T Nation

Clomid and Restoring Natural Test?


I would like to get some feedback from the group about my situation. I will provide the basic information at my diagnosis with Low T ten years ago and where I am today.

I was tested for T my my primary care dr ten years ago with low LH. After seeing many doctors who prescribed different treatments that only raised my T to 350, I saw a Dr who placed me on Testim which rose my levels into the 600’s which I was satisfied. I was also taking Luvox and klonipin for anxiety and I was overweight with a large belly.

Fast forward to 2013, my insurance company informed me that I would need to stop Testim treatments. The choices for gels were Androderm, Axiron, and Fortesta. My doctor did not like any of these choices. In looking at my medical records, my doctor thought I would be a good candidate for using Clomid for a year while tapering off to the point where my own body would revert to making T without any help.

The two factors were I lost 72 lbs over 10 years due to exercise and diet changes and I was in a happier marriage. The Dr did say that my system may take some time to reboot since my system has not produced T on its own for ten years.

After a week on Clomid, I feel like crap and I am unable to maintain an erection. I was wondering if the forum can provide some feedback. The questions include:

How long should I give Clomid to raise my T levels before declaring the experiment a failure?

My doctor wants me to wait three months before getting a blood test with my levels on Clomid. Does this sounds reasonable? I am setting up my own tests through Private MD as we speak?

What are the chances that long term SSRI use has damaged my ability to produce LH without any simulation? I have heard that SSRI’s can damage the hypothalamus. I am afraid my system will not respond on its own once Clomid is stopped?

Other suggestions for increasing my T levels.

I appreciate your feedback.

You did not tell us how long you were on TRT. You should consider that your level of recovery might be capped by your levels from before TRT and that your time on TRT may lower that ceiling considerably.

Most who read this thread will suggest T self injections as per the standard protocol. - read the stickies please

If your testes become smaller and clomid does not improve that, quit.

Some feel like crap in clomid and nolvadex will solve that.

You probably feel like crap because your T levels crashed.

Never heard that SSRI’s damage the hypothalamus. But they can have negative libido effects and reduce T.

Start by reading the advice for new guys sticky and consider that your issues with low T may be symptoms and you need to consider suggested causes. We need to know a lot more info about you.

Thanks for the feedback. I will send more detailed info sometime tomorrow. The challenge I have is I have tested infrequently over the last couple years when I was supposedly stable on Tesim.

I talked to the secretary of my endo today. The endo is a big name in the field who is now working on a part time basis after retiring. I get the sense that he has too many patients and is focused on other items.

After reporting my symptoms, I was told to come back for a blood test in three months and make an appointment to see the dr in eight months. I was told by the secretary that they have used this technique with several patients and it always works. I find this strategy to be ridiculous in terms of the frequency of visits and that the strategy always works. If you have any suggestions for Drs in the MA / NH area, I would be appreciative.

I have been on TRT for 10 years with Testim for the last 9 1/2 years. The only thing I know is my low T was driven by low LH levels which I think is associated with the SSRI.

Question: how long should I give the Clomid a chance to work before declaring the experiment failed? I am going with three weeks as of now. How often are men able to return to long term natural T production after being on TRT several years?

KSman you doing alright? You’re not still robbing graveyards for human hormones are you?

SERM: Will increase LH/FSH in a dose dependant manner. If LH/FSH do not increase, top end of HPTA is defective and you cannot proceed. If LH/FSH are good levels, T should increase. If not, primary hypogonadism and you cannot proceed. If T levels increase and labs show useful levels, you can then after a while start to taper off of the SERM and land on 0.5mg anastrozole per week in divided dosed.

Then later check LH/FSH and T. Do you feel good? Note that too much SERM can cause problems, read the advice for new guys sticky re LH receptor desensitization. You may need anastrozole during SERM use. Too much SERM can also cause T–>E2 that anastrozole cannot control.

[quote]conservativedog wrote:

KSman you doing alright? You’re not still robbing graveyards for human hormones are you?[/quote]

That was morbid!
I have been digging up old girl friends. Is that morbid enough?

[quote]KSman wrote:

[quote]conservativedog wrote:

KSman you doing alright? You’re not still robbing graveyards for human hormones are you?[/quote]

That was morbid!
I have been digging up old girl friends. Is that morbid enough?[/quote]

It’s a good policy not to burn bridges as long as old girlfriends aren’t married. Rekindling friendships and catching up on old times is permitted.

Not every interaction a man has with a woman has to have ulterior motives, unless of course you’re not gay!

I am going to provide some more detailed information on my case. Please keep in mind I lack the medical records from 10 years of tests around by T level. Although I questioned by doctors when I was only getting results in the 350 range on Androgel, I found a doctor to work with me to get my T levels up over 600 on Testim.

