HPGA/HPTA CRASH - RESTART? Is there hope?

[Stosh_112]

Test Numbers are a base... Its how u feel mentally and physically which matters most. Some people feel fine at 400 tot test, and some dont. Before you decide to go TRT consider u current state of well being. Consider do u want to deal with dosing the rest of ur life??? U stated ur hypogonadism has bounced back so HCG isnt needed. after you last clomid run let a few month pass and see how feel. With or without numbers. Then decide about TRT.

[mavsman41]

Thanks for the responses guys.

I'll try to be more patient. I do not want to be on anything permanently but I'm also losing patience with my situation. I'll continue to take a long term systematic approach and see what the bw says Monday.

Kelkel I do want to restart and that is my focus but I guess what I'm asking is: assuming my levels are significantly lower(and they should be) upon cessation of clomid, would a test cycle and proper pct do any harm. Worst case scenario im back at my poor t levels for a 24 year old. I've never used hcg before so I was thinking if I ran an actual hcg/serm pct after a short test cycle I could at least return to the 300-400 level.

I'm 24, I broke up with my girlfriend a few months back(she was an 8 and I'm picky) and I'm single in a big city. As much as I want to "restart" im not cool with lethargy, a mediocre body comp at best, and low t no matter what! I need energy. I'm in the prime of my life and I can't be depending on caffeine to get me through 4 o'clock. I'm going to be starting a job for a Fortune 500 company and I need to get my shit together and figure it out.

I'll post bw Monday. For anyone who has this similar situation I'm sure you get me. I'll be positive and like I said I'll focus on patience.

Thanks for the input guys.

[kelkel]

Well, know that it can take many months for your hpta to return to normal. It's not always just a handful of weeks. Being patient with this may benefit you, then again it may be all for naught. It's a crap shoot really. That said, and to answer your question I don't think a cycle would harm you further. Just run your hcg ON cycle, not off.

[mavsman41]

Hey guys the blood work came in.

Total t: 605
Free t: 12
Estradiol: 58

Looks like total went up about 70. Free is slightly up. Est up about 10 pts.

The doctor I initially visited wants me to continue clomid 25/Ed for another 3 months while my newest doc wants me to administer 25mg/eod for 2-3 weeks and then begin tapering off that, lowering to 3 times a week, 2, then 1.

Any insight into what these docs might be thinking? Looks like I've kind of plateaued at free t of 11-12. Would you suggest I begin the eod regimen or continue to take 25 (half a tab) every night? My doc cannot see me for another three weeks and I have a blood work order I will use in two weeks that will be on a different scale.


Thanks for any input

[austino]

Hey guys the blood work came in.

Total t: 605
Free t: 12
Estradiol: 58

Looks like total went up about 70. Free is slightly up. Est up about 10 pts.

The doctor I initially visited wants me to continue clomid 25/Ed for another 3 months while my newest doc wants me to administer 25mg/eod for 2-3 weeks and then begin tapering off that, lowering to 3 times a week, 2, then 1.

Any insight into what these docs might be thinking? Looks like I've kind of plateaued at free t of 11-12. Would you suggest I begin the eod regimen or continue to take 25 (half a tab) every night? My doc cannot see me for another three weeks and I have a blood work order I will use in two weeks that will be on a different scale.


Thanks for any input

From what I gathered from mine, the Clomid will bump your LH and FSH and you will produce more Test but also more Est. My doc is having me do 50mg/eod with the reasoning that my body will react to it better if it isnt daily. I have no idea if that is bro science or not but I went with it and the results are good. Just continue watching your est if that climbs up more you may start having some emotional mornings like I did.

[mavsman41]

Anybody still following?

I am feeling a bit better, but still holding fat around my waist and hips, little on chest. Typical lower end t issues. Meanwhile I'm running 2 miles in 12 min, bp at 225x13 so strength and endurance are ok. Just really frustrating working my ass off in the gym and still holding fat. Diet consisting of eggs, avocado, fruit, chicken, lean steak, turkey and rice, lots of asparagus/mushroom/peppers/broccoli/sweet potato.

