Seven and One-Half Weeks on TRT After Clomid Failure

[JakeH]

Tried a clomid restart with Defy, due to poor protocol with prior Dr., then returned to TRT with Defy, and I am now planning to drop the AI for the next round of blood work, as taking it makes me feel bad. I think I have plenty of upward room, considering 7 doses of 0.20AI had E2@25.5 at trough.

Overall, I feel good, but I am having a tinge of anxiety 12-24 hours after each shot and trouble sleeping. Question: I wonder if I should lower my Test CYP dose after my 90day blood work and consult to bring the trough down a bit, in order to see if the anxiety and sleep issues are related to high peaks?

Age: 40
Height 73.5"
Weight 192
Daily supplements:
Cialis

I switched to Defy Medical on January 11th for two reasons: 1) my doctor required in-office shots, which prevented dosages every 3.5 days; 2) he would not entertain the idea of multiple shots to prevent my 48-72hr spike that led to my feeling awful every week, with pronounced redness from my nipples to my ears; sweating, ED resistant to higher doses of Cialis and Viagra. So, I felt crazy for three days each week.

I met with Defy on Jan 11th, and I was told I could give a Clomid Restart a shot if I wanted to, though my chance of success is less than 50% due to age, past injuries, etc.

Clomid did raise my numbers, but I felt horrible mentally and physically, so I switched back to TRT/HCG/AI on Feb 28th, 2017.

Here are latest results from 7.5 weeks of 2x per week 80mg Test Cyp/350 HCG/with 0.20 AI the last 3.5 weeks (note: I was told to wait a few weeks to start the AI to give my E2 a chance to rise after it being so low during the Clomid/AI challenge, and I forgot to take it until week 4, because I was feeling good and erections were strong on 5mg Cialis. I did not like the AI side effects, however:numb penis, moods, more anxiety and higher doses of Cialis required).

Blood Draw at 8:30 AM 14 April 2017 (Trough)
Total Test____1130 ng/dL 348 - 1197
Free ________22.3 pg/mL 6.8 - 21.5 [lower at this age?]
E2 Sensitive __25.5 pg/mL 8.0 - 35.0

PRE-TRT
Total Test________232 ng/dL 348 - 1197
Free ____________3.3 pg/mL 8.7 - 25.1
E2 non-Sensitive __39 pg/mL <59
LH _____________3.3 miU/ml REF: 0.8 to 7.6 <<<different range>>>
SHBG___________49.6

1x per week 150mg Cyp, 500HCG (23Sep-Nov7 2016)
Total Test________433ng/dL 348 - 1197
Free ____________7.6 pg/mL 8.7 - 25.1
E2 non-Sensitive __42 pg/mL <59
SHBG___________42.6

1x per week 170mg CYP,500hcg (Nov7-Jan9 2017)

Total Test________979 ng/dL 348 - 1197
Free ____________20.5 pg/mL 8.7 - 25.1
E2 non-Sensitive __46 pg/mL <59
SHBG___________39.6

Restart Attempt
Begin HCG (300ui) daily x 14 days on 23 Jan
Day 14 HCG 300iu Daily
Total Test____325 ng/dL 348 - 1197
Free ________6.6 pg/mL 8.7 - 25.1
E2 Sensitive __10.6 pg/mL 8.0 - 35.0


Begin CLOMID:
Day 14 of Clomid ED 25mg Clomid/0.22AI compounded
Total Test____544 ng/dL 348 - 1197
Free ________9.4 pg/mL 8.7 - 25.1
E2 Sensitive __10.8 pg/mL 8.0 - 35.0
LH __________8.7 miU/ml HIGH REF: 1.7 to 8.6

Day 22 of Clomid (last pill on day 20) 25mg Clomid/0.22AI compounded
Total Test_____639 ng/dL 348 - 1197
Free _________13.4 pg/mL 8.6 - 25.1
E2 Sensitive ___20 pg/mL 8.0 - 35.0
LH __________9.6 miU/ml HIGH REF: 1.7 to 8.6

 

[Sean Mosher]

So how are you doing currently?
25.5 pg/ml isn't bad at all for estradiol.
Do you feel you'd do better at a higher number?

 

[CoastWatcher]

So how are you doing currently?
25.5 pg/ml isn't bad at all for estradiol.
Do you feel you'd do better at a higher number?

These are on point. Don't simply chase a number.

 

[JakeH]

So how are you doing currently?
25.5 pg/ml isn't bad at all for estradiol.
Do you feel you'd do better at a higher number?

These are on point. Don't simply chase a number.

As I noted in the first post, I feel okay overall, but I am getting a bit of anxiety 12-24 hours after injection and I am having trouble sleeping, which leads to my original question of should I consider lowering my dose to see if it is a response to too high of a peak number if my trough is in the 1100s. I will not lower it for another 6 weeks, as I have already discontinued the AI, so I need fresh labs and a consult before I change another variable.

With regard to E2, I would like to see how I feel at a higher E2, since my T levels are at the top end. I have not taken an AI since 10 April, which was my last shot day before the blood test that produced an E2@25.5, and the negative symptoms I associate with AIs have resolved. My penile sensitivity is back, and erections are working like crazy, while the moods have stabilized. I am not sure why I respond to that drug the way I do, but having used it with clomid and a few weeks on TRT, I would prefer to avoid it at all costs.

