so I've recently started clomiphene citrate cycle for 12 weeks with an anastrazole - after 4 weeks of using, my testosterone got to 37,40 nmol as well as my E2 got elevated to 56.12 pg, I currently do 0,5 mgs of anastrazole twice a week with 25mg of clomiphene every other day; my real question is, why do I not feel any drastic changes, even though my test is above the reference range? could it be that my SHBG is too high or maybe a prolactin issue? I've had hyperprolactinemia in the past, though i was a lot fatter and had significantly more bodyfat percentage
I am a 23 year old male, 185 cm and 75 kg, bodyfat around 20%
Hi Freeoxo!
Your testosterone being 37.4 nmol/L (~1,080 ng/dL) doesn’t automatically mean you’re going to feel dramatically different. Serum total T is only one piece of the picture, and chasing a higher number is often where people start treating the laboratory instead of the person.
In your case I’d want more information before touching anything: SHBG, calculated/free testosterone, prolactin, LH, FSH, sensitive E2, TSH/FT4, CBC, liver markers and lipids, plus what symptoms you were actually trying to correct before starting clomiphene.
Also, don’t automatically assume E2 at 56 pg/mL needs to be crushed. Clomiphene can raise both testosterone and estradiol, and 0.5 mg anastrozole twice weekly is already significant enough that I wouldn’t increase it blindly. Estradiol that gets pushed too low can make libido, mood, joints and general wellbeing worse rather than better.
Your previous hyperprolactinemia is particularly relevant, so yes, repeat prolactin properly rather than guessing from your body-fat percentage.
At 23, I’d be especially interested in why you needed this intervention in the first place. Post the pre-treatment bloodwork alongside the current panel and describe the original symptoms. That comparison will tell us far more than a testosterone number above the reference range.
Shark
