T Nation

Clomid for Long-Term Use?

#1

Hello, I’m new to the forum, but not new to the site. A quick bit of info about myself, I’m 35yo, going on 36yo, and had a doctor put me on Clomid 25mg to bring my test levels up from 280. I took Clomid for about 2 months and my levels were around 680. I can’t find a doctor to perform the tests mentioned here (https://www.t-nation.com/pharma/complete-guide-to-t-replacement), and they always tell me that I don’t need my levels tested, because I’m in such good shape. It’s very frustrating, and I often wonder if it’s more of an insurance/costs thing, so that’s why they don’t do it?

I’m tired of chasing doctors down, trying to get answers, trying to find a long-term viable solution to my problem. I realize our levels eventually drop below normal range, but what’s the best solution? I don’t want to take TRT, because my wife and I are still trying for children. I’ve been taking Clomid at 25mg for about 10 months now, and no issues, yet, and I feel alright. I just don’t know if that’s a bad idea, should I stop, should I consider something else? I’m considering stopping completely tomorrow. I’ve been having some mild testicular pain the left testicle. I had my annual physical a few weeks ago, and they checked for hernias and cancer, so I don’t think it’s that. I’m wondering if it’s the Clomid? I just don’t know why it would show up now, after 10 months?

You’d think with health insurance I’d already have these answers, but most doctors know nothing about this stuff. I’ve read all the stickies, and it sounds like there isn’t a definite answer. Also, sounds like everyone else is having the same issues (e.g. finding a doctor, getting tests done, getting good information). I mean, I have money, and will pay for information and help, but sadly, that doesn’t do me any good either, because nobody seems to know, money or no money. LOL

I’m north of the College Station area, a little over an hour from Houston, TX and Round Rock, TX. Any suggestions on a doctor would be great. I have United Healthcare Choice Plus for insurance.

#2

You can order your own labs on line, often performed by Labcorp. Pay out of pocket. Also see the finding a TRT doc sticky referenced below.

TRT with hCG injections preserves fertility
TRT with Clomid maintains LH and FSH which preserved fertility.

Clomid is a drug. hCG is a natural human hormone and it thus better suited for long term use.

How do you feel on clomid. Some guys can feel horrible, they do not react the same.

See where Labcorp testing stations are near you: http://labcorp-locations.com/texas

Post what labs you have in list format WITH RANGES.

You can also eval thyroid status by your self as suggested below.

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.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

#3

Hey KSman,

I did as you suggested, and ordered a full male hormone blood panel, as well as CBC and all. It cost about $200 for everything. I had my labs done this morning at LabCorp here in Texas. I don’t know how long it’ll take to get the results back since our mail is having issues due to Houston, we’re about an hour NW of the city, so the storm caused some issues. Anyway, do you think I could have you review my labs once they’re back? I’m happy to pay you for your services. I’m also going to have my local urologist review them as well. I just want to make sure I’m getting the best information as it pertains to my body and situation. I can PM or email you, too, if you prefer.

Thanks!

#4

You posted:

Again, I’m 35yo, going on 36yo, no steroids. I took Clomid 25mg for 10 months for low-t, and have been off Clomid for 3 weeks. These test results were taken 2 weeks after stopping Clomid, so I wasn’t on Clomid during the time my blood was taken.

Question! What do you do for high Estradiol, Sensitive? Is it something I should worry about? What are my options for getting it to normal range?

LH 5.7 mIU/mL
FSH 3.7 mIU/mL
Testosterone, Total LC/MS 1266.3 ng/dL
Free Testosterone (Direct) 16.5 pg/mL
DHEA-Sulfate 207.9 ug/dL
TSH 3.470 uIU/mL
Prostate-Specific Ag, Serum 0.5 ng/mL
Estradiol, Sensitive 45.0 pg/mL (High pg/mL 8.0 - 35.0)
Triiodothyronine, Free, Serum 3.5 pg/mL

#5

Two weeks is not enough time.

