Clomid Restart w/Defy

[CoastWatcher]

I appreciate you've read over 100 hours on the subject, but I've treated over 10,000 TRT patients and I have to disagree with the statement that "almost everyone has problems when HCG is in the mix".

The majority of men (but not all) do better with HCG incorporated or at worst it is a wash. It is simply a matter of appropriate dosing. I can't tell you how many times a patient has felt poorly on straight Tcyp and the addition of HCG was the missing piece of the puzzle for them to be optimized.

In my own case, I felt no better, but I felt no worse with HCG (and I wasn't utilizing HCG for subjective response, I was very happy with my protocol in respect to how I felt). My own doctor has told me she finds that about 85% of the patients she treats with HCG have a positive response when treatment is initiated, five percent are like me, no subjective feeling about it, and the remaining 10% are unhappy. Much of that frustration winds up being sorted out, but there are some who abandon HCG because of negative side effects. On balance, most of her patients tolerate it well and are pleased with it being part of their therapy.

It's an interesting observation, based on a small sample (nothing like Dr. Saya's experience) because HCG, like many other aspects of progressive TRT protocols, are not widely practiced here in Canada. Far fewer men receive HCG here than in the States.

 

[Worried]

I would like to start by saying that my statements are from a relatively ingnorant view point. And I could be entirely wrong. So then IMIO

I agree. I should have qualified my statement. It seems that there a lot individuals (online) that struggle to find the balance. Most likely the ones who do well have no need to seek help via boards like this.

My contention is, if someone is feeling terrible, as this man is, after only 4 days, why would he continue to administer the same drug that appears to be causing the issue? Or at least at the same dose? I ask because it seems to be the practice, or theory to "ride it out" and wait for the next blood test. I am through with that, and cannot understand anyone suggesting it to anyone else.

We are not cancer patience, being given radiation.

Sorry if that offends, but I have been told over and over (on this forum) to change doctors for a more qualified one such as yourself. And I am not disputing that you are. But this man is experiencing very simular symptoms as myself. Perhaps for different reasons.

The point is, Doctors are "practicing" medicine. They are humans like us. If a man is suffering from a treatment why would he "ride it out?"

Me personally, I am not going to continue to put a substance in my body, that is making me sick. No matter what anyone thinks is the proper protocol.


Again this is just my ignorant infantile opinion, based on, what I have read and my personal experience of the benefits that I have felt sense the subtraction of the prescribed HCG dose.

 

[CoastWatcher]

I would like to start by saying that my statements are from a relatively ingnorant view point. And I could be entirely wrong. So then IMIO

I agree. I should have qualified my statement. It seems that there a lot individuals (online) that struggle to find the balance. Most likely the ones who do well have no need to seek help via boards like this.

My contention is, if someone is feeling terrible, as this man is, after only 4 days, why would he continue to administer the same drug that appears to be causing the issue? Or at least at the same dose? I ask because it seems to be the practice, or theory to "ride it out" and wait for the next blood test. I am through with that, and cannot understand anyone suggesting it to anyone else.

We are not cancer patience, being given radiation.

Sorry if that offends, but I have been told over and over (on this forum) to change doctors for a more qualified one such as yourself. And I am not disputing that you are. But this man is experiencing very simular symptoms as myself. Perhaps for different reasons.

The point is, Doctors are "practicing" medicine. They are humans like us. If a man is suffering from a treatment why would he "ride it out?"

Me personally, I am not going to continue to put a substance in my body, that is making me sick. No matter what anyone thinks is the proper protocol.


Again this is just my ignorant infantile opinion, based on, what I have read and my personal experience of the benefits that I have felt sense the subtraction of the prescribed HCG dose.

You have an obligation to do what you feel is in your best interest in regard to your health. No member of Excelmale makes suggestions or asks questions with any other motive than trying to help others achieve good health. We do that based on our own experience, our discussion with the doctors treating us, and our reading. We draw on the horrible mistakes in treatment that we have either gone through ourselves or learned of here. We share the best practices our own doctors rely on (many of these men and women the leading practitioners in the field), trade research papers that might have passed unread, and encourage each other in the quest for health. We have seen that patience in the cause of health is a virtue, and we have painfully learned when it is time to cut our losses and find more capable medical care.

Your anger and hostility puzzles me as many of us have reached out and supported you through your own TRT/estradiol challenges...and we are glad to have been there. If you feel, as you do, that HCG is of no value, and actually harms you, then it was in your absolute best interest to have discontinued it. Nothing would please all of us more than to know your protocol is delivering for you.

