Peter Attia· MD
in general if you're looking at something longterm I would say typically Clomid or encline which is you know a more Progressive version of the drug all but not FDA approved — neither of those I think are viable longterm at least from a risk perspective you are essentially putting yourself in a position of long-term estrogen receptor antagonism in certain tissues meaning you're going to be missing out on estrogen receptor activity in certain areas of your body that down the line could manifest an array of issues like if you look at the side effects of serms you'll see weird stuff depending on the compound sometimes it's ocular issues or what what do we know about the long-term use of Clomid because that's we've got more data for Clomid than we do encline which is as you said just a very very close derivative of it but they both work the same way they both block estrad the estrad receptor of the hypothalamus correct yeah and then the zuuk chopine component of Clomid which is has two drugs essentially in it because they will have differing effects that component of it is more anti-gonadotropic I believe so it's like something that will — like the en chopine component is far more specific to the serm activity you are seeking in the hypothalamus the zuken is longer halflife less efficacious doesn't even really represent the target therapy of the drug so in general even if if you're looking at cloma that's the only one that has approval so you would potentially have the data but I off the top of my head don't know of any studies that are going decades long to evaluate something like that I don't know if it exists I would be kind of doubtful it exists to be honest but I would think in the from what I've seen at least anecdotally take from that what you will is is typically no one ends up with a stable mood long term or an ability to like it's it's not a sustainable therapy longterm in my opinion for the Vitality component you seek from replacement therapy to begin with so perhaps on paper your testosterone looks good but it's more of a a metric that you're using to justify the drug because you are achieving the target which is look my testosterone's better now but at the expense of literally tricking your brain through inhibiting very very necessary mechanisms so it's not like you are stimulating production through a means that is directly targeted it is more like you are trading off the health of one part of your body to get an outcome that is potentially — ROI justifying in another aspect of your body so at the expense of estrogen receptors working everywhere in the body you're getting more testosterone and is it blocking estrogen receptors everywhere or just centrally yeah it is selective hence serm but it's not perfect as we talked about last time you were going to get — like we could just Google Clomid side effects and you'll see an array of different things I believe including but not limited to skewing of lipid parameters you were the one who taught me about yeah like that's sketchy and like I wouldn't want to have that long term — there's stuff you'd have to track that are very unknown variables at least we kind of know what to expect when you have natural testosterone increasing like what happens at a — you know lipid perspective or a negative feedback perspective or you're not dealing with some I don't know nebulous activity in different tissues and having to account for it so like actual brain inhibition you know is — sketchy to me and from what I've seen people end up — I don't know not in a good State of Mind long term on it but I suppose it's possible you could