Erections are somewhat shitty and not where they once were. I'm also now seeing my ex girlfriend again and I want to lean out and perform like I used to for her... I've obtained 3 bottles of t prop and I may begin a 6-10 wk cycle and come off with the docs assistance. I have 2 months of clomid on hand, about two weeks of nolva, and an otc pct product. I would request hcg as well.

Today is Saturday and my next apt has been moved up to this upcoming Monday so I will not make any rushed decisions. But should I run this idea of a short cycle by my doc? It's summer and I don't want to carry this fat around while only weighing 205-210. It's also very important to me that I don't **** this up with my girlfriend. She is not dating me for sex purely but I'm sure she would prefer a dick that works. Should I just be honest with the doc or will I scare him away? In the big picture I just want my natty levels stable and around 500 and a free of 12-15 but I can't afford to have 600 Tt with free 11 while still taking clomid. I do not plan on using aas long term but right now I'd rather get on, feel better and ensure a quality sex life, then come off with the right pct and see where I am and then evaluate trt possibilities then.

Am I being illogical? Once again any input is appreciated. This has been a grueling journey and I've come pretty far... But still not where I need to be. Thanks guys

[lovbyts]

Yes I'm sure others are still reading/following

No dont talk to your doctor about a cycle unless you want it in your records and could effect insurance in the future among other things.

A cycle is not advisable until you get a better grip on your HRT and everything is working and feeling like it should. Weve all been there and want to do a cycle right away but it's best to wait. Get your body fat down more or you have a higher risk of getting gyno along with other sides.

Also, it's best to know your doctor isnt going to ask for a surprise blood work mid cycle and you either test VERY high or have to make excuses.

Running a cycle now will only complicate things a lot more than they are not and wont fix anything.

[bigdil511]

Yes I'm sure others are still reading/following No dont talk to your doctor about a cycle unless you want it in your records and could effect insurance in the future among other things. A cycle is not advisable until you get a better grip on your HRT and everything is working and feeling like it should. Weve all been there and want to do a cycle right away but it's best to wait. Get your body fat down more or you have a higher risk of getting gyno along with other sides. Also, it's best to know your doctor isnt going to ask for a surprise blood work mid cycle and you either test VERY high or have to make excuses. Running a cycle now will only complicate things a lot more than they are not and wont fix anything.

What would you even say if you started testing off the charts?

[lovbyts]

After about 1yr doctors usually only test once very six months so you can plan around that and some (like mine) only test once a year now.

I would not risk being tested on or close to cycle because he can drop you and refuse service and your insurance could screw you later. Ive read a few post here where doctors refused HRT after a high test.

[austino]

Check out my post about clomid based HRT. You can find it by clicking my handle, I am a low poster and cannot post links yet. Not preaching that it is "the way" but it worked for me. I am also in Texas too!

My reasoning is a little different but still the same idea, secondary hypogonadism and not primary.

[mavsman41]

Hey austino... did you see a urologist or an endo? Whats your gameplan for the clomid long term? Do you plan on tapering and coming off to see what happens to your natural equilibrium?

My goal is to come off and stabilize at a more reasonable number than where I began. May not be feasible, but that's the goal. I'm working my way towards being off and retesting a month after my last tab.

Also, didn't see what your dosage was?

[austino]

Hey austino... did you see a urologist or an endo? Whats your gameplan for the clomid long term? Do you plan on tapering and coming off to see what happens to your natural equilibrium?

My goal is to come off and stabilize at a more reasonable number than where I began. May not be feasible, but that's the goal. I'm working my way towards being off and retesting a month after my last tab.

Also, didn't see what your dosage was?

I have seen them all. Endo, Urologist, hormone therapy specialist (word was he was liberal with his prescriptions.... not the case ill explain more)

Endo result - I was told I dont have a problem and that I shouldnt worry about a thing. Despite the symptoms, mood, foggy brain, etc etc. he said that I should focus on a better diet without knowing what my diet was or what I did for exercise. I wrote him off pretty quickly not because he was stupid, but just because he had no interest.

