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Thread: Clomiphene solo therapy results

  1. #1
    cylon357's Avatar
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    Clomiphene solo therapy results

    Every middle aged man knows (or will know) the drill here - I started feeling listless, tired and getting that damn brain fog. What the hell? Did some reading and decided low T could be the culprit. After doing 'DIY OTC HRT' for a bit and having mixed results, I finally decided to talk to a specialist. I found a good one in my area and we went over my numbers. He suggested we try 50mg clomiphene 3 times a week. He was saying 'I have guys that are in your boat that I can get to 650 total T with clomiphene'. I'm like cool, lets give it a shot.

    Maybe I'm an overesponder or these are just going to be short term results, but I will post up my numbers from October 2nd, 2018 - a full month before starting clomiphene. The second image is my follow up bloodwork. Actually, it is more like confirmation bloodwork that I had done myself because I was sure the doc had ordered the wrong tests or the lab had mixed up the samples.

    I started clomiphene on October 28th and had the confirmation bloodwork drawn on Jan 14, 2019. In mid to late November, we added .5mg once a week arimadex, later bumped up to 1 mg / week (.5, .25, .25)

    Am I just 'lucky'? Any downside to long term clomiphene therapy?

    Clomiphene solo therapy results-cylon357october2018.jpg

    Clomiphene solo therapy results-cylon357january2019confirmation.jpg
    Last edited by cylon357; 01-18-2019 at 11:16 AM. Reason: Added AI info

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    kelkel's Avatar
    kelkel is online now HRT Specialist ~ AR-Platinum Elite-Hall of Famer ~ No Source Checks
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    Solid Total T level.
    What's your Free T level?
    You need to cut back on the AI. No need to be that low. Odds are you'll feel better closer to the top of the range.

    CC is a lesser used form of TRT but obviously viable.

    Only real question is how do you feel?
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    I have my free t number in other results, will post that later. It was clinically high.

    Thanks for the input on the AI! I imagine the doc will say the same thing.

    I feel good - that really is what it's all about anyhow, right? Not great, but better. I imagine dialing in the AI properly will help. But all in all, feeling good, workouts are more productive, etc

    Thanks!

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    I prefer having FT near the top of the range as FT is what works for us, not total T.
    The less AI you can use the better. If you can get completely off it that would be great. Know that with higher estrogen levels you'll have better GH & IGF-1 levels.
    I would think that over time you will crash your E2 at that dose. You won't like this.
    Know that a normal dose of AI for a 500 mgs cycle is about .25mg eod to give you some perspective.

    And yes, feeling good is all it's about. Numbers count but they are not everything. Be sure to keeep an eye on your hematocrit.
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    Here are the results I got back from the doc, that showed numbers that made me think maybe there was a mixup at the lab. Turns out, no, they were probably spot on. Note that the scale is different so the total T number is bigger. Free T is here, too.

    DHT also looks high. I'm long since over being worried about hair loss (started losing mine in my early-mid 20s, and by 30, it was game over, man) but don't want to cause other problems. PSA also doubled from 1.9 to 3.8 - you will just have to take my word for this as I'm too lazy to snip that image.

    Hematocrit is good (I think?) at 45.3 - ref range 37.5 to 51.0%. It seems to stay around 45 - 47 for me.

    Clomiphene solo therapy results-january2019results.jpg

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    Just about everyone I know on TRT (any form) has DHT levels that are at the top or over range. Quite normal.
    Not abnormal at all for psa to spike upon initiation of TRT but then it normally drops back down. Obviously keep an eye on it.
    Yes, hema is good.

    Keep an eye on things and remember that less is more when it comes to TRT. If you can reduce your dose a bit (which you can) and still maintain solid numbers then it's a win-win for you. Meaning less issues down the road such as estrogen and hema.
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    Quote Originally Posted by kelkel View Post
    Just about everyone I know on TRT (any form) has DHT levels that are at the top or over range. Quite normal.
    Not abnormal at all for psa to spike upon initiation of TRT but then it normally drops back down. Obviously keep an eye on it.
    Yes, hema is good.

