Increase HCG or clomiphene?

[bullseye55]

I am a 64 y/o male, non-diabetic, normal blood pressure, been on compounded cream TRT replacement therapy last 4 years. Was experiencing some testicular shrinkage so added HCG two years ago at 350u every other day now up to 500u every other day with a lower dosage of the cream. Combined HCG & TRT will get me total T of around 1000, free in 20s. The HCG alone I get total T 450-500. With nothing I drop to low 200s and free T <5. I haven't been totally satisfied with testicular recovery with HCG. With the current regimen elevates the hemoglobin and hematocrit and phlebotomy every 8-12 weeks. I have had two of Discount Labs 17-OH tests and they both came back around 145ng/dl below the goal of >215. My question is should I increase the HCG dose to see if it will raise the 17-OH or consider adding on possibly 25mg of clomiphene to attempt it through a different pathway and stop the topical cream. I'd like to get a bit more testicular recovery and maybe improve semen, basically clear/watery and minimal now. It could be the testicles are at max and it's just going to take TRT to get me to the level i would like to maintain. I am guessing I'd need 90 days to fully test HCG/CC option without the topical TRT. Just increasing the HCG with the current TRT cream probably would give me answers in 30 days. I feel good on what I am doing, just wondering if my body could do more of the work. Great forum by the way.

 

[Cataceous]

There are some isolated reports of clomiphene working in spite of TRT, but going by Dr. Saya's statements it will not overcome HPTA suppression in most guys. For "testicular recovery" you might look into adding FSH to your protocol if you have the money.

 

[Vince Carter]

Given the age "recovery" might be far fetched, I think HCG is incorrectly regarded in this way, increasing size/fullness/semen/etc etc
if 500iu EOD isn't getting what you want I don't think that there's any amount of trying to stimulate the testes that is going to be different as 500iu EOD is a fairly large dose, in TRT circles. You get in to these doses and Estrogen can possibly be a problem.
In other words if testicular problems and/or failure landed you here to begin with there's quite probably that no amount of added stim is going to change that.

 

[bullseye55]

thanks for the input. When I see my MD next week I think I'll leave the HCG dosage off the agenda. I think I will ask about trying CC in lieu of the topical T. I am currently off the topical T, using only HCG for a couple of weeks. I had a lab value come back with TTL/FT 1500+/40. No dosage changes, maybe just a fluke but I wanted to bring things down. So it might be a convenient time to substitute the CC for the topical T and see how I react. If I get any side effects it will just be back on the topical T with the HCG. I have been lucky with little if any elevated E trouble, at least where a sensitive E2 test will pick up. When I was increasing HCG and decreasing topical T things got a bit elevated similar to what I had happen just recently. E2 got up to 45. When the T levels dropped back down the E2 level was in the mid-30ds and that's common. If I use 0.125mg of anastrozole every 3 days it will drop to 22. I'd like to be in the 20-30 range that Life Extension recommends but my E2 can tank quickly on anastrozole. Based on what I read here a guy should be conservative on the CC doses. Start low and work up. I don't see myself wanting any dosage above 25mg/day. Adding the HCG to the T regimen did get about 80% of the testicular size back and I generally feel pretty good only downside is managing HH with trips to the blood bank.

 

[bullseye55]

I added 25mg of clomiphene daily to my regimen of 500U of HCG every other day and maintained the 0.125mg anastrozole every 3rd day. I have been off topical testosterone since mid-November. The 'after' results below are after taking Clomid for 30 days at 25mg/day. I did get a boost from the clomiphene but at the expense of SHBG and free T. Morning wood has been good, boys might be hanging a bit lower, testicle size not much different size-wise but feel firmer. No gyno, weight gain or other issues. Any idea if this is the peak effect of the CC or if I should expect more continuing, and if so what? I was pleased to see some FSH show up. I am considering cutting the CC dose to 12.5mg/day and maybe start 1 gram of the topical T cream daily and see if the SHBG would drop and free T increase with less CC. I'd be happy with this level of T if the free T was at least 15 and closer to 20 and SHBG down where it was prior to CC. Anyone had any luck driving down SHBG while on CC. I would like to minimize the topical T dose as it elevates my hemoglobin/hematocrit and requires blood donations.
Total T prior to CC 546; after CC 775
Free T prior to CC 15.3; after CC 10.8
SHBG prior to CC 42.6, after CC 92.4
LH prior to CC <0.2; after CC 1.2
FSH prior to CC <0.2; after CC 2.6
Estradiol sensitive prior to CC 8.5; after CC 20
Total Cholesterol prior to CC 205, LDL 115; after CC total cholesterol 167, LDL 102

 

[Cataceous]

Interesting results—thanks for sharing. Nice that you achieved some HPTA activation. I bet the anastrozole is one of the reasons it worked. Give the promising results you might consider switching to pure enclomiphene if you can get a prescription. The zuclomiphene is likely holding you back and/or causing problems. It is estrogenic, probably contributing to the spike in SHBG, and it is not affected by the AI. In addition, zuclomiphene has a very long half-life, possibly several weeks. This means it can continue to build up in you for months.

Adding androgens to drive down SHBG is likely to re-suppress your HPTA.

 

[bixt]

Off topic, but given your numbers perhaps low SHBG guys should consider a tiny dose of clomid such as 12.5mg twice a week to raise SHBG. I believe Dr Saya has mentioned this as well.

