Clomid for Long-Term Use?

[cajuntx]

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.

[KSman]

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.

[cajuntx]

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!

[KSman]

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

[KSman]

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.

[cajuntx]

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

[KSman]

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.