Hi Ksman,
I got LH and FSH tested like you said. I didn’t get bio-T tested cause it was $250 alone for that test. If needed I can afford it, so let me know if you still think I should get that tested in my next lab test. I put all my lab results including the latest into the table below so it’s easier to read. I also put my medication timeline in there too.
Here are my notes from my last visit with Dr Saya on 7/20/16:
“Your body has had a good response . Pituitary gland reved up LH and it actually went above range. Testes responded by increasing testosterone by just about double. That indicates that your testes are fairly capable. Downside is that DHT (erection, energy, libido) only went up to 18. At this point he thinks finasteride is going to be the real inhibitor for me. Might be preventing you from feeling your best. DHT is a double edged sword. Hair loss is usually at high levels. Usually you can attain a good balance at 30s to 40s of DHT and you typically won’t accelerate hair loss. Would recommend cutting in half finasteride or even better switching to topical. You will get a minimal fraction of systemic absorption from topical as what you get with oral. Topical is 1mg per mL (0.1%). For transdermal you typically absorb 10%. So you’ll get 0.1mg in theory per application. If you want to be conservative, you can try cutting down your oral by half and then recheck DHT in 5 weeks. Would continue clomid as that’s working well but also put me on 0.3mg twice a week anastrozole (arimidex) to control estrogen. Testosterone levels are pretty good, but what’s missing is DHT going up and you feeling better. Ideally, we taper off the finasteride, continue on clomid and arimidex, get your TT, DHT, and E2 where they need to be, and then taper off the clomid/arimidex eventually.”
So per the table above, on 7/20/16 I stopped taking 1.25mg/day of oral finasteride and started 0.1% topical finasteride in the form of 1mL/day of minoxidil with 1mg of crushed finasteride tablets dissolved in it. Also on 7/20/16, I began 0.25mg of arimidex, 2x per week (0.50mg total per week). I am continuing the 25mg/day of clomid.
I began clomid on 6/7/16. The next two mornings I noticed morning erections but after the first two days they went away again (I assume from my E2 spiking). Since I started on the arimidex 4 days ago, the morning erections haven’t come back yet. Maybe it’ll take some more time?
So was just hoping for you feedback on the above and any additional thoughts you may have. Thanks so much as usual!