T Nation

Efficacy of Clomid


#1

Dear Forum,

5 weeks on Clomid

24 - 72 hours – possible deeper sleep, no significant change in elevation of symptoms.

Week 1 - no change, no change in elevation of symptoms.

Week 2 – slightly irritable mood, no change in elevation of symptoms.

Week 3 – very irritable and very moody, lots of anger, energy and frustration.

Week 4 – low depressive mood creeping up

Week 5 – depressed, low mood, original manliness/zest/personality sapped out of me. Had sex and penis felt numb, there were tingling sensations in penis and testicles and it was like it took a little more effort to get an erection (never happened before). My chest feels soft, slightly bigger and slightly sometimes saw.

My bloods at 3 weeks on Clomid:

LH - 7.78 IU/L [1.2 - 8.6]

FSH - 10.5 iu/L [1.27 - 19.26]

Testosterone - 14.7 nmol/L [6.1 - 27.2]

Oestradiol level - 173 pmol/L [73.0 - 275.0]

SHBG - 9.4 nmol/L [13.2 - 89.5]

*additional -

Ferritin level - 147 ng/mL [14.0 - 180.0]

Fasting glucose level - 4.8 mmol/L [3.0 - 6.0]

My oestradiol/estrodiol levels are sky high I don’t have oestradiol/estrodiol pre-Clomid. What the hell do I do, I want my old self back before this Clomid, I’m depressed and my manliness/zest is slowly but surely going?

What do I do? Immediately stop? Tapper off alone? Tapper off with AI? Immediately stop and take AI?

**Before clomid:

FSH 5.3 U/L (1.5-12.4)

LH 5.0 U/L (1.7 – 8.6)

Prolactin 178 uIU/ml (86-324)

Testosterone 7.90 nmol/L (8.64 – 29.0)

SHBG 10 L nmol/L (18.3 – 54.1)

Free Androgen Index 79.0 (22 – 104)

**

Support greatly appreciated.

Thank you.


#2

What is your protocol? Dose, and frequency? Most guys seem to do well on very small doses of clomid…anywhere between 12.5 - 25mg EOD. Some require more, but in general lower dose results in better results.

The good is you body responded to the clomid treatment. Your LH & FSH levels increased leading to increased production of natural T. Not knowing more details about your life, such as your desire for fertility, age etc, clomid, or a similar route, may be a great treatment for you.

The bad as you pointed out is the sky high E2. The risk with clomid is that via high LH testosterone is created in the testes in which case an AI would be ineffective. I recommend you read the HPTA stikie as there is great info specific to this treatment. If you cant get an AI, or it dosent work, you’d most likely need to consider lowering your dose which may lower your T and E, or move to an injection protocl where you can better control all variables.


#3

Thank you for your support.

Clomid dose = 25mg/per day

I’m 30 years of age & I was (pre-Clomid)/I am a fit & healthy young man, with an active sex life, with no history of any medical concern. My private doctors (highly reputable) did not advise of any HRT or Clomid, until I bent their arm and they agreed with Clomid. I initiated this whole Clomid process because I thought it was an avenue for ‘improving me’. It’s an immature decision on my part.

How does a healthy young man (with no original real need for Clomid get off it safely?). I want my zest back please.

Thank you lots, thank you.


#4

Your dose is most likely too high. Most guys do 25mg EOD, and maybe more guys do even less at 12.5mg EOD. Personally, I started at 25mg EOD, my E2 began to raise, dropped my dose to 12.5mg EOD and now feeling much better. Some guys actually see their T increase on 12.5mg compared to 25mg.

I was worried dropping my dose would cause me to crash. It’s goes against all logic as my thinking was the higher the dose the higher the T. For whatever reason, clomid just works differently. But in your case at least physiologically it’s working properly, and with the dose dialed in you may find great success.

If you’re done and want to change directions, please read the stickie. A lot of guys feel like shit on clomid, you could be one of them. The stickie covers it all, and is a critically important read to ensure you don’t experience an E2 spike or other issues as you come off.


#5

Thank you @azwildcats, you are a gent.

I’m new to forum platforms and the like, is there a link please? Cheers lots!


#6

#7

Thank you Sir.


#9

Read the stickie thrice, maybe more!

‘Some younger guys with low-T can restart.’ What does ‘restart’ mean? I.e. immediately stopping Clomid and letting the body do the work?

12.5mg Clomid EOD
AI 0.25mg twice weekly (one beginning and one at the end)

EOD = how many days per week? 4?

Does the above protocol sound safe? And how long do I stick it out with this protocol? (5 weeks like the above and then 1 week just with an IA at same dose as above)?

Cheers again!!


#10

Restart means that your body continues to produce normal T levels. TRT is a lifetime treatment, similar to insulin for diabetics. When you introduce exogenous T your body shuts off its natural production. After an extended period of time some people can not produce any, or minimal values, due to their system shutting down.

Since your levels were normal to begin with, only on treatment for a few weeks, and clomid stimulates your HPTA to produce your own T, you should be fine.

EOD is exactly that. MWFS, TTSM etc.

Tapering down is the way to go. Read up on clomid half life and you’ll know exactly what to do.


