Check out the HRT protocol this doctor is offering me... thoughts?

[phuoc.yiu]

Last week I went to a HRT clinic for an evaluation. These are the results from my blood work:

ENDOCRINE EVALUATION
ESTRADIOL (E2): 14.2 [0.0 - 39.8 pg/mL]
TESTOSTERONE, TOTAL: 343 [280 - 1100 ng/dl]
SEX HORMONE BIND GLOBULIN: 22 [15 - 95 nmol/L]
TESTOSTERONE, FREE: 8.0 [4.3 - 24.0 ng/dl]
IGF-1: 120 L [124 - 181 ng/mL]

The doctor offered me the following HRT protocol:

Gonadorelin (GnRH): 25iu 2x/week
Clomiphene (Clomid): 25mg/day
Anastrozole (Arimidex): 0.5mg 2x/week

I told the doctor that I'd think about it and give him my decision later. I was hoping for HCG and Enclomiphene, but the doc told me that HCG is hard to obtain and is being replaced by Gonadorelin. He also said that they do not have Enclomiphene and only offer Clomiphene as an alternative. The doc also said that the Anastrozole is necessary to mitigate estrogenic side effects.

What are y'all thoughts and opinions on all this? I appreciate your feedback, thanks.

 

[buck]

Last week I went to a HRT clinic for an evaluation. These are the results from my blood work:

ENDOCRINE EVALUATION
ESTRADIOL (E2): 14.2 [0.0 - 39.8 pg/mL]
TESTOSTERONE, TOTAL: 343 [280 - 1100 ng/dl]
SEX HORMONE BIND GLOBULIN: 22 [15 - 95 nmol/L]
TESTOSTERONE, FREE: 8.0 [4.3 - 24.0 ng/dl]
IGF-1: 120 L [124 - 181 ng/mL]

The doctor offered me the following HRT protocol:

Gonadorelin (GnRH): 25iu 2x/week
Clomiphene (Clomid): 25mg/day
Anastrozole (Arimidex): 0.5mg 2x/week

I told the doctor that I'd think about it and give him my decision later. I was hoping for HCG and Enclomiphene, but the doc told me that HCG is hard to obtain and is being replaced by Gonadorelin. He also said that they do not have Enclomiphene and only offer Clomiphene as an alternative. The doc also said that the Anastrozole is necessary to mitigate estrogenic side effects.

What are y'all thoughts and opinions on all this? I appreciate your feedback, thanks.

HCG is still available but most clinics can't get it as they used to get it from a compounding pharmacy. So it seems they lost out on the cost overage they used to charge. Big pharma companies are still making it.
Most give up on HCG in my experience and go with testosterone as it is easier to deal with.
Many/most people running real TRT can get away with not using an AI. But clinics like to include it as they can charge a lot. It is like $1 per mg at a drug store.

 

[phuoc.yiu]

HCG is still available but most clinics can't get it as they used to get it from a compounding pharmacy. So it seems they lost out on the cost overage they used to charge. Big pharma companies are still making it.
Most give up on HCG in my experience and go with testosterone as it is easier to deal with.
Many/most people running real TRT can get away with not using an AI. But clinics like to include it as they can charge a lot. It is like $1 per mg at a drug store.

Yeah, that's what I heard about HCG. I know I can always get it from one of the sponsors here if I really want it. I have left over FSA money from 2023 that I need to spend before it expires in March so I thought, why not go to a HRT clinic?

Hopefully this protocol will get me optimized again. I'm 39 years old and not ready to be on indefinite TRT yet.

 

[mexbeast]

I would not touch gonadoreline until you are truly sure of what you want, I'm not sure but it could shot you down for life, I think they use it as chemical castration to stop test production in prostate cancer patients

 

[buck]

I would have to think any thing that you take for the rest of your life to raise T levels will constitute TRT.

 

[phuoc.yiu]

I would not touch gonadoreline until you are truly sure of what you want, I'm not sure but it could shot you down for life, I think they use it as chemical castration to stop test production in prostate cancer patients

Yeah, I did some research on gonadorelin and the potential of permanent shut down is scary. This and the fact that it has such a short half-life that it's effectiveness is questionable. I'll stick to HCG.