Glad to see that you dried out!

I asked you to do more, please see above.

fT3=3.5 is nice, if body temperatures are good.
But TSH=3.47 is way too high, suggesting possibility of elevated rT3 blocking some fT3 activity, perhaps as a result of stress. See the thyroid basics sticky.

TT is high, FT is not. Expect that high E2 has elevated SHBG, increasing non-bioavailable SHBG+T that inflates TT so TT overstates your T status.

CBC: need RBC and hematocrit

Also need AST/ALT lab data to see if liver might be part of high E2.

Clomid 25mg ED is often too high of a dose leading to high E2 levels.

#6

Hi KSman,

Thanks for all of that helpful info. What do you recommend to fix these levels - to normalize? Should I consider Letrozol or Anastrozole, or is that too powerful for my situation. I don’t want to screw myself up. I’m already taking Fish Oil, Zinc, and Green Tea (Matcha Powder). Thoughts?

I had additional tests done, too:

CBC With Differential/Platelet

WBC 4.5 x10E3/uL
RBC 5.51 x10E6/uL
Hemoglobin 16.7 g/dL
Hematocrit 48.6 %
MCV 88 fL
MCH 30.3 pg
MCHC 34.4 g/dL
RDW 12.3 %
Platelets 167 x10E3/uL
Neutrophils 38 %
Lymphs 51 %
Monocytes 9 %
Eos 2 %
Basos 0 %
Neutrophils (Absolute) 1.7 x10E3/uL
Lymphs (Absolute) 2.3 x10E3/uL
Monocytes (Absolute) 0.4 x10E3/uL
Eos (Absolute) 0.1 x10E3/uL
Baso (Absolute) 0.0 x10E3/uL
Immature Granulocytes 0 x10E3/uL
Immature Grans (Abs) 0.0 x10E3/uL

Comp. Metabolic Panel (14)

Glucose, Serum 104 mg/dL
BUN 25 mg/dL
Creatinine, Serum 1.12 mg/dL
eGFR If NonAfricn Am 85 mL/min/1.73
eGFR If Africn AM 98 mL/min/1.73
BUN/Creatinine Ratio 22
Sodium, Serum 142 mmol/L
Potassium, Serum 3.7 mmol/L
Chloride, Serum 99 mmol/L
Carbon Dioxide, Total 24 mmol/L
Calcium, Serum 9.4 mg/dL
Protein, Total, Serum 6.9 g/dL
Albumin, Serum 4.3 g/dL
Globulin, Total 2.6 g/dL
A/G Ratio 1.7
Bilirubin, Total 0.7 mg/dL
Alkaline Phosphatase, S 39 IU/L
AST (SGOT) 40 IU/L
ALT (SGPT) 29 IU/L

Lipid Panel w/ Chol/HDL Ratio

Cholesterol, Total 126 mg/dL
Triglycerides 66 mg/dL
HDL Cholesterol 60 mg/dL
VLDL Cholesterol Cal 13 mg/dL
LDL Cholesterol Calc 53 mg/dL
T. Chol/HDL Ratio 2.1 ratio units

#7

Bloods are OK

Please - need lab ranges

Total cholesterol is way too low. Some guys simply are low. Low levels <160 are associated with hormone issues and increased all-cause mortality. If using a statin drug you need to make some changes but not at your age… Is your diet extreme?

Read about cholesterol hormone cascade: https://en.wikipedia.org/wiki/Steroid_hormone
You could check where DHEA-S is, do not do labs for DHEA, must be DHEA-S

AST is near top of range?
Sore muscles from training?

Glucose=104 is a problem if you did fasting lab work. Insulin sensitivity issue.

#8

I ran some more test. Also, found a hormone replacement doctor who offers concierge service. I ran my labs again (CBC, Lipids, Test, Thyroid), and cholesterol is low due to dieting and heathy eating. He wasn’t too concerned. Actually, he said my labs were good, and I shouldn’t be too concerned.

