Why not low dose clomiphene instead of HCG on TRT?

[Renholder]

Hello all,

Why is it not possible to use clomiphene instead of HCG on TRT? Both stimulate the testes, the other directly and the other indirectly, right?

I`ve tried finding an answer to this and I have read several discussions on other boards, but there does not seem to be a satisfactory answer to this. Several posters says it`s not a good idea, but there is not a single poster who can explain why.

I have a friend who`s been using TRT (now Nebido) for years, but without HCG. I convinced him that he should consider HCG, but he`s very stubborn and wants to try clomiphene instead. I told him my personal opinion which is that I don`t know if it works, but that there seems to be a lot of people who thinks it`s not a good idea.

Any ideas?

I would be much more practical to simply take a pill three times a week. HCG presents a challenge when travelling due to storage issues, although one could possibly solve that by using synthetic HCG (which does not require cold storage if I`m correct).

Thankful if anyone can clear up this for me.

Regards,

Renholder

[oscarjones]

Because when you stop Clomid, which can be fairly hepatotoxic, your elevated FSH, LH and Test will drop back down. Also, you'd need very low doses, or else you'll get skewed Test to Free Test to FSH and LH ratios. For example, your test may be in a perfectly high range, however your FSH could be double or triple a healthy range. The metabolic pathways work in a more complex manor, but you could try and "jump-start" your system with clomid or a PCT type protocol for a few weeks and see how it affects your natural levels of test when you complete it. Long-term therapy isn't practical though.

[Renholder]

Thank you for your reply, but I don`t follow you completely.

If I stop HCG , my testosterone will drop as well?

I know there are people who use clomiphene for monotherapy in the long-term and from what I have gathered, it is not toxic, especially with low doses.

[Simon1972]

HCG will also stop LH production- LH is released from the pituatry gland, while taking HCG , it acts as LH in your body and LH is no longer secreted or ends up being suppressed while taking hcg . so HCG is not what id say was apprpriate to restart HTPA if thats what you are asking.

nolvadex maybe? seems better than clomid from what ive been reading

[oscarjones]

Thank you for your reply, but I don`t follow you completely.

If I stop HCG , my testosterone will drop as well?

I know there are people who use clomiphene for monotherapy in the long-term and from what I have gathered, it is not toxic, especially with low doses.

I apologize my answer was moderately divergent from your question. Replacing hCG with Clomiphene isn't plausable as both have completely different functions. You want the analog virtues of hCG to help sustain some of the naturally occurring hormonal sequences in relation to your HPT axis. Simon explained it quite nicely.

[Renholder]

Gentlemen,

I appreciate your efforts, but I still don`t follow you. I`m usually slow to pick up things, so please bear with me.

I am not talking of PCT or attempting to restart the HPT axis and I`m well aware that HCG shut downs LH production.

I`m talking about using clomiphene instead of HCG while using exogenous testosterone on TRT.

[go2failure]

Gentlemen,

I appreciate your efforts, but I still don`t follow you. I`m usually slow to pick up things, so please bear with me.

I am not talking of PCT or attempting to restart the HPT axis and I`m well aware that HCG shut downs LH production.

I`m talking about using clomiphene instead of HCG while using exogenous testosterone on TRT.

From Dr. Crisler's HCG update:

The P450 Side Chain Cleavage enzyme, which converts CHOL into pregnenolone at the initiation of all three metabolic pathways CHOL serves as precursor (the sex hormones, glucocorticoids and mineralcorticoids), is actively stimulated, or depressed, by LH concentrations. It is intuitively consistent that during conditions of lowered testosterone levels , commensurate increases in LH production would serve to stimulate this conversion from CHOL into these pathways, thereby feeding more raw material for increased hormone production. And vice versa. Thus the addition of HCG (which also stimulates the P450scc enzyme) helps restore a more natural balance of the hormones within this pathway in patients who are entirely, or even partially, HPTA-suppressed.


Dr. Crisler and the other posters are trying to say that HCG is way more beneficial to the TRT protocol than without. Clomid binds to estrogen receptors to work and in some people gives the feeling of estrogen dominance (ED, bloating, fatigue, hot flashes, etc). It also has been known to cause temporary/permanent vision problems starting at low doses. Like the previous poster alluded, at some point Clomid completes the HPTA loop from the stimulation it provides and it begins to negate its own production.

[oscarjones]

Gentlemen,

I appreciate your efforts, but I still don`t follow you. I`m usually slow to pick up things, so please bear with me.

I am not talking of PCT or attempting to restart the HPT axis and I`m well aware that HCG shut downs LH production.

I`m talking about using clomiphene instead of HCG while using exogenous testosterone on TRT.

Basically, supplementing with Test will greatly reduce production of endogenous LH, if not wipe it out completely.

Due to this action, the use of hCG will mimic and replace your decreased LH.

Clomiphene citrate will not help simulate LH production.

