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POSSIBLE ALTERNATIVE TO TRT?

Geardepot

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Clomid has a long history in competitive bodybuilding as an anti-estrogen and something that could help restore testicular function while coming off a steroid cycle. It's never been routinely used as an alternative to TRT, but there are some studies that indicate Clomid may turn out to be cheaper than TRT, possibly equally effective, and with fewer side effects.

How well does it work?
In one study of 36 legitimately hypogonadal men (27 to 60 years old), 25 mg. of Clomid, taken daily for 4 to 6 weeks (until their first follow-up visit), increased testosterone levels by 146%. Their collective testosterone to estrogen ratio improved by about 61%, as well.
"Low dose clomiphene citrate is effective in elevating serum testosterone levels and improving the testosterone/estradiol ratio in men with hypogonadism," concluded the researchers. "This therapy represents an alternative to testosterone therapy by stimulating the endogenous androgen production pathway."
At least four or five other studies have found similar results.
Clomid is what's known as a selective estrogen receptor modulator (SERM). It's undeniably effective in curbing breast cancer growth because when it binds to the estrogen receptor, the fit isn't precise. Because of this lousy fit, it doesn't initiate a reaction, which in the case of breast cancer, is tumor growth. However, the fit is good enough to keep estrogen itself from attaching to the receptor and initiating that same tumor growth. It's a win-win.
In men, the fit to the estrogen receptor is equally lousy, like a suit you buy from Men's Warehouse. As such, it doesn't initiate any "estrogenic" reactions, like storage of fatty tissue or feminization in general. Still, just as with women, the fit is good enough to keep real estrogen from attaching to the receptor and causing those same feminizing effects.
What Clomid also tells the body by binding to those receptors is that it's okay to keep producing testosterone. When there's too much estrogen in the bloodstream, the body figures that it's time to stop making testosterone (because normally, all that estrogen arose from the aromatization of testosterone).
As such, testosterone levels gradually increase while estrogen levels stay the same or drop. The end result is more testosterone and a better testosterone/estrogen ratio. Muscles grow. Fat shrinks. Energy increases. Spermatozoans proliferate and percolate.
Traditional testosterone replacement, while extremely effective, has a couple of potential drawbacks. For one, there's no oral delivery system. That means creams, gels, or shots, the latter option sometimes leading to infections.
Secondly, it's easy and tempting to overdo it (too much of a good thing) so that other side effects surface, like too high a hematocrit level (possibly leading to stroke), possible hair loss (in those susceptible), and possible prostate growth, not to mention an elevated testosterone/estrogen ratio.
These things are either not possible or not likely with Clomid. As testament to its presumed safety, the study that had men on Clomid the longest (40 months) reported no adverse side effects.
Clomid is also much cheaper than TRT, probably by a factor of four.
If it has a drawback, it's that it only works in those individuals who have a normally functioning HPTA (hypothalamis-pituitary-testes-axis). In other words, if your hypothalamus or your testes aren't functioning properly, your only recourse is traditional TRT.
Clomid seems like a viable alternative for men who just want to boost testosterone levels back into normal physiological ranges. The most daunting part about using it though, may be finding a progressive doc to prescribe it.
GD

Source
Shabsigh A1, Kang Y, Shabsign R, Gonzalez M, Liberson G, Fisch H, Goluboff E, "Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism," J Sex Med. 2005 Sep;2(5):716-21.
 

OutToLunch

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The mental sides weren’t worth it for me and the results were diminishing at best
 

belixxx

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Clomid has no advantage over using either Nolva or Torem for LH boosting purposes, but has disadvantages as in emotional sides, and offering no protection from gyno. That said although Torem has the best side effects profile all three can have have vision sides: floaters, occular toxicity, cataracts. This is because the eyes have E2 receptors as well that all three SERMs affect negatively. Also all three serms increase SHBG, decreasing total test to free test ratio.

A much better choice than a SERM would be an AI monoteraphy.

The best choice in my opinion is Exemestane (Aromasin) for this purpose as it lowers SHBG as well (where anastrozole and letrozole doesn't).

https://academic.oup.com/jcem/article/88/12/5951/2661508

Achieved free test numbers are close to what is possible for guys on 400mg/week of Test.

But you have to start with a baseline bloodtest (the E2 should be the LC/MS type test called the 'sensitive'), and titrate the dose individually using two week increments and recheck that you don't go below 15 pg/ml or have low estradiol sides (your dose limit will be whichever comes first). Check hematocrit, HDL-C, HDL-P (or Apolipoprotein A1).
 

