T Nation

Clomid Question: Increased T, No Libido


#1

Hi all,

I'm 30 yrs old, have always been active in sports, lifted weights etc...I've never used anabolic steroids. I've been suffering from fatigue, general low drive, and depression for about 8 yrs now. (judging by the timing, I think this may have come from taking Accutane in college) I've seen a bunch of doctors...finally they found I was slightly hypothyroid. (I guess you have to be an overweight, middle aged woman for doctors to even check this).

I also had low T levels (as low as 227 total). I took a bionutrients test which showed that my Vitamin E, Magnesium, Zinc and Selenium levels were all low about a year and a half ago...I got those back to normal and my thyroid tests improved...I felt better but still not great.

About a month and a half ago my libido just completely shut down for whatever reason...NO erections at all...I was able to find a TRT specialist who told me I had the T levels of an Old man. My total T level was 443 (surprisingly high for how I felt), free T was 59 pg/ml and Estradiol was 32. My doctor put me on a 5 day Clomid challenge test and my T level rose to 740 and my free T tripled to 185 pg/ml...since I had such a good response, he prescribed 50mg Clomid M-F (2 days off) and Arimidex 3x per week...

It's been a full month since I started and I feel no better at all...This shouldn't be happening...I've had to turn down dates (potentially one with an Eagles cheerleader) and haven't been going out because my confidence has hit rock bottom. I'm trying everything...just started acupuncture...have been thinking about ordering a supplement called Passion RX which I heard good things about...

So my questions are...anyone have a similar experience that they recovered from? How long should it take and are there any supplements or anything that could help???

Thanks!


#2

Hey man welcome aboard...hopefully you can find what you're looking for here...

I have a couple questions:
-what is the bionutrients test? Was it from a specific lab, or what? I'd be interested in the specifics
-How did you go about getting your nutrient levels back to normal? Individual supplementation?
-What are your T and E2 levels with this treatment? Your doc should be following up with labwork
-Does your doc intend to keep you on clomid long term?
-Is it your libido that is in the tank (meaning you see women as objects of art rather than lust) or are you just impotent (no erections)? The latter can be bridged with cialis until you get going again/

It appears that you are secondary hypogonadal judging by your response to the clomid challenge. Unfortunately, I am not very familiar with good secondary treatment, but I do know the following:

-A lot of men have issues with clomid causing estrogenic side effects. These people opt for nolvadex and this helps resolve the symptoms
-You could be driving your E2 too low with the AI, or it could be too high from the SERM and not enough AI. Both of these can cause severe libidio issues. You need blood tests to put the pieces together.
-You need more blood tests, or post the results if you have them. Look at the Bloodtest stickey on the main page--those are the results we are usually looking for to paint the whole picture.
-If your HPTA was supressed for some reason (Accutane?) then the clomid challenge may have actually rebooted everything. I would talk to my doctor about weaning off the clomid slowly (over the course of 4 weeks!) and see if your HPTA has recovered and is able to operate without exogenous supplementation.


#3

Thanks...I really appreciate the response. To answer your first question, the Bionutrients test was done by Spectracell Laboratories...I took individual supplements - Zinc Glycinate, Magnesium glycinate, Wheat germ oil for Vitamin E, and Ionic selenium. I forgot to mention my B12 was somewhat low as well, although I had been getting a B12 shot every month for a while - didn't seem to make a huge change but couldn't hurt to get another. I've actually been vegetarian for about 4 years, so getting enough protein is a concern, but I do eat eggs every day and also fish at least 2 or 3 times a week...I actually switched to this diet for health reasons and thought it would help my fatigue, which started several years prior.

I just got my bloodwork done today, so I will post the results when I find out. I'm not 100% sure what my Dr's plan is - that's something I need to ask... My libido is weak but is on and off, and impotence has been the problem for the past month and a half. I'm hoping the last comment you made is the case...possibly my T levels have been rebooted by the Clomid but for some reason actually taking it is causing issues. I will discuss this with the doctor.

Thanks again!


#4

Slightly hypothyroid? Are you iodine deficient? Using sea salt [no iodine]?

Get a high potency B complex vitamin with trace elements and iodine.

What are your cholesterol numbers?

Please post lab results. Post numbers and we need ranges as well. Not all labs speak the same truth. Your problems may go beyond T.

Read the stickies!
Read the post of others.


#5

This was the most recent labwork taken before starting Clomid. I will update in a few days when I get my most recent results back.