So, use Test with hCG. Clomid is a different beast.

Simple!

[Renholder]

Basically, supplementing with Test will greatly reduce production of endogenous LH, if not wipe it out completely.

I follow you 100%.

Due to this action, the use of hCG will mimic and replace your decreased LH.

Absolutely. That`s why we take HCG either on monotherapy or as a supplement with TRT to maintain testicular function. I follow.

Clomiphene citrate will not help simulate LH production.

When used with TRT? Why not?

It most certainly increases LH if used as monotherapy.

[Renholder]

Dr. Crisler and the other posters are trying to say that HCG is way more beneficial to the TRT protocol than without. Clomid binds to estrogen receptors to work and in some people gives the feeling of estrogen dominance (ED, bloating, fatigue, hot flashes, etc). It also has been known to cause temporary/permanent vision problems starting at low doses. Like the previous poster alluded, at some point Clomid completes the HPTA loop from the stimulation it provides and it begins to negate its own production.

I do not follow. Especially the last sentence?

From what I have learned, side effects on clomid are typically dose-related and not really an issue with the type of doses we are talking about here. On clomiphene monotherapy, which there are several good studies proving it`s efficacy compared with exogenous testosterone treatment and with LESS side-effects (none actually), the most used dose is 12,5 mg every day. I used that dose myself on an attempt of montherapy and experienced NO side-effects at all. Unfortunately, it did not boost my testosterone signifcantly and increased my SHBG.

For me, I would consider going lower than that if I were to use it along with TRT instead of HCG .

If I`m not completely mistaken, Crisler now uses clomid monotherapy with a select few of his patients and have changed his opinion from earlier when he were completely opposed to it.

What am I missing here?

[go2failure]

I do not follow. Especially the last sentence?

From what I have learned, side effects on clomid are typically dose-related and not really an issue with the type of doses we are talking about here. On clomiphene monotherapy, which there are several good studies proving it`s efficacy compared with exogenous testosterone treatment and with LESS side-effects (none actually), the most used dose is 12,5 mg every day. I used that dose myself on an attempt of montherapy and experienced NO side-effects at all. Unfortunately, it did not boost my testosterone signifcantly and increased my SHBG.

For me, I would consider going lower than that if I were to use it along with TRT instead of HCG .

If I`m not completely mistaken, Crisler now uses clomid monotherapy with a select few of his patients and have changed his opinion from earlier when he were completely opposed to it.

What am I missing here?

What he is saying is HCG restores the production of pregnolone, progesterone, dhea, and the creation of those molecules not just from the organs, which puts stress on them without the proper enzymatic stimulation to promote the conversion of Cholesterol into the necessary steroid molecules.

Here is a link to a sheet which will show you the flow of the steroid molecules.

upload.wikimedia.org/wikipedia/commons/1/13/Steroidogenesis.svg

(add the htt.p:// onto the beginning)

So basically, it's VERY foolish not to be on HCG when you have the choice to be on it. It restores the natural processes of making the hormones in your body and gives you a much healthier treatment and allows you to feel good again. CLOMID... does not do any of this of this ... AT ALL... In addition to the bullshit sides some get from it... some being permanent

[Simon1972]

clomid binds with estrogen receptors.
the body recognises that there is a "lack" of estrogen and releases LH to stimulate the testes to produce more testosterone .
If you take testosterone your body will try to convert it into estrogen- taking clomid at the same time will bind to the estrogen receptors-


so your question is interesting- would your body release its own test in an attempt to convert to estrogen- considering your injected test is struggling to convert to estrogen and find balance?

somehow i think it wouldnt be a good way of tackling the problem- too many conflicts- best to use hcg to keep your testes "alive" and clomid/nolva to kickstart them when you get off trt.

[Vettester]

When used with TRT? Why not?

It most certainly increases LH if used as monotherapy.

Oscar's statement below summarizes it nicely.

The thing with Clomid, you might be able to prompt some GNrH activity with adding it to a protocol, but the HPTA will have a tendency to stay suppressed as long as you're taking any form of exogenous medication, such as HCG or test cyp. Everything is working on a negative feedback loop between the testicles and the HPTA. Either exogenous compound will basically signal the HPTA to stop production, thus suppression is at hand. And depending on how long you've been suppressed, or what diagnosis was established with the HPTA, such as secondary hypo, then there's a strong chance that Clomid or any other SERM will just spin your wheels with producing LH at the axis, getting you really nowhere.

In essence, it's just sounds counterproductive if you're trying to establish some form of exogenous medication treatment for hormone therapy.

Basically, supplementing with Test will greatly reduce production of endogenous LH, if not wipe it out completely.

Due to this action, the use of hCG will mimic and replace your decreased LH.

Clomiphene citrate will not help simulate LH production.

So, use Test with hCG. Clomid is a different beast.

Simple!

Yes ^^ Very Simple!

