26, UK, Just Prescribed Clomiphene - Opinions?

Thank @KSman as always your advice is invaluable.

DHT Results: 4487 pmol/L (860 - 3400)

Last bloods were taken 24 hours after Sustanon injection so these will probably be peak numbers.

I am convinced my E2 levels are responsible for all negative effects I am experiencing. Was becoming overwhelmed with potential Thyroid issues and adrenal fatigue etc but I read today that excessive E2 can be suppressive to the pituitary and so my plan is to keep it simple and get my TT and FT to the higher end of the “normal” range and E2 70-90 pmol/L.

I have gone from the very bottom of the range to way above it in a short time and that has no doubt put stress on my endocrine system. My plan:

  • Reduce my need for AI (hopefully eventually remove it) by:
    Reduce HCG dose to 100IU ED (-33%)
    Reduce T dosage to 40mg 2x PW (-20%)
  • Get referral from Doc to an Endo
  • Attempt to solve and correct excessive aromatising prior to TRT by addressing any vitamin/mineral deficiencies

Doc appointment next week. I will be requesting tests for:
TT
FT
E2
Iron/Ferratin
Vit B12 + D
Zinc
Magnesium
CoQ10
IGF-1
TSH
tT3
fT3
tT4
fT4
Pregnenalone

Couple questions:

  • Should I request any more tests?
  • My Progesterone came in at 2.7 nmol/L with no range - is this a good number?
  • Is it better to take AI ED in smaller doses?

Who is paying for the labs?
With “normal” TSH there could be some back pressure.

The cost of testing Vit-D25 probably pays for more than a year of 5000iu Vit-D3.

B-12: Just get a high potency B-complex multi-vit that has trace elements including 150mcg iodine + 200mcg selenium

IGF-1: At your age will be normal. And if was low and not covered, you might not be able to afford GH.

Skip pregnenolone and test DHEA-S. At your age DHEA should be quite good.

When thyroid is weak the increased/restored metabolic demands of T can be more than a thyroid deficient body can deliver. So focus should be thyroid.

How many labs should be thrown at iodine deficiency. Have you described your iodine intake sources?

Have you read all of the thyroid basics sticky and noted implications of stress and over training?

Some do T+AI+hCG EOD for an easier to maintain routine.
Anastrozole has a decent half-life.
But if injecting twice a week and taking AI at that time, serum T and anastrozole levels will roughly peak and fall together and that satisfies the need to have these match.

Progesterone is required for progesterone–>cortisol in the adrenals.

Google progesterone lab ranges male
http://www.hemingways.org/GIDinfo/hrt_ref.htm
Ranges can vary by lab and country.

I live in the UK so funding the tests is not an issue provided I can convince my doctor I need them. Also, I’m not sure DHEA-S is available in the UK.

I began to supplement with Iodoral 50g per day as per your recommendation in Aug 17’ but didn’t feel it made any difference so discontinued. I’ve since bought a liquid solution + selenium.

I have read the thyroid sticky and have since changed jobs (far less stress) and haven’t been able to lift weights for 3 months due to shoulder injury, my job however is very manual so plenty of exercise and I have gained muscle/lost fat since TRT. Diet remains healthy and varied.

Noted concern on thyroid, especially considering my body temps (96.4f currently 21:00 UK time) Hopefully next bloods will shed some light.

Just done the calcs for a revised AI dose:

156 (current E2)/80 (target E2) x 1.5 (current ai dose)

Comes to nearly 3mg per week, doesn’t this seem a little excessive?

It’s been a while since I posted - I’ve actually been off TRT for 5 weeks now and went cold turkey. Overall I don’t feel much different off the gear, sleep was perhaps better but that’s all.

Interestingly my body temps have come back up since stopping and I normally hit around 97.5f in the afternoons. I read that E2 can suppress thyroid function so maybe that’s the reason. Had my thyroid bloods done:

TSH 1.3mu/L (0.35 - 5.0)
Free T4 15.3 pmol/L (9 - 24)
Free T3 5.9pmol/L (3.5 - 6.5)

Other bloods:

Serum B12 418 ng/L (200-900)
Zinc 13.15 nmol/L (11-24)
Vitamin D 98 nmol/L (75-200)

So thyroid looks OK but still low on certain minerals despite supplementation.

I think by now the sustanon is out of my system and I’m producing my own T (balls are bigger than I ever remember them). One thing I have noticed over the last week or so is that I suspect my E2 has climbed again as I’ve noticed some water retention, libido has dropped and depression came back on a couple of days.

High E2/Low T was the very reason I started TRT in the first place but I want to try to balance my hormones naturally. Things I am doing:

  • Lift Weights (short, intense)
  • 8+ hours sleep
  • Meditate, reduce stress
  • Supplement Zinc, Vit D/B12 Ashwaganda, Calcium D-Glucerate
  • Regular cold showers
  • Keep BF below 12%
  • Avoiding excessive alcohol intake (2-3 glasses red wine per week)
  • Consuming probiotics (fermented food, apple cider vinegar)

I don’t understand what more I can do to improve my levels so what could be the reason for my body producing/converting so much E2? Liver tests have come back normal so I don’t know what else to test.

The only thing I can think left to test is gut function. What am I missing here?

You just convert more testosterone into estrogen than the next guy.

Results back from doc:

E2 125 pmol/L (0-145)

Once again said I was in the “normal” range and nothing to worry about It’s interesting, as time goes on I’m starting to become familiar with the way my body responds to high/low E and/or low T. Think it’s safe to assume my natty T is back in production and is once again getting converted to E readily.

I’m going to stick this out until my appointment in may and try an AI dose of 0.5mg 2x per week. I should be able to get a full blood panel done then including LH, FSH, prolactin etc and weigh up my options from there. I’m not opposed to the idea of getting back on TRT just would like to know if there’s any way I can produce my own hormones sufficiently first.

Had pretty bad depression the last 2 days and my first panic attack in 2 years which really sucked. Hopefully the AI can at least help with some of these symptoms.