Quest Diagnostics 5/3/11:

CHOLESTEROL TOTAL: 185 125-200 mg/dl
HDL CHOLESTOROL: 85 > or = 40 mg/dl

TRIGLYCERIDES: 64 <150 mg/dl
LDL CHOLESTEROL: 87 <130 mg/dl
CHOL/HDLC RATIO: 2.2 < or = 5.0

VITAMIN D, 25 OH TOTAL: 27 30-100 ng/mL

TSH, 3RD GEN: 2.60 .40-4.50 mIU/L
T4, FREE: 1.2 .8-1.8 ng/dL
T3, FREE: 3.0 2.3-4.2 pg/mL

SEX HORMONE BINDING GLOBULIN: 26 (Ref Range not established)
PROGESTERONE: <0.5 < 1.4
ESTRADIOL: 32 13-54 pg/mL
TOTAL T: 443 250-1100
FREE T: 59.4 35-155

I have been taking Kelp on and off for a while, I actually switched to lugol's iodine a few months ago. Stopped taking it however, but I will stay on the Kelp. (I think the lugol's possibly made everything worse) Also since these results, I started taking Vitamin D3...about 10,000 or 20,000 IU a day...I understand fixing this issue will take time, but I think I should at least be able to get back where I was a month or so ago (General fatigue, No Impotence)


#6

Good that you set off correcting the D deficiency. Once you have front loaded at 10-20k iu for a couple weeks, you should back off to around 6-10k iu/day. 10k iu keeps me in the 80's range, which I feel is close to optimal, but I seem to need more than most.

Thyroid hormones are def out of whack. T3 and T4 are on the lower end. For whatever reason, iodine replenishment seems to increase TSH (that was the case for me, and a couple other guys I've seen on here). I'm not sure if that is short term while iodine stores are being replenished and things are clearing out, or what.

KSMan has more insight into that if he cares to share it.

Lipids are excellent! You aren't on a statin drug right?

Your E2 is slightly high for your T levels. Most feel best between 20-30, with the lower end of that range being more common. AI should help this. What is your current AI dose?


#7

So I heard back from my doctor, my Total T level is now 1182 and my free T is 244 after 5 weeks on Clomid (Original levels were 443 and 59). He didn't let me know my Estradiol level, so I will have to follow up on that...also for whatever reason he just decided to test my T levels so I don't know whether there were changes in thyroid, Vitamin D levels, etc... I am really not feeling better at all, can barely get it up and when I do, it's weak. His advice was to take 2 weeks off of the clomid which I've started doing over the past few days.

VTballa - I'm not on any statin drugs. I've been taking 1mg arimidex 3x per week for a month and have just stopped it a few days ago. I also have been taking the Passion RX herbal supplement 2 days on, 1 day off for a week...seems to be helping slightly but no huge change yet.


#8

Your erection difficulties and general feeling of unwell could be related to your high dose of Adex. 3 mg/week is quite a bit and could be driving your E2 into the ground...I would definitely get ahold of that E2 report


#9

TSH can swing with iodine replenishment [IR]. But when you finish IR levels and switch to maintenance levels, TSH will end up wherever it wants to be. Then you know that any issues with TSH are not a result of an iodine deficiency.

I was 98.4 F when I got up this AM, no iodine supplementation for 10 days [during road trip].

Low progesterone creates some concerns re downstream adrenal hormones.

With a strong clomid response, LH might be high creating some E2 problems similar to high dose hCG. Critical that you get on top of that E2 data!

If you feel emotional, might be the clomid and nolvadex should be tried. If short tempered and bitchy, that can be high E2. Clomid is the first line drug for things like this, but that is a problem, nolvadex should be.


#10

Hey I took iodine and my tsh/thyroid actually got WORSE. Which is why I opted for Armour Thyroid (which isn't helping I actually felt better mentally without it)...I think a lot of people here kind of focus too much on the thyroid when a lot of guys here don't actually have much of a problem...Like, yeah your thyroid hormones may not be at the upper range and your TSH may not be 1 but you aren't hypothyroid. Especially if you don't have any symptoms of hypothyroidism (depression, hair falling out but no bald spots, brittle hair, fatigue, weight gain, can't lose weight, feeling cold all the time).

I was also on Accutane when I was younger (I was also Vegan for 5yrs)...but I doubt there is a connection between your issues and Accutane but who knows as that is a nasty drug.

My advice? I would do what VT said and wean yourself off Clomid. See how you do. Your hormones seem to be fine so there may be another issue going on here. I definitely wouldn't take any thyroid medications if I were you.


#11

Just to add something that I have found out. I contactd a doctor who had a youtube video posted about using clomid or Nolvadex to raise testosterone. He stated it can really raise your levels. He should be releasing another video shortly he told me. Here is his 1st video

Anyway I asked him a couple of questions and this is what he had to say:

Hi, check SHBG - sex hormone binding glob also, w/ LH and T total + free values.

I asked if there will be a need to take Clomid or Nolvadex for life or use it as a kickstart.

Reply:

KICK START , THEN LATER USE LOWER DOSE THEN STOP.

IF YOU CAN TRY TO GET CLOMID.
BEST --

If you can get Clomid it would work better. 50 mg daily at night. TMX dose is usually 10-20 mg per day . 20 mg most common. Can have some E2 effects w/both

So after a period of time he recommends to be off it completely. Not sure how long though but I am going to try maybe a 4 week kickstart. But before I do I want to get my E2 levels checked so I have a baseline.

This is just something I wanted to share to keep in mind maybe.


#12

I stopped listening in the first 2 minutes when he started saying that Testosterone binds to Estrogen...WTF? I would rather let my dog steer my motorcycle than let this idiot drive my medical care


#13

I think he probably just worded it incorrectly.