Hormone specialist - self proclaimed specialist at best. His default answer is throw a lot of Test at you and move on. Now I am sure some here would love that but I, like you, still want to have kids so for now I want to keep myself fertile. For him, there was no other option except Test.

Urologist - She has been my rock star doc through all of this. We both have the outlook that this is all one big experiment to improve the quality of life. She listens to everything and makes note of improvements or digressions. We seek alternative methods to aid the medication or reduce the need. We started with monthly visits and blood work every 4 weeks. Now we are at every 3 months but we still email each other during that time for updates and questions. Options and choices are presented (clomid vs test vs straight hcg etc etc) and we weigh out the pros and cons while still focusing on feel and on the numbers. My test was near 900 this past round with free T at 25'ish. These are a little high but she knows how much I am at the gym and simply put is okay with it knowing that it will help my goals as well.

I 100% agree with the comments above, go to a Urologist, not an Endo or your local doc that prescribes you extra strength aleve. They will be more interested in making you whole again vs just dumping a diagnosis on you and script.

Long term goals - I will cycle off at some point this year. 30 day cycle down, 2-4 weeks off, blood work and review. As I mentioned, this is a controlled experiment so we will see what happens next. I hope that this restarts my system but I never made it crash due to any steroid use or other hormone tampering. My expectations are low with my empty sella configuration of my pituitary gland but regardless, this is working.

My latest bw
Estradiol 38
PSA .6
TSH 2.7 (.5 - 4.7)
Free T4 1.14
Test 996 (300 - 1080)
Free Test 24.9 (4.8 - 25.7)
Sex horm 31 (16.5 - 55.9)
WBC 5.8
RBC 5.65

I have been researching and Clomid is considered off label (not intended originally for this use) and there is a company call Repros that is waiting for FDA approval of a clomid offshoot designed specifically for secondary hypothyroidism call Androxal. Its not available but once it is, I intend on trying it.

I also at some point will do 6 months on Test only (w/ hcg) to see if there is a difference too but same story, will slowly come off, go without anything for a month or to base line, then ramp up on the new protocol.

[mavsman41]

Dude how you feeling? I know you're on the clomid but your numbers look absolutely ideal. Even if you come down by 30-40% that's not bad. I know numbers are simply reference points but those are great!! Highest I've hit is 660 tt and 14 free t this last week.

If it makes you feel any better I think you're looking golden at this point! Keep us updated with bw as you come off!

As for me, I'm actually meeting my urologist tomorrow to discuss a few months of test with hcg because I can't deal with my symptoms right now as I start my new job and begin a relationship. My numbers improved and that's all great but they still aren't optimal for my age and with a docs supervision im sure this cycle won't bring any further harm. I need the energy, libido, fat loss ect. Maybe a myopic mindset but I can't help it. It's been a rough ride. The good thing is this doc understands.

Finding a legit uro is such a relief. He actually cares.

[mavsman41]

I'll continue to post and throw up my gameplan for my test/hcg/arimidex cycle and let you all know blood work after. I'm really excited about feeling good again even if it is exogenous. I think the hcg will help me come off successfully, avoid a crash, and then we will be able to evaluate where my real levels are once again.

Idea is to administer hcg 2-3 times a wk (dose undetermined) and .5 arimidex eod. Goal is to keep balls firing, estrogen down at a manageable level, cut fat which helps with my testosterone and put on a little muscle for my lady .

To anybody who is following: I think he will prescribe enanthate. That's fine, but bloat and water retention scare me and that's why I obtained prop. Can I avoid the water with arimidex?

Also, could I use prop alongside the enanthate to get a kick while the enanthate becomes active? I know it will be a few wks until I feel it. The goal is to lean out, obtain energy I've been missing for a year, improve my sec drive, and put on a few lb of quality muscle. Not a bulk cycle.. Looking for quality of life and some fat loss.

