Age 29
I have arranged my first advice only consult on call with DrSaya of Defy medical later this week.
My labs are as follows
Total T: 600
SHBG :43
FREE T : 3.7ng/dl
Lh remians between :2-4
Fsh: 3.5
Estrogen : 23
I haven’t written ranges as experts over here know already.
Based on these numbers and reading experience of some other members on this forum with Defy, I’m assuming he will put me on clomid before trying trt. Since Clomid is said to increase SHBG. Wouldn’t further increase in SHBG would do more damage?
Your Total T of 618 is deceptive, it’s higher because Free T is lower, so really the LH is a better indication of testosterone production. Clomid will increase SHBG and lower your Free T even lower than it is now. I wouldn’t say clomid will cause damage, it’s reversible by simply stopping clomid.
You may struggle on TRT without very frequent dosing or without an AI. Getting the AI dosing right is not always easy, you may spend months trying to get it right and in the process crush estrogen more than once.
You should start TRT in isolation on very frequent dosing using insulin syringes, add HCG later if you want.