T Nation

Clomid + Arimidex Dosage


#1

Hi all,
I am 41 year old male. Long story short, started using clomid a month ago after having some symptoms of Low T ( low libido, absent morning wood , difficulty putting on muscle etc) hoping that it could raise my testosterone level .

before clomid a month ago :
FSH: 2.9 mIU/mL (1.27-19.26 range)
LH : 2.4 mIU/mL (1.7-8.6)
TT (serum) 3.1 ng/mL ( 1.75-7.81)
Free T (serum) 4.6 pg/mL (5.53-27.9)
E2 sensitive: 31 pg/mL (20-47)

after a month of 12.5 mg clomid everyday
FSH: 3.1 mIU/mL (1.27-19.26)
LH : 4.1 mIU/mL (1.7-8.6)
TT (serum) 7.1 ng/mL ( 1.75-7.81)
Free T (serum) 17.5 pg/mL (5.53-27.9)
E2 sensitive : 67pg/mL (20-47)

My T increased , but so did the E2. May be that’s why I didn’t feel any changes with regards to libido etc as a result of the increased T. Now I will use arimidex for the increased E2. Is 0.25 mg eod a good dosage to start with? I will also appreciate to hear your thoughts on how long to use clomid and its dosage . Thanks…


#2

so no one with any suggestions?


#3

I am in the same boat. Took 25 mg Clomid daily for about 6 weeks.

T went from 200 to 600
Free T from 7 to 20.
Estradiol went from 13 to 37

Mood, energy, strength, sexual function, all have improved. Libido is almost nonexistent. Zero sex drive. Began adding .25 mg Arimidex EOD to lower E2 and address nipple itching and burning. Those are symptoms of sky high e2 right guys? Got some fluid retention in feet and have since backed off the Arimidex. Interested to know if you or anyone else is having issues with Clomid plus an AI as a TRT alternative.


#4

Yes robohobo, I have been also feeling better when it comes to energy ,strength.However can’t say sexual function much improved. It is somewhat unstable. .I also have a very low libido.
I didn’t have the nipple symptoms. I feel that I have become more emotional, probably because of the increased E2. Started taking arimidex since a week now, 0.25 mg twice a week. I think low libido is caused by clomid itself as I ve read it from other people’s experiences.


#5

Some do not do well with Clomid and feel better with Nolvadex.

Try ~.5mg anastrozole per week in divided doses.
Dose depends on your serum available T, FT is not as strong as TT.
SHBG will be increased by high E2, creating more T+SHBG that is not bio-available, lowering FT and inflating TT. Do E2 labs in 3 weeks. If you feel crashed, you are an anastrozole over-responder and will need to reduce dose by a factor of four. Small doses need to be managed by making a solution of anastrozole in vodka, 1mg/ml and dispensing by the drop or volume.

Have you had any blows to the head that might injure pituitary?
When did your T levels seem to slip? Sudden or creeping over years?

Thyroid issues can also affect energy, mood and libido.

Your E2 was high relative to FT before Clomid. Suspect liver is not clearing E2 properly. Some meds, Rx or OTC can do this by competing for same enzyme pathways that clear E2.

Please post other lab work.
CBC
hematocrit
AST/ALT
fasting glucose
fasting cholesterol

Higher Clomid/Nolvadex doses are discouraged as high LH/FSH can lead to a lot of T–>E2 inside the testes, but this does not seem to apply to you as a problem. So your liver remains a possible factor with high E2.

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

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

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

Hi KSman,

No, I didn’t have any blows to the pituitary or had any accidents.

I used Paxil for around 5 years at doses around 10-20 mg for depression .I have recently read about ssri’s negative effects on testosterone. Do you think this might be a cause? I stopped using it recently …

The first time I had a blood test done was 3 years ago, and my TT testosterone was at 3.1 ng/ml (2.49-8.36) and FT 7.3 pg/ml (5.1-41.5) . I didn’t think much about it back then as I didn’t have symptoms that I am having now.

This year I started having some low T symptoms such as very low libido, sleep disturbances, unstable erectile function .I can’t remember the last time I had a morning erection.I can’t say I had low energy , may be because I work out regularly.So I visited an endocrinologist . He asked for certain tests including T3,T4,TSH the results were ;
(28-11-2016)

Total Test 3.6 ng/mL (1.75-7.8)
Free Test 7.5 pg/mL (9-55)
Free T3 (serum) 2.9 pg/ml (2.5-3.9)
Free T4 (serum) 0.64 ng/dL (0.61-1.12)
TSH 7.5 mIU/L (0.3-4.2)
FSH 2.5 mIU/mL (1.27-19.26)
LH 1.8 mIU/ml (1.7-8.6)
Prolactin (serum) 13.4 ng/mL (4.1-18.4)
E2 31 pg/mL (20-47)
DHEA 216 mcg/dl (30-333)
Vit D3 30 ng/mL (30-100)
Cortisol (serum) 14.1 mcg/dL

After these results he diagnosed me as hypothyroid and prescribed 75 mg of Euthyrox everyday. He asked for further tests in a month. He said he wanted to see my testosterone levels after fixing TSH. He also asked me to supplement with D3. The results in a month came as: (06-01-2017)

Total Test 3.1 ng/mL (1.75-7.8)
Free Test 4.6 pg/mL (9-55)
Free T3 (serum) 3.4 pg/ml (2.5-3.9)
Free T4 (serum) 0.83 ng/dL (0.61-1.12)
TSH 1.9 mIU/L (0.3-4.2)
FSH 2.9 mIU/mL (1.27-19.26)
LH 2.4 mIU/ml (1.7-8.6)

TSH dropped to its range but Testosterone was even lower. The dr couldnt offer much about the low testosterone, he said he could prescribe sustanon/nebido .I didn’t want that and told him that I wanted to try clomid. So I started it on my own after taking his opinion (He didn’t have much experience about it)

As you said -Suspect liver is not clearing E2 properly, I thought about many supplements I have been using for years. BCAA s , Protein Powders etc (never steroids) Can it be a reason? Those supplements damaging the liver? I have recently started supplementing with grape seed extract and broccoli extract for the E2 in addition to the Arimidex.

I’ll have the other lab works you asked in my next lab visit. Thanks a lot for your help…

Best,


#7

KS Man, Can Estradiol levels be accurately measured while on Clomid monotherapy? Test being used is Labcorp Estradiol sensitive Roche ECLIA Methodology range 7.6 to 42.6 pg/l


#8

Why not?

I do not believe that Clomid is cross reactive to that test.

We do see tested E2 levels get quite high with any SERM if the induced LH/FSH is high, causing a lot of T–>E2 inside the testes [which cannot be controlled by anastrozole as it does not work inside the testes]. High hCG doses can do the same.