[mavsman41]

I really appreciate all the replies.

I actually decided to run things by my doctor AFTER we went over what his thoughts were on my progress. He said that he was happy with my progress and believes I should move to 25mg mwf which I already have, then move to Monday Thursday. In three or four stop completely and blood work in a month after cessation. He also added that I should have the ability to shed my waistline fat when I quit the clomid due to then estradiol issues we have all spoken of.

I said, " please do not view me as a juicehead and I hope you will not think I'm completely foolish for asking but, I obtained prop and want to take it for blah blah...."

He said "I don't think that's unreasonable and after what you've been through I get it. I usually prescribe enanthate when we go that route but in your case I would advise against it. You are making great progress. I could give you hcg and aid you in coming off properly but I advise you take caution and practice patience"... Then gave me free cialis for improved erections!

I will continue to be patient and await post clomid numbers. Looks like I have a really understanding and knowledgeable doc. He was very comforting and this is a complete 180 from other experiences I've had with docs.

1 week mwf 25mg, one week Monday Thursday 25 mg. retest in 2-4 weeks after. That's the plan. Damn it sucks being patient but my mind is in such a better place. Worth it if my levels somehow stick/ improve.

Anybody with similar issues...Keep following I'll update this week and next about how I feel and how things go with the sex drive.

[MMAasrealasitgets]

really interesting read here.

I too had issues with low T and went onto TRT (details on another thread) and now off TRT since late 2013 and still not back to normal. Nuts good, morning horn present, lowish labido and T levels low alongside LH / FSH (the references you use differ from mine so not comparable but my BW has been done in n/mol.

I found TRT was OK (on for 2-3 years I think) but my levels never got out of the high teens (n/mol) and that was on Test Under every 7-8 weeks as a depot inj.

I am now also looking to improve my T levels and thinking a clomid PCT even after this period of time may help but just looking at what levels would be needed to help the restart but of course recognise the fact they may never get me back to where I felt I was.

I totally hear the OP on the Drs just saying ' give it time - go cold turkey' - I have waited too long under the Endo (2nd one) and wasted time so now I have also turned to this forum for real opinion and real help.

keep us posted on progress and BW (I will find a compatibility prog to change the ref range so I can compare with my own).

What mg of Clomid did you take and how long for?

[mavsman41]

And to anyone who is following and is just beginning their journey into solving a testosterone issue.... my advice is to visit with a urologist rather than an endo. 9/10 endos will be focusing on diabetes patients and will write you off/ tell you you look fine/ tell you to get on an ssri. Google a urologist knowledgable in reproductive assistance (i.e. helping couples conceive). These urologists will have much more experience in what we are dealing with because they get many trt patients who want to have children, cannot, and then they help them come off with hcg, nolva, clomid and restore testosterone/fertility. They are simply more experienced with these issues in particular. I was actually extremely impressed my doctor prescribes enanthate because I've only heard of docs using depot/undecoanate and these are less than ideal for my situation at least.

I'd be happy to answer more questions too.

[MMAasrealasitgets]

And to anyone who is following and is just beginning their journey into solving a testosterone issue.... my advice is to visit with a urologist rather than an endo. 9/10 endos will be focusing on diabetes patients and will write you off/ tell you you look fine/ tell you to get on an ssri. Google a urologist knowledgable in reproductive assistance (i.e. helping couples conceive). These urologists will have much more experience in what we are dealing with because they get many trt patients who want to have children, cannot, and then they help them come off with hcg, nolva, clomid and restore testosterone/fertility. They are simply more experienced with these issues in particular. I was actually extremely impressed my doctor prescribes enanthate because I've only heard of docs using depot/undecoanate and these are less than ideal for my situation at least.

I'd be happy to answer more questions too.

cheers man, I have seen an Uro and an Endo and agree in general with what you say but the main killer is that they say your in range 8-40 and I am 8-9 etc etc. Considering their demographic it appears they dont wish to help only 'time will be the helper' and thats crap in most cases!