For the record, no one referred to your opinion as either "ignorant" or "infantile." Those are your words.

 

[Dr Justin Saya MD]

Patience is a virtue in just about every facet of life. Medical treatment, and particularly hormone related medical treatments, are no exception. The reason is simple...changes in the body TAKE TIME and the subjective response to said changes takes EVEN MORE time. There are no guarantees in hormonal treatments, even as some believe with TRT. However, without patience one is most certainly doomed to failure 9 out of 10 times from the start.

 

[Worried]

Anger and hostility... hmm.

Ignorant and infantile is a truthful and frank estimation of myself in regards to TRT. Not a sarcastic remark.

 

[Worried]

Patience is a virtue in just about every facet of life. Medical treatment, and particularly hormone related medical treatments, are no exception. The reason is simple...changes in the body TAKE TIME and the subjective response to said changes takes EVEN MORE time. There are no guarantees in hormonal treatments, even as some believe with TRT. However, without patience one is most certainly doomed to failure 9 out of 10 times from the start.

This is just me thinking and asking. If a certain dosage is causing panic and anxiety, and other negative side effects, (And this is not toward you alone, but a question for the practice of TRT in general) why not make an adjustment? Can these hormones not be introduce in a progressive nature, so as to minimize the shock to the system?

 

[Dr Justin Saya MD]

This is just me thinking and asking. If a certain dosage is causing panic and anxiety, and other negative side effects, (And this is not toward you alone, but a question for the practice of TRT in general) why not make an adjustment? Can these hormones not be introduce in a progressive nature, so as to minimize the shock to the system?

Of course, but I think you are missing the bigger picture of an HPTA restart (for which the OP has valid reasons of pursuing). With a restart, due to the very fact of coming off of TRT (and the inherent HPTA suppression of same) and attempting to resume and stimulate natural production - in many cases you very likely ARE going to feel worse before you feel better. It's the nature of the process that is occurring in the body.

From your other posts in your previous thread I can tell you've had fairly bad experiences with some of your treating physicians and it caused you a lot of stress, anxiety, and quite possibly suffering. It seems, at least to my eyes, that due to this you harbor some resentment that seems to be directed towards the medical field in general. Please understand that I see much of the suffering caused by poor regimens and uninformed providers...AND I help to fix these poor patients on a daily basis.

 

[johndoesmith]

This is just me thinking and asking. If a certain dosage is causing panic and anxiety, and other negative side effects, (And this is not toward you alone, but a question for the practice of TRT in general) why not make an adjustment? Can these hormones not be introduce in a progressive nature, so as to minimize the shock to the system?

Because you may be attributing negative symptoms to the wrong thing.

Say OP's symptoms are from something else random, but just happen to coincidentally happen now, or are simply due to the hCG not having had enough time to work.

I may be entirely off base here, and someone correct me if I'm reading this situation wrong, but due to how hormones work, which is slow it's possible the hCG hasn't had enough time to kick in and produce many effects.

So, it's due to withdrawal, and the hCG hasn't had time to correct that yet.

Making an adjustment in dose before the body has acclimated to it, is foolish, and often leaves people chasing their tail as the effects are delayed. What you did many weeks ago affects you today, so the change you make today doesn't affect you for many weeks, so if you change things today without the effects from weeks ago having kicked in you won't know what is doing what.

Hopefully that's understandable, I'm a bit under the weather, and didn't read the full thread.

 

[JakeH]

Because you may be attributing negative symptoms to the wrong thing.

Say OP's symptoms are from something else random, but just happen to coincidentally happen now, or are simply due to the hCG not having had enough time to work.

I may be entirely off base here, and someone correct me if I'm reading this situation wrong, but due to how hormones work, which is slow it's possible the hCG hasn't had enough time to kick in and produce many effects.

So, it's due to withdrawal, and the hCG hasn't had time to correct that yet.

Making an adjustment in dose before the body has acclimated to it, is foolish, and often leaves people chasing their tail as the effects are delayed. What you did many weeks ago affects you today, so the change you make today doesn't affect you for many weeks, so if you change things today without the effects from weeks ago having kicked in you won't know what is doing what.

Hopefully that's understandable, I'm a bit under the weather, and didn't read the full thread.

I knew going into the Clomid Restart that is was going to be bumpy. I hit a dip, but have since pulled out of it, just as I am transitioning from HCG to Clomid. And, as Johndoesmith and Dr Saya said, attributing every up and down to hormones is unfair and shortsighted.