[Renholder]

What he is saying is HCG restores the production of pregnolone, progesterone, dhea, and the creation of those molecules not just from the organs, which puts stress on them without the proper enzymatic stimulation to promote the conversion of Cholesterol into the necessary steroid molecules.

Here is a link to a sheet which will show you the flow of the steroid molecules.

upload.wikimedia.org/wikipedia/commons/1/13/Steroidogenesis.svg

(add the htt.p:// onto the beginning)

So basically, it's VERY foolish not to be on HCG when you have the choice to be on it. It restores the natural processes of making the hormones in your body and gives you a much healthier treatment and allows you to feel good again. CLOMID... does not do any of this of this ... AT ALL... In addition to the bullshit sides some get from it... some being permanent

Thank you.

I know that it`s foolish to not be on HCG when on TRT and that`s why I`m currently using it. But I do not understand how clomid does not do anything of this AT ALL? And I never heard of the side effects being permanent?

When I was on clomiphene monotherapy, I experienced zero side-effects (25 mg ED) and I would expect to use a lower dose if I were to try it now in addition to the TRT I`m using (Nebido).

I read about a guy on another forum who asked similar questions with HCG vs clomiphene. He had bloodwork showing much higher levels of pregnolone when he used clomid with his TRT regime, than when he used HCG.

[Renholder]

And depending on how long you've been suppressed, or what diagnosis was established with the HPTA, such as secondary hypo, then there's a strong chance that Clomid or any other SERM will just spin your wheels with producing LH at the axis, getting you really nowhere.

I still do not quite follow. Producing LH at the axis? Spin my wheels?

Like Michael Scott says in The Office. Please explain this like you would to a 10 year old. Then, explain like you would to a 5 year old. Maybe I can blame my brain fog for being slow?

I don`t mind pinning HCG 2-3 weekly as it is very easy and painless, but the reason I`m contemplating clomiphene instead is because it is far more practical when I`m on the road and traveling. Unless I get synthetic HCG, I can`t maintain a normal HCG dosing schedule while traveling around. Another thing is that I may have been feeling worse the days after I pin HCG, although I can`t say for sure if it`s random. Maybe it`s E2 spikes or something, but the doses are low (200 IU 3X), so I don`t know really.

The pharmacy is also out of HCG for a few weeks, but I have clomiphene at hand.

Regards,

Renholder

[DanMan250]

A lot of guys are cycling between clomid & HCG with good results because HCG can lose its effects after a time eg 6 weeks HCG followed by 3 weeks of clomid then repeat

[Vettester]

A lot of guys are cycling between clomid & HCG with good results because HCG can lose its effects after a time eg 6 weeks HCG followed by 3 weeks of clomid then repeat

I've been on HCG for over 2 years. How will it lose it's effect. It just simply mimics The LH signal to the testicles in place of the HPTA when it's suppressed.

[kelkel]

^^Agree. I see no reason for it to lose its effects unless massive doses are used leading to possible desensitation.

[Renholder]

I`m sorry guys, but I still do not feel any of you have provided an explanation that I can understand. I do not have fresh HCG at hand, so I will try 25 mg clomiphene EOD for a few weeks now and see what happens.

I asked the same question at Dr Johns forums and he does not seem to hold the same viewpoint as most here:

That's a great question.

THEORETICALLY clomiphene would be superior to HCG. However, it just does not work out well for many.

You will just have to try it to see.

[Vettester]

I`m sorry guys, but I still do not feel any of you have provided an explanation that I can understand. I do not have fresh HCG at hand, so I will try 25 mg clomiphene EOD for a few weeks now and see what happens.

I asked the same question at Dr Johns forums and he does not seem to hold the same viewpoint as most here:

I'll try to explain this differently ... The main thing you are looking to get is LH (luteinizing hormone), right? LH, will stimulate the testicles to produce testosterone , also known as endogenous production.

There's two (2) ways that the LH signal can get to the testicles to get them working ...

1) By the brain. This is achieved in the pituitary region of the brain, and is also referred to as the HPTA (hypothalamas pituitary thyroid axis). This is where you hear the term "axis" being used. When the axis is healthy, it will produce LH and signal the testes to produce endogenous testosterone. This will be regulated via a feedback loop to the "axis", which tells it when enough testosterone is in the body, or when more is needed. When serum levels drop, the axis gets the call to send more LH, then the testes go to work again ... The cycle repeats itself over, and over, and ...

2) When the HPTA does not function correctly, which can also be diagnosed as secondary hypogonadism, then a patient can look at HCG to signal the testes to produce endogenous testosterone. HCG, as explained by Oscar is an LH analogue, an exogenous method if you will to deliver that hormone to the testicles. Again, the testicles won't produce testosterone, or very little of it without the LH signal.