Chinese guy

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i like to inject the real hormone not something that my body wont optimally use and i get sub optimal results. 100-150mg per week and you are golden. why mess with a winning formula
 

belixxx

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i like to inject the real hormone not something that my body wont optimally use and i get sub optimal results. 100-150mg per week and you are golden. why mess with a winning formula
Because there are more than one type of problem, and injecting exogenous test isn't always the best solution.

Let's say you are secondary hypogonadal (so your testes are capable of working fine), or completely healthy and just looking for an edge.

If you don't want to shut down your endogenous production for whatever reason (you want kids, or hate ball shrinkage) you'll need to stack HCG with that test. If you are prone to excess aromatization eg estrogenic sides then you'll also need an AI.

Why bother with all three if you can get away with only using exemestane and get the desired result?

Other cases where your testes aren't capable of producing enough test even with the correct input signal (be it LH or HCG), then you have obviously no other solution but injecting test itself.
 

Chinese guy

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Because there are more than one type of problem, and injecting exogenous test isn't always the best solution.

Let's say you are secondary hypogonadal (so your testes are capable of working fine), or completely healthy and just looking for an edge.

If you don't want to shut down your endogenous production for whatever reason (you want kids, or hate ball shrinkage) you'll need to stack HCG with that test. If you are prone to excess aromatization eg estrogenic sides then you'll also need an AI.

Why bother with all three if you can get away with only using exemestane and get the desired result?

Other cases where your testes aren't capable of producing enough test even with the correct input signal (be it LH or HCG), then you have obviously no other solution but injecting test itself.
you are totally right

however the described situations arent TRT. they arent replacement therapy so thats why i said just inject what the body isnt producing.

if somebody wants an edge then thats fine but its not trt.

nobody who needs trt can get away from injecting testosterone, or they wouldnt need trt
 

belixxx

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you are totally right

however the described situations arent TRT. they arent replacement therapy so thats why i said just inject what the body isnt producing.

if somebody wants an edge then thats fine but its not trt.

nobody who needs trt can get away from injecting testosterone, or they wouldnt need trt
Well the first situation I listed was secondary hypogonadal. Where your testes ARE capable of producing enough testosterone, but aren't getting a large enough signal. A lot of people jump on TRT in that case too as far as I know.

Now don't get me wrong I am not against TRT at all. But if one can postpone it by 10 years with taking aromasin only, I would choose that option until I can't anymore...
 

Chinese guy

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Well the first situation I listed was secondary hypogonadal. Where your testes ARE capable of producing enough testosterone, but aren't getting a large enough signal. A lot of people jump on TRT in that case too as far as I know.

Now don't get me wrong I am not against TRT at all. But if one can postpone it by 10 years with taking aromasin only, I would choose that option until I can't anymore...
agreed

but i however fully disagree on EVER using AI's in trt related sphere. bodybuilding dosages and overloads yes, trt never. i read enough science to know that AI's are absolute disaster for our bones so i will never take 1 AI tab while on trt. this is something very few people seem to know but so important
 

belixxx

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agreed
i read enough science to know that AI's are absolute disaster for our bones so i will never take 1 AI tab while on trt. this is something very few people seem to know but so important
I don't claim to be knowledgeable in this department, but I haven't seen a single study that showed bone loss in males from AIs (I am deliberately not adding 'at trt dosages' here because literally all the AI studies that I have seen on males use dosages that are common for female chemotheraphy => So 25mg exemestane/day or 2.5mg letrozole/day or 1mg anastrozole/day, maybe I remember seeing one 1mg anastrozole EOD, but that's it). Can you link some that you mentioned here?

In women there is no question about it, but let's not compare a say 30% E2 suppression (men) to a 90% E2 suppression.
 

Freedom15Muscle

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I recently used clomid for trt purposes. I've been on for two years and decided to come off. After 8 weeks my test was drawn at 588. Not good...not bad. I never got sides and honestly feel good. The only thing...I have zero sex drive. I've been like a rabbit for years even before my steroid use. Nothing has killed my drive or even come close to clomid. Seems this is a side effect for others too.