 

[bullseye55]

Ironic you mention enclomiphene. I was looking at that option last night. Got stalled out on the availability. Sounds like 25mg per day of that would be a good starter. If I could get my body to do 100% with hcg and enclomiphene I would be pleased. It was nice to see the fish show up. Maybe with more time lh would kick in. I do have the hcg to take care of lh. My doctor was not enthused about cc and wanted me just to go back to try with the hcg. I had to give this trial and see what part of the body might be holding my t level down. When he sees the cholesterol drop he might feel differently. Any help on the enclomiphene would be appreciated. Point me where I can get a legit source. My problem with blood donations is not the giving but it depletes my iron so I need to supplement that which is a pain. One more thing maybe I should mention is I did start low dose cialis 5mg daily. Getting a bit of upper GI effects hope over first month or so it will subside. No other I'll effects. It does put the body in more of a "ready state' big incentive to also continue is my c-reactive protein dropped to 0.5 never been below about 1-1,2 before. So that benefit is for real. No blue vision tint like Viagra with this dosage. Things work without either but it does enhance the enjoyment.

 

[bullseye55]

I doubt if I could get the hpta to do all work so see hcg as something I need to continue. Just trying to find the best thing to assist. Since my testicles are still functioning I would like to use those options first if not creating other issues. Good thought on low shbg guys trying low dose cc. I bet it would work. Anybody try tongkat ali for shbg elevations? I did some boron years ago when just using T. It never did much. When I dropped the T dose and started hcg it seemed like shbg settled in at the midpoint. Was rare for me to check it.

 

[Cataceous]

... Any help on the enclomiphene would be appreciated. Point me where I can get a legit source. ...

If "legit" implies a prescription then known sources are Tailor Made or via Defy Medical. But if you mean something that's a research chemical and known to be the real stuff, then it's more problematic. Nootropic Source is fairly reputable and sells an enclomiphene citrate solution. Is is legit? I don't know.

 

[xqfq]

If "legit" implies a prescription then known sources are Tailor Made or via Defy Medical. But if you mean something that's a research chemical and known to be the real stuff, then it's more problematic. Nootropic Source is fairly reputable and sells an enclomiphene citrate solution. Is is legit? I don't know.

I would caution anyone thinking of using any of the research chemical / gray market sites for this right now. None of the vendors who do legit 3rd party testing have enclomid and at least one legit vendor has tested many batches and all have failed. I can’t find any third party testing information for the above mentioned vendor, for instance. I’ve even seen blood work for guys taking some of these products that look like they’re taking anastrozole (very low E2, high free T, lowered SHBG)

 

[bullseye55]

Thanks for the input on the enclomiphene sourcing. I am reducing the dosage of the clomiphene to 12.5mg daily for 30 days and then re-test. In addition to reducing the clomiphene I did restart 1 gram/day of a topical 2% testosterone cream. I want to see if these changes still keep some of the LH and FSH that I got with the higher cc dosage but lower the SHBG and improve free T. If that's the case I will keep taking the CC and maybe even try 12.5mg of CC every other day. If the lower free T/high SHBG continue with lower clomiphene dosage I will probably just drop the clomiphene and go back to topical T and of course my HCG every other day. I am continuing the anastrozole 0.125mg every 3rd day unchanged. If a reliable/safe enclomiphene could be found I'd sure like to swap the CC for it and see any differences. To stay with CC I'd need to get over 800 on total T and free 18+. I know I can get 1000/20 with topical T and HCG with no problem. it just sometimes spikes and of course there are the required blood donations/iron replacement I'd like to avoid if I can. Does anyone have any personal experience with adding DMSO to a topical T product to improve absorption? I have some personal experience with that but would probably open another posting on that subject alone.

 

[bullseye55]

Just a bit of an update. I have completed 30 days of the clomiphene at the reduced dosage of 12.5mg daily and added the 1gram of 2% topical testosterone. Lipid profile unchanged. FSH and LH are up on the lower dosage of cc. SHBG down as is total testosterone. HCG dose and anastrozole unchanged dosages. The latest lab info is in bold. I was expecting T go up. The topical product I am using was compounded last May so that may be part of the problem. Reducing the dosage of the clomiphene did lower SHBG and I did get more of a boost in FSH and LH in the 2nd 30 day period even at the 12.5mg dosage. I'd appreciate any comments. I still want to get the total T/FT in the 800/18 range or better. I don't want to bump the cc dosage so only option I see is the topical T. Try a new batch was originally planning on stopping the cc after 30 days of the 12.5mg but the nice bump in LH and FSH have me rethinking that or possibly go another 30 days.
Total T prior to CC 546; after CC 25mg daily 775; after 30 days of cc at 12.5mg & TRT 550
Free T prior to CC 15.3; after CC 25mg daily 10.8; after 30 days of cc at 12.5mg & TRT 9.3
SHBG prior to CC 42.6, after CC 25mg daily 92.4; after 30 days of cc at 12.5mg & TRT 71.4
LH prior to CC <0.2; after CC 25mg daily 1.2; after 30 days of cc at 12.5mg & TRT 3.4
FSH prior to CC <0.2; after CC 25mg daily 2.6; after 30 days of cc at 12.5mg &TRT 4.4
Estradiol sensitive prior to CC 8.5; after CC 25mg daily 20; after 30d 12.5mg cc & TRT 16.2
Total Cholesterol prior to CC 205, LDL 115; after CC total cholesterol 167, LDL 102, same