Unanswered Taking low dose clomid while on TRT

[andyreed]

I moved this over from Male Anti Aging Medicine as I got no responses in 24 hours.
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I have a separate personal thread -- but I hope for this thread to be more a general discussion of the merits/pros/cons of taking low dose clomid while on long-term trt ((probably injections)).

I understand that while on trt, clomid won't be super effective, but I am trying to understand whether say one 50mg pill weekly could be enough to keep your lh/fsh ticking over and at least maintain a bit of fertility and testicle size.

This article suggests, that trt and clomid can be taken together with good results. See the case study on the 47 year old man.


Clinical practice guidance for the use of clomiphene citrate in Male Hormone Replacement Therapy (HRT) Guth MA - Acta Med Int
Acta Medica International, Official publication of Teerthanker Mahaveer University, Moradabad, India
www.actamedicainternational.com

"""Clinical practice guidance for the use of clomiphene citrate in Male Hormone Replacement Therapy (HRT)"""

""" Our case study reflects a five-year study of a 47-year old man seeking treatment for andropause. Baseline levels for total testosterone (TT), free testosterone (FT), estradiol, DHT, LH, and prostate specific antigen (PSA) were measured and recorded at the outset of the HRT. The patient commenced HRT using compounded testosterone cream (CTC) 100 mg applied topically each day. The topically applied CTC was fully absorbed within two hours. Target levels for TT and FT were achieved. After one year on HRT, the patient observed evidence of HPTX down-regulation confirmed by low-normal serum LH levels. The patient was then taken off CTC and given CC 50 mg/day to test the efficacy of CC as monotherapy. The target level range for TT was 750-900 ng/dL and FT was 20-25 pg/mL. As shown in [[Figure 2]](http://www.actamedicainternational.com/viewimage.asp?img=ActaMedInt_2015_2_1_14_209435_f2.jpg), the optimal ranges were based on the testosterone level that a typical male 20-year old would produce.
 Figure 2: Normal total testosterone production with aging
[ **Click here to view** ](http://www.actamedicainternational.com/viewimage.asp?img=ActaMedInt_2015_2_1_14_209435_f2.jpg)
On CC monotherapy, the patient achieved only 66% of target for TT and less than 66% for FT. Taking 50 mg/day of CC together with 100 mg/day of CTC proved to be too high a dose of T, as serum TT and FT generally exceeded the targeted levels.
After trying various combinations and allowing the body time to adjust to adjuvant therapy, the patient was stabilized to reach target levels for TT and FT on a dose of 25 mg/day CC together with 100 mg/day of CTC. Average post-treatment TT levels were 538 ng/dL in the CC monotherapy portion of the study, and 982 ng/dL when CC was used as adjuvant therapy to HRT. Average post-treatment FT levels were 14.7 pg/mL in the CC monotherapy portion of the study and 22.0 pg/mL in the adjuvant CC portion. CC consumption raised serum luteinizing hormone levels from the lowest quartile with HRT to the mid-point and third quartile of the reference range [1.7, 8.6] mIU/mL."""

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Could this be the best of both worlds? Keep your nuts, the pituitary ticking over, and get the major advantages of straight testosterone supplementation?

If this is possible -- which many forums suggest... I want to convince my doctor to let me inject test crypt and take maybe 1 clomid 50mg pill a week.

 

[CroLifter]

It may work as I started to recover using clomid while still having low levels of exogenous test in system. But the thing is that those were suboptimal expgenous levels. I am pretty sure i wouldnt have started recovering if my test levels from exogenous source were normal for me.

But i agree that you should try it out and report back.

And I am not sure if i would want to be on clomid long term. Occular toxicity worries me.
But then again, how toxic is it compared to hcg?

 

[andyreed]

It may work as I started to recover using clomid while still having low levels of exogenous test in system. But the thing is that those were suboptimal expgenous levels. I am pretty sure i wouldnt have started recovering if my test levels from exogenous source were normal for me.

But i agree that you should try it out and report back.

And I am not sure if i would want to be on clomid long term. Occular toxicity worries me.
But then again, how toxic is it compared to hcg?

Hey CroLifter -- really appreciate you replying with a data point. I would not expect to make much testosterone/lh/fsh while on injections, but if i could just keep enough cooking over that i kept my balls -- i'd be grateful. That's really my goal. If i was married, I would not care. But, being on the open dating market with shrunken nuts is a real confidence hit.

I have been on clomid 50mg 4x a week for almost three years and so far I have had zero occular side effects. I feel great in truly everyway except libido. Energy, strength, body fat loss is solid. I doubt I would run into too much trouble on maybe a clomid a week. My endo doesn't think clomid is actually that toxic and its over played, since androxal etc was almost approved.

 

[CroLifter]

Hey CroLifter -- really appreciate you replying with a data point. I would not expect to make much testosterone/lh/fsh while on injections, but if i could just keep enough cooking over that i kept my balls -- i'd be grateful. That's really my goal. If i was married, I would not care. But, being on the open dating market with shrunken nuts is a real confidence hit.

I have been on clomid 50mg 4x a week for almost three years and so far I have had zero occular side effects. I feel great in truly everyway except libido. Energy, strength, body fat loss is solid. I doubt I would run into too much trouble on maybe a clomid a week. My endo doesn't think clomid is actually that toxic and its over played, since androxal etc was almost approved.

I think it would be worth it to asses long term toxicity of hcg vs clomid because both do pretty much the same thing - keep testicles working.

And hcg does it better and no matter the dose of test you are injecting,

Studies showed that 250 iu of hcg eod is enough to achieve full endogenous testosterone production.

Pituitary is usually not the problem when it comes to recovery it is the testicular size that is the limiting factor.