Clomid is compound, also known as a SERM, which is designed to stimulate the "axis" to produce LH & FSH. If your "axis" is shutdown, suppressed, not working, whatever you want to call it due to hypogonadism, then there's a good chance that clomid will have minimal effect, and it will probably not sustain gonadotropin production (LH/FSH) for very long. And as Oscar mentioned, using Clomid as method for a therapy solution isn't practical.

So, if there's a chance that your "axis" will function normally by running a clomid protocol, like a PCT, then by all means go for it. If your HPTA is anything like mine, then it's suppression is irreversible, thus Clomid would just be "spinning my wheels" if I took it. Therefore, I use HCG, which doesn't have anything to do with trying to get the brain to produce LH. It's just an exogenous (outside) source of the LH analogue, and my testicles don't care how they got it, they're just glad they got it.

Ren, that's about the best 10 year old, childlike explanation I can give you. Just keep reading up on it and stay involved with the forums, hopefully more time with our forum here. Any questions?

[Simon1972]

basicaly the way i see it - clomid can be used if you have secondary hypogonadism - i think the question is wether long term use is safe, i know on a blog by a male health doctor that clomid is recomended over HCG if the pituatry is working as its less cumbersome etc...

http://www.maledoc.com/blog/2010/04/...ge-5/#comments

i subscribe to that line of thinking- if you have a functioning pituatry- why not excersise it? im not convinced shutting down pituatry function is a good option- something about that doesnt sit right with me.

also men taking clomid experience low libido and become emotional experience gyno - all are symptoms of high estrogen ( from aromatase conversion) i would suggest taking an AI temporarily alongside the clomid when these sides develop temporarily ( few days).

clomid increases test and also increases estrogen (thru aromatase conversion) which is free to bind- good if its in the right ratio- if it gets out of ratio eg too much estrogen,thats when the sides flare up , an AI which prevents the estrogen from being manufactured and thereby binding with the estrogen receptors in your manboobs may be a good idea.

its a fine balancing act- dont forget about the rebound effect if clomid is stopped. a taper off clomid or Dosing on an AI at the end of a clomid cycle is a good way of preventing sides.

does anyone else agree with my thinking>?

[oscarjones]

Read this, OP.

http://forums.steroid.com/showthread....#.T-k97PXhe7I

The statement Crisler makes about clomid being "theoretically" superior may hold virtue, however that's about all. If it were a true found maharajah in the grand scheme of endocrine control and axis regulation, then every man would be on it; Crisler explains that only few men find it to be so.

I say go for your Clomid exchange, if your sentiment is grand, and explore it's ability to restore even a fraction of endogenous activity that hCG has proven aid with, not just theoretically.

It sounds like you have a good understanding of the question and are just searching for a concrete answer as to why theory is overpowered by empirical success, and you quite possibly could be barking up the wrong tree. I could go into the science in more detail, and honestly, it's an interesting debate, however, I think the driving force would become an overzealous attempt to deconstruct old mantras about hCG therapy.

You discussed the efforts of clomid with monotherapy and I'd say that it's fine and can work for some (not commonly without skewed and overshot FSH and LH blood results in comparison to test serum levels), however again it's not practical for many other reasons, especially in broad spectrum balance, otherwise there'd be no TRT and all the guys would be popping the fairly hepatotoxic citrate once a day.

If I were you, I'd re-examine how the HPTA functions when exposed to exogenous test, why it gets suppressed due to such, and how clomid relates to the HPTA under suppression, this will eventually lead you to the theoretical yet paradoxical conflict between the use of hCG and Clomid under such an environment.

[DanMan250]

I've been on HCG for over 2 years. How will it lose it's effect. It just simply mimics The LH signal to the testicles in place of the HPTA when it's suppressed.

Well i've been reading the posts on Dr Crisler's site and on the Meso site for over a year and there are quite a number of guys there who believe that downregulation of LH receptors occurs within 6-12 weeks of consistent HCG use. They weren't taking large amounts of HCG either. As far as clomid is concerned, there are some guys who believe that they get a libido boost by taking very small amounts like 12.5mg 3 x week whilst on TRT. Personally I have used clomid on its own and thought it made my libido worse.

[Vettester]

Well i've been reading the posts on Dr Crisler's site and on the Meso site for over a year and there are quite a number of guys there who believe that downregulation of LH receptors occurs within 6-12 weeks of consistent HCG use. They weren't taking large amounts of HCG either. As far as clomid is concerned, there are some guys who believe that they get a libido boost by taking very small amounts like 12.5mg 3 x week whilst on TRT. Personally I have used clomid on its own and thought it made my libido worse.

I know what you're saying, I have heard many of these statements and others over the years. However, what I have yet to see is any clinical evidence at any level. So far, it's just been anecdotal discussions. If there's any clinical reports that can support any of it, I would love to see it posted up. I've also worked with a reputable doctor in the LA area, who provided a lot of patients HCG mono therapy, dating back to the 90's. Last I spoke with him, he stated that he had yet to see one patient get desensitized from HCG therapy. He was actually more in tune to pull a guy from the cypionate for a month or two to give the body a break, but he would up the dosage on their HCG during that period to compensate it.