 

[phuoc.yiu]

I would have to think any thing that you take for the rest of your life to raise T levels will constitute TRT.

My mistake. I meant that I'd like to try a protocol that can get my body to produce more test on it's own, as opposed to just using exogenous test right now and forever. I was hoping I won't have to start doing that until I'm older.

 

[Kaladryn]

Clomid is nasty stuff, it is a stereoisomer (2 part drug), one part stimulates T production and has a very short halflife, and the other part inhibits T production and has a very long halflife. You want just the first part, enclomifene, if possible.

Clomid completely shuts me down when I go off it, like completely, including sperm production, I had a bad experience using it under my doctors supervision, he was surprised as well. I asked him for enclomifene originally but it's impossible to find even with a prescription as of 2021, thanks FDA.

 

[mexbeast]

There is a lot of enclomifene in the market, but only God knows if it's real

 

[phuoc.yiu]

There is a lot of enclomifene in the market, but only God knows if it's real

I just scored a prescription for enclomiphene from Strut Health (legal telemedicine clinic). $201 for a 90 day supply of 12.5 capsules. It seems pricey but I have unused FSA money from 2023 that I spent on it. I have to spend it all before it expires in March, lol.

Based on what I read on their website and other online reviews, they seem legit. I'll know for sure once I get bloodwork done.

 

[buck]

My mistake. I meant that I'd like to try a protocol that can get my body to produce more test on it's own, as opposed to just using exogenous test right now and forever. I was hoping I won't have to start doing that until I'm older.

If you start HCG typically that means taking it forever as once a person stops there levels drop down to where they were previously. Unless you are coming off a cycle and just hoping to restart your T production.

 

[mexbeast]

I just scored a prescription for enclomiphene from Strut Health (legal telemedicine clinic). $201 for a 90 day supply of 12.5 capsules. It seems pricey but I have unused FSA money from 2023 that I spent on it. I have to spend it all before it expires in March, lol.

Based on what I read on their website and other online reviews, they seem legit. I'll know for sure once I get bloodwork done.

Please let us know how it works for you, especially if you get blood tests

 

[mexicanhombre]

Clomid is nasty stuff, it is a stereoisomer (2 part drug), one part stimulates T production and has a very short halflife, and the other part inhibits T production and has a very long halflife. You want just the first part, enclomifene, if possible.

Clomid completely shuts me down when I go off it, like completely, including sperm production, I had a bad experience using it under my doctors supervision, he was surprised as well. I asked him for enclomifene originally but it's impossible to find even with a prescription as of 2021, thanks FDA.

while this may be true for you, this is not true for majority. Clomid in majority of patients boost sperm production. It does not "shut you down" as evident by a proportional rise in LH and FSH.

 

[Kaladryn]

while this may be true for you, this is not true for majority. Clomid in majority of patients boost sperm production. It does not "shut you down" as evident by a proportional rise in LH and FSH.

"Clomid" is actually 2 drugs, one boosts, one inhibits, the drug that boosts is more powerful (and is about 2/3rds of "clomid") and overrides the one that blocks, thus leading to the rise in LH/FSH. The one that inhibits has a MUCH longer halflife (around 20 times longer) so it can shut you down when coming off.

But there is also another pathway, strong stimulation of GNRH can cause down regulation of gonadotrophin receptors and inhibit LH/FSH, this is how Triptorelin works BTW, when used for prostate cancer therapy.

This combination of long halflife inhibition of around 1/3rd of the clomid stereoisomer and receptor downregulation frequently leads to massively shutdown when discontinuing clomid.

Short cycles of clomid combined with other drugs to mitigate these effects may be successful in some individuals, but the evidence of any long term positive outcomes is dubious and anecdotal at best.

 

[big_lech]

Gonadorelin is junk. Better off ordering HCG from a reliable source. Pretty sure the half life of gonadorelin would require you to pin it every 2-3 hours (don’t quote me).