Back to Endo tomorrow-advice needed-new labs

[wemmington]

So i'm 36 no history of steroids and my main symptoms were fatigue, brain fog, low libido and loss of interest in life. My labs before treatment were TT 251(250-1100) and free T was 68(35-155).

I'm trying to get my girl pregnant so test cyp is out for now and the Endo first prescribed me HCG at 3000iu 2-3 time a week but the script was $1k for the month so he changed it to clomid 50 mg ed.

After 4 or 5 days on clomid I felt great, almost all symptoms were gone except it seem to have no impact on libido. After the first week the brain fog came back and I felt about the same as before treatment. So I got my labs today after 18 days on clomid and total test is 633(250-1100) and free is 145.6(35-155) so the numbers look pretty good but I still feel like shit.

The last week or so I have been taking clomid 50 mg eod and that seems to help some but I still don't feel right. I wondered why the Doc didn't test E2 but I read something about high e2 doesnt matter on clomid because it wont bind to the receptors the same or something like that. Does anyone know more about this?

Any other thoughts? I want to have a game plan when I go to the Doc tomorrow.

Thanks

 

[Un1baller]

I tried clomid only at 25 mg ED and my levels got to about 600 like yours yet I really didn't feel any different so I stopped clomid. Now, I am back, and I am starting TRT with test injections and HCG to remain fertile because I also want kids in the future. Why not do test and HCG together?

 

[Megatron28]

If you go to Prices, Coupons and Information - GoodRx and search on Pregnyl which is a brand of hCG, you can get a coupon to buy it for about $72. That is 10,000iu so it would last you a week. There may be cheaper generic options as well that you should search for. You will have to pay out of pocket instead of through insurance though.

Pregnyl - Prices, Coupons, and Information - GoodRx


But if you don't want to do this, clomid may do the trick. Looks like you are getting decent results although I would have liked to see what your LH and FSH are at since you are trying to increase your sperm production. And by the way, high E2 while using clomid does matter. Definitely always check your estradiol levels.


Another option to discuss with your Endo is Arimidex-Monotherapy. See the following medical study.

Effects of aromatase inhibition in elderly men with low or borderli... - PubMed - NCBI


If none of these work, hMG is an option. It mimics FSH but it costs even more than hCG.

Finally, check out my signature below if you want to get blood work done on your own. It may be cheaper than going through your endo. Use the Buy Lab Tests Online | Private MD Labs one. Hormone Panel for Females -- it is for men too.

 

[Megatron28]

A lot of endos will want to help you conceive first and then migrate you over to Testosterone injections. Don't let them put you on gels, creams or pellets.

But Un1 brings up a good suggestion. Many guys on TRT with hCG as well have been able to conceive. And they typically only use 500iu of hcg twice a week. So it would be a lot cheaper.

 

[wemmington]

I tried clomid only at 25 mg ED and my levels got to about 600 like yours yet I really didn't feel any different so I stopped clomid. Now, I am back, and I am starting TRT with test injections and HCG to remain fertile because I also want kids in the future. Why not do test and HCG together?

Thanks for the reply.


If I was trying to preserve fertility to have kids in the future I would for sure do test/hcg but were trying to get pregnant right now so I thought best to hold off just a little bit since were only having one kid so as soon as shes pregnant i'm going on test/hcg.

 

[IMT staff]

1k a month for HCG?

Yikes

 

[Megatron28]

1k a month for HCG?

Yikes

His doc has a boat payment to make.

 

[muscletank]

TRT plus HCG has been shown to be effective in preserving fertility and also achieving higher total T than Clomid.

Testosterone+ HCG Preserves Healthy Sperm in Men on Testosterone Replacement Therapy (Injections and gels)

Tung-Chin Hsieh, Alexander W. Pastuszak, Kathleen Hwang and Larry I. Lipshultz*,***8224;

From the Division of Urology, University of California-San Diego (TCH), San Diego, California, Scott Department of Urology, Baylor College of Medicine (AWP, LIL), Houston, Texas, and Department of Urology (KH), Brown University School of Medicine, Providence, Rhode Island


Purpose: Testosterone replacement therapy results in decreased serum gonadotropins (hormones produced by the pituitary gland- LH and FSH- that jump start testicular function) and intratesticular testosterone (inside the testicles), and impairs spermatogenesis (sperm production), leading to azoospermia (no viable sperm) in 40% of patients. However, intratesticular testosterone can be maintained during testosterone replacement therapy with co-administration of low dose human chorionic gonadotropin, which may support continued spermatogenesis in patients on testosterone replacement therapy.

Materials and Methods: We retrospectively reviewed the records of hypogonadal men treated with testosterone replacement therapy and concomitant low dose human chorionic gonadotropin(HCG). Testosterone replacement consisted of daily topical gel or weekly intramuscular injection with intramuscular human chorionic gonadotropin (500 IU) every other day. Serum and free testosterone,estradiol, semen parameters and pregnancy rates were evaluated before and during therapy.

Results: A total of 26 men with a mean age of 35.9 years were included in the study. Mean followup was 6.2 months. Of the men 19 were treated with injectable testosterone and 7 were treated with transdermal gel. Mean serum hormone levels before vs during treatment were testosterone 207.2 vs 1,055.5 ng/dl (p<0.0001), free testosterone 8.1 vs 20.4 pg/ml (p = 0.02) and estradiol 2.2 vs 3.7 pg/ml (p = 0.11). Pretreatment semen parameters were volume 2.9 ml, density 35.2 million per ml, motility 49.0% and forward progression 2.3. No differences in semen parameters were observed during greater than 1 year of followup. No impact on semen parameters was observed as a function of testosterone formulation. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Nine of 26 men contributed to pregnancy with the partner during followup.

Conclusions: Low dose human chorionic gonadotropin appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy.


************************************************** *************************************************


Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression

This study shows that HCG can keep intratesticular (inside the testes) testosterone - ITT normal even when they are exposed to testosterone injections. An HCG dose of 500 IU every other day increased ITT to levels higher than baseline. All other doses failed to achieve normalization of baseline ITT. ITT is crucial for Leydig cells to work properly so that they do not atrophy (lose volume due to inactivity)

ncbi.nlm.nih.gov/m/pubmed/15713727/

 

[Profion9k]

un1baller. You have to be aware that some tc´s are messuared with their B-HCG; if there is a relationship between b and hcg i dont know.. I choose not to go that route as my markers were meassured within b-hcg and afp.