[Simon1972]

hey vette, what do you do ? if i can ask?

[Renholder]

Clomid is compound, also known as a SERM, which is designed to stimulate the "axis" to produce LH & FSH. If your "axis" is shutdown, suppressed, not working, whatever you want to call it due to hypogonadism, then there's a good chance that clomid will have minimal effect, and it will probably not sustain gonadotropin production (LH/FSH) for very long. And as Oscar mentioned, using Clomid as method for a therapy solution isn't practical.

So, if there's a chance that your "axis" will function normally by running a clomid protocol, like a PCT, then by all means go for it. If your HPTA is anything like mine, then it's suppression is irreversible, thus Clomid would just be "spinning my wheels" if I took it. Therefore, I use HCG , which doesn't have anything to do with trying to get the brain to produce LH. It's just an exogenous (outside) source of the LH analogue, and my testicles don't care how they got it, they're just glad they got it.

Ren, that's about the best 10 year old, childlike explanation I can give you. Just keep reading up on it and stay involved with the forums, hopefully more time with our forum here. Any questions?

Thank you for taking the time to explain like you would to a 10 year old.

I do believe I follow you and if I can be frank, I do believe I already knew what you told me. When you say clomiphene would be spinning your wheels, I assume you mean that it does not successfully stimulate your pituitary to produce LH?

For me personally, I know that clomiphene treatment did increase my LH levels in the past (without too much of an increase in free testosterone sadly) and I know with a 99% certainty that I`m secondary. If I understand you correctly with regards to irreversible suppression, that is the case for me as well, since my levels do drop back after stopping clomiphene treatment. Or does it not work for you at all? Is that what you mean by irreversible?

Regards,

Renholder

[Renholder]

i subscribe to that line of thinking- if you have a functioning pituatry- why not excersise it? im not convinced shutting down pituatry function is a good option- something about that doesnt sit right with me.

also men taking clomid experience low libido and become emotional experience gyno - all are symptoms of high estrogen ( from aromatase conversion) i would suggest taking an AI temporarily alongside the clomid when these sides develop temporarily ( few days).

clomid increases test and also increases estrogen (thru aromatase conversion) which is free to bind- good if its in the right ratio- if it gets out of ratio eg too much estrogen,thats when the sides flare up , an AI which prevents the estrogen from being manufactured and thereby binding with the estrogen receptors in your manboobs may be a good idea.

From what I can tell, the side effects are mostly completely dose related. With the low doses I`ve seen in studies on clomiphene monotherapy, no side-effects were reported. I did not experience any side-effects either.

Most of them seemed to restore enhance sexual function on clomiphene as well, but reading about the experience of others, loss of libido seems to be a common experience.

Regards,

Renholder

[Renholder]

Read this, OP.

http://forums.steroid.com/showthread....#.T-k97PXhe7I

The statement Crisler makes about clomid being "theoretically" superior may hold virtue, however that's about all. If it were a true found maharajah in the grand scheme of endocrine control and axis regulation, then every man would be on it; Crisler explains that only few men find it to be so.

Crisler never recommended using clomiphene instead of exogenous testosterone until recently, but now uses it in a select few of his patients that function on it. Naturally, it only works on guys who are secondary.

As for why every man is not using it, I assume there may be many reasons for that. Clomid is not FDA approved and money may be another reason. The big pharmaceutical companies would rather sell us expensive testosterone than a cheap pill that has been around forever.

I always assume everyone know more than me on this board, but maybe I should ask if you guys have read the studies on clomiphene monotherapy? There have been several side-by-side studies with TRT where clomiphene shines and delivers the same results cheaper and with less side-effects.

I say go for your Clomid exchange, if your sentiment is grand, and explore it's ability to restore even a fraction of endogenous activity that hCG has proven aid with, not just theoretically.

It sounds like you have a good understanding of the question and are just searching for a concrete answer as to why theory is overpowered by empirical success, and you quite possibly could be barking up the wrong tree. I could go into the science in more detail, and honestly, it's an interesting debate, however, I think the driving force would become an overzealous attempt to deconstruct old mantras about hCG therapy.

You discussed the efforts of clomid with monotherapy and I'd say that it's fine and can work for some (not commonly without skewed and overshot FSH and LH blood results in comparison to test serum levels), however again it's not practical for many other reasons, especially in broad spectrum balance, otherwise there'd be no TRT and all the guys would be popping the fairly hepatotoxic citrate once a day.

If I were you, I'd re-examine how the HPTA functions when exposed to exogenous test, why it gets suppressed due to such, and how clomid relates to the HPTA under suppression, this will eventually lead you to the theoretical yet paradoxical conflict between the use of hCG and Clomid under such an environment.

