Hi, It's been a while since I posted. My Dr. started me on a regimen of clomid for 1 month - mg 3x week - then had me swithch to HCG for 3 months (500iu 3x weekly. I did quite well on the HCG. My testicles started to grow larger and I felt much better - had much more energy, thoughts were clearer, etc. Now, after the 3months on HCG he has put me back on Clomid (25mg 3x weekly). His rationale is that he does not want my body to become desensitized to the HCG. For the past two weeks since I've been on the Clomid I have been in a fog, unable to think clearly and have felt totally drained, absolutely no energy or sex drive. Today has been the first day that I have felt well - the brain fog began to lift some this afternoon.
Has anybody else delt with this? Is my doctor's reasoning about becoming desensitized to the HCG at 500 ius 3x a week sensible or is he just being over cautious?
I go to see a new Endo on Fri. July 11th and am trying to get on cabergoline (have very high prolactin). Will be having new labs done then and possibly a new MRI to see if have a prolactinoma (last check was 2 1/2 years ago with nothing detected). Will post the results when I get them.
Any help with the Clomid/HCG thing would be appreciated.
I think he is being over cautious. That said, he sounds pretty good. He is using very reasonable thinking to try to restart you. However, the high prolactin is probably a huge issue. You don't say how high but that is likely the root cause of your issues. My advice is to stick with this doctor and tell him your feelings about the HCG if necessary. He is much closer to the cutting edge than 99.9% of the doctors out there. What is his name and city?
From what you guys have experienced and heard, how effective is HCG monotherapy for most people? Does it tend to wane after awhile similar to what androgel can do? Is there anyone out there that has taken HCG consistently for a long term and had it work great with no hiccups? Is it used more for short term "restarts"? It seems that many of you after awhile have had HCG and Tcyp shots combined together in doses. Is this a correct observation? Give me some of your war stories and/or success stories relative to HCG. The reason I am so interested is that I am seeing Shippen soon and imagine that he will want to try to something with HCG from the start unless a red flag from somewhere else comes back on my blood work which I should have on Monday and will send out to you guys...Your stories/experiences really have helped me during this difficult period.
Also, one thing I forgot to mention in my earlier posts is that from age 13-22 I was extremely active. I played a collegiate sport in college and ran/lifted weights 4-5 times a week at a very, very high level. I was in extremely good shape. For the last 3-4 years I have basically been consumed with work, stress and have put on probably 30-40 pounds with the past 3 years. To say the least I rarely work out anymore and/or have physical activity. I have had probably 2-3 people tell me that if they had to bet money, they would bet that my low t stemmed from something to do with me being in such good shape, strong and working out at such a high level to basically now being sedentary and having seldom physical workouts and/or physical activity. Basically they say I went from one physical extreme to the next. What is everyone's thoughts on this? If this could be the case, what would a potential solution/remedy for this be c/o medicine? Could my T be reversed back to higher numbers if this is the case assuming I start working out again like a trojan mule? Sorry for the long post but everyone's comments have really helped me get thru day to day thus far. Please comment on everthing above if possible....Thank you.
I'm seeing Dr. James Biddle in Asheville, NC - he practices Integrative Medicine and is very open minded.
As for the prolactin - as of April it was at 74.1 (down from 102 this time last year).
Estradiol was 2
Testosterone, Total 248 (highest its been in about 2 years)
Testosterone Free 2.36
Free Testerone 58.5
As said, these levels are all from April. I am having new labs done when I see the Endo next week and will post those when I get them.
Do you think that the mental haze and fatigue could just be an adjustment period with the Clomid? I will be asking the Endo what he thinks when I see him (have been told by others that he is pretty open minded). I know that the Prolactin is definitely a problem and wanted to try the HCG treatment to get things started before taking anything else.
My doctor is deliberately keeping me off of Testo and wants to use it only as a last resort. He feels that someone my age, 41, should try other means before having to take the testo the rest of my life, thus the Clomid and HCG.
Just a question, has anyone ever tried taking the two of these together? I did a little experiment while on the HCG of taking 25mg Clomid 1X week for 3-4 weeks and noticed a marked improvement (had some extra Clomid left and decided to see if it would help).
