T Nation

Back on Clomid, Total T Fine, Libido Still Gone. What Next?


#1

I’m baaaaaaack.

So I’d previously been on clomid and eventually tapered off for about a year with no ill effects. I was getting blood work done every few months and my total t was always in the 550-700 range and I felt fine. At the time I was taking Zoloft, 100mg a day, as I had been for years. Eventually I started feeling depression creeping in, and the Zoloft slowly stopped working. I switched to Wellbutrin, 150mg. I felt incredible for three or four weeks and then crashed HARD. Felt weepy and sad and had no libido at all.

I booked an appointment with my doc and he said that in some very rare cases, Wellbutrin can absolutely crush peoples’ testosterone levels. We checked my free T. 104ng/dL. I’m 27. So I got off the Wellbutrin and back onto the clomid, and that’s all I’m taking.

My free T is now 650ng/dL. I still have absolutely no libido, I can’t get it up at ALL, even with cialis or something. It’s wreaking havoc on my relationship. I need to get back in and see a psychiatrist for a new antidepressant because I know that isn’t helping matters, but I can’t imagine my depression is so bad that it would effectively break my dick and balls. Doc says testes are PHYSICALLY fine.

Anyway, got bloodwork done on Wednesday for free t, total t, and e2. Maybe some others but that’s the three I remember. Assuming those come back in normal ranges, what should I be checking next? I want to be prepared and mostly just want my bits to work. It very well COULD just be depression but I want to have all my bases covered, given my history.

Thanks!


#2

My guess is that it’s from the Clomid - plain and simple. Clomid has been known to cause both depression and low libido. I don’t even know how you could stay on for such a long time. I was on for a week as part of a PCT and felt like throwing myself out a window.

You need to find a better way to keep your T levels high and Clomid is not the answer. Get off the Clo and you’ll feel better in a few weeks (Clomid has an insanely long half life so it will take a good two weeks before you feel different).

Why can’t you run some test with HCG and an aromatase inhibitor? Better to deal with controlling estrogen sides (which a good AI will do) than deal with feeling shitty all the time from Clomid.


#3

Hey man,

Sorry, I’m not sure I made the timeline clear. I was on Clomid from June - October 2014 and then tapered off. No problems from October 2014-June 2016. I already had zero libido when I started back on the Clomid in mid-July of this year, it just hasn’t come back yet.

As far as test/HCG, my doc - who came highly recommended from some members here, oddly enough - is just a little worried about fertility in the future, but I’ve got an appointment to go back and see him this week and I am going to broach the issue this time for sure.


#4

You mentioned you started back up in July- So are you on Clomid now? If so what dose?

8 months is a long ass time to be on that drug for and it’s no wonder you had zero libido and depression over the summer.


#5

Mood: Thyroid status can be a huge factor.

Not concerned with normal results, need the number and ranges.

Are you taking Vit_D3? And Vit_D3 reserves depleted during the winter?

How were E2 and AST/ALT changing?


#6

Jim: I’m sorry, I may not be making myself clear regarding time on and off. I was on Clomid for about 3-4 months in 2014 and then stopped in October of 2014. I was not taking Clomid from October 2014 until June of 2016. During that time I had regular blood work done, just on my total testosterone. I had no symptoms of low t, felt fine, everything worked very well, and my total testosterone levels were anywhere from 550ng/dL - 700ng/dL during those tests.
My libido vanished around late April of this year, around the same time that my depression started to come back and I started taking Wellbutrin. I started taking Clomid again in late June/early July of this year because my total testosterone levels were at 104ng/dL. My depression symptoms and weight gain have all but ceased, my libido is just still gone. Every time I’ve been on it’s been 25mg/day.

KSman: I do not have my most recent blood work results available yet, I will post them as soon as I get them. Should be this week. I just wanted to be prepared in the event that they looked shitty. I am taking D3, but not as regularly as I should be. I need to get back on the wagon for sure.
I will try to get my thyroid checked as well if these incoming blood results look normal, though I suspect I’ll need to go someplace else (labcorp?) for that or see a different doctor as my doc I am seeing now is just a urologist and I’m not sure he can order thyroid tests.

If we need different results, what exactly should I book labwork for? Like, really specifically, let me know EVERYTHING I need and I’ll book it.

I think it really may just be my depression/anxiety ruining my libido and drive, but unfortunately it’s nearly impossible to see a competent psychiatrist where I live unless you want to pay $1000 out of pocket. I’ve got a consult tomorrow that should be helpful, as well. So, trying to attack this thing from all angles.


#7

ok - I think I get it. Your depression acts up so you take the Wellbutin. Wellbutin tanks your T-levels (and probably libido from reports I’ve read) so you take Clomid to jack up the T-levels. Depression goes a away a bit but you still are on Clomid.

It’s a vicious cycle - and I understand about depression and anxiety (had bad depression in college and dealt with bouts of anxiety / panic attacks several years ago). Wouldn’t wish it on my worst enemy. I totally feel for you.

Here are my thoughts - firstly, depression kills libido. The Wellbutin also kills libido (and testosterone - and the two may be linked). And finally, Clomid kills libido. You have a triple whammy of libido-killers.

A quick thought - first - assuming your depression is under control at the moment - you can stay off the Wellbutin. Next, - you have to get off the Clomid. Check out some forums and google it - LOTS of guys complain about libido issues on clomid. (It actually made me severely depressed and anxious myself -while also killing libido). Ask your doc about Nolvadex or get some from a peptide company and try that at 20 mg/day - or better yet - just get off everything and see where your T-levels end up. Now that you are off Welbutin - you do not need to be on Clomid. Trust me - this is part of your problem.