#11

This is easy. A lot of guys have a horrible experience with clomid. Ask to switch ASAP to Nolvadex. Most docs do not understand this anywhere, but things are more dismal in the UK.

E2=173 is way to high. This is happening because Clomid dose is too high for you. Did you have E2 tested before?

Clomid 25mg is way too much for you. Try 10 Nolvadex.

After you get this sorted out, your T levels will be what they will be for you and may or may not be satisfactory.

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.


#12

Thank you lots @KSman, you and all the members being here & commenting does lots for confidence & support. Thank you all.

E2=173 reading 28.07.2017. Unfortunately, I believe I do not have any other record of E2 in 2017 (I checked this with GP Friday gone) (which is uber silly from GP).

In week 3 I complained of the Clomid ‘making me frustrated’ and my endocrinolgist (former key endo at UCLH London, England) recommended increasing dose to 50mg/per day (even after seeing latest E2 levels).

Clomid has decreased my joint pain, and general strange aches/pains and fatigue (and I feel a little stronger, sleep is a little deeper, and I don’t wake up mornings always tired). BUT since week 4/5 low mood, had sex last Thursday 13th and things were fine-ish and I newly experienced numbness in penis, and tingling sensations in testicles, and it seemed it took extra effort to get an erection and my erection was softish and didn’t last like it used to. I used to be sexually active 3-4 times a week, week 4 & 5 on Clomid only once a week active!! My libido is sleeping away.

Right now, like today - I took 25mg of my Clomid and within 4-7 hours I had real low mood?!

Wiith 5 weeks of Clomid I have put on weight (have not weighed myself) - my appetite has increased lots.

I mean in the UK (with steroids and other general meds’) they say as soon as you see side effects QUITE immediately. I will email endo first thing in the morning about tapering off and putting your suggestions across.

I’ve posted thyroid panels before and GP ‘reassure’ me all is well. I don’t have a thermometer at my home nor weighing scales! haha! (recently moved out of parents home).

Iodine wise - I think I maybe deficient because scarce outer eyebrows the norm since 16 years of age.

@KSman from your experience and leading this forum - a 30 year old like me - will I get my normal zest,libido,erections back? I suppose Clomid wakes you up a bit - I have decided I can live with fatigue, brain fog and a temper, but not depression, reduced libido and erection stuff (even the slightest change/reduction real seems strange). **I have read as much as my brain can digest re: Clomid half life - 6wks to 3-6 months for Clomid to leave the body (if ceased immediately for example).

I have read avidly the HPTA stickies, I’m a bit thick and I can’t get my head around your recommended ‘Nolvadex tapering off of Clomid method’?

Much obliged for everything Sir.


#13

Good luck with the docs. They probably do not understand how SERMs can create high E2.

Many there are iodine deficient. If you do not eat much dairy, all the worse.

Your fT4 was below midrange.
Just get a thermometer and get it done. ;}


#14

@KSman cheers.

  1. Stop Clomid right now.

  2. 10 mg Nolvadex EOD - 4-5 weeks??

  3. Labs at week 5.

Are we good like that? Can I suggest the above to my endo’?

After the above, can I cease Clomid?

Cheers!


#15

Your SHBG is a bit low and if you ever decide on TRT you are going to have to inject at least E3.5D or EOD using smaller doses. If you had to bend your doctor’s arm to get them to treat you with Clomid or TRT, they are likely not going to be able to help you in the long run. I imagine it’s frustrating to have to wait months to see a doctor only to be jerked around do to inexperience!


#16

I do not know what your objectives were taking clomid. A switch to Nolvadex can be instant, not reason to pause, they both do the same thing. What you endo thinks or how he reacts is unknown.


#17

@KSman Thank you. What dosage and frequency of Nolvadex? Cheers.


#19

Consultant Update:

I saw the best UK male hormone endocrinologist, advisor to ministry of health & national health service, represents UK internationally. He’s gold standard, numero uno.

Delved through all of my paperwork, lab work, took symptom notes and consulted with me for 1hr 20mins. Nice chap.

He understands that commencing Clomid was out of my ‘anxiety’ to ‘improve’, that I had low T but was not symptomatic and I should and can (safe to) cease Clomid immediately.

Reading the great T Nation Forum online and going to the doc’ is making my head spin.

Advice? Even moral support guys. Please?


#20

Fairly straightfoward query, as before - is it Nolvadex as a standalone or with A.I?

Thanks.


#21

Your SHBG level is abysmal. No matter how you increase your testosterone, you will always have estradiol problems because of that low SHBG and your excessively free fraction of testosterone.

If your endocrinologist had any sense at all, he’d take your extremely low liver output of SHBG as a sign of metabolic dysfunction and attempt to treat it. Increasing SHBG would allow your HPTA to naturally adjust to a higher level of basal testosterone production, and you’d no longer have low testosterone.

The reason you were “asymptomatic” is because you’ve had an abnormally high FT% your whole life, but there are consequences to this. Lower SHBG values increase metabolic clearance of testosterone, but do not significantly alter metabolic clearance of estradiol. Therefore, you’re always going to be a bit estrogen dominant.


#22

How is low output of shbg treated? If AST and alt are good how do you treat what you call a metabolic problem?