I was diagnosed with low T in 2003 with levels around 200. The blood work indicated I had normal FSH levels but low LH levels. I was 33 yo at the time. My height was 6 ft tall and I weighed around 250 lbs. My waist size was 40 inches and I had large pot belly. I had been taking a SSRI since 1997 called Luvox since 1997 and the dosage continued to increase since I had increased OCD symptoms. This was also supplemented by Klonipin at times of high stress.

In addition, I started a low carb diet about five months before being diagnosed with low T. I was working out as well without seeing much in the way of results.

I started using Clomid and discontinued usage of Testim on 5/20/2013. The dosage prescribed by by doctor is to take one 50 mg Clomid tablet on Monday, Wednesday, and Friday of each week. I started to feel like crap about three to five days after 5/19/2013.

I called my doctor on 5/28/2013 to report my symptoms. I talked to my doctor through his secretary. I was told that feeling like crap is normal for the first four to six weeks when transitioning to Clomid since it may take the body that long to start producing T. I was told that this technique always works and I should wait three months to get my blood checked and eight months to see the Dr to start tapering off Clomid.

As you can imagine, I was less than happy with that explanation. My am changing doctors regardless. I called Private MD Labs and ordered the tests (thanks sticky note. I received my results back the very next day which I thought was amazing. The key numbers are as follows.

T - 31
LH - 0.7
FSH - 1.1
E2 - the test came back as less than six without a specific result. This reading was labelled as low.

In addition, I now weight roughly 180 lbs with a waist size of 33 inches. The doctor feels this weight loss is the primary reason I might be able to produce T naturally again.

Based on the information I have provided, I have the following questions.

  1. How long should I wait before declaring the Clomid experiment a failure and trying a new approach? I am planning to test myself weekly until my normal T levels or restored or I give up on this plan. Due to business travel, I am going to abandon the approach on June 10 if I fail to see results.
  2. Is the fact that my LH and FSH are measureable although very low a good sign that my pituitary gland is being stimulated by Clomid?
  3. How often are men able to restore normal levels of T after being diagnosed with low T?
  4. Does the dosage seem low? I see most other posters using Clomid are taking higher dosages.
  5. Where can I find a doctor who will Rx twice a week shots in the MA / NH area? The Boston medical community is very conservative.

I appreciate any help.

Two other pieces of information.

  1. My insurance is through Blue Cross and Blue Shield Anthem. Does anyone know what they cover in terms of shots? I tried calling them to find out and I was able to get this information due to lacking a diagnosis code.

  2. My blood work back in Dec was close to 1100 for T levels. However, the test was about an hour after applying the gel. I since understand that this can inflate the numbers.

You should have started the clomid while still on the Testim for a couple weeks. You probably want to test after 4 weeks on just clomid.

If LH doesn’t hit the high end of the range you are definitely secondary. You can either try to diagnose why, or try HCG to see if you are also primary. You should be able to tell base on clomid response unless LH doesn’t come back at all.

I personally would have started with HCG. If your balls aren’t capable of producing, it doesn’t really matter if you are also secondary.

I got tested again yesterday and I have more information. I am unsure why but I have not received many responses. I would appreciate any guidance any feedback since I want to have a solution soon while giving the current solution enough time. It took me over a year to get the right dosage on Testim and I do not feel like going through this again.

I got tested yesterday and I received my results today. The test was two weeks after starting Clomid. Although all the key levels were up, my T level is well below normal. The key numbers include.

T - 136
LH - 2.1
FSH - 3.1
E2 - 5.1

The big questions I have that I am still having a challenge getting an answer.

How long do I need to wait to see the optimal results on Clomid? From the results, I see that I am now getting a response although low. I am trying to figure out if the issue is effectiveness, the amount of start up time, and the right dosage.

What questions should I ask a Dr in advance to see if I retain their services? I am looking to switch Drs since mine wants me to wait eight months to be tested even though I just started a new treatment. I am aware from ten years ago that some doctors consider anything within the normal range as normal. I had to visit four doctors before I could find a doctor who realized that reading of 350 is not normal for a guy in his 30’s. The members of this groups are aware this is not true.

Does anyone know of any doctors in MA that accept insurance that understands the protocols listed here on the website?

Have you heard of any men be able to produce T naturally once starting TRT?

Based on the questions, I am either going to continue a couple more weeks on Clomid before making a change to T injections or start taking injections as soon as I can find a doctor.

I appreciate any help.

Waverunner… Were you ever able to locate a good and willing TRT doctor in the NH area? Having a tough time finding one that “gets it” myself…

I was able to locate a Dr in Amherst but the doctor does not take insurance.

two weeks is too soon. At least 4 weeks before you get a really good picture. How much and how often are you taking? you should also post units and ranges when you post lab results.