Sent from my S2 using Tapatalk
 

Chinese guy

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I don't claim to be knowledgeable in this department, but I haven't seen a single study that showed bone loss in males from AIs (I am deliberately not adding 'at trt dosages' here because literally all the AI studies that I have seen on males use dosages that are common for female chemotheraphy => So 25mg exemestane/day or 2.5mg letrozole/day or 1mg anastrozole/day, maybe I remember seeing one 1mg anastrozole EOD, but that's it). Can you link some that you mentioned here?

In women there is no question about it, but let's not compare a say 30% E2 suppression (men) to a 90% E2 suppression.
plenty of studies showing AI's are horrible for bones, yes males and in trt dosages of test. just check rob kominiarek on youtube, he is a clinitian and there you can see all the research on this.
 

belixxx

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plenty of studies showing AI's are horrible for bones, yes males and in trt dosages of test. just check rob kominiarek on youtube, he is a clinitian and there you can see all the research on this.
Hi,

I am looking but I haven't yet found a video based on which I could find an actual study. Or where he would say what estrogen levels he is targeting when putting men on TRT. Dr Rand Macclain targets 15-20 pg/ml and I have never seen a study that showed bone problems arising above 15 pg/ml.

So I still don't see anything that you should run into problems using an AI as monoteraphy if you monitor your E2 and stay above 15pg/ml.

Also if you do worry, you can always run 60-120mg raloxifene along with it. That being the only SERM I know of not having potential vision and eye related side-effects and proven to effect bone and lipid metabolism in a positive way.
 

Chinese guy

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Hi,

I am looking but I haven't yet found a video based on which I could find an actual study. Or where he would say what estrogen levels he is targeting when putting men on TRT. Dr Rand Macclain targets 15-20 pg/ml and I have never seen a study that showed bone problems arising above 15 pg/ml.

So I still don't see anything that you should run into problems using an AI as monoteraphy if you monitor your E2 and stay above 15pg/ml.

Also if you do worry, you can always run 60-120mg raloxifene along with it. That being the only SERM I know of not having potential vision and eye related side-effects and proven to effect bone and lipid metabolism in a positive way.
in TRT estrogen (E2) is of NO issue, zero. it is healthy, therefore never suppres E2

Ai's and diminished bone density: https://www.youtube.com/watch?v=gxjIZqXMhdw&t=608s
 

belixxx

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in TRT estrogen (E2) is of NO issue, zero. it is healthy, therefore never suppres E2

Ai's and diminished bone density: https://www.youtube.com/watch?v=gxjIZqXMhdw&t=608s
I find that an overly strong statement. Even the doc says in the video he uses it sometimes. He just doesn't prescribe it by default unlike for example Dr Rand Macclain, who can also be found on youtube and claims to have the same amount of patients and credibility. It's the interviewer who says classic media dumb s*.*t like: 'they're evil, viscious, toxic, bad-bad substances that were never intended for use in men'. The doc doesn't, he just said he doesn't prescribe them automatically, as a prophylactic dose, unlike a lot of physicians.

Also that is the same video I found yesterday. That's the one based on which I could find no study, and that contains no information on what E2 levels he targets.

AIs don't cause bone density loss. Overusing them might, but I still haven't read a single study that shows this in men. So if your E2 is say 35 and you use AI's to target the levels of 15-20 no bone loss occurs.
 

belixxx

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This study is done on men:
https://www.ncbi.nlm.nih.gov/pubmed/10902781

" this level of aromatase inhibition does not negatively impact either kinetically measured rates of bone calcium turnover or indirect markers of bone calcium turnover, at least in the short term."

I do remember reading such sentences in more than one studies.

I still couldn't find any that would show a negative effect in men (eventhough these studies tend to not focus on targeting an E2 range like discussed above, they're using a fixed dose, they don't lower it if E2 is suppressed below 10, and still no bone problems...)
 

Chinese guy

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This study is done on men:
https://www.ncbi.nlm.nih.gov/pubmed/10902781

" this level of aromatase inhibition does not negatively impact either kinetically measured rates of bone calcium turnover or indirect markers of bone calcium turnover, at least in the short term."

I do remember reading such sentences in more than one studies.

