4 Different Ways to Treat Low-T with Nimbus

At Nimbus we want to provide you personalized treatment regimens specific to your unique situation. What makes Nimbus different from other companies is that we go the extra mile for our patients and provide a unique platform that is simply non-existent at other men’s health platforms. For men who are suffering from low testosterone, Nimbus offers more than your traditional or “standard” testosterone replacement protocols which often call for painful injections that are not free of side effects for most men. At Nimbus, we offer a comprehensive approach towards managing testosterone replacement therapy. Nimbus’s standard of care is unmatched and is made from the highest quality pharmaceutical ingredients, compounded in specific ratios and dosage forms, that are most suitable for your preferences and individual lab results recommended by one of our many Nimbus physicians. Today, we will discuss three different ways that Nimbus treats low testosterone, why we believe those methods are better than the typical standard of care, and the potential adverse effects one might want to be aware of when starting a Nimbus hormone optimization protocol.

  Low testosterone ( aka Low-T) or “hypogonadism” is a common occurrence that affects as many as 10-40% adult males overall overall  and has a prevalence of up to 30% in young adult males aged 15-39 years of age.1 It is also estimated that testosterone levels will decrease as part of normal aging, roughly 1% each year after age 30 for most men. As a result, testosterone therapy is an avenue that some men may choose to pursue simply as they get older or even more so if they are experiencing symptoms of low-T that are often a source of anxiety or inconvenience for them.  Some of the symptoms associated with low-T include but are not limited to: increased body fat, decreased muscle mass, decreased sex drive, erectile dysfunction, brain fog, depression, and irritability just to name a few.2 Traditional testosterone presciptions used to address these issues come ina variety of dosage forms namely testosterone gels, creams, and injections. All dosage forms of testosterone must be prescribed by a doctor and after obtaining a diagnosis of low-testosterone from a blood test. LIke any prescription medication, TRT is not without its side effects. Side effects of the typical TRT regimen, specifically the injectable formulations  include fluid retainment, acne, prostate enlargement, mood swings, increased red blood cell production, and even sleep disturbances.3 In addition to the potential side effects, testosterone prescriptions can also be costly as many forms such as gels and injections can cost hundreds of dollars per month if not covered by your prescription drug insurance. At Nimbus, we are aware of all of these issues and have provided alternatives to traditional testosterone gels, patches, or creams. Nimbus utilizes four specific prescription medications to treat low-T in any age group. Those four medications include Clomiphene (Clomid), Pregnyl (HCG, Anastrozole, and Testosterone. We will break down each of these individually. 

Clomiphene

What is clomiphene?

Clomiphene is a prescription treatment that increases testosterone levels by causing the brain to release more FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone). This interferes with the ability of estrogen to block signals to release these hormones to have their desired effect.  FSH and LH are essential for normal testicle function and testosterone production.3  Clomiphene is not FDA-approved as a treatment for low testosterone levels but is used “off-label” by physicians.  Off-label prescribing is the term used when a physician prescribes a medication for a specific condition different from the condition the medication was originally approved for by the FDA. Off-label prescribing is common and approximately 20% of all prescriptions are done off-label. If it wasn’t for off-label use, many prescription medications would not have the reach they do today.  We only use medications off-label when there is high-quality safety and efficacy data available. If there is not enough evidence for its safety, we will not use it for our patients. 

Why is clomiphene part of my treatment regimen?

Your Nimbus testing indicated clomiphene is an effective option for restoring normal testosterone levels because of suboptimal LH levels.  Clomiphene is an alternative treatment option that is effective in men younger than 55 who have low levels of LH.  LH is the hormone responsible for the production of testosterone.  Clomiphene effectively restores normal testosterone levels, especially in men younger than 55 who do not have diabetes, heart disease, or hypertension.4

Is clomiphene effective for restoring normal testosterone levels?

A study looked at clomiphene treatment for 400 men with low testosterone levels who had been on therapy for up to 3 years.  It found that clomiphene treatment restored normal testosterone levels in 88% of the men treated, and 77% reporting improvement in symptoms of Low-T.5  Another study compared testosterone injections to clomiphene and found nearly equivalent levels of symptom improvement and satisfaction.6  Clomiphene is recognized as a viable alternative treatment to testosterone-based therapies.

Are there potential adverse effects from taking clomiphene?

Adverse effects have been reported in 8-11% of men taking clomiphene in clinical studies; however, these are all minor incidents.  Those trials reported fluid retention, breast tenderness, nausea, dizziness, fatigue, visual disturbances, and changes in mood as the adverse effects.5-7

Pregnyl (HCG)

What is Pregnyl (HCG)?

