Height: 6 foot
Waist: 35 inches
Body fat: Around 18%
quite a lot of hair on arms, lot of facial hair, grows quickly
lower abdominals, love handles, puffy nipples which at higher BF levels looks like gyno. This has never changed.
low energy, brain fog, sometimes anxious/depressed/lacking mental clarity/ ability to concentrate, feel like it is harder to lose fat and hard to put on muscle. Not on any other drugs. Never taken steorids/prohormones. Have no issues with feeling cold or tolerating cold. I usually feel hot and have night sweats in bed reguarly. I have low libido but can get and maintain an erection, this seems to vary though and sometimes i really do not feel like having sex. This is the reason i went to my doc in Sept 2016 who found i did have low T and then referred me to a Urologist who gave me a full horomonal panel which found i have low E and Free Test.
- I drink alcohol on average once every 1.5 weeks fairly heavily (5- 10 drinks) for the past 10 years. This has mostly been vodka. I have probably had around 25 beers in the past year, the rest vodka.
- Diet is usually low carb, with occassional binge on ice cream (once very weeks). For example, 2 eggs breakfast, salad at lunch usually with nuts then chicken or grass fed steak and vegetables at dinner. I was taking fish oil (flameout) for a few years but stopped around 6 months ago, have been doing so for the past month. I use iodized salt but often dont eat my own food. My diet has at times in the past year been intermittent fasting and eating a relatively low fat diet. I have recently (past month) started to eat eggs every day in an attempt to ensure i am getting cholestirol. I get several portions of veg every day, rarely eat fruit. i have recently (past month) actively tried to eat fish more often. I am not sure if i get enough iodine or selenium. I take 3000 IU vit D every day and calcium. I take ZMA have night and have for the past 12 months. I do not eat a lot of dairy or farmed fish, so not sure xenoestrogens are an issue for me (or at least one i can influence). I am gonna try and get organic greek yoghurt if i do eat dairy again in the near future to avoid xenoestrogens, i try and do this with steak and chicken too. I take pro-biotics as i had a concern about that influencing mood and i do not take ny foods with naturally occuring pro-biotics in. I take these every morning on an emtpy stomach, before i take spike shooter energy drink. I am worried spike strips my stomach of gut cultures. i have had spike on average half a can 3 days a week for the past 6 months - with a week off when i have been on holiday about 3 or 4 times. I do drink out of plastic containers usually, as i cant be fucked to use glass all the time. Also note, i have always had a relatively high body fat, i have gotten to sub 10 which involved CV every day (was cycling to work), weights 3-5 times a week and a reasonable diet/limited binging.
- An average of 5 cigarettes a week for the past 6-12 months. I tend to smoke when i drink. Trying to give this up and have certainly lowered this in the past month.
Lab results with ranges:
- Blood pressure - normal - 110/72
In Sept 2016 in afternoon (was drinking and smoking a lot at this time):
- TOTAL T: 168 CL - range - 300-900 ng/DL
- FREE T: 26.8L - range - 47 - 244 pg/ML
Oct 31st 2016 (ranges)
- FSH - 3.7 (1.5 - 12.4 mIU/ml)
- LH - 5.5 (1.7-8.6 mIU/mL)
- Prolactin - 6.1 (4.04 - 15.2 ng/ML)
- Estradiol - LOW 14.85 - (23.8 - 60.7 pg/ML)
- Total Test: 438.6 (249 - 836 ng/DL)
- SHBG: 48.1 (16.5 - 55.9 nmol/L)
- Free Test Index (FTI) 31.6 LOW (35 - 92.6 index)
- TSH: 1.08 - 0.27 - 4.2 uIU/ML)
- Vit D was reported as low (annoyingly lost these lab results)
- Vit B reported within range
- Cholestirol/blood pressure/calcium/kidney and liver function all within range
- weight train 5 or 6 times a week. I do legs a couple of times a week which involves lunges, glute bridges, pull throughs (no squats/DLs due to injured back in past few months). Rarely have a week off but recently did when back was injured. I often take Spike energy drink before training else i struggle wake up and it makes it super easy to get "warm enough to train" (i train at 6am every morning)
I fall asleep early between 8:30 and 9:30 pm and sleep through til 5:30am
Testes never ache, but i have a varroceil vein. Had scan to confirm. Tetes never ache.
Happened last week but i don't recall that for the past few months. Libdio definitley lower than when i was younger but no marked decrease in past 10 years. Can get and maintain erection but often desire is not there to have sex. Have sex about once per week with mrs who says it is not enough.
- Increase libido, ensure good sperm count, reduce brain fog/tiredness/anxiety. I want to feel awesome.
- I am wondering whether low T is hampering my gym gains and making it harder to lose fat
The approach is:
- Doc has prescribed 25mg daily Clomiphene for 30 days - TRT not an option as i want to have kids. I am worried about sides - specifically increased E leading to depression etc. He says if this does not work we need to treat varicose vein. After 30 days i have another blood test.
- He also wants me to get my blood pressure done again next week.... so after one week on Clomiphene
- Even though he has already prescribed... we are still awaiting sperm analysis from the fertility clinic. I want to have kids in a few years.
DOC made no mention of the folllowing... these are my thoughts
- taking milk thistle due to concern about liver
- Drink less (2 drinks per week max), stop smoking
- Get Vit D levels up - they have been "low" since Sept (test again in one month)
- I took 25 mg yesterday, had a great gym session today but feel "anxious"
- Am considering taking the 25mg every other day
- Am going to taper off the clomid by reducing from every other day to every 3 days towards end of the 30 days, then take one half tab after 5 more days then stop. Thus I will be left with extra clomid.
- Do I have T tunnel vision, should i even bother with a SERM? I know I need to reduce my alcohol and smoking, but i really doubt how much that will increase energy/libido/gym performance. I also have to get my vit D levels up.
- Should I take the Clomiphene? Obviously the sperm results are a big part of this, it doesnt seem manay people have had an improvement in brain fog etc on this, but have imprvoed in the gym and some peeps have oestrogenic sides (which isnt great!)
- I am considering taking 25 mg every other day and not every day, which is not quite following the doctor's orders, the long half life of the drug and my worry about increasing E are the reasons - thoughts on this? I am not worried about the eye problem thing, that seems to occur mostly in women on high does but more about increasing E.
- given the half life of Clomiphene is so long, could i just stick to the one tab and see how i fare in one week? I am also concerned about down regulating my LH receptors and doing hard to un do damage
- The doc says Clomiphene is toxic to the liver and i should not drink at all, that true? Could not find much evidence to support this. Can I drink at all on Clomiphene? Would 4 beers be OK - once in the 30 day period i am on it? Note - i am taking milk thistle
- With these symptoms, should i get a thyroid test? I dont have any of the symptoms described in the thyroid sticky. I have no idea if i am iodine or selenium deficient, should i get this tested?
- any other tests I should try? i know there is stuff in the stickies.... but my main thoughts are around thyroid