In response to Cataceous’s suggestion on my 12/17/20 posting I am offering the first of my enclomiphene progress reports and observations.
Some background -
I am not on TRT. Libido has been an issue throughout my adult life.
Last year I was doing ok with an imprecise protocol of Clomid 12.5 mg and DIM 200 mg (along with a tadalafil 20 mg assist) 3 to 4 times a month depending on how I felt. Total T in the 800s on average and with estradiol high normal to high.
For reasons unclear to me my estradiol tested <20 last December while my TT was tested out at 820, and FT at 98.5. My libido however had been stronger during this particular month but this could possibly be explained by a brief interlude with a woman of unusual tastes.
By July of this year my libido began to diminish. During the final week of July, I increased protocol to four times a week - a mistake. Labs on 08/07/20: TT 1283, FT 84, and estradiol 43, DHEA 171. I stopped everything for a month - a mistake too. By 10/05/20 my labs show that my TT dropped to 340, Free T to 34 and estradiol to 23. I felt it.
I resumed my 3 times-a-week (including DIM) protocol and according to my LabCorp testing of 11/06/20 my levels quickly returned back to what they had been before. Unfortunately libido did not return as it once was. I made an appointment with Defy and later quit Clomid 12/07/20.
On 12/11/20 I began my new protocol prescribed by my doctor from Defy: 12.5 mg enclomiphene daily to keep my TT at upper limits to overcome effects of both high SHBG and low Free T, and 50 mg DHEA because my natural levels have been low.
Lab comparisons with Clomid:
Defy-LabCorp 11/06/20 – Total T 924 ng/dL [264-916], Free T 9.7 pg/mL [6.6-18.1], Estradiol 37.5 pg/mL [8-35], SHBG 106 nmol/L [19.3-76.4], LH 5.8 mIU/mL [1.7-8.6], DHEA-s 174.1 ug/dL [48.9-344].
Quest 11/18/20: Total T 878 ng/dL, [250-1100] *Free T 81.2 pg/mL. [35-155] Estradiol LC/MS 31 pg/mL, <OR=29 pg/mL
Lab comparison with enclomiphene:
Quest 12/15/20: Total T 822 ng/dL, [250-1100] *Free T 66.7 pg/mL, [35-155] Total estrogen 150.8 pg/mL. [60-190]
Quest 12/21/20: Results still Pending – Total T, Free T, Estradiol, SHBG, and DHEA.
1- Previously, if I had taken 12.5 mg Clomid (instead of enclomiphene) 5 days in a row, my TT would have been higher. 2- My Free T has since become lower. I am wondering if these two conditions could be due to the introduction of 50 mg DHEA and/or residual zuclomiphene. Otherwise not much difference after only 5 days.
As of this writing, there is still no improvement with libido. Although occasionally there is a very subtle feeling of something on the verge. I’m thinking that residual zuclomiphene could still be exerting a negative influence due to its relatively long half-life. Hormone balance may still be in process. I found that three grams Citrulline helps a little for morning wood despite no libido. I’m thinking citrulline may be a good adjunct for tadalafil.
In retrospect “more is not better”. In my case, increasing Clomid may have been a mistake. I should have taken “natural fluctuations” seriously and kept my Clomid dosage to a minimum. But then, from what I have read on the subject, there is the eventual possibility of zuclomiphene saturation – if I understand correctly. Or perhaps the delicate balance of T/E ratio was disturbed? I think I may discontinue DIM. There is a lot of conflicting information concerning both DIM and DHEA.
At this point with so little information available to me, I can only post my observations/labs for those interested, patiently wait, and ride out this process until my 90 day supply is finished – for better or for worse. I plan for another lab after January 15. Meanwhile I will post my 21/21/20 lab results when they become available.