T Nation

Clomid User for 7 Months - Need Advice


#1

Im 44 and was feeling very week and lethargic all the time. Dr tested me for low t and it was 168. He told me to see a specialist and I eventual ended up with dr saya (started with crisler but he left). Was started on .25 clomid eod. Test went up to 480 e2 went up to 40.1 they stated me on anastrozole .15 compounded with dim 200mg 3 times a week. E2 came down to 30 test stayed around 480 for three months maybe four then dr saya told me to try .25 clomid ed and see if my t went up. I just had blood drawn after a few months of .25 ed and t went up to 520. Free dropped from 15 to 12 lh was 8 e2 was still 30.

I felt no better with 25 every day and since my levels barley climbed I think it would be best to go back to 25 eod. It seems like I felt better when I was eod.

The biggest thing that I have noticed while on clomid is considerable less anxiety than I normally had before starting it. That in itself is enough to keep me on clomid but I really havent had any other benefits that I have noticed. I wonder if I started trt and hcg would I still have the noticeable difference in anxiety along with the other benefits that come with a t level in the 1000 range?

If I get off clomid and start trt and hcg and the anxiety comes back will stopping and going back to clomid return me to the same place as before with the reduced anxiety and t levels around 500?

I really dont want to go back to living with anxiety again but I would like to feel better than I do now and its my understanding that 500 is still a very low t level and getting it around 1000 should make a world of difference.

Curious if anyone has any experience with going from clomid to trt and then back.

Is it normal for anxiety to lessen when getting your t levels to increase? It has made a huge difference on the quality of my life and I dont want to go back to dealing with it again. Thanks

My prolactin was 0.3 this last blood test. Can that be right? Is that bad


#2

You need to check TT, FT, E2 AND LH/FSH to see what the SERM is doing. If LH/FSH are lowish, your pituitary is the problem. If LH/FSH are high, your testes are the problem and hCG would have limited effects too.

Low prolactin is better than high, but perhaps that points to a pituitary insufficiency also notably if LH/FSH were low on the SERM.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Lethargy can easily also be from low thyroid function, often a result of not using iodized salt. You can eval thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid fT3 is part of the body’s temperature control loop and fT3 regulates mitochondrial activity in your cells, creating ATP, the foundation of your energy levels. Note that statin drugs can interfere with all of that in some individuals.


#3

Ksman thanks for the quick reply. After reading your post a year ago I took my temp every day for a week and it was low 96.4-96.8. I had my thyroid checked by an endo and he said it was fine. I started taking 200mcg of selenium and 325 mcg of iodine every morning anyway based on what I read in your thread. I really cant tell if it helped as I broke my old mercury thermoter and have not replaced it. I have a digital but I dont think its accurate at least it wasnt anywhere near what the old mercury one was before I broke it. Wouldnt my thyroid be ruled out if the endo said it was fine? I have his blood test results somewhere what do I need to look for?


#4

E2=30.5pg/ml with midrange T suggests that you are not clearing E2 as effectively as one would hope or maybe you have higher amounts of body fat where T can aromatize to E2. You will feel better nearer to E2=22pg/ml. Your current T and E2 levels make you quite estrogen dominant.

Anastrozole is all that is needed, DIM complicates things and ties you down to a compounding pharmacy. To get near E2=22pg/ml, increase dose by a factor of 30/22. But if you switch to TRT, everything goes out the window. Your LH=8 may be pushing up testicular T–>E2 as well. If that is the case, we know that anastrozole cannot control T–>E2 inside the testes - docs do not understand the reasons why. T levels inside the testes are very high and the T competitive anastrozole simply is out gunned. In some cases, T levels inside the testes can approach 100X serum T levels.

LH=8 is very strong, pituitary is working well with clomid. Your testes are weak and after this time, the testes have fully responded to LH and it does not get any better. A restart seems unobtainable and hCG would not be an option as that is simply more LH receptor activation which is shown to be insufficient. More clomid will simply may E2 worse.

With low body temps and low thyroid function, we can expect that transdermal T delivery would fail, leaving self-injected T as your best option.

The lab ranges of thyroid hormones are overly broad and the ranges include many who are not doing well. TSH should be closer to 1.0, T3, T4, fT3, fT4 should be midrange or a bit higher. If you have adrenal fatigue from stresses, there is a whole new level of complications.

TSH range 0.5 - 5.5 typical implies that people can have an 11:1 range of this hormone and be “normal”. Does not happen. And this statistical normal range is now interpreted to be a “normal” state of health which is ridiculous.

What was your source of iodine before?
Outer eyebrows sparse?
Dry skin or general hair thinning?
Feeling cold easily?

Thyroid can easily make your energy levels low, affecting every system in your body and create mood/depression issues.

The drastic change in prolactin is unexplained and a third lab would clarify. But the higher reading was not a concern and there is not evidence that prolactin affecting T levels.


