T Nation

5 Week Clomid Results with Initial Primary Hypogonadism Diagnosis


Hello Forum! I have been perusing for the last few weeks.

I hope some of you may be able to help me with my situation.

I am in my early 30s - pretty healthy (slightly overweight) - 6'1" 220 pounds. (20-25 pounds overweight)

In Feb 2015 - I went to the urologist to get my ED situation checked. He checked my testosterone levels - and I had results of 224ng/dL (range 348-1197) [LOW]

I went back a week later to have them rechecked - tests were
Total T = 164ng/dL;
FSH = 19.2 (HIGH);
LH - 6.0 (Higher end)
Prolactin = 13.2 (Higher End)

He said I likely have Primary Hypogonadism and before putting me on testosterone replacement, we can check if Clomid works... chances are it will not. Lets.

5 weeks later at 25mg ED Clomid

Testosterone = 466 ng/dL (Range 348-1197)
Free Testosterone = 12.9 (Range 8.7-25.1)
SHBG = 21.8nmol (Range 16.5-55.9)
Prolactin = 6.7 (Range 4.0 - 15.2)
LH = 13.4 [HIGH] (Range 1.7 - 8.6)
FSH = 31.0 [HIGH] (Range 1.5 - 12.4)
Cortisol = 29.6 (HIGH) (Range 2.3 - 19.4)
ACTH, Plasma = 22.6pg/mL (Range 7.2 - 63.3)
TSH = 2.56 (0.45 - 4.5)

So my testosterone is up by almost 300 points.. but so is my FSH and LH. If I had primary hypogonadism - then Clomid should not work... however, it seems to be working, albeit not as effectively as others (as I have on the forum).

Most of the people seem to have Low LH and Low FSH - secondary...

Any theories as to what is going on?

Any help?


My suspicion is that your testicles are working more because of more stimulation but they are probably not working optimally. Hence the primary hypogonadism.

That is a decent reaction to clomid at 25 mg in five weeks.

Where are you located?


Cortisol is high. https://www.T-Nation.com/supplements/truth-about-adrenal-fatigue
Check E2 and fix if high.
Check cholesterol and fix if low.
Check DHEA-S. If not at the top of the normal range supplement micronized DHEA.

Retest T
If still low compared to LH you could try prolensis to assist the testes or Forskolin to aid in the conversion of DHEA to T.


TSH too high, should be closer to 1.0
Are you using iodized salt for years? [you need iodine]
thyroid looks/feels enlarged or lumpy
dry skin
sparse outer eyebrows
feel cold easily

Check oral body temperature when you wake up AND mid-afternoon and post

read the thyroid basics sticky and note references to:
iodized salt
adrenal fatigue
Wilson’s book

You are primary, but beating a dead horse.
high LH may lead to high E2 and high T–>E2 inside the testes where anastrozole cannot help
read the advice for new guys sticky

Action items:
read two stickies
post temperatures
respond to all questions