every other day instead of every day the last 2 weeks. Free test and bio available were back in range after only two weeks of pharma clomid (bloodwork results above)