T Nation

5 Week Clomid Results with Initial Primary Hypogonadism Diagnosis


#1

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?


#2

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?


#3

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.


#4

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
iodine
TSH
fT3
fT4
rT3
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