Maybe more along the lines; Estrogen readily binds to the androgen receptors in cells which leaves less opportunity for the free testosterone.


#14

Hey all...thanks for the help...It's been several months - not really feeling any better. I'm pretty convinced it's a thyroid issue even though my TSH seemed ok...I just have all the classic symptoms - My hair is starting to get really thin and unhealthy looking, fatigue (especially early in the day), sensitivity to cold, etc... It didn't seem like Synthroid did anything after 3 months...but maybe I need to be on something like Armour or a natural thyroid med that also has T3 in it.

Could anyone recommend a good doctor in Philadelphia? My other doctor is very difficult to get in to see and he's outside the city...I'm starting to feel like it's not worth the trouble.


#15

I was just about to respond with a recommendation for you and then I noticed your last line, "can anyone recommend a doctor"

They are few and far between but you are lucky. I noticed that you live in Pa near Philly and one of the best Doctors in the hormone replacement world works out of Reading. His name is Eugene Shippen. I got his name from a list provided by a guy on the all things male website. It is moderated by a guy John Crisler. He is one of the best and there is a small group of them that understand all this.

I wanted to try Shippen first because he was close. I made the appointment, then got a copy of his book and realized just how much this guy knew. I went to see him and he was great. He really knows his stuff and this is his thing. I have been to see several other endos and they all blew me off. This guy has been helping men and women for years. He does almost no promoting like any good doctor would. He has a small unassuming office with his wife and another nurse helping him. He is not cheap but your insurance should cover some of it.

He suggested I go off my test and arimidex and Hcg and try just clomiphene for a while and see where my t levels come out. He gave me some pure testosterone drops that he has a compounding pharmacy make up. They work great.

Get his book, read it and make an appointment. Your very lucky that he is in your area.


#16

Hi Brip, what about other hormones like dhea and pregnenolone, cortisol etc. I noticed your progesterone was very low which could indicate that your hormone production is being shuttled towards cortisol(pregenolone steal) and eventually as cortisol levels drop this can also effect they way your body metabolizes thyroid and can cause hypothyroid problems even if thyroid itself is functioning ok?? I would be looking into adrenal fatigue/insufficiency. vidoe link about pregnenolone steal.


#17

regarding pregnenalone, I have been on a topical pregnenolone that I have a compounding pharmacy prepare. I was using 20 mg 4 times a day and adding 15 and 10 mcg of T3 with each application. The idea was to raise resting metabolic rate. The added pregneneolone was expected to raise cortisol. The T3/T4 was taken to fully utilize the cortisol. I don't think I did it long enough to say it helped but it did have me feeling better. I was hoping it would lower my E2 level that were in the high 30s and low 40 even on 1 mg of arimidex a day.

My present doctor said he did not think the added pregnenolone probably was not doing what I was hoping it would so I think the idea is still in the testing stages of theropy.


#18

I also want to take clomid but i wonder whether i have to take something that will bring the estrogen down when i will take it and i doubt the effectiveness of clomid since you guys are more for HCG..
Advice?


#19

Hello All,

I haven't posted on here for a while...this is just a follow up. My symptoms have not improved at all...still incredibly frustrated. I currently am seeing Dr.Garabedian who is part of Holtorf Medical Clinic. He has me taking Bioidentical T3 hormone to improve my reverse T3 issue. I started off taking 10mcg, now up to 20 mcg along with 2.5 mg of Cortisol. I've been doing this for almost 7 weeks...

Not only did this not make me feel better, I was feeling terrible with a lot of hypothyroid symptoms a few weeks ago. Feeling slightly better now either because my dose was raised or additional iron supplementation, but I still think it's too low and probably suppressing more thyroid hormone than it's providing.....

Along with this, my doctor has me back on Clomid...which I'm not too thrilled about because it didn't do anything for me last time. (My total and free test improved greatly but no change to my symptoms) I'm a bit worried because I've been on it for 7 weeks and I'm not taking Arimidex this time around, and I have no idea what my Estradiol level is because my current doctor doesn't even seem to test this....

My DHT level before starting the Clomid was 20 which was below the range (25-75). He didn't seem to concerned with this...but from what I understand this could majorly be contributing to my libido issues (and possibly my hair loss ones). What does Clomid do to DHT levels vs. Androgel or something similar? I'm really thinking I'm running out of options and should maybe try a testosterone gel...Any advice? These "Experts" are really getting me nowhere...


#20

just wanted to share with you that i've gone through a lot of the same trials that you have as well as dealing with the frustrating doctors who don't seem to care and/or know what they are doing.

saw one doctor - a highly recognized (and very old) urologist at UCLA medical center who told me, verbatim, "you're a good looking guy - you don't have anything to worry about"

this comment in response to my telling him how crappy and low i felt pretty consistently and with blood work to back it up.

LONG story short - i wanted you to know that i've done 3 testosterone pellet treatments so far out here in CA and they have been, so far, the best course of action i've had yet.

they are a pain in the ass - literally - to receive, but you do feel the results and you feel it consistently for about 4-6 months.

cheers