Just as I would not expect to lose 10 pounds in 3 weeks, I did not expect my hormonal milieu to change/reset/settle all within 3 weeks.

 

[johndoesmith]

I knew going into the Clomid Restart that is was going to be bumpy. I hit a dip, but have since pulled out of it, just as I am transitioning from HCG to Clomid. And, as Johndoesmith and Dr Saya said, attributing every up and down with hormones is unfair and shortsighted.

Just as I would not expect to lose 10 pounds in 3 weeks, I did not expect my hormonal milieu to change/reset/settle all within 3 weeks.

Well, it's natural. TRT is a HUGE change in a man's life and is always on your mind when you're beginning, thoughts like "is this it? Did it kick in? Wait, what was that?" are constantly happening.

Plus, the average guy who's starting TRT(by this I mean clomid, hCG, or TRT. Basically anything that is used to treat low testosterone) most likely has terrible thought patterns and lacks the ability to make a decision easily. I know this because I was that guy. I recognize how that feels, how it works, and how it slowly but surely changes when on a proper protocol that achieves levels of testosterone we'd all be happy with.

I also see that your thinking has changed slightly, what you said here is absolutely completely reasonable, and is an example of how I changed. I didn't notice it myself, it's almost impossible to do so, but I remember I had a car problem 2 months after starting, needed new calipers and rotors. The price was $700 or something maybe close to $1000.

Got an Uber to the shop to pick up my car, driver worked on cars, and I made the decision there to buy the parts and hire this guy. $400. Done. Easy.

If that happened before TRT, I would have spent days feeling like the world was ending. I didn't notice it, but my therapist said "wow, you made a decision, without calling a lawyer, doctor, engineer, an accountant, and getting a PhD".

So basically I'm trying to say something changed, but it's only been a few days, so it's probably mental.

 

[JakeH]

Day 2 Clomid (30days since last Test Cyp 160mg)
Feeling really good so far. I have been able to have sex (still using daily Cilais, but lower dose) and libido has been good, and my head-space and outlook have been positive. Workout recovery has been the same, but that never was my issue anyway.

Changes so far in last 30 days:
1) I have lost 8 pounds, without changing workout schedule or food intake (I track both). My arms and neck are 3/4" smaller, as well as my traps, but my waist is the same (33");
2) the acne on my shoulder and back have cleared completely;
3) the lobster-like color I had taken on from my nipples to my ears has subsided, also.

I will post my blood work from the last day of HCG when it arrives next week and update every few days.

I have blood work scheduled for 14 days on Clomid and 28. The former is for my own interest and just in case things turn due to estrogen issues, the 28-day test is for my consult with Defy.

 

[Dr Justin Saya MD]

Day 2 Clomid (30days since last Test Cyp 160mg)
Feeling really good so far. I have been able to have sex (still using daily Cilais, but lower dose) and libido has been good, and my head-space and outlook have been positive. Workout recovery has been the same, but that never was my issue anyway.

Changes so far in last 30 days:
1) I have lost 8 pounds, without changing workout schedule or food intake (I track both). My arms and neck are 3/4" smaller, as well as my traps, but my waist is the same (33");
2) the acne on my shoulder and back have cleared completely;
3) the lobster-like color I had taken on from my nipples to my ears has subsided, also;

I will post my blood work from the last day of HCG when it arrives next week, and update every few days.

I have blood work scheduled for 14 days on Clomid and 28. The former is for my own interest ad just in case things turn due to estrogen issues, the 28-day test is for my consult with Defy.

Thanks for the update JakeH. As an FYI, I wouldn't anticipate robust lab numbers with your draw at the end of the 14 days of HCG - the purpose of that is primarily to prime the testes to respond to the LH/FSH that will soon be produced by the pituitary (in response to the Clomid). You never know, we've seen it all so will be interesting to see.

 

[JakeH]

Thanks for the update JakeH. As an FYI, I wouldn't anticipate robust lab numbers with your draw at the end of the 14 days of HCG - the purpose of that is primarily to prime the testes to respond to the LH/FSH that will soon be produced by the pituitary (in response to the Clomid). You never know, we've seen it all so will be interesting to see.

