Changes in Serum Testosterone After Sublingual Enclomiphene Citrate Combined With a Mineral Oxide Delivery System: A Retrospective Case Series of 15 Men.

Warren S

Cureus20 May 2026

PMID42170362PMCIDPMC13189365DOI10.7759/cureus.109299PepBankPUB-42170362

Summary

Background Declining testosterone levels in adult males represent a significant clinical burden. Conventional testosterone replacement therapy (TRT) with exogenous androgens suppresses the hypothalamic-pituitary-gonadal (HPG) axis, causes testicular atrophy, and impairs spermatogenesis, outcomes that are unacceptable for many patients. Enclomiphene citrate, a selective estrogen receptor modulator (SERM), stimulates endogenous gonadotropin release and has been studied as an alternative to exogenous TRT. Objective This study aims to describe 60-day changes in serum total testosterone in 15 adult men treated with a compounded sublingual formulation, TBooster 365 (Best 365 Labs, Salt Lake City, UT), containing enclomiphene citrate 25 mg, boron 10 mg, vitamin C 10 mg, spermidine 10 mg, and the MODS MAX mineral oxide delivery system per 1 mL dose. Methods This is a retrospective case series of 15 consecutive adult male patients with symptomatic hypogonadism, enrolled regardless of baseline total testosterone level, treated at a single private longevity medicine practice located at an elevation of 4,500 to 5,500 feet. All blood draws were fasting morning samples analyzed at reference laboratories by liquid chromatography tandem mass spectrometry (LC-MS/MS) or immunoassay. The primary outcome was the change in total serum testosterone at 60 days. Results All 15 patients demonstrated increased total testosterone at 60 days. Mean total testosterone increased from 347.0 ng/dL to 805.0 ng/dL (mean change: +458.0 ng/dL; 95% CI (326.3, 589.6); t(14) = 7.46; p < 0.0001 by paired t-test; Wilcoxon signed-rank W = 0, p = 0.0001). The paired-samples Cohen's dz was 1.93; the pooled-SD Cohen's d was 2.37. The mean body weight change across the cohort was -0.5 lb (range: -40 to +15 lb), with individual patients gaining, losing, or maintaining weight without a standardized diet or exercise protocol. Sensitivity analyses excluding the largest responder (Patient 4, who was also on concurrent GLP-1 receptor agonist therapy with substantial weight loss) and restricting to patients with a body weight change of 10 lb or less both preserved the primary finding (dz 2.35 and 2.31, respectively). No serious adverse events were documented during the 60-day period. Conclusion In this retrospective uncontrolled case series of 15 symptomatic men, a compounded sublingual protocol containing enclomiphene citrate, boron, vitamin C, spermidine, and MODS MAX was associated with increased total testosterone after 60 days. Because the study lacked a control group, standardized symptom assessment, luteinizing hormone (LH)/follicle-stimulating hormone (FSH) measurements, and long-term safety monitoring, causality, clinical efficacy, fertility preservation, HPG-axis effects, and the independent contribution of MODS MAX cannot be determined. Prospective controlled studies are needed.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study3

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone3

In this study, Enclomiphene was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Enclomiphene.

01HumanNot a test of Enclomiphene aloneCase report or seriesEfficacy outcome
In symptomatic men, TBooster 365 containing enclomiphene, boron, vitamin C and spermidine was associated with increased testosterone after 60 days.
In plain wordsIn symptomatic men, TBooster 365 containing enclomiphene and other active ingredients was linked to higher testosterone after 60 days.
Peptide
Enclomiphene
Outcome
IncreaseTotal testosterone
Study
n = 15
Analysis
Primary
Outcome group
Sex hormones and fertility · Endocrine and hormones
Measurements
Baseline testosterone
347 ng/dL
baseline
Testosterone
805 ng/dL
60 days
Mean change
458 ng/dL
60 days
Mean change 95% CI
326.3 to 589.6 ng/dL
60 days
Source sentences
Summary
Mean total testosterone increased from 347.0 ng/dL to 805.0 ng/dL (mean change: +458.0 ng/dL; 95% CI (326.3, 589.6); t(14) = 7.46; p < 0.0001 by paired t-test; Wilcoxon signed-rank W = 0, p = 0.0001).
3 context sentences(design, population, supporting numbers)
Summary · context
The primary outcome was the change in total serum testosterone at 60 days.
Summary · context
Methods This is a retrospective case series of 15 consecutive adult male patients with symptomatic hypogonadism, enrolled regardless of baseline total testosterone level, treated at a single private longevity medicine practice located at an elevation of 4,500 to 5,500 feet.
Summary · context
Objective This study aims to describe 60-day changes in serum total testosterone in 15 adult men treated with a compounded sublingual formulation, TBooster 365 (Best 365 Labs, Salt Lake City, UT), containing enclomiphene citrate 25 mg, boron 10 mg, vitamin C 10 mg, spermidine 10 mg, and the MODS MAX mineral oxide delivery system per 1 mL dose.
In this study, Enclomiphene was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Enclomiphene.
Show in the study text Report a problemFND-4217036201
02HumanNot a test of Enclomiphene aloneCase report or seriesEfficacy outcome
In men receiving TBooster 365 containing enclomiphene and other active ingredients, mean weight fell slightly, with individual gains, losses or no change.
In plain wordsMen receiving TBooster 365 containing enclomiphene and other active ingredients gained, lost or maintained weight.
Peptide
Enclomiphene
Outcome
MixedBody weight change
Study
n = 15
Outcome group
Body weight · Metabolic and weight
Measurements
Mean weight change
−0.5 lb
cohort
Weight change range
−40 to 15 lb
cohort
Source sentences
Summary
The mean body weight change across the cohort was -0.5 lb (range: -40 to +15 lb), with individual patients gaining, losing, or maintaining weight without a standardized diet or exercise protocol.
1 context sentence(design, population, supporting numbers)
Summary · context
Methods This is a retrospective case series of 15 consecutive adult male patients with symptomatic hypogonadism, enrolled regardless of baseline total testosterone level, treated at a single private longevity medicine practice located at an elevation of 4,500 to 5,500 feet.
In this study, Enclomiphene was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Enclomiphene.
Show in the study text Report a problemFND-4217036202
03HumanNot a test of Enclomiphene aloneCase report or seriesSafety outcome
In men receiving TBooster 365 containing enclomiphene and other active ingredients, no serious adverse events were documented during 60 days.
In plain wordsNo serious adverse events were documented during 60 days in men receiving TBooster 365 containing enclomiphene and other active ingredients.
Peptide
Enclomiphene
Outcome
Not applicableSerious adverse events
Study
n = 15
Outcome group
Adverse events · Whole body
Source sentences
Summary
No serious adverse events were documented during the 60-day period.
1 context sentence(design, population, supporting numbers)
Summary · context
Methods This is a retrospective case series of 15 consecutive adult male patients with symptomatic hypogonadism, enrolled regardless of baseline total testosterone level, treated at a single private longevity medicine practice located at an elevation of 4,500 to 5,500 feet.
In this study, Enclomiphene was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Enclomiphene.
Show in the study text Report a problemFND-4217036205

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Version 2Current
21 Oct 2026, 15:58 UTC
Study results updated
Version 1
21 Oct 2026, 12:50 UTC
First added · source update from Europe PMC

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