Anyone switch from Clomid to HCG?

[MikePA]

I am a 50yo. Started seeking treatment about 18 months for Low T symptoms. Initial rounds of blood work showed borderline Low-T around 320-350. Doctor put me on 50mg Clomid monotherapy 3xWeek. Then took about 6 months of wild fluctuations of Estrogen, Thyroid levels (I am hypothyroid), and related levels to get under control. Clomid has some known negative Thyroid effects. Added a dose of AI 3xWeek and now Estrogen levels in good range and Thyroid has stabilized. Net result was my testosterone levels now consistently around 770. I feel better, but not "great". Libido is better, but not great. Overall mood is a much better on most days. Just don't have the energy and drive I expected if my T levels came up. Doctor suggested I now switch to HCG monotherapy of 250IU 6 of 7 days per week for possible better results related to energy, weight loss, libido, etc.

Question: Has anyone experienced using both Clomid and HCG monotherapy at different times? If so, be interested in your experiences and your personal comparison of both therapies.

Feel like I am crazy switching off something that is "working" to an unknown. But I guess if the HCG produces worse results over next 8 weeks, I can always switch back.

Thanks

 

[Systemlord]

It doesn't sound like TRT is in your doctors toolbox, clomid for a 50 year old who is expected to have androgen deficiency is odd. The success rate of Clomid after 30 years old, well let's just say the math is not on your side at all.

Same odds with HCG monotherapy, very poor.

 

[Vince Carter]

SHBG is probably high and Free T low but need your labs to have any kind of meaningful discussion. An increase is TT is a tiny part of the puzzle.

 

[Vettester Chris]

In similar fashion with Systemlord, this doesn't sound statistically favorable for someone who is 50yo.

Your objective makes sense, you want to increase your testosterone serum & free/bio test to an optimal level for sustained wellness (I'm 51, I desire the same thing LOL) ... Then, why not just administer testosterone cypionate and be done with it? IMO Clomid as a SERM is a decent route to restart the HPTA, which is popular with younger men that are shutdown, but even then it's a temporary treatment protocol.

Depending on the Leydig cells, HCG Solo may work, it may not work, and ultimately if it does work then you will have increased testosterone serum ... Or, you could just administer Testosterone Cypionate and have increased testosterone serum levels. Or for many here including myself, a moderate amount of cypionate in conjunction with a smaller amount of HCG covers the best of both worlds (endogenous & exogenous).

 

[MikePA]

Thanks for the initial feedback. My doctor is not opposed to TRT, but initially gave me the option to try solo Clomid (or HCG) option to see if my body can produce itself. In general, the Clomid has raised my TT levels, but here are some recent labs which clearly indicate an elevated SHBG now while on Clomid.

June 2017 (Initial test, pre-clomid therapy)
TT 378 Range 348-1197 ng/dL
SHBG 36.0 Range 16.5-55.9 nmol/L
Estradiol 19.5 Range 8.0-35.0 pg/mL
(sensitive)

Sep 2017 (after 3mo Clomid therapy)
TT 779 Range 264-916 ng/dL
Estradiol 32.1 Range 8.0-35.0 pg/mL
(Sensitve)

January 2018
TT 750 Range 264-916 ng/dL
SHBG 61.0 Range 16.5-55.9 nmol/L
Estradiol 35.2 Range 8.0-35.0 pg/mL
(Sensitive)
Free T - not tested

June 2018
TT 716.5 Range 249.0-836.0 ng/dL
FreeT 92.4 Range 50.0-210.0 pg/mL
SHBG 70.8 Range 16.5-55.9 nmol/L
Estradiol <25.0 Range 11.3-43.2 pg/mL

I appreciate the input that Clomid is better suited to a younger guy looking for a restart. Clomid definitely raises SHBG and my labs clearly indicate too high. As mentioned, I am scheduled to start the HCG monotherapy this week for 8-10 weeks, then labs and doctor appt.

At that point, if not where I want to be, agree that the option to go on TRT (+HCG) is the plan.

Thanks

 

[CoastWatcher]

You show remarkable patience - a real virtue when playing this game. It's particularly in short supply when men turn to Clomid and HCG. I wish you the best...

 

[Kirk001]

I don't see why guys would want to bother with clomiphene or HCG monotherapy if fertility is not a concern, or unless their doctor gave them no other choice. But then again I'm probably biased since clomiphene was such a failure for me.