I still couldn't find any that would show a negative effect in men (eventhough these studies tend to not focus on targeting an E2 range like discussed above, they're using a fixed dose, they don't lower it if E2 is suppressed below 10, and still no bone problems...)
i made a post, but it got deleted i guess.

in the book of the guy amped up, he cites hundreds of research papers on the fact that AI's have on bone density and that guys on trt should never use AI's, dr rob kominiarek and others also say the same.

to each his own, but in trt i am never taking an AI, stay far away from it. E2 high in trt is healthy for myriad of things.
 

belixxx

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i made a post, but it got deleted i guess.

in the book of the guy amped up, he cites hundreds of research papers on the fact that AI's have on bone density and that guys on trt should never use AI's, dr rob kominiarek and others also say the same.

to each his own, but in trt i am never taking an AI, stay far away from it. E2 high in trt is healthy for myriad of things.
Hi again,

I am really not trying to be a douche here, but if I can't find a single research paper on google that would show that AIs used for LH boosting in men have a negative effect on bone density. And you do a quick search yourself and you'll only find about 5 to 10 studies about adult men taking anastrozole, exemestane and letrozole for LH boosting puproses in sum. Then I don't find it at all possible that hundreds showing bone loss could exist, again I would absolutely be happy about finding a single one...

E2 high however is definitley not a positive thing (hint: prostate cancer), it is just as bad as E2 low.

There is a healthy RANGE you should be in. If that doesn't require you to be taking AIs than don't. However that doesn't mean that if you take the right amount of AIs without oversuppressing your E2 than they will cause bone loss automatically, just because they're evil.

Here is a study on AIs in MEN from 2014:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143915/

The last paragraph before the Conclusion:

'In the studies published so far aromatase inhibition in men did not appear to be associated with adverse effects on bone in a number of studies [37,59,82,83], but in a more recent study a decrease of spine BMD was observed after one year of treatment of elderly men with anastrozole [84].'

You can check the listed 4 studies at the end of the linked study that didn't show adverse effects, and also the one with elderly men that did.

My point being with this entire thing here:
AIs aren't either 'good' or 'viscious bad-bad' substances. If you can get by without using them than feel free to do so. If you can't fine tune your E2 without them than by all means feel free to do so, if you monitor that you don't overdo it, than nothing bad will happen.

This I also believe to be true in the case of monotheraphy, where you use them basically as a testosterone booster. I don't see a way where you can use them without controlling the results with bloodtests. But I don't see the harm if you use them properly...
 

Chinese guy

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Hi again,

I am really not trying to be a douche here, but if I can't find a single research paper on google that would show that AIs used for LH boosting in men have a negative effect on bone density. And you do a quick search yourself and you'll only find about 5 to 10 studies about adult men taking anastrozole, exemestane and letrozole for LH boosting puproses in sum. Then I don't find it at all possible that hundreds showing bone loss could exist, again I would absolutely be happy about finding a single one...

E2 high however is definitley not a positive thing (hint: prostate cancer), it is just as bad as E2 low.

There is a healthy RANGE you should be in. If that doesn't require you to be taking AIs than don't. However that doesn't mean that if you take the right amount of AIs without oversuppressing your E2 than they will cause bone loss automatically, just because they're evil.

Here is a study on AIs in MEN from 2014:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143915/

The last paragraph before the Conclusion:

'In the studies published so far aromatase inhibition in men did not appear to be associated with adverse effects on bone in a number of studies [37,59,82,83], but in a more recent study a decrease of spine BMD was observed after one year of treatment of elderly men with anastrozole [84].'

You can check the listed 4 studies at the end of the linked study that didn't show adverse effects, and also the one with elderly men that did.

My point being with this entire thing here:
AIs aren't either 'good' or 'viscious bad-bad' substances. If you can get by without using them than feel free to do so. If you can't fine tune your E2 without them than by all means feel free to do so, if you monitor that you don't overdo it, than nothing bad will happen.

This I also believe to be true in the case of monotheraphy, where you use them basically as a testosterone booster. I don't see a way where you can use them without controlling the results with bloodtests. But I don't see the harm if you use them properly...
hundreds of studies proving this, just listen to rob kominiarek and read the other guys book. no AI's for me thanks
 

hoodstark

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Experience

Hi. Some background but I feel I have something I can add here that may help some folks. I am on clomid for hypogonadism. Clomid for the most part worked wonders for me. Test total 260 to 640. Free 10 to 15. Also the overall increase in energy associated with such. BUT...

It has caused some EXTREME joint pain for me. Not a lot of research of using this off label so doc doesn’t really have any explanations. I am very in tune w my body and this joint pain got to the point I had to stop taking it. After that joint pain disappeared. As amazing as this drug is this just goes to show we still need some research done for using it off label.
 

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