I will try using clomiphene for a few weeks, just as an experiment.

Would you please tell me how clomiphene is hepatoxic? I have yet to read that clomiphene is toxic any other place than here. Other SERMS, yes, but not clomiphene from what I can tell.

As for why TRT would not exist, see my previous point. For guys with primary hypogonadism, obviously they would be needing exogenous testosterone, but I`m quite sure many guys who are secondary have the potential to function well with a SERM. If not clomiphene, then maybe another one. Androxal which is under development could be interesting.

As long as the pharmaceutical companies can sell testogel, I`m quite sure they will not encourage any efforts to replace it with cheap clomiphene citrate.

Regards,

Renholder

[go2failure]

Crisler never recommended using clomiphene instead of exogenous testosterone until recently, but now uses it in a select few of his patients that function on it. Naturally, it only works on guys who are secondary.

As for why every man is not using it, I assume there may be many reasons for that. Clomid is not FDA approved and money may be another reason. The big pharmaceutical companies would rather sell us expensive testosterone than a cheap pill that has been around forever.

I always assume everyone know more than me on this board, but maybe I should ask if you guys have read the studies on clomiphene monotherapy? There have been several side-by-side studies with TRT where clomiphene shines and delivers the same results cheaper and with less side-effects.



I will try using clomiphene for a few weeks, just as an experiment.

Would you please tell me how clomiphene is hepatoxic? I have yet to read that clomiphene is toxic any other place than here. Other SERMS, yes, but not clomiphene from what I can tell.

As for why TRT would not exist, see my previous point. For guys with primary hypogonadism, obviously they would be needing exogenous testosterone, but I`m quite sure many guys who are secondary have the potential to function well with a SERM. If not clomiphene, then maybe another one. Androxal which is under development could be interesting.

As long as the pharmaceutical companies can sell testogel, I`m quite sure they will not encourage any efforts to replace it with cheap clomiphene citrate.

Regards,

Renholder

I havent seen any articles or presentations by him recommending Clomid over exogenous T. I did however see the post you referred us to, which didnt exactly say it was a reliable method of treatment. So, I get the impression you were already going to try this treatment and were just looking for a reason not to, good for you. But here are the facts.

HCG is better--if E sides, use AI's
T plus HCG is better--if E sides, use AI's
Clomid is not proven to be better, it is hit and miss with consistency, has a long list of potential neg sides, can cause temporary/permanent vision problems/tracers, and sometime requires AI's as well

So really, you brought nothing new to us and we presented nothing new to you in regards to the best option. Good luck in your efforts, I hope it does work for you and without sides.

[Renholder]

I havent seen any articles or presentations by him recommending Clomid over exogenous T. I did however see the post you referred us to, which didnt exactly say it was a reliable method of treatment. So, I get the impression you were already going to try this treatment and were just looking for a reason not to, good for you.

It is on his forums. Obviously, he only recommends it over exogenous testosterone IF the treatment is successful. But now we are discussing monotherapy and my inquiry was about why clomiphene could not be used instead of HCG as an adjunct with TRT. For me, it was not successful as monotherapy (which I assume could indicate that it would not do enough for my testicles under TRT either).

After a long Skype session a week ago with Dr. Shippen, I am rethinking the HPTA-Restart.

A number of my patients have responded well to the clomiphene challenge. This shows the HPTA is indeed intact. Yet when the SERM-class drug was withdrawn, testosterone levels once again plummeted.

With the proven benefit of low dose clomiphene, at 12.5mgs (1/4 tablet for convenience), or even less, I am now willing to maintain treatment, long term, on same.

Those who did not enjoy the subjective benefit of the on-treatment testosterone increase may have been sensitive to the estrogen agonism (mimic) half of the clomiphene, or zuclomiphene. Others experienced a sharp increase in SHBG (again, from the estrogen half of the drug), and so would have needed incredible--unattainable--gains in T just to produce bioavailable androgen levels sufficient to make them feel good.

Others simply have too much estrogen, either way.

For the latter example of therapy failure (by subjective report), we will add in aromatase inhibition, to hinder the conversion of T to E. For those with elevated SHBG, we can add in some oral Danazol to lower same. Once resultant dosages are titrated, we should be able to include all in the same cap, to save the patient money.

In my talks with Dr. Shippen, and well as Dr. Anna Cabeca (Functional Medicine physician extraordinaire) it is my belief residual toxic insult is the culprit behind resumption of the hypogonadal state once clomiphene stimulation of the HPTA is withdrawn.

Anyone who experienced good increases in T with clomiphene, without persistence upon drug withdrawal, is now welcome to go on clomiphene long-term. Depending upon the case, we may add in anastrozole and/or oral Danazol.

Keep in mind, "success" in previous restart attempt is defined merely as sufficiently increased testosterone production. Whether you felt better at the time or not is not reason for deferment. We can adjust estrogens and SHBG as necessary to yield positive subjective response.