I guess it's about making a risk vs reward judgement on switching... I mean if you feel good on clomiphene now, but you're switching to try to feel better although you might end up feeling worse... hard to say, kind of a personal decision. Although you'll have to switch at some point, the clomiphene won't work forever as you age. Tough call

 

[CoastWatcher]

I don't see why guys would want to bother with clomiphene or HCG monotherapy if fertility is not a concern, or unless their doctor gave them no other choice. But then again I'm probably biased since clomiphene was such a failure for me.

I guess it's about making a risk vs reward judgement on switching... I mean if you feel good on clomiphene now, but you're switching to try to feel better although you might end up feeling worse... hard to say, kind of a personal decision. Although you'll have to switch at some point, the clomiphene won't work forever as you age. Tough call

You raise points that are hard to refute. In the practice where I am a member, the Clomid success rate - I have been told - is very low. In part, that's attributable to the fact that many guys simply get fed up and ask to switch to a standard TRT protocol. But we do have members here at EM who succeed...

 

[MikePA]

Have to say I agree with all the comments, especially that Clomid and HCG mono are not really a long-term strategy as I will eventually need to start TRT anyway. I appreciate the input. Sounds like the consensus is to go on TRT (now) rather than messing around with Clomid/HCG mono and hoping for the best result.

 

[Vettester Chris]

Have to say I agree with all the comments, especially that Clomid and HCG mono are not really a long-term strategy as I will eventually need to start TRT anyway. I appreciate the input. Sounds like the consensus is to go on TRT (now) rather than messing around with Clomid/HCG mono and hoping for the best result.

Exactly! Your goal is to optimize your testosterone, so no better way at 50yo than to just get the real deal and there's no guessing. Even with HCG Mono, you are on a multi-injection program every week, so IMO I'd rather just get on a program that ensures me the best results.

 

[CoastWatcher]

Exactly! Your goal is to optimize your testosterone, so no better way at 50yo than to just get the real deal and there's no guessing. Even with HCG Mono, you are on a multi-injection program every week, so IMO I'd rather just get on a program that ensures me the best results.

On the mark.

 

[3DMission]

Clomid & HCG Monotherapy

Mike,

Thank you for sharing, I’ve experience clomid monotherapy, Testosterone injections mono, and HCG mono so I can speak to all three.

Clomid is off label use for men so there are few studies to support long term effects. I can tell you that after a while I really stared to notice the side-effects of Clomid where it got so bad I couldn’t wait to stop. The ONLY reason I was in Clomid was for fertility. Once I had my son I stopped and went on T only.

Then I started HCG to become fertile again and once we got pregnant I stopped again. If you’re estrogen sensitive to Clomid I think you will definitely be E sensitive even more so on HCG. Make sure you barely dilute your HCG, it should heavily concentrated. For some unknown reason more dilution affects estrogen levels. For example, you’ll get 10,000 units of water and 10k of HCG. Mix 5ml of water to all 10k HCG and take .25ml which would be 500iu HCG. Very concentrated is better plus less fluid to inject. You can even concentrate it more, but it gets harder to inject such small amount with a big syringe.

HCG mono and Clomid mono both raise my T levels on labs, however the actually feeling is completely different on T. Go by how you feel, not by what labs say. Since fertility isn’t of importance to you then there’s no real reason for HCG, but some men report simply feeling better by adding some HCG into their routine.

Personally, I recommend .25 Testosterone 3x a week and .25 HCG 3x a week. M, W, F. I draw the HCG first then the T next and inject it all together in my thigh.

I’ve got to ask, how is your experience with the AI? How much does the doctor have you taking? Do you notice any side effects and how quickly does your doctor test you after taking the AI to see if your estrogen levels went down? Also, what symptoms do you experience that lead you to believe you estrogen levels are high?

If you think you felt good on Clomid, buckle your seatbelt brother because T-injections will help you feel so much better!