As for your ongoing bouts of depression - that’s a tough one. I would definitely get tested for Vitamin D - or just start taking 3,000IU for a few weeks and see how you feel This will raise your T-levels and if you were low (and almost everyone who doesn’t live in a sunny climate or works outdoors is deficient) and also boost mood, sense of well being a lot.

Lastly, stress causes havok with libido in general. you are no doubt stressed about your depression issues, and also relationship issue from the lack of libido - not to mention the normal stress from just life /work etc. a few things I’d recommend here - do some Googling and check out Rhidiola Rosea - it’s an adaptogen and I’ve used it for anxiety and it’s known to boost your mood. 250-500mg 1x per day. Trust me, this works. Lastly - try Xanax. I’m not trying to push drugs - but this puts people in a more relaxed state where libido can kick in a bit - just check with your doc to make sure it lines up with your treatment protocol. But clearly, from where I sit - the Wellbutin and Clomid were killing your T and Libido - so you some how need to stay off those products. (Clomid will take about 2 weeks to clear your system - so be patient). Let us know what the bloods look like when you get them back.


#8

Things stated here are not generally true, but may be so for some individuals who react differently or metabolized drugs differently. Wellbutrin is often used as a SSRI replacement or added to to address sexual effects of SSRI’s.


#9

Here we go!

Has a couple docs run a couple labs so this is a bit of a hodgepodge.

Total T 667 (Range 300-1080ng/mL)
Free Component 170 (Range 47-244ng/mL)
E2 39 (Range <=47ng/mL)
SHBG 18 (Range 11-80nmol/L)

TSH 1.7 (don’t have range on this one yet, different doctor)
Vit D 27 (same as above)

Any thoughts? My first thought is that E2 is WAY too high.

Also thyroid-wise I have a fairly iodine rich diet and my body temperature fluctuates between 98.1-98.8 with little variation. I get sick like clockwork - mid-spring and mid-winter I’ll get an upper respiratory infection for 4-5 days. Other than those two times a year I don’t get sick. I’d need T3 and T4 tested to be sure but at this point my E2 being at 39 at that time of day strikes me as a likely culprit for my low libido, ED, moodiness/depression, and increased fat gain on my torso.


#10

Okay I read something from KSMan about Clomid affecting E2 via LH if you take too high of a dose for too long and that Anastrozole won’t work if that’s what I did, something like that? Anyone? Paging KSMan…


#11

Please edit your post with lab ranges and actual for SHBG.

TSH may be suggesting more iodine. Do not neglect selenium.

You were on clomid for these labs? Explain dose and duration.

E2=39 can make you feel horrible.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

#12

Updated with the details of what I have in writing. SHBG doesn’t seem alarming in the same way that E2 does.

I was on Clomid 25mg/day for those labs. I had been for maybe 3-4 weeks if memory serves.

Will start supplementing iodine and selenium as well. I have read the stickies. :slight_smile:


#13

High E2 and low SHBG puts you into some risk groups. But some guys simply have unexplained low SHBG.

TSH is still a concern, should be closer to 1.0


#14

Every time I’ve had bloodwork done that included SHBG it was in that ballpark. Now granted both of those other times it was when my free and total T were much lower, but I think the high E2 is a more likely culprit. I also don’t have the bloodwork here but when I first started going through this stuff years ago I had my thyroid checked a few times and didn’t have any issues with TSH, T3, T4, rT3, etc - now of course things could have changed in the past few years but again I am not sure thyroid should be my focus with an E2 of 39.

FWIW, I don’t know if time of day or diet affect TSH, but that test was in the late afternoon/early evening and not fasted.

What “risk groups” does that put me in? Is anything to be done about, well, any of this? I am not on any steroids, I don’t have metabolic syndrome, I am not obese, I don’t have acromelagy, I don’t have ovaries, and I don’t have any symptoms of Cushing’s Syndrome that can’t be explained by something else (no abnormal fat gain on the back or face, no easy bruising, slow healing, bone weakness, muscle loss, etc). Would it not make sense to try to address the high E2 first and then see if things improve? Open to any and all suggestions.


#15

Any diabetes or insulin resistance issues?


#16

Definitely no diabetes, no insulin resistance issues that I’m aware of.

Minus this hormonal stuff and a bad knee, to my knowledge I have no health issues.


#17

Knee: If you have soreness and inflammation in your knee, you may find that Rx 15mg meloxicam provides good relief. You take once a day, bed time is a good routine. Very inexpensive generic. I get a years supply of 360 doses from Walmart [USA] for $40. That is a cash price and bypasses insurance restrictions of 90 days etc. I understand joint pain.

Nothing else worked for my osteoarthritis in my fingers. Joints were red, swollen and sore - now mostly resolved.


#18

Knee’s biomechanical. Related to plantar fasciitis and weak/right hip flexors. Goes away with proper stretching.

So what should I start doing to knock out different factors in my bad broken dick? Low dose of Adex? Should we do more thyroid first?


#19

You really need to fix E2. If anastrozole does not work well enough as expected, could be from clomid inducing T–>E2 inside the testes where anastrozole does not work.

If you get near E2=22pg/ml and libido does not improve, you can swap clomid–>nolvadex and see if that helps.

Thyroid: Your body temperatures convinced me that things were OK. You suspect otherwise?


#20

I don’t. Thyroid seems fine to me. I think I have some UGL Adex (from Ironmag) that’ll get me through until I can find the real deal. Don’t think doc will prescribe. How should I be dosing it?

Also I’m assuming OTC stuff like arimistane isn’t worth a damn for these purposes?

I’ll monitor everything and get more blood work done in… how long? Assuming I should stay off the clomid?