Why not low dose clomiphene instead of HCG on TRT?

[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!)

[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.

[Renholder]

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 ...

HCG may or may not have failed, it`s hard to say and I may have jumped on exogenous testosterone too early, but I`m trying to pull my life together the best I can on my own without a doctor who knows what he`s doing. Read my prior post on why I abandoned HCG mono.

http://forums.steroid.com/showthread...14#post6010014

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?

What I intended on discussing was the use of clomiphene VS HCG while on exogenous testosterone.

If I understand correctly, clomiphene is FDA approved for women, but not for use with males and for treating hypogonadism.

Where did you find that it is actually hepatoxic? I`ve only read similar studies that MrManGuy84 linked to and toxicity is not mentioned, I believe.

I have my BW while using clomiphene also.

[go2failure]

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.

We're not hunting for your bloodwork, so put it in here if you want an analysis by anyone who can help you. Elevated estrogen, if that was indicated will definitely make you feel like shit. Before stopping you should have added an AI on the day of inj. You cant classify yourself as one of those people with great bloodwork who still feels bad because you didnt have great bloodwork. What im trying to say is you pulled out before you came but then you dIdnt even ccomee--wtf oVer?

[Renholder]

We're not hunting for your bloodwork, so put it in here if you want an analysis by anyone who can help you.

No need to hunt for my blood work when I have posted it multiple times and updated my thread several times with questions without getting any new answers.

However, this thread was not about my personal situation, but a discussion on clomiphene VS HCG as an adjunct to TRT.

Not seeing any good reason or arguments against trying it, I will continue with my experiment.