    Keep an eye on things and remember that less is more when it comes to TRT. If you can reduce your dose a bit (which you can) and still maintain solid numbers then it's a win-win for you. Meaning less issues down the road such as estrogen and hema.
    I imagine that the conversation with the doc (this coming Tuesday) will echo much of what you have said here. I was wondering when I got my results back if maybe we could dial everything back a little and still get good results. It would be nice to get off the AI or at least dial it back a little. We will definitely discuss that.

    And thank you for taking the time to help a noob! It is greatly appreciated.

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    No worries Cylon! Please update this thread after your doctors appointment.
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    Not saying this has anything to do with your high PSA but it is something to avoid. In school, they say not to do a Digital Rectal Exam (DRE) and then blood work because it temporarily raises PSA levels.

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    Quote Originally Posted by Quester View Post
    Not saying this has anything to do with your high PSA but it is something to avoid. In school, they say not to do a Digital Rectal Exam (DRE) and then blood work because it temporarily raises PSA levels.
    Hmm, that is interesting to note. I haven't had a DRE in about 15 months. With my luck, the next time the primary care says I need one will be the day they have a new doctor, Dr Shrek.

    Quote Originally Posted by kelkel View Post
    No worries Cylon! Please update this thread after your doctors appointment.
    Will do for sure!

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    Ok, just got done with the doc. Here is what we discussed:

    Lower the arimadex to .5 mg / week from 1 mg per week.
    Lower the clomiphene from 3x50mg / week to 2x50mg / week.
    (At this point, I thought about asking to see his quads, because he was sounding a lot like kelkel lol)

    Add DHEA 25mg daily
    Add Finasteride 2.5 mg / week (1 half tab once a week)
    Add Cialis 5mg / day (I asked about this because, you know, cialis!)

    He doesn't want to quit the arimadex entirely right now, because I'm fat ATM. My words, not his. He was kind enough to say 'when you are carrying around a few extra pounds, you can get a little more aromatization.' How benevolent and kindly said. It's ok, tho, I know the score and know what I need to do in the fat loss arena. He also seemed to think the finasteride might be a short term thing, like a 90 day course. I have more bloods in 90 days so we will see where all this lands me.

    So, it felt like a pretty good visit to me. BTW, my insurance covers the cialis (generic) at 5mg/day for BPH. $7 a month for 30 tabs or $15 for a 90 day supply (90 tabs).

    I have some questions, though. The doc addressed them to some extent, but I'm looking for a second (or third or nine hundredth) opinion.

    1 - What's the story with the DHEA? Seems like I have seen mixed results with this, particularly that it can increase Estrogen disproportionately.
    2 - I'm presently taking tamsulosin .4mg / day. Anybody have experience with tamsulosin (generic flowmax) and cialis together on a daily basis?
    3 - Fears about Finasteride... unfounded? He said low dose once a week was not going to present issues. This is primarily to address DHT being a little high.

    Also of note: I take a handful of OTC supplements, though I will document those separately.

    Thanks to everyone for their input thus far!
    Last edited by cylon357; 01-22-2019 at 11:51 AM.

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    1. Nothing wrong with adding dhea. Just make sure it's a micronized product so it survives the first pass through the liver.
    2. No experience with both together but it's a good combo regardless, especially for BPH. Cialis is approved by the FDA for BPH.
    3. I'd consider asking doc to hold off on Fina just yet and see if the reduction in T levels correlate to a reduction in psa. I just don't like adding another med based on only one BW. If after another month it was still at a undesirable level then add it.

    Fina is quite effective when needed (I'm on 5mg daily for bph). I'd change his dosing protocol slightly though. Most will automatically prescribe it daily based on it's half life (app 6 hrs) but serum levels build and it can last for 3-4 days if I recall correctly. Based on that I'd split the given dose to twice per week. Just a thought....

    Yes, Fina can hit some people negatively but the overwhelming majority do just fine.
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    Yeah, I was thinking about holding off on the finasteride. I tend to prefer a more constant, consistent state so if I go the finasteride route, it will be in divided doses. I will do the same with the arimadex, with the goal of cutting it out entirely at some point.

    I don't really like making a bunch of changes all at once because it can be hard to tell what did what, exactly. I will likely do the DHEA and the cialis (took my first dose of that pre-workout today) and see how things go from there.

    Thanks!

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    Good on all points. One change at a time is crucial especially if you're banking on blood work to denote changes.
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