Pregnyl or HCG (Human Chorionic Gonadotropin) is a prescription medication to treat low testosterone levels.  Pregnyl works in the body like the natural hormone LH (Luteinizing Hormone), which tells the testes to produce testosterone. Pregnyl is not FDA approved for increasing testosterone but is prescribed “off-label”.  Off-label prescribing is the term used when a physician prescribes a medication for a specific condition different from the condition the medication was originally approved for. Off-label prescribing is common and approximately 20% of all prescriptions are done off-label. We only use medications off-label when there is high-quality safety and efficacy evidence available.

Why is Pregnyl part of my treatment regimen?

Pregnyl was identified as a viable treatment option based on your age and Nimbus hormone testing.  Pregnyl can help restore normal testosterone levels in men who produce enough LH, but the testes are not responding to that signal.  Pregnyl is also used in men on testosterone who desire to maintain fertility.8

Is Pregnyl effective for restoring normal testosterone levels?

Pregnyl effectively restored normal testosterone levels in testosterone deficient men.  Studies show similar improvement in metabolic markers, blood sugars, and lean muscle mass compared to testosterone therapy.9  Pregnyl is also associated with a lower rate of adverse effects compared to testosterone therapy.10

Are there potential adverse effects from using Pregnyl?

Pregnyl is well-tolerated, but adverse effects have been reported in clinical trials. Headache, restlessness, fatigue, ankle/feet swelling, mood changes, and breast tenderness have been reported.11

Anastrozole

What is anastrozole?

Anastrozole is a prescription treatment that works by blocking the aromatase enzyme.  This enzyme converts testosterone to estradiol (the primary form of estrogen).  Anastrozole is not FDA-approved for low testosterone treatment but is used “off-label” by physicians. Off-label prescribing is the term used when a physician prescribes a medication for a specific condition different than the condition the medication was originally approved for. Off-label prescribing is common and approximately 20% of all prescriptions are done off-label. We only use medications off-label when there is high-quality safety and efficacy evidence available.  

Why is anastrozole part of my treatment regimen?

Your Nimbus Hormone test indicated that estradiol levels were elevated due to increased aromatase activity. Aromatase activity and estradiol levels increase as we age and as our body adipose tissue percent increases.12

Is anastrozole effective for restoring normal testosterone levels?

Anastrozole affects testosterone levels in two distinct ways.  By lowering circulating estrogen levels, anastrozole causes an increase in LH (Luteinizing Hormone) which is the hormone responsible for telling the testes to produce testosterone. 

The second effect is by suppressing the conversion of testosterone to estrogen.  Anastrozole will decrease the estradiol/testosterone ratio by approximately 77%, meaning more testosterone is available to the cells in the body.13

Are there potential side effects from using anastrozole?

The adverse effects of anastrozole therapy occur when estrogen levels are too suppressed.  Estrogen has several different effects in men, including maintaining bone density and several aspects of sexual health, prostate health, and metabolism.14  At Nimbus, we monitor estradiol levels during therapy and adjust anastrozole dosage if estradiol levels are too low.  Other adverse effects that have been reported include stomach upset, bone pains, mood disturbances, and fluid retention.14

Testosterone

What is testosterone?

Testosterone is the principal androgen hormone responsible for the growth and development of male sex organs and secondary sex characteristics in men.  It plays a crucial role in bone mass, mood, sex drive, fat distribution, strength, red blood cell production, fertility, and muscle mass.  Studies have shown that low testosterone levels are associated with an increased risk of early death from all causes and cardiovascular disease.15

Why is testosterone part of my treatment regimen?

Based upon several factors, including your age, medical conditions, and Nimbus Hormone test results, your physician decided testosterone replacement therapy (TRT) was the best course of action to restore normal testosterone levels.  There are several forms of TRT, including troches that dissolve under the tongue, testosterone patches, testosterone gels, and testosterone injections.  At Nimbus, we only use bio-identical hormones, which are precisely the same hormones our body produces.  You and your physician will decide upon the proper delivery mechanism as each has their own unique benefits and drawbacks.

Is testosterone therapy effective for restoring normal testosterone levels?

Multiple studies have shown that TRT is effective in restoring normal testosterone levels.  TRT therapy also improves the quality of life, muscle mass, muscle strength, symptoms of depression, and low libido associated with low testosterone levels.16,17

Are there potential adverse effects from using testosterone?

Using bio-identical hormone therapy and monitoring testosterone levels minimizes the chance of adverse events.  At Nimbus, our goal is a testosterone level of 600-800 ng/dL.  The negative effects of TRT typically occur when testosterone levels occur beyond our natural range.  This is especially true for testosterone injections which cause the most prominent peaks in testosterone levels. Side effects include fluid retention, increased blood pressure, prostate growth,, mood disturbances, testicular shrinkage (injections when used without Pregnyl), signs of estrogen excess (injections when used with anastrozole), increased red blood cell counts, burning at the injection site (injections), skin itching (patches), and skin rash (injections/patch).

Aria Hastings

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