Recovery Log!! (in HM ONLY)

Nov 12th lab results:

Total T: 11.6 nmol/L (trough)
LH: 2.9 IU/L 1.0 -- 7.0
FSH: 1.9 IU/L 1.0 -- 8.0
Estradiol: 80 pmol/L

SHBG: 16.6nmol/L 10 -- 70


Comments:
These are pretty interesting results. It seems like I am getting some LH, FSH even taking testosterone gel which shows estradiol is more supressive to the HPTA than testosterone. This also goes against bro science that says you will have zero gonadotrophins when you take exogenous testosterone.

Estradiol at 80pmol/L is pretty much perfect that's around 21pg/ml on the American scale.

My SHBG has increased from mid 14s to mid 16s which is encouraging since I've been taking Metformin for high fasting blood sugar and it could indicate my low SHBG is indeed due to insulin resistance.
 
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That lab test was on,
10g Testim
0.25mg Anastrozole
5mg Tamoxifen m w f
500mg Metformin daily
No refined sugar for two weeks
 
Does the gel/ tamoxifen/arimidex combo feel better than just being on gel?

Subjectively.... im not sure. lol.

I am thinking of switching to ultra low dose injections like 8-10mg 2-3X per week since the gel is barely absorbing. And continuing to take Anastrazole and Tamoxifen.
 
This is the 6 month plan:

Goals are,
1. To get my endogenous production going again
2. To fully restore fertility and maintain it on Tamoxifen ONLY
3. To slowly come off replacement rather than "jolting" myself off after 6+ years. This approach will be easier on my mind and body and hopefully by the time I get to Tamoxifen only phase my body will be used to producing it's own LH and FSH for bunch of months so it will be a seamless transition off treatment (versus shock to my system)

Four months;
Dec Jan Feb March
Ultra low dose T/Anastrazole/Tamoxifen;
Combination of exogenous testosterone and some endogenous LH FSH

Two months;
April May
Beta Hcg/Anastrazole/Tamoxifen;
Get my testicles fully going again

One month;
June
Tamoxifen ONLY
Endogenous production only

Ongoing;
July onwards
Tamoxifen maintenance 2X per week
Restore and maintain fertility for 5 years; allow my body to re-establish homeostatis with endogenous production. Take cialis, horny goat weed, and other supports for sexual function while I recover. Expect this phase to be at least 6 months, maybe upto a year.

Timing here is setup so I am completely off exgoneous hormones in summer of 2017; which is important because coming off treatment in the winter is a fucking bitch.
 
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This study Dr Scally posted is a reminder of why I am taking Tamoxifen right now, and why I am trying to transition off TRT. After a certain amount of time on and also my age (mid-30's) it may be more difficult to regain my fertility and sperm count and mobility.

I never thought fertility would be important to me or I would care but these days I am thinking more about it and I think at some point I would like to father children. Or at least one kid lol

Kohn TP, Louis MR, Pickett SM, et al. Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy. Fertility and Sterility. http://www.fertstert.org/article/S0015-0282(16)62919-9/abstract

Objective - To determine factors that influence sperm recovery after T-associated infertility.

Design - Clinical retrospective study.

Setting - Academic male-infertility urology clinic.

Patient(s) - Sixty-six men who presented with infertility after T use.

Intervention(s) - T cessation and combination high-dose hcg and selective estrogen modulator (SERM) therapy.

Main Outcome Measure(s) - Whether patients successfully achieved or failed to achieve a total motile count (TMC) of greater than 5 million sperm within 12 months of T cessation and initiation of therapy.

Result(s) - A TMC of greater than 5 million sperm was achieved by 46 men (70%). Both increased age and duration of T use directly correlated with time to sperm recovery at both 6 and 12 months of hCG/SERM therapy. Age more consistently limited sperm recovery, while duration of T use had less influence at 12 months than at 6 months. Only 64.8% of azoospermic men achieved a TMC greater than 5 million sperm at 12 months, compared with 91.7% of cryptozoospermic men, yet this did not predict a failure of sperm recovery.

Conclusion(s) - Increasing age and duration of T use significantly reduce the likelihood of recovery of sperm in the ejaculate, based on a criterion of a TMC of 5 million sperm, at 6 and 12 months. Physicians should be cautious in pursuing long-term T therapy, particularly in men who still desire fertility. Using these findings, physicians can counsel men regarding the likelihood of recovery of sperm at 6 and 12 months.
 
Current Protocol
12 mg T cyp 2X per week
Anastrazole 0.25mg 1-2X per week
Tamoxifen 5mg m w f

Metformin 500mg (for insulin resistance, low shbg)
No refined processed sugars in my diet i.e. no cakes, donuts, cookies, sweets etc.

