Doctor has suggested clomiphene possibly followed by TRT. I have questions

Hello everyone,

I am new here so I will try to include all the information that I have seen in other posts. Please be patient.

I am 39. 5’ 8" and I weigh 135.

I am overall a healthy man, albeit, I do feel myself getting older. I play football with kids and work out approximately 3x week. Recovery is taking longer and longer. I find myself staying sore for days. I recently went to the doctor with complaints of lethargy and never feeling “awake”. I am constantly tired with lack of motivation. I am not depressed and my sleep study was normal.

Lab results were as follows:

CBC- Normal
BMP- Normal
LDL- 30
HDL- 72
LDL/HDL ratio- 0.4
Cholesterol- 111
Triglycerides- 28

Free Test- 47.6
Total Test- 389
Estradiol- 30

I would be ecstatic to start a regimen that would help get me feeling back to my normal self, but I am also curious to hear what other seasoned people might think of my labs.

If I left some information out, please let me know and I’ll reply with additions.

Thanks!

lab ranges for the free test would be good. Also if they drew your SHBG, not that you can change it.

Your total testosterone is low, and your free test, if its the ranges i am thinking of… is basically AT the bottom of the range… Way too low for your age, but not unexpected.

You would feel better on TRT. You can do what your doc says and try the clomiphene first. I have seen it raise peoples Test, but not help with the effects of low T.

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Why would clomephine raise your test but not have the same effects of TRT raising your test?

Lab ranges for the free test through Quest Diagnostics are:

Free Test- 46.0-224.0
Total Test- 250-1100

Clomid is effective. When I first tried it for half a tab a day, my T went from 240 to 790.

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your free test was literally where mine was when i started TRT. Felt awful, depressed, tired, low libido/mood, couldn’t put on muscle.

Not sure why the clomiphene has had that effect on people, its just something i have seen with a few people. May not be the case for you. Worth trying first i would say.

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I wish more people understood that low test doesn’t always mean low libido. My wife doesn’t like the thought of me starting TRT because she’s afraid I’m going to become a monster obsessed with sex. When in reality, I really just want some energy and a good night sleep.

My doctor was against TRT the last time I saw him for this. I was about 36 and my levels were mid 400s. He said that once I go down this road, I would have to continue the road. This time I saw his nurse practitioner and he was much more open to the idea and supported it. At this point I don’t care if I have to continue down this room. I’m ready to feel good again.

I just left the doctor and he is starting me on test and not Clomiphene. I’m so excited to start feeling better.

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What dose?

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100mg/wk. Recheck labs in 6wk

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Perfect. Most docs start too high. This is good.

6 weeks will be a fairly good indicator of where your test levels will be but it’s prob not long enough to decide to adjust or not. I would wait at least 10 weeks and see how you feel. Last thing you wanna do is not be settled in and start messing with dosing.

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Good starting point. My BEST advice having been on TRT only 9 months: do NOT over subjectify every little thing after starting.

I read these forums for over 1 year before starting and my levels reached 211 total test before starting.

I’ve had a very smooth run. Don’t let every sneeze, fart, or random thing make you think you need to chase dose changes, added compounds etc.

@s.gentz is right on the money and far more experienced but yeah, tortoise not the hare…

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I do have one question I forgot to ask him. Is TRT a life long thing once started? Or, if after several months I don’t love it for some reason, can I stop taking it?

It is meant as a life long treatment.

You can stop but you may not be able to recover to the same levels at which you started.

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I don’t know why, but last night I started getting nervous. How much does it increase your libido? The wife and I really had a rough night last night when I told her I was starting because we are already so different libido wise.

It’s not gonna turn you into a sex crazed freak. Ideally getting your levels where they should be would return you to how you used to be before your test levels declined.

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Thank you to everyone for being so helpful, especially to someone that is new and a bit nervous.

I am sure I will have many more over the coming months. I already have a very high sex drive and I am just scared this will make me insatiable.

Doctor has recommend giving the injections subq. I should start this evening. How long on average until you feel a difference?

What’s interesting is no one talks about other medications like this; i.e., “I’m diabetic/hypothyroidal/a-fib/cirrhotic/etc. but my doc said if I use (appropriate medication), I’ll be on that road forever.”

You might “feel” something in a week or so. It’s gonna take 5 weeks or so for the test to reach full blood saturation and from there the body will adjust to the new hormone profile.
We are all different so my experience will most likely be different from yours.

You’re right. As a nurse, I can definitely understand that comparison. I also suffer from psoriasis and no one has ever said to me that I’ll be on my monthly injections forever. It was assumed. Because I have a disease. This should be viewed in the same way. Not necessarily a disease, but a hormonal problem.

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