T Nation

Clomid Side Effects


Some quick info about me: I'm a married 30yo, been on some form of TRT for the last 3 years. Right now I'm seeing a urologist who took me off Androgel and put me on Clomid last spring, because my wife and I want to have a baby.

After 6 weeks off Androgel and 2 weeks on the clomid, went back to see the doc. He asked me how I felt and I said I felt no difference, still exhausted, etc... He countered with "well I have good news!" and told me my total T had gone from the 200's up to the 500's.

At the time, I thought well shit, it must be all in my head. After finding this forum I realize that total T is not the only important factor. But I need some guidance as far as what kind of blood work I should ask for. Heres a list of symptoms/concerns:

-Always tired
-Cannot get out of bed in the AM (used to wake up 1st alarm, all the time)
-Complete lack of motivation to do anything
-I've gained quite a bit of fat and lost muscle, I look significantly different now than even before I'd ever been on TRT.
-Sex drive is pretty low
-I have less of an appetite than usual
-Workouts pretty much suck, make me feel beat instead of invigorated

I have all the blood work going back for the 3 years if you need it, but since being on Clomid I only have Total T and sperm counts. My family doc actually did test for things like Free T and LH. No tests have ever been done for estrogen levels. Can anyone help me dial in what tests I should ask for, and why I need to ask for them?


I was on clomid briefly and my T value was 790, a tripling in T from 240 with half a tab!

Why would you go for a total of 6 weeks without TRT?

What were your T values during most of your TRT and on Androgel?

My andrologist-urologist checks LH, FSH, prolactin, and estradiol. He checks hgb and hct, but that has little to do with symptoms or treatment for hypogandism - just checking to see that blood doesn't get too thick.


Post labs and ranges.

What was the dose of Androgel.

Your had TT=200+ on AndroGel. You were not absorbing and probably converted a lot to E2 that would make you fat and bitchy. Non absorption of transdermal T is a symptom of hypothyroidism.

age: 30

feel cold easily?
getting iodine in your salt or vitamins?
how do you react to major stress?
you feel wiped out in the afternoon?
changes to skin, nails or hair?
any reduction in your width of peripheral vision?

Keep using this thread for your updates and questions. Do not inject your "case" into the threads of others or the stickies.

Read the stickies and posts of others.

Check your body temp when you first wake up, before getting out of bed. Record this for a while. Ideal is near 97.8, 97 or lower is a definite problem.


What was your dosing like? I take 50mg every other day.

I went 6 weeks off of TRT, to "reset" before my first appt. with the urologist. This was at the suggestion of the referring urologist, who told me I was "fine" and was ready to show me the door until I told him I haven't had morning wood since I was 21 or 22. At that point he gave me the referral b/c he felt he couldn't help with hormonal issues.

I'll post my bloodwork shortly. Looking through them, I've had LH, FSH, and Prolactin tested before and they were all normal even when my T was low. Estradiol has never been tested.


My T was not 200 when I was on Androgel, that happened when I came off it for 6 weeks prior to seeing my current urologist. That probably changes your mind about the hypothyroidism?

My dose of Androgel was 4 pumps, or 5 grams per day. When I was on it, I felt like it masked the fatigue but didn't feel like it completely went away. I did notice a difference through. I also got more muscular than I had ever been, although with more bellyfat that when I was younger. a few people I play ball with said I looked like I was juicing. If you look at my profile, those pics are from when I was on Androgel. I don't have any good pics of what I looked like before, but I can post some current pics if that would help. I've basically retained the fat but lost alot of the muscle.

Tried upping the dose to 6 pumps/7.5 grams for a while, but it had no effect on how I felt.

Age: 30
Height: 5'11
Weight: 190
Waist: 34

feel cold easily? No.
getting iodine in your salt or vitamins? My multivitamin says it has 150mcg Iodine 100%dv.
how do you react to major stress? People would say I get stressed out easily
you feel wiped out in the afternoon? YES
changes to skin, nails or hair? Before TRT, I noticed my skin was really dry and I was really thirsty all the time. On androgel, that went away for the most part. Now on Clomid, dry skin and thirst are back. My hair is receding(baldness is in the family). Body hair is growing like a weed though.
any reduction in your width of peripheral vision? Not that I've noticed.

I forgot to mention in my 1st post, another symptom I have is no morning wood. that's probably important.

Blood work to follow in my next post.


Blood work, from most recent to oldest. All blood was drawn early in the morning, not fasted.

(Age 30, Clomid 50mg every other day)
s-TSH 1.26 uIU/mL (0.34-4.82)
TESTOSTERONE, FREE 69.9 pg/mL (47.0-244.0)
TESTOSTERONE, TOTAL 345.0 ng/dL (245-1600)
TESTOSTERONE, %FREE 2.0 (1.6-2.9)
SHBG 32.2 nmol/L (13-71)
FREE ANDROGEN INDEX 37.1% (14.8-95.0)
ESTRADIOL 35.2 pg/mL (ND-56)
DHEA-S 249.0 (80-560)
VITAMIN D25 47.7 ng/mL (31-100)

March 2010
Total T was @500 (dont have a copy of the bloodwork, but I think this is all he tested. This was a few weeks after starting Clomid 50mg every other day.)

