How much clomid to prevent testicular shrinkage?

[ximoosea]

Hi all and thanks for this forum...it is a great learning tool.

I am 48 years old and started TRT at the start of the year. My Pre-TRT baseline was through LifeExtension using Labcore:
T: 576 (348-1197)
Free T: 11.5 (6.8-21.5)
DHT: 48 (30-85)
DHEA: 180 (71.6-375.4)
E2: 26.9 (7.6-42.6)
Hematocrit: 43.4 (37.5-51)

My doctor started me with 100mg/week of Test-cyp. Injection just once per week. I was concerned with testicular shrinkage...just due to cosmetic reasons since there are no plans to have additional children. Thus, he also prescribed 50mg per day of Clomid. No AI was prescribed and he would rather not use any if control can be maintained without. Thus, this has been my regiment since Jan 3rd, 2014.

I just had my first set of blood tests taken since starting. Unfortunately, I am on work assignment in China and only get back to the US around Christmas time. I had a very difficult time finding a hospital in China to do the testing and once I found one, the male panel of tests were very limited and not very useful. However, since this is all I have available I hope it can be of some use.

China test results (March 7): (These results were 36 hours after my weekly injection, thus should be close to the high.)
T: Just reported as >1000
Free T: They could not test for this
DHT: They could not test for this
E2: 43 (7.6-42.6)
Hematocrit: 49.8 (37.5-51)

I know it is not ideal information. However, based on this my doctor's advise is to continue the program unchanged. He rightfully says it is hard to know if the T was actually 1200 or 2000 since neither it nor Free T could be determined. However, he says that since my E2 is not sky high and my Hematocrit die not increase significantly, then this indicates that nothing major needs to be adjusted. Note: He firmly believes that E2 should always be at the very high side of the range because he believes there is little downside and also some studies that show this is better for stroke and heart disease long term. I know many on this board may disagree with this, but this is his beliefs.

Sorry for the long background. My real question is: How much clomid is really needed to prevent testicular shrinkage? I would prefer for my E2 to come down a bit and am wondering if it would be beneficial to reducing clomid to 50mg EOD? I suppose it could also be helpful to change the 100mg/week into 50mg E3.5D. I am open to this but do not relish the thought of more injections and also have a bit of a concern if I have a full year's worth of needles since this was not the original plan...I would have to see. Perhaps it is possible to get gear in China, but I don't know how easy it would be and I don't want to draw any more attention than necessary.

Thanks for taking time to read, and for all of the great advice that is given on this forum.

 

[jomamma007]

48 with a total t of 600.
That's the average T level of a 20 year old. You should have improved your lifestyle man. No legitimate doctor would prescribe trt with those levels. Your estrogen was perfect too -__-.

HCG
/thread

Ditch the clomid. Split up your injections.

 

[Megatron28]

Why did you go on TRT? Your pre-TRT numbers look great!

 

[MBB]

Why did you go on TRT? Your pre-TRT numbers look great!

Ditto, your pre numbers are shitloads better than mine were and I'm 25.

 

[ximoosea]

Thanks for the reply although I am not sure I agree. You say "ditch the clomid", but my main question was how much clomid is needed to prevent testicular atrophy?...by ditching it you are saying none is needed and I do not think this is correct.

While I understand that 576 T at 48yo is not anywhere as low as many people have, it seemed low to me. While I do not have a baseline from when I was younger, I could clearly tell huge differences in the past years....my weight lifting was much more difficult, I was always tired, sex drive was non-existent, etc. I did not see huge increases during the first 5-6 weeks after starting but I am clearly now much better off in all of the areas mentioned above versus before starting.

Also, I understand that I can always improve my lifestyle, but honestly, it was not that bad to begin with. I have lifted weights for years, run at least one marathon a year. Weight is 195-205# at 6'2" and quite lean. I pretty clean but perhaps drink a few too many beers on the weekends. I also find your comment about "no legitimate doctor would prescribe TRT with those levels" a little concerning. Without trying to get defensive, a lot of research I have seen also supports increasing to a higher range for a variety of reasons. While I researched my doctor fairly extensively, I would be interested in other's views of this.

 

[Daniel_IMT_Staff]

Clomid while on TRT will have no effect.

 

[Mprtz]

Your HCT went from 43 to 50 in 3 months? How is this not a significant increase? You are going to need to donate blood soon and often.

 

[methos0123]

I have to agree with everyone else. You should not have started on TRT with those numbers. I haven't heard of clomid being used to stop shrinkage, HCG is used for that.

 

[IMT staff]

yup clomid + TRT = worthless

 

[Alpin]

I doubt that was a conventional endo that put him on TRT with numbers like that. His Bio Avail. T might be low-normal to mid-normal. I don't see his LH, FSH, Prolactin being tested anywhere. It's a shame.
No way of knowing. Who knows, if he has sleep apnea or other underlying issues that are giving him that runned down feeling.
The levels you have at 48 were the levels I had at 25.....
I had sleep apnea and had I known I had it and treated it...I would not have hoped on HRT.

 

[jomamma007]

You know having a 600 T level at 48, you probably had a 1000 level in your 20's.
Lucky 5%'r. You could definitely feel a decline like Cashout did. Only other member on here with great levels at 40+ that I can remember.

