T Nation

42, Trying to Restart T, Low FSH, Body Doesn't Like Clomid


#1

Age 42,
Height 5’11"
waist 41.5"
Weight 224 (max weight last year 262lbs)
-Endomorph body type, super high bone density (Z-score 3.5)
Hair- 7 on the chewbacca scale
Fat seems to be now localized on my belly and sides.

Started this process last February, At the time I weighed 262lbs 42% body fat (via DEXA scan) and felt like total ass, had GP test my T, Total - 224, free 0.3, no morning woods, 0 Libido.
Started lifting weights (heavy) and cleaning up my diet, I hadn’t lifted in 17 years.
_Discovered since my gallbladder was removed in July '15, can’t drink caffeine without getting nauseous!_Which makes life suck even more without coffee in it.
6 weeks later T tested again T Total 280, Free 2.5 (GP says keep lifting) Weight at 258 lbs
July rolls around T now up to 296, Free 4.5 weight, weight to 245 lbs Libido coming up so are things in the morning.
November, stall out on Linear progression (Starting strength), 1 RPM’s (Bench 252, OHP 172, DL 375, Squat 300). weight at 224 estimate BF 25% I’m now falling asleep at work on heavy days, no energy for cardio on off days. Libido is a once a week thing now, if I’m lucky, ED comes and goes.

Sleeping anywhere from 7-8 hrs a night, though drinking a gallon of water a day makes this hard.

Go to see local DO/Hormone Doc that my wife sees for her hormones in November.

Following Blood work in November 2016 (Labs taken at Labcorp):
TSH: 1.52 uIU/ml (0.45-4.5)
T4: 7.1 ug/dL (4.5-12)
Free T4:1.39 ug/dL (0.82-1.77)
Free T3:2.6 pg/mL (2.0-4.4)
Reverse T3 20.2ng/dL (9.2-24.1)
Free Thyroxine Index: 2.1 (1.2-4.9)

A1c: 5.4
Insulin: 10.9 uIU/mL
glucose: 93

Dhea-Sulfate 135.4 ug/dL (102.6-416.3)
Coritsol: 13.9 (ug/dL)
Vit D 25 Hydroxy D2+D3 = 24ng/mL

Estradiol: 21.5 pg/mL (7.6-42.6)
PSA:1.0
LH: 4.6 mIU/mL
FSH: 0.9 mIU/mL
DiHydrotest:26 ng/dL
SHBG: 35.6 nmol/L (16.5-55.9)
T total 296 ng/dL(348-1197)
Free-T 7.5 pg/mL (6.8-21.5)

Consuming about 2500 calories a day (tracking with my fitness pal, with macros leaning away from carbs) and have moved on to a intermediate program (3 days a week), which I had to stop because of falling asleep at work. I have backed way off the weights (both volume and reps). I’m trying to get down to 15% body fat, but just can’t seem to move the fat off anything. Doc seems to think I’m metabolizing all my T. She thinks because of my age and health that they can restart my HPT system.

But, Hormone doc was concerned about low FSH number and sent me to an endocrinologist, also put me on 5,000 IU’s of D3. Endo put me on 50mg of Clomid once a day and then wanted to see my labs again after 6 weeks. First day I took the Clomid (16th of Jan), my brain spun up to 10,000 rpm, it was great, had some problems with body temp, hot/cold flashes but not too bad, was feeling pretty good, then last week my eyes started getting blurry, and was getting sensitive to light, got so bad I went to bed at half time during the Superbowl! Endo backed me off the clomid to 25mg a day, vision still getting worse so we stopped it.

During this time Hormone doc has me taking Calcium D-Glucarate and Revestrol. Taking a 100mg zinc, K-2, supplements.

Endo now wants to try HCG. Suggesting I take 5000 IU 3 times a week, and what I’m reading that is way too big a dose.

Any suggestions how I progress from here? I’m also like to keep the option of having some more kids (I know sounds crazy) some day. But I would like to get my weight down and have my brain start working at full capacity. I feel like I’ve lost about 30 IQ points in the last 15 years.

(Also not having T show up at the gym with you is a bitch when OHP is involved)

Thanks, worldskipper


#2

Just a noob and haven’t posted my Labs yet. But considering your LH is not bad, but T is low. Which means primary gonadism. Restart will probably not work. Your low FSH is more for sperm creation, but please all the guys who know more about this correct me if I’m wrong. I’m here to learn more…


#3

Not sure why they put you on clomid when your E2 wasnt high. You need Testosterone! Only then would need an AI and I prefer Arimidex.

Expect resistance and ignorance from your Docs. Read all of the newbie stickies, and read pretty much EVERYTHING written by KSMan. Then take all that info and head to your Dr and tell you him you need TRT and you want to self inject (so you can pin every 4 days). Tell him you also want an Anti-aromatase to prevent increases in E2 and if you’re worried about your balls, then ask for HCG.

I am 52 and the wife is WAY more concerned with me being responsive to her in the bedroom than she is what size my balls are! And beleive me, I am more “responsive” than she can handle. Im ready for at least 2 a days (everyday) and she can only handle that on weekends. Still we are having sex at least 5 times a week. Not too bad for my age.


