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Author Topic: Bloodwork questions. Doc recommending clomid, 100ngl test for 8 weeks, and an AI  (Read 38 times)

BasedInSeattle

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(Doc recommending HCG just to keep on-hand for fertility.)

First time post. Appreciate all feedback, none of which I shall construe as medical advice.

Basically I’ve never tried test or anything else beyond what’s considered natural. Ex-heavy drinker and thc user but I’ve been clean for months and I’m getting fit with a personal trainer and dieting. Just did a 3-day zero-calorie liquid fast and now doing keto for fat loss.

Goal is to be physically and mentally fit. Prefer “natural” approach primarily but open to test and other approaches.

Will post blood results shortly with additional questions (accidentally hit the post button before I completed this post my bad).

Bloodwork: https://ibb.co/jZRPKRz

When my body makes T, it also then makes about twice as much estrogen as it should. What gives? Doc recommending clomid for this.

He also said I could do 100ngl test for 8 weeks and an AI. Also HCG on-hand for fertility. After 8 weeks check blood again for adverse reactions. Then just prescriptions and home injections twice per week with extra doses prescribed if I want and check in every 3-4 months.

Seems like a bit much. What do y’all think?
« Last Edit: June 20, 2021, 01:18:30 am by BasedInSeattle »

Cataceous

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Welcome to the forum! I'd say your testosterone level is borderline, with calculated free testosterone a little below the bottom of what's considered a healthy normal range. This means that many guys are fine at these levels, but some may experience symptoms of low testosterone. Your estradiol does appear to be high relative to testosterone, at 0.75%. The normal range is more like 0.3-0.6%. One confounding factor in your measurement is that it was done with a standard immunoassay test. These tests are reliable and repeatable, but they are subject to cross-reactivity, which can artificially inflate the numbers. It's good to perform an occasional cross-check by measuring estradiol with a sensitive—LC/MS/MS—method. Clomid is a poor choice of treatment for elevated estradiol. It stimulates even greater production and is itself estrogenic.

TRT is not something to take lightly. It is a major disruptor or suppressor of many endogenous hormones. Side effects are common. In addition, it can take many months to properly evaluate the results. There are other options to try first that are less invasive. These include testosterone nasal gel, enclomiphene and AI monotherapy. All of these have the advantage of not shutting down the HPTA. Using a nasal gel such as Natesto is a good way to see if higher testosterone is actually helpful. Enclomiphene is the non-estrogenic component of Clomid. It can still raise estradiol, however. AI monotherapy is very uncommon, but could be suited to your situation if your relatively high estradiol is confirmed. Dosing would be tricky, because any normal doses of an AI such as anastrozole (Arimidex) could lower your estradiol by too much. I'd start with something like 20 mcg per day as a low-and-slow approach.
« Last Edit: June 20, 2021, 01:20:57 pm by Cataceous »
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 59, Ht: 5'10", Wt: 154 lbs
Protocol: 2.4 mg T propionate subQ qd, 3.2 mg T enanthate qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

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ghce

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IF I was in your shoes I would sit tight for a few months more and continue with the exercise program, keep off the alcohol and THC and eat a green leafy diet, retest in 3 months time then if you have negative symptoms come back to the forum for some more reading and ask questions.
Age:59, Height 6' 3" weight 92.5KG
2014 Androderm Patches
2014-2016 Oral Andriol 160mg Daily
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 
Reference Range Adult males  1000-6000 pmol/L

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