Thanks, Dr. Saya. I did not expect good numbers, but I wanted another data point to match to symptoms. The results came in:

Total Test-- 325 Low ng/dL 348 - 1197
Free-- 6.6 Low pg/mL 8.7 - 25.1
E2 Sensitive--10.6 pg/mL 8.0 - 35.0

Day 4 Clomid (32 days since Test Cyp injection)
Current Protocol: Clomid 25mg/anastrozole 0.22 ED.

The roller coaster continues. The evening of day 2, all of day 3 and into today have been marked by an extreme low mentally. My emotions were all over the place, and more so yesterday, especially after losing an erection during sex, which I will discuss with my therapist (upside: I was able to get an erection). My libido is still good, but I feel a bit numb all over. I have communicated all of this to my girlfriend, and she has been great about it, but I think she is frustrated, which feeds back into my loop.

Physical signs of note:
left testical seems to be back to TRT size, after having gained some size on HCG shots.
Dark circles under eyes last two days, despite 8 hours of sleep.
Up three times to pee the last two nights.

So, the journey continues. I hope things begin to improve soon. It is bad when one longs for the pre-TRT days, when feeling bad was intermittent (i.e., every few weeks) and PDE5s worked better.

I have an email into Defy to confirm with Melissa that it is still prudent to have an AI compounded with my Clomid, considering my starting E2 of 10, and the possible risk of driving it too low.

 

[JakeH]

I should note, also, that Discountlabs.com turned my labs in two business days, so my remark earlier about lag time was off base, johndoesmith.

I officially stand corrected, Nelson.

 

[johndoesmith]

Thanks, Dr. Saya. I did not expect good numbers, but I wanted another data point to match to symptoms. The results come in:

Total Test-- 325 Low ng/dL 348 - 1197
Free-- 6.6 Low pg/mL 8.7 - 25.1
E2 Sensitive--10.6 pg/mL 8.0 - 35.0

Day 4 Clomid (32 days since Test Cyp injection)

The roller coaster continues. The evening of day 2, all of day 3 and into today have been marked by an extreme low mentally. My emotions were all over the place, and more so yesterday, especially after losing an erection during sex, which I will discuss with my therapist (upside: I was able to get an erection). My libido is still good, but I feel a bit numb all over. I have communicated all of this to my girlfriend, and she has been great about it, but I think she is frustrated, which feeds back into my loop.

Physical signs of note:
left testical seems to be back to TRT size, after having gained some size on HCG shots.
Dark circles under eyes last two days, despite 8 hours of sleep.
Up three times to pee the last two nights.

So, the journey continues. I hope things begin to improve soon. It is bad when one longs for the pre-TRT days, when feeling bad was intermittent (i.e., every few weeks) and PDE5s worked better.

I have an email into Defy to confirm with Melissa that it is still prudent to have an AI compounded with my Clomid, considering my starting E2 of 10.

Misread what OP said disregard this.

 

[JakeH]

No, I wonder if I need to STOP taking my daily AI which is already compounded with my Clomid, because I started the protocol at E2 of 10. I am afraid that 0.22 of AI ED may be too much.

Either way, I wanted Defy to have the latest information, so they could adjust if needed.

 

[johndoesmith]

No, I wonder if I need to STOP taking my daily AI which is already compounded with my Clomid, because I started the protocol at E2 of 10. I am afraid that 0.22 of AI ED my be too much.

Either way, I wanted Defy to have the latest information, so they could adjust if needed.

Oh, that makes more sense, I must have misread what you said.

Definitely worth a call or email to ask.

 

[JakeH]

I updated my original post to reflect the protocol, so it is less ambiguous. Thanks for the reply.

 

[Worried]

I had low e2 for over two weeks. Felt like what your describing. Do you have dry mouth, feel dehydrated? Joints hurting? If so I recomend ionic fizz with Vitamin d, calcium, and magnesium. It helped me to cope. Also juicing a lot of greens with lemon ginger and garlic. All those things can only help (your sysmtoms), even if you don't have low e.

 

[JakeH]

Oh, that makes more sense, I must have misread what you said.

Definitely worth a call or email to ask.

Spoke with an RN on Defy's staff, as Melissa was off today. She said that 0.22 AI ED was a very low dose and that they would not change my protocol based on the blood work done the day before I started Clomid and anastrozole (taken day 14 of HCG), but that I should wait for the 30 day test. The decision to use AI was based on my non-sensitive readings (taken pre-TRT and 3 months on TRT), so I am a bit worried, but will submit to their expertise.

It is difficult to gauge how much an AI could lower my E2 in 30 days, but the tone on forums makes it seem as though it works rapidly. Nonetheless, I will stay the course.