Yes, SERM only can work. Do labs to see what it is doing and note the success criteria.
We see guys with oddly different things often enough. Perhaps your body is more sensitive to fT3.
Would be good to see that the thermometer also has expected results with another health person.
I have no further suggestions re dosing. However with labs one can adjust doses up/down or quit.
I’m going to just stay the dosing you recommend for Nolvadex in the HPTA Restart thread, and I’l get my labs drawn in a few weeks to see what’s going on. Can I come back to you for advice depending on what my labs show down the road?
KSman, I’ve been on 20mg Nolvadex for two weeks now, and my latest labs showed no change whatsoever. Actually, my total T has decreased, down to 69 ng/dl.
I’m thinking maybe my testes aren’t up to the job of making testosterone at the moment, and that I should try a few weeks of HCG first.
Just really quickly, based on my labs showing I don’t have an iodine deficiency, what could be causing my hypothyroid state?
How long should I taper off the Nolvadex before I start HCG? Do I even need to taper given that nothing has happened?
From the compounding pharmacy at the hospital close to where I live. I don’t think there’s something wrong with the potency of the actual prescription, since this is the stuff they give to cancer patients.
This is a diagnostic opportunity, assuming the Nolvadex is good.
n this case, you can test LH/FSH. If low, the hypothalamus/pituitary is dysfunctional. If LH/FSH is good, testes are dysfunctional. Or try hCG and if that does not work, testes are dysfunctional.
Thyroid: fT3 is low, rT3 is getting interesting.
If you take T4 meds, you may get more T4–>rT3 which would be counter productive. In that case, T3 meds would be best.
Please read the thyroid basics sticky re rT3 issues and treatment
So SERM increased FSH but not LH?
That is odd.
Just so you know, elevated FSH can be from a testicular cancer. It TRT is started, its a stronger sign as FSH and LS should to to near zero. FSH producing pituitary adinomas are rare.
Note that LH is released in pulses with a short half life. So there is the possibility that average LH is better than detected.
Will be on the road. My coverage here may be thin.
That is seriously worrying! I had high FSH levels before I took Nolvadex though.
Are you suggesting that I take thyroid medication too? I understand the connection between rT3, T3, and T4, but I just don’t know what you meant by “interesting”.
Well, I do feel like shit, THAT’S for sure! Are my reverse T3 levels really all that high? It seems like my fT3 is already so low that it doesn’t matter, but maybe I’m misunderstanding this.
@KSman, I found a GOOD endo, FINALLY. He’s a neuroendocrinologist, and he thinks the root cause of what I’m experiencing is my thyroid (as you had suspected).
He’s put me on cytomel, 37.5 mcg BID, and he also wants me to take Clomid. The dose he prescribed for the Clomid is 50 mg EVERY DAY though, and that seems WAY too high, given everything I’ve read.
That is a very high dose of clomid, but you reported not responding to novladex… For someone else, I’d suggest lowering it, but with you, I’m not sure that’s the best course of action…
Watch for adverse effects of clomid, it is not for everyone.
Nolvadex did not work? While on a SERM, test TT, FT, E2, LH/FSH. If LH/FSH do not get up, your hypothalamus+pituitary are not in the game.
T3 meds. Watch your body temperatures. You could get too warm and feel agitated. That is a fast acting drug. I get a compounded time release product and see to be good with a morning dose.
Your rT3 was normal, but not low. So it was having some effect. As you take T3, TSH should be driven down and T4 would be reduced, reducing T4–>rT3. As rT3 is reduced, your fT3 has a greater effect. So you can expect that your T3 medication might have an increased effect and should be watching for effects of that. I have 5mcg time release T3 caps and can take multiples to find out what works best for me. I had been taking desiccated thyroid meds [T3+T4] and they did not work, from there we suspected rT3 causing problems. I do not have a good feeling about 37.5 mcg fast release dosing. Can you cut the pills if need be?
Getting thyroid fixed might help with your primary hypogonadism.
.