29yo, low-t (230): Does my docs plan make sense?

[DrApollo]

I am 29 years old and recently had my test measured and it came back at 230. No wonder I've felt like crap and put on weight over the last year. I am wanting to get back into the gym, drop some fat, and put on some muscle. I'm 5'8 265lbs. I would like to get down to 220lbs with more muscle tone. I've never been slim, never enjoyed cardio, but was big into lifting about 10 years ago (used to be a member on this site). If it matters, I never used any test in the past, my levels got down to 230 all on their own.

My doctor has prescribed me 100mg test cypionate injections every 2 weeks and 100mg of clomid every day. I was wondering how long it would take with this treatment before I notice a change in energy and a return of libido? I know my test levels are extremely low and this treatment will probably only get me up to normal 30 year old levels, but how should I approach my diet and workout routine at this point? Should I focus on a lower calorie diet with some light cardio to lose the extra fat and do basic lifts to build a bit of muscle tone first? Or, would it be better for me to eat a diet that focuses on building bulk muscle, realizing that the increased muscle and activity will eventually cause the fat to decrease?

I would like to hear your all's advice on any part of this. Whether it be the treatment, the time I should feel its effects, my workout plan, diet, etc. Thanks for the help and motivation!

[DrApollo]

Okay I read the stickies and am sorry for not including all my bloodwork stuff. Here is what I got:
Free Test: 59.7 pg/mL (Reference Range 47.0 pg/mL - 244.0 pg/mL)
Total Test: 227.0 ng/dL (Reference Range 300.0 ng/dL - 1080.0 ng/dL)
Prolactin: 13.7 (Reference Range 2.1 - 17.7)


Total cholesterol: 256 mg/dL (Reference Range100 mg/dL - 200 mg/dL)
Triglycerides are off the charts-1100mg/dL. They couldn't calculate my LDL because the triglycerides were so high.
My blood work does not have FSH, LH or TSH listed.

My blood pressure has increased from 130/80 two years ago to 150/90 currently. This is with blood pressure medication and and a change in diet including less red meat and sodium.
My weight has gone from 230 to 265 in the last 18 months without much change in lifestyle. BMI is now over 40.

I have all the mental manifestations of low-t. My depression is being treated with Effexor, insomnia treated with Ambien. I have ADHD so luckily my medication helps a bit with the daytime drowsiness but only for half the day. If I get 10 hours of sleep I am still ready for bed by 6pm.

Also, I have a beautiful wife with a killer body and yet my libido has become non-existent.

Hopefully this has given you all a bit better picture of what I am dealing with. Thank you for the advice!

[jasondd1]

No offense but find another doc. That protocol looks ridiculous!!!! test every 2 weeks is stupid and 100 mg of clomid every day is freaking insane. Most that try clomid are 25 mg eod. There is no one i know of that does both test and clomid. It defeats the purpose.

[DrApollo]

He started me out on Clomid only. He said that HRT would make me infertile while taking it. I made a follow-up visit and told him that my wife and I are not trying to get pregnant right now and won't be for several years. He said okay and prescribed me the cypionate injections. He said that Clomid turns on my natural test production. Cypionate injections replace natural test production and makes it turn off. He said taking both at the same time would make it easier to jump start my fertility and natural test production once we decide to have kids and in the meantime help raise my levels.

[jasondd1]

Thats a lot of clomid. I'd find another doc. This is a marathon not a sprint, you might as well get someone that knows what they are doing. Test every 2 weeks shows he's not up to date with current protocols. If I am over stepping my limited knowledge base please someone correct me.

[2Sox]

I agree with Jason's evaluation above. It's an interesting idea you doctor has about taking clomid and T simultaneously but I never hear of it before. Have you ever asked your doctor the cause of your low T? Seems there are a few missing blanks here.

[kelkel]

Wow. Agree with the guys above and what 2Sox said about finding the cause would really have been nice before initiating any type of therapy.
Clomid for HRT is fine. Testosterone for HRT is fine. Both at the same time is ridiculous. Not to mention that amount of clomid. The clomid will do nothing to stimulate LH/FSH function while on exogenous testosterone and will not make restarting easier until the test clears your system. Great theory but there's no science to back it up. Any blood work conducted for LH/FSH in that scenario would show no activity.

[VTX1800]

I've been down that road as well, I was originally prescribed clomid 25mg daily along with 200mg test depo per week Hcg 300iu mwf....after doing further research I stopped taking the clomid. I did notice a slight drop in overal test levels after stopping clomid and continuing my protocol.

[Chauffeur]

The other posters have already stated the pertinent info for you, but I'm just chiming in to agree with them completely.

100mg of testosterone E2W is not an effective treatment and will likely leave you feeling like garbage. Most guys start around 100mg every week and adjust from there if needed.

That dose of Clomid is INSANE. That's like 4x the maximum dose that most guys take. You WILL feel terrible on a dose like that. And it's been mentioned already, but Clomid shouldn't be taken along with testosterone. That doesn't make any sense.

[DrApollo]

I have an update. The test cypionate I am taking is 200mg/ every 2 weeks. I somehow got 100mg in my head and was wrong. The Clomid dose is 50mg. I really don't know how I managed to get the numbers so backwards in my head, but I feel a little better about my doctor now at least.

So 200mg of cypionate every 2 weeks is closer to a normal starting dose, right? Each vial is one 200mg dose-should I continue taking it in one 200mg shot every 2 weeks like my doctor prescribed, or is it better to split the dose into 100mg/week injections?

And even though the clomid is 50mg and not 100mg as first mentioned-you all are of the opinion that I should quit taking it?

[kelkel]

better to split the dose into 100mg/week injections?

Yes, split the dose. Lose the clomid.

[DrApollo]

Thanks kelkel. I will take your advice and save the Clomid for the future and start splitting the injections up this week.

[VTX1800]

You can never go wrong with stock-piling. Things happen, natural disasters, (RIOTS) doctors relocating, etc etc. I just had an extremely rough time getting back on my protocol after relocating to St. Petersburg FL. The clomid I was originally prescribed at 25mg a day was somewhat of a life saver for 3-4 weeks when I ran out of meds and couldn't find a doctor that would treat me.

[kelkel]

You can never go wrong with stock-piling.

Yes, never let a script run out without filling it up. I'm definitely a med whore.