Endo Says Secondary Hypo, Defy Says Primary

Pharma / TRT Testosterone Replacement
1

Im 25 5’11"

Total T increased from 320 ng/dl to 714 ng/dl and Free T increased from 58.1 to 171. My doctor from DEFY says that my Free T Should be higher. Why? LH currently is 4.5 and FSH is 3.4
Still dealing with erectile dysfunction unless I apply manual stimulation and am tired most of the day. My endo says that I have a case of secondary hypogonadism while Defy doc says that its primary. Which is it?

AS of right now, I am on a regimen of 25 mg of clomid ED, 25 mg of DHEA, and .25 mg of anastrozole twice/week. Should I opt for test cypionate?

2

There’s no reason why it can’t be a mixture of both, give your labs to 10 different doctors and you’ll get many differing answers like you’re normal and in range. Endo’s are typically ignorant in endocrine disorders related to HPTA/testosterone. Defy medical deals with HPTA/testosterone related endocrine disorders for a living and happen to specialize in it where endo’s do not.

In the end it doesn’t really matter if it’s secondary or primary, at the end of the day you still need TRT. Most guys need Free T to be high normal or higher to feel good, men who have Free T midrange feel like something is off and feel lost.

Something tells me you don’t feel good on clomid, very common.

3

I suppose you need to ask him. You are at 2.39% free testosterone. Free test percentages between 2-3% are considered good. Ultimately, the number is fine IF you are feeling good. Some need to run higher levels in order to appreciate the full benefits of TRT.

4

Clomid could be causing sides.

Your numbers look good. What’s the plan to get you higher? Imo you don’t need to go higher.

Clomid can make numbers look good but make you feel blah.

Also if the anastrozole is lowering your estrogen to much , that is a problem too.

Maybe drop the anastrozole and do 25mg eod. Or go to injections if you need trt.

BTW if clomid raised your numbers that much your testes do work. Most likely secondary.

1 Like
5

As of 3/30/2019 my labs are as follows on a regimen of 25 mg of clomid ED + anastrozole 3x/week:

TT: 907 ng/dl
Free T: 213 pg/mL
Estradiol: 36 pg/mL
DHT: 23 ng/dl
LH: 4.2
FSH:5.9
I noticed my DHT is low. Is this good or bad? Why is my T high but DHT low? 25 mg ED was too much, so my nurse practitioner reduced my dosage to 12.5 mg ED and adjusted my anastrozole to 3x/week in conjunction with my clomid. Are these results okay or should I request to move on to an alternative?

6

DHT may be low on paper, but the question is it low for you specifically.

How do you feel?

7

slightly better. libido has improved somewhat. would I experience any physiological changes or no?

8

Usually libido and mood improve in the beginning, then decline and you feel unwell even with good numbers. You should just accept the fact that clomid is used for a period of time and stopped, if you don’t correct the cause for low T, levels will eventually drop back down to baseline.

Looking to make a full recovery on clomid is just a fantasy for the great majority of men.