I am a 50yo. Started seeking treatment about 18 months for Low T symptoms. Initial rounds of blood work showed borderline Low-T around 320-350. Doctor put me on 50mg Clomid monotherapy 3xWeek. Then took about 6 months of wild fluctuations of Estrogen, Thyroid levels (I am hypothyroid), and related levels to get under control. Clomid has some known negative Thyroid effects. Added a dose of AI 3xWeek and now Estrogen levels in good range and Thyroid has stabilized. Net result was my testosterone levels now consistently around 770. I feel better, but not "great". Libido is better, but not great. Overall mood is a much better on most days. Just don't have the energy and drive I expected if my T levels came up. Doctor suggested I now switch to HCG monotherapy of 250IU 6 of 7 days per week for possible better results related to energy, weight loss, libido, etc.

Question: Has anyone experienced using both Clomid and HCG monotherapy at different times? If so, be interested in your experiences and your personal comparison of both therapies.

Feel like I am crazy switching off something that is "working" to an unknown. But I guess if the HCG produces worse results over next 8 weeks, I can always switch back.

Thanks

 

[MikePA]

Thanks for your feedback. My experience with AI has been good and I have had more positive benefits than any side effects. My E levels were at the top end of normal, and the AI brought them down. The AI did improve my mental 'stability' and also helped improve libido. Currently on a low dose of anastrozole of 0.1mg 3x week.

Since I was out of Clomid meds, I am currently on HCG mono (as prescribed) to (hopefully) keep my T levels up until I can get back into the doctor in next couple of weeks and discuss switching over to TRT vs just Clomid/HCG mono.

 

[3DMission]

HCG Mono

Hi Mike,

Thanks for sharing, I’m curious how often you test your E levels and what we’re they before the AI and then after the AI. Can you share any insights on symptoms you experience if you feel like you estrogen may be increasing? I feel like I’m struggling all over the place with my E levels. Last I checked they were 64.

How many IU’s of HCG are you taking and frequency? What did your doc instruct you for dilution ratio of water to powder? Also, is it subq or IM?

I’m just really curious to see how different docs prescribe this.

Thank you,

Chad

Thanks for your feedback. My experience with AI has been good and I have had more positive benefits than any side effects. My E levels were at the top end of normal, and the AI brought them down. The AI did improve my mental 'stability' and also helped improve libido. Currently on a low dose of anastrozole of 0.1mg 3x week.

Since I was out of Clomid meds, I am currently on HCG mono (as prescribed) to (hopefully) keep my T levels up until I can get back into the doctor in next couple of weeks and discuss switching over to TRT vs just Clomid/HCG mono.

 

[MikePA]

I get my E level checked with every round of blood tests, so generally every 3-4 months. E levels before AI (while on Clomid) had risen to the 32-35 range (labs above) which is at the top end of the normal range. After AI cycle, level was down to around 22. When E levels were high, most of the issues were mental and 'emotional' stability - fatigued, depressed, 'sensitive', high anxiety. Also had low(er) libido. Your E level seems very high to me.

I am on 250IU of HCG 6 of 7 days per week -- so total 1500IU per week. Doc referred me to a local compounding pharmacy that pre-mixes and comes all ready in syringes. 30 day supply at a time. So this is super convenient. I do SubQ injections. However, I just started the rounds of HCG in the last week, so no results yet.

As noted, I am going to push to switch to TRT (+HCG) at my next doc appt based on all the input in this group.

 

[MikePA]

Wanted to check back in after a few months and thank everyone for the great input. At my last appointment, my doctor agreed and switched me over to TRT + HCG injections (and removed Anastrozole/AI temporarily).

I feel great in all aspects! - energy, libido, mood, etc.
After just a couple of weeks on the new program, the change was remarkable. I just got my first round of labs back after 3'ish months on the program. My TotalT, FreeT and Estradiol are a bit high. And finally, my thyroid levels are back in normal ranges. I am going to try and convince the doc just to put me back on Anastrozole to reduce Estradiol back down into the ~20 range when I go back in January. Does anyone feel that that T level (free or total) is just way too high?

Dec 2018
TT 1235.8 Range 264.0-916.0 ng/dL
FreeT 34.4 Range 7.2-24.0 pg/mL
Estradiol (Sensitive) 45.0 Range 8.0-35.0 pg/mL
T3 Free 2.8 Range 2.0-4.4 pg/mL
T4 Free 1.67 Range 0.82-1.77 ng/dL
TSH 1.210 Range 0.450-4.500 uIU/mL

Thanks again for all the input. After starting this journey 18 months ago, finally feel like I am where I want to be.