I was only on the Clomid for 3 months, but really did notice a difference. Had been on Testo for about 1.5 years about 5 years ago and took myself off due to side effects (night sweats, irritability, increased agression). The Testo shrunk my testicles and did not solve any problems. I went to my current doctor after moving to NC, and a run-in with a very closed minded Endo, to see if he could help restart my system. The combo of HCG and Clomid have caused growth in my testicles, they are not back to where they originally were but they are larger. My feeling is that they are also producing more T, I say this because I feel much better than I did before I started the treatment. This will really be seen when I do my labs next week.
As for the decrease in physical activity with you, it probably could play a small part, but I doubt that it is the whole thing. I know others who took desk jobs after being very active and they did not become Hypogonadal. Stress is definitely a killer for Testo and you said that you have plenty of that as do I. For you, as with most of us, it is most likely a combination of things that has caused your symptoms, it just a matter of finding out what these things are. For myself, I did not know that I had high prolactin or that it would lower my T. My doctor spent time to try and find out if the prolactin was high just because my T is low or if the the T was low because my prolactin is high. I believe that we've narrowed it down to the prolactin being the cause. My Dr. then decided that it would be good to try to restart the system ahead of my seeing a new Endo to give me a head start if the Endo decides to put me on cabergoline for the prolactin (the testes are generally the last thing to come online when restarting the HPTA so he wanted to give them a headstart).
HRT and Ishwardas. Very interesting posts by both of you. HRT, Everyone looks for reasons as to why this has happened to them. Almost none of us ever know the real answer. I understand your suspiscion of very physical to sedentary lifestyle but I doubt that is the real cause. I know there are people who can use HCG alone, but sadly they seem to be a minority. My suggestion is to try it and if it is not working after various dosing changes after about 3-4 months then tell Dr. Shippen you can't wait anymore to feel normal and you want to add T to the mix. It took me six months to get to that point. Maybe you will be lucky and it will work for you without any additional T.
Ishwardas, it is quite common to use clomid and HCG together to restart. Your doctor is very progressive, maybe you can just give it a try and tell him you feel great on that protocol and ask if he can keep you going in that direction for a bit. I think the normal course is to remove the HCG first and then the clomid but to be honest I"m not sure. Maybe someone who has done a restart can chime in. By the way, prolactin is known to suppress the hypothalmus from stimulating the pituitary to send LH. So it is well known to cause low T.
Hayfarmer you said that you were on HCG monotherapy per Shippen for approximately 6 months initially then he started adding in T into the mix. How long after he started adding the T into the mix did it take you to get your T levels stable and your symptoms eliminated?
By the way exactly what were your symptoms before seeing Shippen? Fatigue, ed, low libido, brain fog, etc?
How about now....Now that you and Shippen have found what works best for you and your dosages stablized are you still having issues with low libido, fatigue?
My main concern is low libido...I am desperate to get this taken care of. I feel confident that if I can get the libido back the ed will take care of itself.
Not trying to get too in depth into what your problems were, just curious as I am anticipating the doctor trying to treat me in a similar manner.
I had been on androgel for 4 years before seeing Shippen. WHile on androgel I had long periods lasting from weeks to months where I had Ed issues and low libido. Other times I was fine.
After combining T cyp and HCG things improved pretty quickly. Within a month. It is still not perfect. Libido is the holy grail of TRT. Mine is still not that great at times. But, the ED is much much better. Once I get going there is a much lower chance of any ED issue. I have never had any significant fatigue issues even before any treatment when T was as low as 98 (thats total T). I did have brain fog issues but they have been resolved whether on androgel / HCG mono / or HCG and T cyp combined. Everyone is different
Just wanted to give an update.....Went to see the new Endo today - he seems to be very good. He agreed with my Dr. using the Clomid and HCG to try to restart, but feels that the Prolactin levels are too high (74.1) so has put me on Cabergoline (0.5mg twice a week). He wants me to "put the clomid on the back burner for now" and just use HCG (500 units 3x week) in conjuction with the CAB. He told me that he feels that that the HCG will help me more since the Clomid is basically not going to do anything but effect spermatogenisis and that we could add it back in at a later date in conjuction with the HCG if necessary.