Anyways you need HCG alongside your testosterone shots. Not clomid.
This is my point.

 

[Alpin]

You know having a 600 T level at 48, you probably had a 1000 level in your 20's.
Lucky 5%'r. You could definitely feel a decline like Cashout did. Only other member on here with great levels at 40+ that I can remember.

Anyways you need HCG alongside your testosterone shots. Not clomid.
This is my point.

very possible this guy could do small PCT's a few times a year or maybe a restart before going all out TRT with numbers like that....
We don't have his LH, FSH, Prolactin levels either.
what ever the case is....Bottom line is this guy needs to donate blood fast before he decides what his next move is.
And TT fluctuates...it can go up or down by a 100 ng/dl or so within a short while...
I've had 663 ng/dl and 580 ng/dl on diff labs within a 2 month period....

 

[Mprtz]

While I agree that going on TRT at the OPs levels is proactive at best and unnecessary at worst, I don't think it's the same situation as someone jumping the gun in their 20s.

Through my late forties I felt the effects of my dropping hormone levels. Knowing that I was going to end up on TRT anyway, if I could go back in time and start a few years earlier I would do it. My quality of life would have been better.

Maybe the OPs levels would have stayed at a medically reasonable level, but maybe they would continue to drop - impossible to say - but at best he'd be looking at medically acceptable middle-aged levels.

EDIT: this is not to take away from the fact that the OPs doc doesn't seem on the ball. Educate yourself to protect yourself!

 

[ximoosea]

Thanks all for the feedback. While many of you seem to think it was bad advice to jump into TRT, a few of you disagree. Personally, I could just tell my levels were down significantly from when I was younger. I have been very cautious to not fall into the mental placebo effect and am 100% sure that the past 3 months of treatments has resolved many of the original symptoms I was seeing....fatigue, lack of strength, libido, morning erections, etc. Thus, regardless of what many have said, it seems to be the right direction for me and I feel lucky since I read about so many people that do get on TRT and still feel bad.

Several posts mention that Clomid will not work with T. However, after my doctor recommended this to prevent testicular atrophy I did some research. There are multiple articles that mention things like "Clomid ***8211; active ingredient clomiphene citrate ***8211; is an anti-oestrogen that makes the brain think that there is too little steroid hormone circulating in the blood, regardless of actual level. As a result higher levels of steering hormones are produced, which stimulate testosterone production in the testes." Statements like this and others lead me to believe that Clomid does trick the body into thinking it needs to produce testosterone...even if your testes are less than effective, it at least keeps them working where they do not shrink.

Since there are such different views on this subject, let me rephrase the original question another way. How long would the average person be on TRT (using just Testosterone and not Clomid or HCG) before they begin to see shrinkage? After 3 months I have seen no shrinkage and possible a bit of growth or extra firmness although this, admittedly, could be imagination. Assuming, as many of you said, that Clomid will not work with T, then at what point should I start noticing shrinkage?

 

[MBB]

Since there are such different views on this subject, let me rephrase the original question another way. How long would the average person be on TRT (using just Testosterone and not Clomid or HCG) before they begin to see shrinkage? After 3 months I have seen no shrinkage and possible a bit of growth or extra firmness although this, admittedly, could be imagination. Assuming, as many of you said, that Clomid will not work with T, then at what point should I start noticing shrinkage?

The penis isn't what shrinks/atrophies, it's the testicles. It's quite common to see a perceived increase in size/fullness of the penis whilst the testicles still atrophy.

 

[ximoosea]

The penis isn't what shrinks/atrophies, it's the testicles. It's quite common to see a perceived increase in size/fullness of the penis whilst the testicles still atrophy.

Sorry if it was not clear but this whole thread is talking about testicular shrinkage, not penis shrinkage. It is even mentioned in the subject line. I am quite aware that T does not cause penile shrinkage.

 

[MBB]

Sorry if it was not clear but this whole thread is talking about testicular shrinkage, not penis shrinkage. It is even mentioned in the subject line. I am quite aware that T does not cause penile shrinkage.

I think I got a little confused when you said growth and firmness, never heard of that happening after starting TRT without HCG.

 

[Daniel_IMT_Staff]

I think this whole thread is confusing.

Ximoosea and his doc are convinced clomid is used to help testicle atrophy and OP has read a study stating it is used for that. However that is in the context of NO TRT.
Ximoosea please take the advice of the people in this thread trying to help you and advise you that your doctor is severely misinformed. Or, try another TRT forum and ask the same question. Surely if everybody says clomid isn't for atrophy during TRT you have to humble yourself to consider you and the doctor is wrong.

To answer your questions about average time for atrophy. There isn't a average time as side effects are individual.

All the good programs include hCG as a staple for very good reason and not only for atrophy.

TRT is very knowledge based, the doses and medication used for an individualized plan. Your doc doesn't seem to know what he is talking about and that can be detrimental for your health and well-being.

Good luck and stick around and share your experiences

 

[jomamma007]

Sorry if it was not clear but this whole thread is talking about testicular shrinkage, not penis shrinkage. It is even mentioned in the subject line. I am quite aware that T does not cause penile shrinkage.

Really? Mine fell off but my bench went up 100lbs so well worth it.

Anyways lol, your study about clomid producing more test and enlarging the testes is for natural guys.
When you have exogenous testosterone in your system, it won't do much.