Q. I am already on Elevate-T to boost testosterone while preserving fertility. Can I use it with any other meds that will support fertility goals even further?
A. Yes. Low dose gonadorelin or hCG are often used in men on exogenous testosterone to help protect from fertility collapse. But keep in mind that gonadorelin and hCG can also be used to further augment fertility in men on Elevate-T.
Q. I want to get the most out of Elevate-T. Will I get a stronger effect using it on all 7 days of a week instead of only 5 days out of 7?
A. Elevate-T may exert more favorable benefits if cycled 5 days out of 7. The key active ingredient in this formulation is enclomiphene which opposes estrogen receptors in the hypothalamus to induce a cascade of downstream effects. However, whenever a biological signal is present for prolonged periods, it may potentially down-regulate the receptors it acts upon. Cycling the Elevate-T is a best-practice to ensure the medication does not weaken over time.
Q. I understand Elevate-T is preferred over testosterone replacement in men with fertility aspirations, but are there any other reasons why one would opt for Elevate-T?
A. Whilst testosterone replacement can be executed responsibly within physiologic norms, many patients are nevertheless leery of direct hormonal administration. Testosterone is sometimes associated with adverse effects such as elevated hematocrit, increased prostate specific antigen (PSA) and worse serum lipid levels. The enclomiphene in Elevate-T has not been associated with significant serum biomarker alterations. Moreover, Elevate-T tends to boost testosterone within physiologic norms which is less likely to trigger side effects such as acne or hirsutism linked to supraphysiologic testosterone levels.8
Q. You also offer a Test Booster which seems comparable to Elevate-T. Which one is better for me?
A. The SERM used in Test Booster is clomiphene, which is a racemic mixture of both enclomiphene and zuclomiphene. Purified enclomiphene is the sole SERM in Elevate-T. Whereas enclomiphene exerts desirable pharmacological effects, zuclomiphene is responsible for estrogenic side effects. As such, enclomiphene exhibits a more favorable adverse effect profile than clomiphene.2-4 Furthermore, when zuclomiphene was administered in isolation, it adversely affected testicular histology such as Leydig cells, seminal vesicles and epididymis.9 This is echoed in the finding that compared to clomiphene, enclomiphene not only induces a more robust gonadotropin release, but is also associated with an improvement in total motile sperm cell counts.4 The choice of whether to use Test Booster or Elevate-T would also factor in patient preference and cost.
Q. Other than tracking sex steroid hormones and related biomarkers such as SHBG, is it necessary to monitor any other labs with Elevate-T?
A. Since Elevate-T carries less risk than exogenous testosterone for worsening serum PSA, blood lipids, and hematocrit, monitoring these would be contingent upon other concomitant risk factors but would not be deemed mandatory.
Q. My estrogen labs have risen in addition to my testosterone on this med. Should I be concerned?
A. A modest increase in estrogens along with testosterone is nothing to be concerned about. As part of normal physiology, your body will covert some testosterone to estrogen. Enclomiphene (in Elevate-T) generally induces the fewest estrogenic side effects amongst SERMs. It is a misconception that estrogen and testosterone necessarily antagonize each other. When testosterone and estrogen increase in tandem, it may amplify an array of anabolic and libido effects. By itself, estrogen has a weak anabolic effect. But it does play a role in muscle regulation, sensitizing it to exercise stimuli and testosterone’s actions. The increase in estrogen may also have cardioprotective and neuroprotective effects, improve bone mineral density and body composition, and enhance mood and cognition.10,11