 

[CoastWatcher]

As I noted in the first post, I feel okay overall, but I am getting a bit of anxiety 12-24 hours after injection and I am having trouble sleeping, which leads to my original question of should I consider lowering my dose to see if it is a response to too high of a peak number if my trough is in the 1100s. I will not lower it for another 6 weeks, as I have already discontinued the AI, so I need fresh labs and a consult before I change another variable.

With regard to E2, I would like to see how I feel at a higher E2, since my T levels are at the top end. I have not taken an AI since 10 April, which was my last shot day before the blood test that produced an E2@25.5, and the negative symptoms I associate with AIs have resolved. My penile sensitivity is back, and erections are working like crazy, while the moods have stabilized. I am not sure why I respond to that drug the way I do, but having used it with clomid and a few weeks on TRT, I would prefer to avoid it at all costs.

It's not unreasonable to wonder if slightly less testosterone, given your trough reading, might be a positive move. If you weren't dealing with the anxiety you mentioned, would you be satisfied with where you stand?

 

[JakeH]

It's not unreasonable to wonder if slightly less testosterone, given your trough reading, might be a positive move. If you weren't dealing with the anxiety you mentioned, would you be satisfied with where you stand?

Yes, I would be satisfied at this point. I spoke with Defy (they are on it, I swear), and Melissa said to drop to 0.35 ml (70mg) every 3.5 days to see if the lowered dose makes a difference with my post-injection symptoms, and then we will reconsider when we meet in 6ish weeks. I feel fortunate to be very close to being tuned-in already.

 

[CoastWatcher]

Yes, I would be satisfied at this point. I spoke with Defy (they are on it, I swear), and Melissa said to drop to 0.35 ml (70mg) every 3.5 days to see if the lowered dose makes a difference with my post-injection symptoms, and then we will reconsider when we meet in 6ish weeks. I feel fortunate to be very close to being tuned-in already.

You really aren't far at all from being balanced. Good luck.

 

[JakeH]

Yes, I would be satisfied at this point. I spoke with Defy (they are on it, I swear), and Melissa said to drop to 0.35 ml (70mg) every 3.5 days to see if the lowered dose makes a difference with my post-injection symptoms, and then we will reconsider when we meet in 6ish weeks. I feel fortunate to be very close to being tuned-in already.

6 weeks later, I had more blood work done prior to my consult on June 2nd. I have not felt as good the past few weeks at 70 mg T Cyp and 350 HCG every 3.5 days (No AI), but wanted to give it a full 6 weeks before I went back to my original dose. My prescription is still for 80mg E3.5days, so I will return to that. It is wild that dropping from 160mg per week to 140mg per week reduced my total Test by almost half.

13.5 Week Blood Draw at 8:30 AM 19 May 2017 (Trough)
Total Test____675 ng/dL 348 - 1197
Free ________16.5 pg/mL 6.8 - 21.5
E2 Sensitive __25.3 pg/mL 8.0 - 35.0


7.5 Week Blood Draw at 8:30 AM 14 April 2017 (Trough)@80mg Test Cyp/350 HCG/with 0.20 AI E3.5 days
Total Test____1130 ng/dL 348 - 1197
Free ________22.3 pg/mL 6.8 - 21.5
E2 Sensitive __25.5 pg/mL 8.0 - 35.0

 

[madman]

6 weeks later, I had more blood work done prior to my consult on June 2nd. I have not felt as good the past few weeks at 70 mg T Cyp and 350 HCG every 3.5 days (No AI), but wanted to give it a full 6 weeks before I went back to my original dose. My prescription is still for 80mg E3.5days, so I will return to that. I it wild that dropping from 160mg per week to 140mg per week reduced my total Test by almost half.

13.5 Week Blood Draw at 8:30 AM 19 May 2017 (Trough)
Total Test____675 ng/dL 348 - 1197
Free ________16.5 pg/mL 6.8 - 21.5
E2 Sensitive __25.3 pg/mL 8.0 - 35.0


7.5 Week Blood Draw at 8:30 AM 14 April 2017 (Trough)@80mg Test Cyp/350 HCG/with 0.20 AI E3.5 days
Total Test____1130 ng/dL 348 - 1197
Free ________22.3 pg/mL 6.8 - 21.5
E2 Sensitive __25.5 pg/mL 8.0 - 35.0

You are closer to 700 I would try 150mg week split to 75mg every 3.5 days you may hit 900s as you have nothing to loose except another 6 weeks of your time until you retest levels as being at the very upper end is not always good. I would look into your hcg as it could possibly be why you feel so wound up as some have been known to get insomnia/anxiety from hcg.

 

[JakeH]

You are closer to 700 I would try 150mg week split to 75mg every 3.5 days you may hit 900s as you have nothing to loose except another 6 weeks of your time until you retest levels as being at the very upper end is not always good. I would look into your hcg as it could possibly be why you feel so wound up as some have been known to get insomnia/anxiety from hcg.

Good points all. I will speak with the Dr about that. I do not mind tweaking and testing every 6 weeks.

As for the HCG, I would like to try TRT without it, but I am getting married soon and would like to try to have kids in two years, so I do not want to let my testes go idle and then try to jump start them later with HCG.