 

[madman]

Wanted to check back in after a few months and thank everyone for the great input. At my last appointment, my doctor agreed and switched me over to TRT + HCG injections (and removed Anastrozole/AI temporarily).

I feel great in all aspects! - energy, libido, mood, etc.
After just a couple of weeks on the new program, the change was remarkable. I just got my first round of labs back after 3'ish months on the program. My TotalT, FreeT and Estradiol are a bit high. And finally, my thyroid levels are back in normal ranges. I am going to try and convince the doc just to put me back on Anastrozole to reduce Estradiol back down into the ~20 range when I go back in January. Does anyone feel that that T level (free or total) is just way too high?

Dec 2018
TT 1235.8 Range 264.0-916.0 ng/dL
FreeT 34.4 Range 7.2-24.0 pg/mL
Estradiol (Sensitive) 45.0 Range 8.0-35.0 pg/mL
T3 Free 2.8 Range 2.0-4.4 pg/mL
T4 Free 1.67 Range 0.82-1.77 ng/dL
TSH 1.210 Range 0.450-4.500 uIU/mL

Thanks again for all the input. After starting this journey 18 months ago, finally feel like I am where I want to be.

What is your trt protocol- testosterone dose/hcg dose and injection frequency.....most importantly what were your SHBG levels pre-trt and where does it sit now (3 months on trt)?

 

[madman]

Wanted to check back in after a few months and thank everyone for the great input. At my last appointment, my doctor agreed and switched me over to TRT + HCG injections (and removed Anastrozole/AI temporarily).

I feel great in all aspects! - energy, libido, mood, etc.
After just a couple of weeks on the new program, the change was remarkable. I just got my first round of labs back after 3'ish months on the program. My TotalT, FreeT and Estradiol are a bit high. And finally, my thyroid levels are back in normal ranges. I am going to try and convince the doc just to put me back on Anastrozole to reduce Estradiol back down into the ~20 range when I go back in January. Does anyone feel that that T level (free or total) is just way too high?

Dec 2018
TT 1235.8 Range 264.0-916.0 ng/dL
FreeT 34.4 Range 7.2-24.0 pg/mL
Estradiol (Sensitive) 45.0 Range 8.0-35.0 pg/mL
T3 Free 2.8 Range 2.0-4.4 pg/mL
T4 Free 1.67 Range 0.82-1.77 ng/dL
TSH 1.210 Range 0.450-4.500 uIU/mL

Thanks again for all the input. After starting this journey 18 months ago, finally feel like I am where I want to be.

Your previous post
June 2017 (Initial test, pre-clomid therapy)
TT 378 Range 348-1197 ng/dL
SHBG 36.0 Range 16.5-55.9 nmol/L
Estradiol 19.5 Range 8.0-35.0 pg/mL
(sensitive)






- relief/improvement of low t symptoms is what truly matters and although lab work is critical as it is important to know how said dose of testosterone effects ones TT/FT and e2 among other critical health markers.....how you feel overall plays a big part

- although your TT/FT/e2 may seem a bit high to you seeing as your SHBG was 36 nmol/L (pre-clomid) and assuming it was around the same pre-trt it would be smack dab in the middle as the reference range is 16.5-55.9 nmol/L (36 would be the mean).....I would say your TT/FT levels look good and regarding your e2 if you are not experiencing any elevated e2 symptoms I would not touch a thing and definitely avoid using an aromatase inhibitor to try and lower it back down into the 20 ish range especially seeing as you stated "I feel great in all aspects! - energy, libido, mood, etc."



Now if one had low SHBG than running a high FT level could cause issues and I would say they definitely have room to bring their TT/FT levels down as e2.....especially free e2 would be through the roof!



It is critical to know your SHBG pre-trt and also how it is effected on your trt protocol as SHBG will dictate ones dose/injection frequency.

 

[MikePA]

Thanks for the feedback. Unfortunately, I did not get SHBG ordered (mistake on the order), I will order myself now just to get it in a few days and post.

Just prior to starting TRT, my

SHBG 52.7 Reference Range: 19.3-76.4 nmol/L

In terms of protocol, I am using a Testosterone cream applied to scrotum daily.
Testosterone Lipo 200MG/ML applying 0.5ML per day.

Injecting HCG 0.25ML/250 Units (of 1000U/ML) daily as well.

Thanks