Bloodwork and Clomid/TRT Recommendations

Pharma TRT
1

Hi all - just came across this community - thankfully, as I am trying to interpret my latest bloodwork/quite a confusing appointment at a TRT clinic in UK. Figures are below:

FSH: 1.7 IU/L (range: 1.0 - 12.0)
LH: 0.8 IU/L (range: 0.6 - 12.1)
Oestradiol: 56.0 pmol/L (range: 40-161)
SHBG: 49.5 nmol/L (range: 14-72)
Total Testosterone: 24.47 nmol/L (equates to 706 ng/dl) (range: 8.3 - 30.2 nmol/L)
Free Test: 0.423 nmol/L , 1.73% (equates to 12.2 ng/dl)

TSH: 2.012 mIU/L (range: 0.35 - 4.94)

All other results came back in normal range - happy to provide other figures if useful. 32 Y/O.

Symptoms: very low libido, poor mood, irritability, significant fatigue, no facial hair

Doctor thought my high SHBG was killing my free test total and, given the other figures, that this low free T was the cause of my symptoms. He recommended Clomid (given it avoids the infertility side-effects of Nebido), but said it doesn’t work with 50% of people. As a “back-up option”, in the event that Clomid doesn’t work for me, Dr suggested freezing my sperm and trying Nebido.

I am a relative newbie to this discussion, but would really appreciate the thoughts of others. Many thanks!

2

If this is true, clomid will increase SHBG substantially. Wrong move. TRT, HCG and FSH is the right move. Just because hormones are in range doesn’t mean that you won’t experience symptoms, the low estrogen is causing some of your symptoms.

Nebido is unpopular and with good reason, the longer esters tend to cause treatment failure in a lot of men. See if you can get ethanate or sustanon. There is Balance My Hormones and also Men’s Health Clinic in the UK that offer other alternatives to nebido.

3

Better solution than giving someone with high SHBG something that will further increase it.

4

Thanks for the reply. Spoke to someone else this morning who seemed to take more interest in the oestradiol, LH and FSH readings (and also had more nuance re. treatment options e.g. TRT + HCG). He did say, though, that my figures aren’t necessarily indicative of someone in need of TRT and they look “in a good place”. Lots of mixed messages. What is your impression?

5

If I am you, I’m trying a course of testosterone for a couple of months. Then you will know. Therapeutic trial.

6

The fact is your estrogen is low and I see this in guys with suboptimal Free T values or an aromatase deficiency.