#5

I switched back to .25 eod this week. I felt better eod and with t levels only going up 40 points taking it every day I just didnt think it was worth it.

Until I read your write up on thyroid function I never took anything as far as suplments. I now take iodine 200mcg and selenium and 325 mcg every day. I have been doing so for probably 8 months.

Defy’s pharmacy no longer compounds dim with anastrozole so they sent me .15 caps that they compounded. I asked for 1 mg tabs (I could source locally) I could split and take and they said I would not be able to get them exact and it would make my e2 crash if I took to much. They said they want me on .15 3 times a week. I think they like you using their pharmacy to get more money from you. I can complain about defy as other than that they have been superb especially if you compare them to the quack endo I was seeing.

I do take 200 mg daily dim supplement

What was your source of iodine before? DIET ALONE
Outer eyebrows sparse? FULL THICK DAGO BROWS

Dry skin or general hair thinning? Skin is fine. I am going bald. It has been slowly progressing for the last three years. I have very long hair and am starting to look like trump with the comb over. I am very vain about my hair and have worn it long in a ponytail since I was a young man 25 years at least. I tried finastrad some years back but had bad sides and quit after six months. From what I have read monixidl will not work on a receding hair line and that is what I am dealing with. I have thick hair on the sides and back but it is disappearing every more quickly from the hairline back. It seems to have sped up since taking clomid but it is probably just progressing naturally.

Feeling cold easily? No the very much the opposite I like it cold in the house and run the air on 67 at night. My feet do get cold from time to time but not the rest of my body.


#6

Dissolve 1mg anastrozole tabs in vodka,1mg/ml and dispense by the drop after counting drops per ml.

My formula for computing new dose works very well. Defy is shooting from the hip.

325mcg iodine is a maintenance dose, may not be enough to get out of the hole, but a good start.


#7

What would be the proper amount of iodine to take to get out the hole? With my tsh being 1.85 is that what you consider bad thyroid function? Any other test that I should look for or have done to see how my thyroid is functioning?

Do you think I would feel better if I started trt and got off the clomid? I like clomid and have not had any sides but if I can feel better with higher t then I would do trt now rather than years from now.

I was kind of hoping to be able to do clomid until I got closer to 50 then start trt. But if I can feel like I did when I was twenty now then I want to and if that means injections every 3 days then so be it.

Biggest fear is starting trt and getting my anxiety back. The biggest thing about clomid for me is I no longer feel anxious. Not sure if thats the effect of more T or if its something to do with clomid itself. Regardless I like it and do not want to lose it. Any thoughts on anxiety and trt vs clomid?

Have you known anyone who feel less anxious after starting clomid? Just curious if its normal to have reduced anxiety from taking clomid.


#8

Anxiety: Might be reduced by high LH. hCG injections might have similar effects acting on LH receptors. Many on TRT who later start hCG, single change, report improvements in mood.

I encourage you to seek the benefits of higher T levels and better T:E2 ratio by getting near E2=22pg/ml
Very few here are on clomid alone. In your case, testicular output is low and might become lower as high LH might degrade LH receptor response.

With my suggested goals, your body composition, mood, energy, libido should improve greatly.


#9

KSman thanks for the advice. I would like to feel the absolute best that I can and from all that I read here it seems like I would feel best with a t level of 800-1200. I would love to try trt and see how I feel on it. The only thing that worries me is if I dont like the way I feel can I go back to the clomid regimen that I am on now with the same results as before starting trt?

If I get on trt what kind of levels should I shoot for? I am a 44 6’2" 250 lbs fat guy around 30 bmi. I eat a strick paleo diet and have for 2 years. I dont work out at all but want to start some time in the future. Thanks


#10

you need to exercise


#11

It was so much easier in my twenties. Now that I am older I just cant seem to get started. I know that once I get into it for a few months it will be easier but I just cant seem to get started. I have pieced together a nicer weight pile than I have ever had and not used it once. I know I need to and I am trying but I have been saying that for almost two years now. I hate myself for being so fat and lazy. I have lost a little over 80 pounds in the last two years since cutting out carbs but that isnt enough. I want to get back to 200 lbs and I would like a little definition again. I was hoping that getting my t levels up would help me get motivated but that hasnt happened. I do feel better than I did but its not as big a difference as I was hoping for. My t level went from 176 at its lowest to 520 at its highest a few weeks ago. Will lifting stimulate my t levels any more than what the clomid alone is doing?

Maybe I just need to start trt and see how I feel with 800 to 1200 t levels. Maybe I would get motivated and start exercising with t levels much higher than what clomid can make my testies produce.
I am just scared that if I start trt and dont like it that going back to clomid wont work for me like it had been. I would hate giving up the little bit of progress I have made and not be able to get it back.