Sam-e 4000mg
Fishoil 8grams
Vitamin d3 2000mg

New additions
Vitamin c 1000mg X2 am, pm (to support adrenals)
I am looking into adding DHEA 50mg as well due to my low dhea-s and low a.m. cortisol.
 
Does the gel/ tamoxifen/arimidex combo feel better than just being on gel?

I have experimented with not taking tamoxifen for few days and then re-adding it and I do think I feel "healthier" with the tamoxifen in this protocol versus T only. This may be PURELY psychological but judging from my LH and FSH it IS doing something. Also my boys seem to hang lower when I take tamoxifen.

Again, this might and probably is COMPLETELY psychological but it will be interesting to see my next blood draw in December to see if my gonadotrophins have risen anymore on the combo or if they the same or have decreased.

As for Anastrazole I am now MICRODOSING it.

I started at 0.25mg (1/4 tablet) then I went down to 0.125mg (1/8th tablet) now I basically take just a SLIVER of it every three days so it's just a super tiny amount.

This shit is powerful and I was finding even the 1/8th tablet was too much.
 
Current Protocol
12mg T cyp 2X per week Sun, Wed
Tamoxifen 5mg 3X per week Sat, Tues, Thurs
Anastrazole 0.125mg X2 per week

Sam-e 4000mg
Fishoil 8g
Vit d3 2000ius

Metformin 500mg
No refined or processed sugars

Recently added,
Vitamin c 2000mg X2 daily
Multi-vitamin with Iron


I feel decent on this protocol. Especially the days I dose Tamoxifen.

I plan to stay on this for 4 months until April 2017.

The next phase of the plan is substitute out the 12mg T cyp with 500ius Hcg at the same dosing frequency. And keep everything else the same. Do that for a few months and then stay on the Tamoxifen only for 30 days and then Tamoxifen maintenance 2-3X per week.

I am basically baby stepping this recovery to minimize the impact on my life.
 
It feels like the Tamoxifen is not working anymore.
This will be proven or disproven through blood tests but like, I am not feeling the same subjective good feeling I was getting from it anymore.
I would feel good and calm and stronger and some other testosterone symptoms when I dosed it. And lately im not feeling those things. Also my testicles seem much smaller.

Maybe it was too much to expect it to work while on exgoneous T.

Will see what the next bloodwork says.
 
I definetly think Tamoxifen has stopped working to boost my natty T. :(

Will see what LH FSH shows on the next blood work to confirm or deny this fact.
 
The combination of testosterone undecanoate with tamoxifen citrate enhances the effects of each agent given independently on seminal parameters in ... - PubMed - NCBI
"Tamoxifen citrate plus T undecanoate treatment produced a satisfactory improvement of total sperm number, motility, and functional sperm fraction after 3 and 6 months."

In this clinical study they used Tamoxifen at 10mg X2 per day.

Therefore, I have upped my Tamoxifen dose from 5mg EOD to 10mg DAILY.

Protocol is,
12mg T cyp 2X per week
10mg Tamoxifen DAILY at bedtime


I am hoping this will help maintain some natty production.
 
New bloodwork
Tuesday December 27 2016

LH 2.6 1.0-7.0 IU/L
FSH 2.0 1.0-8.0 IU/L
Estradiol 52 <162 pmol/L

I am still waiting on Testosterone and SHBG.

My protocol 10mg T cyp injections (eod) + 0.25mg Arimidex/week + sporadic Tamoxifen.
 
Ok full blood work results;

Testosterone 15.3nmol/L
SHBG 15.6 10-70 nmol/L
LH 2.0 1.0-8.0
FSH 2.6 1.0-8.0
Estradiol 52 <162pmol/L

Surprised I have some gonadotrophin activity when my T is that high.

My SHBG was 16.6 on my last blood work so it's dropped a bit which sucks. I've made a shit ton of lifestyle changes so I was hoping this value would be higher.
 
Update!!
I am adding 1000ius Beta Hcg per week to get my testicles going again.

Protocol
Jan/Feb/March
0.25mg anastrazole
1000ius Beta Hcg per week
10mg T injections 3X per week

April/May
Discontinue testosterone

0.25mg anastrazole
500ius Beta Hcg per week
5-10mg Tamoxifen mon wed fri

June
Discontinue Beta Hcg

Icariin 60% 3-5cps per day
10mg Tamoxifen daily 30 days

July onwards
Tamoxifen 10mg maintenance 2X (indefinetly)


That's it!!










 
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