(Age 29, After 6 week layoff from Androgel, before Clomid)
Prolactin 6.0 mg/mL (2.5-17.0)
FSH 5.4 mIU/mL (0.7-11.1)
LH 4.2 mIU/mL (0.8-7.6)
TESTOSTERONE, TOTAL 243.0 ng/dl (245-1600)

(Age 28, Androgel 5grams (4 pumps))
TESTOSTERONE, FREE 133.4 pg/ml (47.0-244.0)
TESTOSTERONE, TOTAL 518.0 mg/dl (245-1600)
SHBG 22.5 nmol/L (13-71)
Free Androgen Index 79.8% (14.8-95.0)
Ferritin, S 120.0 ng/ml (20-250) (done to check for Iron deficiency)

(Age 28, Androgel 2.5grams (2 pumps))
SED RATE/ESR 4 mm/hr (0-15)(I dont know what this was for)
s-TSH 1.13 uIU/mL (0.34-4.82))(I dont know what this was for)
Prolactin 11.2 ng/ml (2.5-17.0)
LH 3.7 mIU/mL (0.8-7.6)
TESTOSTERONE, FREE 66.7pg/mL (47-244)
TESTOSTERONE, TOTAL 302.0 mg/dL (245-1600)
SHBG 26.9 nmol/L (13-71)
Free Androgen Index 38.9% (14.8-95.0)
The following were also tested, I don't know what the reasoning is or what they mean
Rheumatoid Factor by NEPH <8.69 IU/mL (<15)
ANA SCREEN negative
ANTI-SCL 70 (SCLERODERMA 70) negative

(Age 27, had never used TRT at this point)
FERRITIN, S 167.0 ng/mL (20-250)(checked for iron deficiency)
TESTOSTERONE, FREE 77.0 pg/mL (47-244)
TESTOSTERONE, TOTAL 362 ng/dL (245-1600)
SHBG 29.9 nmol/L (13-71)
FREE ANDROGEN INDEX 42.0% (14.8-95.0)

Prior to this I was just trying various anti anxiety meds such as wellbutrin, effexor, and a few others I cant remember, as the doc thought that depression/anxiety was the problem.


Also important but forgot to mention: when I first stepped up to 5grams on the Androgel I felt fucking awesome, back to normal with good sex drive and energy levels. But it just started to wear off over time. Thats basically what happened between Oct '08 and Feb '10, mood, energy, and sex drive kept regressing, and that's why I got a referral to another doctor.


Sounds to me like E2 could be your problem. I would get that checked out on the double.


2.5 grams of Androgel isn't even a clinical dose. Why did he have you so low?

Yeah, you should get estradiol checked. I get it checked every doctor's visit, once every three months.

If you don't feel alright on 5 grams, you can go to 7.5 or 10 grams. My doctor - and most competent doctors - don't just treat what they see from a test, but also treat how you feel and symptoms. Recently my hematocrit got high, but being a young guy, my doc suggested I go from 10 to 7.5, but if I didn't feel alright, just go back to 10 grams.

I don't feel like myself when I'm below 700 or so, which is why my doc keeps me at 700 to 1000 ng/dl with ten grams of gel.

There's no need to "reset"; you just dump the Androgel and start taking clomid. Clomid also has a dose dependent response. You might not feel good at 50 mg every other day, but better at 50 everyday. I took 25 everyday, which turned out fine, but if there wasn't a good response, my doc would've went up to 50 everyday, or 50 one day and 25 the next. I felt very good on that small clomid dose.

You might not have morning wood, but still have nocturnal erections.

Get the estradiol checked.

You can have normal LH and FSH and still be hypogonadal.


Please go back to your post for the labs and use the "edit" in the lower RH corner and add the lab ranges to the numbers.

s-TSH is serum TSH, the hormone that tells your thyroid what to do. That is a good number, still good to check waking body temps.

Read the stickies, you will learn a lot.


Added reference ranges to lab results


Ok, I am going to ask for estradiol to be tested. Besides total & free T is there anything else I should be checking, given my past lab results?


Total T
Free T
Estradiol Sensitive
Vitamin D25-OH
Cortisol (8am blood draw)

have you read the blood test sticky?


Do not test only LH, test LH and FSH. LH moves too much hour by hour, FSH is steadier and is a better indicator. When on TRT, testing LH or FSH is rather pointless. We already know that your FSH is not high from a FSH secreting testicular cancer. Testing LH/FSH when on a SERM does provide good data.

Test DHEA-S. Your T levels are really low and FSH/LH are not. So part of the problem is with your testes. Low DHEA levels could contribute to this. Do not test DHEA, test DHEA-S.


My urologist sent me back to my family doc to get labs done. I posted my most recent labs in the blood work post above. Everything came out in the normal range, including estradiol and DHEA-S. My free and total T levels look about like they did a few years ago, before I ever started TRT.

I also remember seeing in a thread here once about the importance of the ratio between T and E2 but I can't remember what was considered good or bad.

Since everything is "normal" my doctor isn't going to do anything at this point. He suggested asking the urologist about upping the clomid dose. Anyone have any suggestions as to what I should do next?


are you still on Clomid? how long will you continue? any concern about the long term impact of continuous use?

did the doctor refuse to test your Cortisol levels?

push the doctor to treat your symptoms or find the cause of your symptoms (or find a new doc if possible). I had to go through 8 doctors before I found ones who knew what they were doing.


I am still on clomid. The doc says I can't stay on it for long so I'm thinking he will want me to come off it next time I see him, at least for a while. I can't be on anything else though since I want to have kids.

I just forgot to ask the doctor to test Cortisol levels.

I guess I don't really know what I can push my doctor to do at this point? Up the dose of the clomid? Does my estrogen level need to come down even though its in the normal range?


"I can't be on anything else though since I want to have kids."

hCG with TRT protects the testes. Sperm counts will go down, but one is often fertile. If not, clomid can be used when you want to make babies, or HMG. One could also stop hCG and use clomid for a couple of weeks every six months to episodically deliver LH+FSH.