#4

Update:
Got off clomid (that crap was bad for my vision ho-boy)
Convinced Hormone doc to start me Hcg using KSMan’s recommendation.

Started taking it Feb 23 (major issues with Insurance)
Taking 250units of Hcg EOD, along with Vit. D, iodine drops (Lugols 5%, 4 drops a day), Revastrol (200mg), K2, and calcium.

Labs taken last week before last (Apr 7th)
TSH: 1.67 uIU/ml (0.45-4.5)
T4: Not sampled
Free T4:1.42 ug/dL (0.82-1.77)
Free T3:3.2 pg/mL (2.0-4.4)
Reverse T3 - Need to be re-sampled - 23.3 ng/dL (9.2-24.1)
Free Thyroxine Index:Not Taken

A1c: 5.4 Not taken
Insulin: 10.9 uIU/mL Not taken
glucose: 93 No change

Dhea-Sulfate 143.7 ug/dL a little higher than last time
Coritsol: 13.5 (ug/dL) (AM range - 6.2-19.4)
Vit D 25 Hydroxy D2+D3 = 33 ng/mL

Estradiol: 29.8 pg/mL (7.6-42.6)
PSA: Not taken
LH: 0.1 mIU/mL (big drop here)
FSH: <0.2 mIU/mL (big drop here)
DiHydrotest:35 ng/dL
SHBG: 36.7 nmol/L (16.5-55.9)
T total 440 ng/dL(348-1197) up from last time ye-ha
Free-T 11.5 pg/mL (6.8-21.5) (up from last time!)

I have been feeling so much better, my brain is coming back online, and I am having less cases of the GAS (give a shits) which is nice. Since I’ve been metabolizing what little free-t I had I had backed off at the Gym (reducing volumes) but I am starting to look more ‘swole’ when I do hit it, and I’ve been loosing the love handles as well. I’m actually starting to ‘notice’ the other sex as well…

I did run out of Revestrol 2 weeks ago which at the time I didn’t think much of, but for me it was enough cause other issues like a return of the GAS and loose joints to the point of hurting when moving around (like a pregnant woman!) It must have been keeping the E2 in check, I’ve started that back up and am upping my D3 intake.

I’ve got a doctors appointment next week to discuss this, I could use some advice on my options at this point:

  1. Continue with the Hcg for a while longer to see if the numbers come up some more and then move onto Nolvadex.
  2. Start with the Nolvadex now.
  3. Start TRT now
  4. Or something else?

#5

Need lab ranges, use pencil icon to edit in to above post.

What was range for rT3 last year?
Stress can increase rT3 as part of adrenal fatigue.
Training with low-T and low thyroid function stresses the adrenals.

fT3 is now mid range!
Now check body temperatures.

Take 25mg DHEA every day, not with high fiber foods.

If hCG is not producing decent results, your testes are weak and using a SERM instead does not change that.

T levels are not good enough. Suggest:

  • self inject 50mg T cyp/eth twice a week, use #29 1/2" 0.5ml insulin syringes
  • 0.5mg anastrozole at time of injections
  • 250iu hCG SC EOD

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#6

Thanks KSman, I will edit the post and add the ranges later!

I will look into the rT3 as well.

–Just read your sticky on Thyroid, yesh. I think I’ve got a rT3 issue. I will start tracking my temps! Might explain why I’m cold more often than not. I will add this to discuss with Doc.

As to the Thyroid function, hormone doc said they were great, she was surprised how good they were.

Yeah I was suspecting the the testes were dropping the ball(z).

As to the temp ranges, that exergen topical temp scanner (we use it for the kids) will that work for temps?


#7

Holy CRAP! Just got my rT3 numbers. It’s at the top of the range, no wonder my ass is dragging! I’m eating more which seems to help some, but I think it’s going to take some chemical intervention now, this explains why I’m still falling asleep at work!

Good thing I’m about to go to the doc here in about 1.5 hrs!


#8

When you do battle with the doctor, point out that your FT=3.2 should support good body temps and energy, rT3 is the problem as it interferes with fT3 at T3 receptors.

Too bad you do not have those oral body temperatures.


#9

Sorry for the late reply, had to leave town for work and am now back to my computer.

Well I’m on T now, and it already seems to be helping. (I can sure tell when it burns off now!)
My doc wanted to put my on the exact same protocol that you recommended. She had mentioned that the ‘guru’ of Baylor was using this method.
She also put me on Selenium (200mg) per day and had me drop my intake of Iodine to 3 drops per day. To see if we can lower that rT3 number.
She also recommended that I take saw palmetto for the ‘difficulty’ I was having in not emptying my bladder all the way at night.

On the body temps, I gave her the paper, and she said she had listened to a presentation on the “Wilson Protocol” but wasn’t very comfortable with it. I had been very inconsistent with my temp taking (on your recommendations) but I’m now charting this every couple of hours. (How is the best way to look at this data? Graphing, tables, etc?)
I will get a couple of weeks of data and then I will contact the doc about it.

She wants me to get blood work done in 2 months and call her before then if I have any issues before then.

All in all a good visit, thanks for the research you’ve done KSman, Being able to go to the visit equipped on the basics of the endocrine system really helped.