[mavsman41]

Well I'm glad this thread could be of help potentially. I started taking 25 mg (half a tab) of clomid in mid/late February of this year. I used a pill cutter to accurately slice them in 1/2 and took each half tab with something to eat (protein shake, almonds, quest bar) an hour or so before bed as things began to wind down. I was hoping this could increase the absorption. As I know a serm can be toxic, I increased my water intake and become more cognizant of my alcohol use but still drank.

Fairly quickly I noticed a slight improvement in erections but nothing crazy. Felt lethargic and depressed like before. After 45-60 days my energy was noticeably improved and I no longer had the "brain fog" that was so pervasive before. I could actually focus and my ability to focus has actually continually increased. While I didn't notice anything in my physique, I did have a friend say "dude you look so much more solid". I think the clomid helped me shed some Bf and water.

Many people have reported that they feel like a beech on clomid because along with the increase in testosterone comes a higher estriadol. I had a few occasions of excessive emotion but I never cried, broke down ect. I think that's probably overblown or just varies from person to person. The estriadol increase has however caused me to hold fat around the waist/hips and that pisses me off. No acne. No "tracers" or anything negative with my eyesight.

All in all, it's been ok and has given me some hope. Give it a shot.

Oh and I'm now taking 25 mg/mwf for a few weeks and then will take it 2x/wk for a few then stop entirely.

[bigdil511]

If you are within range your endo or urologist won't help you from my experience. I had to find trt specialist before anyone would even admit I have a problem with low t.

[mavsman41]

Pct:
Clomid: 50/25/25/25/25eod/25eod
Nolva: 20/20/10
Otc pct product

Idea would be to run the clomid like I have in previous months. Seems successful but it does take time.

[MMAasrealasitgets]

why the short period of Nolva, whats the thinking behind that?

[mavsman41]

Well, here is the update guys. A good six years have passed, so I apologize for not following up.

After discontinuing the clomid, my system eventually tanked back to 300-400. Luckily, I've been working with a rockstar doc in Dallas and my life has changed for the better. How? TRT.

My TRT protocol is as follows:

M/W/F: Cypionate .2 ml (40mg), .5 arimadex, .25 ml hcg (120 mg cypionate, 750 mg hcg, 1.5 adex)

When I first started TRT, I was right in the sweet spot with 100 mg/week. This was split into two shots on Monday's and Thursdays. We started off with no aromatase inhibitor and utilized 1,000 units of hcg/week.

Over time I've required a bit more to achieve the same T levels. I feel the best when my Total T is around 800 - 1,000 and my estradiol sits around 30-35. This requires the use of .6 ml cypionate/week (120 mg). I've dialed back the hcg just a bit, and I am currently trying to reduce my AI dosing by injecting more frequently (3 times vs 2 times). I am sensitive to E2 spikes, so I am managing this more than most and hcg is difficult on the estradiol.

My SHBG is in the middle of the pack, and when my total T gets about 800 or so, my "free" T is top of the range. However, the most recent literature does put into question the validity of "Free T". Kind of interesting......

Initially I had intense anxiety about committing to exogenous hormones for good, but I trust my doctor, I've educated myself for years now, and I FINALLY FEEL LIKE A DAMN HUMAN.

I have my life back.

When I sleep, I actually feel recovered and refreshed. When I lift, I actually see gains again. When I keep my diet and macros in check, I lose body fat. My focus is there when my discipline is there. I am more patient. I am way more confident.

I still deal with depression, but I am more capable of managing it and my anxiety is under control.

I wish I had done this in college. I missed so much because I was exhausted every day. If you truly have a medical condition, I highly rec that you seek an expert, and pursue TRT. It is therapeutic and has changed my life for the better.

Hope this update is of use. Unfortunately I don't have my records in a succinct panel that I can upload - I had to extract all my records one by one from the patient portal at my doctor's office, but I am more than happy to answer questions if you have them.

I hope this is helpful to someone who is dealing with a similar battle. I was in a very dark place when I started this thread but have made it to the other side. You can too.