I did my thyroid tests again, checked for auto-immune stuff, all came back negative and normal. The high estradiol levels were from the Clomid. My test levels dropped from 1266.3ng to 604ng after being off the Clomid for 6 weeks. I believe my baseline is around 400s… My estradiol levels dropped to 18 pg/mL, too, so it was from the Clomid. I did notice some strength and energy loss coming off the Clomid.

I started a new protocol last week - taking anti-estrogen supps, and Clomid 25mg for 2 days on, and 1 day off, and have noticed mood has improved, as well as strength and energy. I feel great. See details below…

Apparently, a doctor out of Florida has done some research on Clomid, and some men have the issue where E levels rise too much with the use of Clomid. My local doctor wanted to try either 25mg Clomid EOD or 25mg Clomid every 2 days with 1 day off. I’m also running I3C, Calcium D-Glucarate, and DS Triazole every day to see if it helps estradiol levels. I’m going to cycle off of the I3C, Calcium D-Glucarate, and DS Triazole every 8 weeks, with a 4 week break. Doc told me to let him know if I need Arimidex, but just don’t want Arimidex, want see if there is a holistic approach to this, first. I don’t know if it’s good to cycle on/off Clomid, too since that causes a change in hormones. There is still so many unknowns with long-term use. The only research I’ve found is one conducted in the UK with a group of men for 3 years, and there weren’t any issues. Also, further research shows even HCG doesn’t hold up long-term for some, and Clomid is still a better option for those wanting to preserve fertility.

I changed my workout routine as well, AST might be from my previous routine, yes, sore muscles. I’m going to run full labs again in 8 weeks, and will post results. I don’t want TRT therapy since we’re wanting more kids. Also, it seems many of the TRT options have just as many unknown side effects, if not worse. Positive note, my wife is pregnant, and we’re having a healthy baby girl, so Clomid definitely helped.

#9

Hello. I just want to briefly chime in here. I don’t have all the answers; as a matter of fact, I just recently returned to this site because I’m having trouble with my own low T treatment.

However, I did recently discover that clomid seems to cause wicked insomnia for me. I took clomid for years thinking that my insomnia was caused by stress and other illness, only to be shocked when I started sleeping better when I stopped taking clomid. I think it snuck up on me because the insomnia appeared gradually.

By the way, I just want to say to anyone who is thinking about paying out of pocket for labs, never never never just walk into the lab and have blood drawn without some prior payment arrangement. LabCorp and others will absolutely rip you off, charging sometimes 20x as much as what they bill insurance! It’s a shame that their billing is so horribly unethical and predatory, especially considering what a valuable service they provide.

I did some research online before paying OOP for labs myself and found that there are several companies that will order your tests for you from LabCorp and secure a discount for you. (Best of all, you can order the tests you want and receive results all with no clinical visit.)

#10

Interesting, I haven’t had any side effects like insomnia. Occasionally, some mild tension headaches, but don’t think it’s from the Clomid.

I agree about the labs. It’s much cheaper to order online. I have a doctor locally that’ll do my CBC, Metabolic Panel, Estradiol Sensitive, and Test/LH for $52. I think the online tests are pretty good, too. They’re a little more, but very comprehensive. I ordered a test online for $245, covered thyroid and everything, went to LabCorp, took about 2-3 weeks to get results.

#11

All SERMs like clomid can cause high T–>E2 inside the testes and anastrozole cannot control that. If E2 is high, SERM dose is too high. SERMs are often misused.

Get Labcorp labs thru lef.org, see blood work, or other online lab companies. You can never get insurance to pay for labs done this way.

Some guys simply feel horrible on Clomid. Nolvadex does not do that.

hCG does not fail, testes change.

"taking anti-estrogen supps"
Exactly what? Anastrozole is best choice.