T Nation

Clomid Therapy - Lab Help?


#1

Hello all,

I am a 30 year old male. So I initially started Clomid therapy 4 years ago. At that time I had a testosterone level of around ~250.

After taking it I immediately felt better and then those effect seemed to wane over the coming months.

I have now been taking Clomid 25 mg nightly for 4 years and feel worse than I ever did. My libido is completely nonexistent to the point that my marriage is really suffering. I don’t ever even think about sex. I am fatigued, moody (cry at sad stories on the radio). I had labs drawn this morning and they are below, compared to labs drawn in January. I have an appointment with my Urologist in two weeks.

7/11/18 Labs with reference ranges:
Prolactin 10 ng/mL (3-16)
Estradiol 48 pg/mL (10-50)
Total Testosterone 1385 ng/dL (220-890)
LH 7 mIU/ml (1-10)
FSH 5.8 mIU/mL (1-10)

1/22 labs (reference ranges the same as above)
Total Test 966
Free Test 140.7 pg/ML (35-155)
prolactin 8
Estradiol 42
TSH 1.168 uIU/mL (0.350- 4.940)
FSH 5.7
LH 7.1

Previously my Urologist stated I did not need an aromatase inhibitor as I was still in the normal range.

Do you think this is all Estrogen to blame? I defintely could lose a good 20 lbs (all abdominal fat) but I am healthier now in regards to diet/exercise then I was in January and the level is still on the rise.

Help!


#2

The crying spells is high estrogen, I’ve experienced it myself. You need to find a doctor that considers a plan of action based off labs and “symptoms”, not one chasing labs numbers. Obviously if you have high E2 symptoms, your doctor needs to take action. I have high estrogen right now and experience the same crying while watching sad movies, moody and irritable.

I noticed you don’t have any SHBG labs, it’s indicating you need a new doctor because this one seems hesitant. Inexperienced doctors are afraid of prescribing AI’s for fear of crashing estrogen levels. You need to seek a private specialists who can prescribe compounded doses of arimidex and properly balance all your hormones.

Men don’t usually feel well on Clomid at any dosage, why aren’t you on TRT? I advise you not to start TRT with your current doctor, endo’s and urologists suck at TRT. You need to seek treatment privately with a hormone specialists. Defy Medical is an option who offers telemedicine, I had a consult today and they are fabulous. All medicine is mailed to me. Doctors are top notch.

The alternative is what, continuing as you are?


#3

Do you plan on giving us the scope on your interaction with defy? With all due respect. U talk up a storm about defy u were super excited about the consult and you do not update us on your trt journey? Or am I being impatient?


#4

Not on TRT as I am trying to have children with the next year and told by multiple Urologist to wait until after done with children.

This doc I go to told me from the onset he was very comfortable with hypogonadism in younger men and clomid therapy in general. Per him the T:E ratio was more important than the number but I don’t know.

Always open to try a new doc… Live in Chicago if anyone knows someone local.


#5

There are tons of men having babies on TRT when HCG is added to the protocol, you can even add FSH treatment to your TRT protocol to get the wife pregnant, then stop the FSH until such time you’re ready for another child. Your doctor is a bit behind the times, your suffering seems unnecessary.

There aren’t many doctors who know how to play the TRT game.


#6

A few other labs came back:

TSH 1.819 uIU/ml (0.350-4.940)
Free Test 238.1 pg/mL (35-155)

Any other thoughts? Should I ask about going on an aromatase inhibitor at this visit?


#7

So I went to see my urologist today.

He says that given the above numbers I should “feel like a warlord.” He does not understand why I am feeling so badly. He thinks maybe we should reduce the dose of Clomid. I am currently taking 25 daily he wants me to go down to 25 mg three times per week with repeat labs in a month.

He does not feel Arimidex would be useful as the T:E ratio is still appropriate.

He also mentioned that given the fact that I have a history of TBI (bilateral frontal lobe hemorrhage following car accident) before this all began I should get an MRI of the brain. I am not sure what he would be looking for given my normal prolactin level.

Any thoughts on all this @ksman or anyone else?


#8

The majority of men on clomid generally don’t feel well even with good numbers are your doctor is stumpt which tells me one thing, he doesn’t do this sort of thing often or else he would know your results are quite common.