My guys will tell you I have always been happy to try a restart. For those with failure to restart (meaning the system did not keep running once we stopped the clomiphene) we can try the new protocol. It would be great if we could NOT use TRT to restore health and happiness. Just call Renee, tell her what you want, and make an appointment. We'll get started right away.

But here are the facts.

HCG is better--if E sides, use AI's
T plus HCG is better--if E sides, use AI's
Clomid is not proven to be better, it is hit and miss with consistency, has a long list of potential neg sides, can cause temporary/permanent vision problems/tracers, and sometime requires AI's as well

So really, you brought nothing new to us and we presented nothing new to you in regards to the best option. Good luck in your efforts, I hope it does work for you and without sides.

How is HCG better? I assume the success rate could be higher, but there are certainly individuals who respond well to clomiphene.

I still believe side-effects are dose-related and the doses recommended by most modern TRT doctors are FAR below what is used earlier and in PCT cycles. There are no reports of negative side-effects on the studies I`ve read on monotherapy and one study in fact concluded that it had less side-effects than exogenous testosterone.

Thank you.

I will report back on what happens and if I notice any subjective differences. FWIW, I`ve been feeling better lately and something always felt "off" the day after a HCG shot. Could still be random.

And I hope I don`t come across as argumentative, because I`m really trying to understand and get to the bottom of this.

Regards,

Renholder

[go2failure]

It is on his forums. Obviously, he only recommends it over exogenous testosterone IF the treatment is successful. But now we are discussing monotherapy and my inquiry was about why clomiphene could not be used instead of HCG as an adjunct with TRT. For me, it was not successful as monotherapy (which I assume could indicate that it would not do enough for my testicles under TRT either).

Explain why HCG was not successful? Where are your blood tests? T, E, cortisol, dhea, pregnenolone, progesterone, SHBG, Free T after administration of HCG... You have not provided a clear picture as to why it failed for you, perhaps more disappointing for you--the cessation of a treatment that could have been better and for a vast majority is.

How is HCG better? I assume the success rate could be higher, but there are certainly individuals who respond well to clomiphene.

Clomid works best alone, if it works at all. HCG works regardless and if you were having sides you should have posted your labs post administration. Highly likely your sides with HCG were E2, easy fix--but right now who knows, NO LABS. *shrug*

I still believe side-effects are dose-related and the doses recommended by most modern TRT doctors are FAR below what is used earlier and in PCT cycles. There are no reports of negative side-effects on the studies I`ve read on monotherapy and one study in fact concluded that it had less side-effects than exogenous testosterone.

You've been informed, by multiple people about the sides from Clomid--thats your choice to take on naturally.

I will report back on what happens and if I notice any subjective differences. FWIW, I`ve been feeling better lately and something always felt "off" the day after a HCG shot. Could still be random.

No one, not even your DR. can help you without complete labs, when you get some labs post HCG administration we can work with you

And I hope I don`t come across as argumentative, because I`m really trying to understand and get to the bottom of this.

Regards,

Renholder

Well, hopefully this made it easier for you to understand, you see, the therapies outlined here do work, but they were never meant to be done half-assed. In my own case, I have been on T only for 2 years for the primary reason of 6 retarded specialists who refused to run labs tests provide HCG treatment, and /or AI treatment, and/or other hormones deficiencies. Tomorrow I'm seeing a DR. who may finally treatment me correctly, so we'll see. Most important thing is to not discount a therapy due to lack of information (labs!)

[kelkel]

Sure hope that doc is ready for you go2failure! Good luck!

[Vettester]

hey vette, what do you do ? if i can ask?

Mostly gigolo work and camel cleaning ... You referring to career, hobbies, etc.?

Sorry Ren for any hijacking, but maybe Simon's question is sub related to the topic, not sure though ...

[Vettester]

Ren, if you're saying that HCG mono-therapy failed, then I have no idea how you think Clomid will do the job. If the testicles didn't respond to exogenous LH analogue administered from HCG, then they're not going to be receptive to any LH that 'might' get naturally produced from the HPTA.

I know G2F addresses this, but what were your test labs with the HCG Mono? If it was moderately or majorly low, then that might indicate your diagnosis as being primary, so those dogs won't be hunting no matter how you try to feed them.

This is an interesting thread, but quite puzzling just the same ...

[HRTstudent]

I did not read all the posts in this thread. But i did pose a similar question to this in recent months. Basically, many of our answers will probably come from the new drug using an enantiomer of clomid. i tihnk the drug is something with an 'a.'

I believe the clomid replacing HCG may very well have merit. Personal anecdotes are scarce at this point because it simply hasnt been done that much i figure.

[Simon1972]

Mostly gigolo work and camel cleaning ... You referring to career, hobbies, etc.?