The dosage prescribed by by doctor is to take one 50 mg Clomid tablet on Monday, Wednesday, and Friday of each week. I started to feel like crap about three to five days after 5/19/2013.

Keep in mind that you’re trying to get rid the symptoms of low testosterone, not just raise the lab numbers. I took the exact same dosage of Clomid you’re taking, and within 5 weeks it raised my levels from 270 to 700 without doing anything at all for my symptoms. Apparently this is fairly common with Clomid, because it has other effects beside raising the T levels.

Obviously SERMs are the best choice if they work, because they’re temporary and they restore completely natural HPTA function in people who are secondary. But it’s hit or miss with them, and (I was told by a TRT doctor) they seem to be more likely to work in people whose low T came from a specific, identifiable cause, like steroids or painkillers.

If you are secondary, HCG monotherapy is probably a more reliable way to boost natural production than a SERM. If primary, obviously you will need testosterone.

Allot of guys on SERMs don’t monitor or address E2. This is a huge mistake. Your results will be completely different if you keep E2 in check. If it doesn’t raise T, then it really doesn’t matter. But if it raises T, you can’t really say it’s not going to work if you don’t address E2 levels.

If it raises LH but not T, you’re primary and need Test.

If it doesn’t raise LH, try HCG.

If it raises T, check E2 and get it to a reasonable range before writing Clomid off. If you still have sides, you can try nolva.

I just got the results from the weekly testing I am conducting on my own. Here are some of the key numbers.The tests were completed by lab Corp in the AM while fasting.

T - 346 ng / dL Range is 348 - 1197
LH - 5.5 mIU / mL Range is 1.7 - 8.6
FSH - 6.6 mIU / mL Range is 1.5 - 12.4
E2 - 8.1 pg / mL Range is 7.6 - 42.6

Based on these results, I am pleased that the numbers are moving in the right direction. My initial LH was .7 when I was diagnosed and I see that number is now in the normal range. I wondering if my testes are slow in restarting production. However, I am concerned that my T levels will flatten out and I will be unable to get my levels without a fight with the Dr. since I am moving into the lower half of the normal range.

I have a couple of questions.

How long does it take for individual to see numbers stabilize on CLOMID?
How would you approach the Dr. if they come back and say my levels on normal while being in the lower half of the range? I have found a Dr. who I think will work with me whom I am meeting with next week. However, my experiences have been that doctors are only concerned with getting you win the normal range.
Can you make any assumptions on my free testosterone levels based on the E2 number? I’ve been testing using the Lab Corp female hormones test and this test does not calculate free testosterone.

I appreciate all previous feedback and any future feedback.

I just completed four weeks on Clomid and I have tested myself again to see the outcomes. These tests were conducted through Lab Corp and I completed a seven mile run earlier that morning. I am unsure if high levels of exercise right before a test can impact the results.

I would like to get your take on what steps to take next. I have been advised that I should give Clomid a four week trial before discontinuing. The lab work this week were very interesting on a number fronts.

T - 398 ng / dL Range is 348 - 1197
LH - 9.2 mIU / mL Range is 1.7 - 8.6 HIGH
FSH - 8.0 mIU / mL Range is 1.5 - 12.4
E2 - 21.0 pg / mL Range is 7.6 - 42.6. This number is an increase from 8.1 the previous week

More interesting is my red blood cell count which has dropped into the below normal range both this week and last week. Is this common for men undergoing TRT or with low T numbers? The numbers are

RBC ? 4.06 x10E6 / uL. Normal is 4.14 ? 5.80. My reading three weeks ago was 4.49

I see some good but a lot of bad in these numbers. The good is my ability to produce LH is restored. I was diagnosed as secondary ten years ago due to my inability to produce enough LH. The bad is around the low T number, the increase in E2, and the low red blood cell count.

I have a couple of questions. I beg the forum to provide some answers to these questions. The whole process of having to switch TRT has been very frustrating due to the lack of info I am receiving. Although I feel better than when I first started Clomid, I still do not feel like myself.

What are the chances of my testes producing T at a normal rate after ten years of TRT?
Is there a connection between low T and a low red blood cell count?
How would you approach the Dr. if they come back and say my levels on normal while being in the lower half of the range? I have found a Dr. who I think will work with me whom I am meeting with next week. However, my experiences have been that doctors are only concerned with getting you win the normal range.
Is the rise in my E2 levels concerning although the number is still low?

I appreciate all previous feedback and any future feedback.

I would probably stay the course for a few more weeks to see if T continues to rise. If not you are primary and need t injections.