Sorry Ren for any hijacking, but maybe Simon's question is sub related to the topic, not sure though ...

hhah sorry Vette just read that you had experience with patients in a previous thread and thought maybe you were in the medical feild. it would be nice to know we had a dr in the house. .sorry to hijack Ren!

just so everyone knows an enantiomer is a mirror image of clomid ( reverse molecule) thanks to google.

as far as clomid over HCg - from what i read Hcg ends up becoming resistant after 6 weeks, clomid would bypass the resistance as well as stimulating the suppressed pituatry.... thats why i see a benefit considering clomid or nolva in this case

[Vettester]

Simon, no such luck, I'm far removed from the medical field for making a living. We had a doctor posting here about six months ago, but he vanished. Guess our benefits didn't suit him ...

On the clomid, I can only presume that OP won't benefit from it if he's already failed with HCG . I don't believe we've seen one blood lab to help us decipher anything here. I guess if it doesn't work, then HRT is inevitable, unless living with low T plan "B".

[oscarjones]

What exactly are we discussing here? The use of Clomid vs hCG monotherapy? Or, the use of Clomid vs hCG while on exogenous Test? If you believe a monotherapy type approach will work for you, then so be it, however I'd REALLY love to see the labs on your hormones after dosing Clomid for 25mg everyday. I am a huge advocate of Test being utilized along with proper ancillaries for a replacement protocol, and I think a lot of guys miss the important factors of having ALL hormones in a proper range, and not just free and total test.

Also, who said Clomiphene wasn't FDA approved? That's ludicrous it's been on the market since 1999, and is manufactured by PAR pharmaceuticals, which is in Spring Valley, NY.

In addition, yes the drug can be considered as "hepatotoxic" as it's a contradicted therapy for those with a history of liver disease or dysfunction.... Yes... it's Hepato-toxic...

Edit: Yes, just confirmed that some cases of clomiphene citrate treatment have resulted in all sorts of neoplasms and elevated transaminases in relation to hepatitis. Where do you come up with it NOT being hepatotoxic is what I want to know, along with the rest of your theories about the drug?

[MrManGuy84]

I wanted to post a link to a collection of studies I put together on another forum, but my post count is too low to do so.

Search this into google and it's the first to come up:

"every full text clomid study you've ever wanted"

A few points from looking over these studies (check them out yourself!)

1) Clomid raises testosterone to about 250% of baseline in just about every study.

2) Symptoms of low testosterone , in the studies that survey them, are generally reported about half as often after treatment as compared to baseline. Some are more optimistic than this but this is what I saw on average.

3) At the low doses used in the studies (usually anything from 50mg/day to 25/EOD) the studies say over and over again that no side effects were reported. I think one of them mentioned one guy who had visual disturbances that went away when he got off. So less than 1% side effects of any kind even with prolonged use (easily over 100 men across these 8 studies).

4) There is no evidence that any additional side effects emerge with prolonged use (at longest the studies go out about 3 years).

5) It seems to sustain its effect with prolonged use. One study did note a slight dip in T levels and symptom relief at around the 2 year mark, but it doesn't get lower after that. The other long-term study didn't mention this.

6) Estrogen usually goes up, but Testosterone goes up more.

7) Results can take as little as one week for T elevation. Most studies seem to agree that 4-8 weeks is a reasonable time to see some real results. One study noted 8 weeks as the time where T levels finally plateaued.

Seems pretty clear to me that for some men at least, this is a really good treatment. I would like more anecdotal stories, too. But still. Every one of the men in those studies is a real person.

As for the original question, it seems to me that clomid would work along with TRT to stimulate the testis and keep them from shutting down, but whenever this question gets asked doctors/forum guys seem to think it wouldn't. I'm a little puzzled myself.

[Renholder]

Explain why HCG was not successful? Where are your blood tests? T, E, cortisol, dhea, pregnenolone, progesterone, SHBG, Free T after administration of HCG.

No one, not even your DR. can help you without complete labs, when you get some labs post HCG administration we can work with you

Why do you assume I do not have labs? Do you think I`m that stupid? I`ve posted my blood work in a thread I made earlier, but I did not get much comments on it post HCG.

HCG was not successful since I felt like SHIT after using it for two weeks, although to my major surprise blood work showed a substantial increase in both total and free testosterone . E2 was slightly elevated as well (I don`t have access to a sensitive test here in Norway), so that MAY have explained why I did not feel better on it.

The reasons I started with exogenous testosterone treatment are several: 1) I`ve read about people who have great BW on HCG, but still feel the same. Even Crisler has mentioned this phenomenon; 2) I was desperate to get better and after spending three years of my life feeling like shit, I just don`t have the patience to fool around any longer; 3) I do not have a knowledgeable doctor to help me and he was not interested in prescribing an AI. He did not even know what HCG was before I mentioned it.; 4) I will always have the opportunity to get back on HCG mono at a later date, maybe with a better doctor. For now, my priority is to function normally and get my life back.