Short story is (probably secondary) low t at age 27. Level was 215 this spring. Now, after some exercise, weight loss, stress reduction, better diet etc., it is 265.
Endocrinologist said this was not serious and showing improvement, so wouldn’t do anything. Went to a TRT specialist who prescribed 50mg Clomid MWF.
I’ve been taking this for about a month, and it’s like I’m taking nothing…no side effects, and no positive results either. Will get labs done in several weeks to check.
I’d be interested in hearing any anecdotal info that people have about this. Does it usually take a while to work? Thanks
I had less than impressive results from nolva, but I didn’t run it that long and have issues with adrenal output and thyroid that probably effected the outcome.
Blood work will tell the story. My E2 rose with T, which would definitely counteract any benefit of increased T. If T and E rise, you can try knocking E down and see how you feel.
Worse case it will provide some diagnostic info. If LH/FSH are high but T is low, you know you are primary and need to look at replacement. If LH/FSH are still low, you can probably assume you are secondary. You could try an HCG challenge to confirm.
Thanks. I am curious to see what the E2 will look like…although I already asked this doctor what he would do if it was high. He is not a fan of aromatase inhibitors because of bone density issues. My bone density is a little low now, and I’m taking vit. D to counteract that. We will have to see what happens.
Got my lab results and met with the TRT doc, so I figured I would post a follow-up. Results from about 5 weeks of Clomid 50 mg MWF:
Total T went from 265 to 697
FSH went from 2 to 2.5
LH went from 2 to 2.5 (these seem suprisingly low for the T level. Doctor thought they might have been higher and then cycled down)
Estradiol went from 28 to 38
Actual change in low-t symptoms: essentially none
Now I have to decide what to do. Doc gave me a few options:
Continue with Clomid to 6 months and then taper off for 3 months. Is possible that the SERM is masking the benefits of the higher T, and that those benefits will be more evident afterwards. SERM could permanently raise T. Supposedly this happens in around 40% of patients.
Switch to HCG only
Switch to TRT
There is also the concern of the estradiol. 38 is a bit high, but not drastically high, and anyway the T to E ratio has doubled, so you would think that the overall effect would be better. This doctor does not seem too thrilled about using AIs because of bone density issues. Since it only has to go down a moderate amount, I am looking into using some Zinc. Will have to do more research.
AI’s work by inhibiting the aromatase enzyme in serum from converting T to E. Once the T-E conversion has taken place, it’s useless.
If E2 drastically rises with a SERM, then it can be tough to diminish these E2 levels because the aromatization is probably happening inside the testes, not in blood serum. I don’t believe AI’s can counteract ITT aromatization. You’ll need to let your liver clear out the E2 that’s already in the blood, and reduce the SERM dosage, if not taper completely off.
Now, that doesn’t seem to be the case with you. After 5 weeks on Clomid, E2 has gone up a little. 38 is still high, but it’s not drastic (like 60 or 100). An AI may be helpful. Here’s a supplement I found on LE that I’m considering getting:
I used Clomid instead of Nolvadex because that’s what the doctor prescribed. I’ve read on here that some people have more side effects with Clomid, but I haven’t experienced any problems. Sample size of one, so take that for what it’s worth.
Regarding the long-term effects of a SERM restart: the 40% is an estimate from the doctor. He did say that people seem more likely to experience this result when the secondary low T is from a specific, identifiable cause (like steroids). That’s not really the case with me, so apparently my odds for that result would be lower.
How do I feel? Okay, I guess. It’s hard to know if things that I notice are results instead of a placebo effect. I haven’t had the kind of light-bulb-clicking-on experience that some people describe. Energy and libido not particularly high.
I would be interested in hearing how the HCG works out. I have read that it can produce the numbers without any change in symptoms, but I guess the only way to know is to try it. I’m concerned about maintaining fertility in the long term, so HCG would be better if it worked.
Noticed my nipples have been kind of sore for a couple days…I’m paranoid about getting gynecomastia. With that and the higher than ideal E level, I am trying out zinc. 60 mg today, and 35 per day after that. Multivitamin has 1 mg copper. Will see how this goes.
[quote]TheRedneck wrote:
Yes, it is higher than I’d like.
What do you think about the idea that AIs will lower bone density?
I will see how the zinc works for now.[/quote]
I think zinc will do jack all in lowering the e2, hope I am wrong. Because if zinc would be that effective everyone would be on it instead of forking out more money on prescription AI’s.
The bone density I am also interested what ksman thinks. I was under the impression that this could be an issue in high dosages for a long extended time. So if females are on 1mg a day for years this probably comes into play??
I’ve been on 50mg Clomid EOD for 3 weeks. Started getting hot flashes about 2 weeks into it. Get them probably 10 times a day, mostly in the evening. Kind of annoying, especially since I’m noticing no benefit.
Not sure if I’ll stick with it another 3 wks to my next appt.
Fixrun: Hot flashes might be because you get estrogen side effects from Clomid. You can try Nolvadex and see if that provided relief.
Bone loss from AI: AI’s do not cause bone loss. Low estrogen’s cause bone loss. As we are modulating E2 levels within normal range, there is no issue. And note that the bone loss issues are for women where AI used causes deep estrogen deprivation. For males, testosterone maintains bone health by creating an anabolic state that maintains the foundation of bone structure - collagen. Men with low T suffer bone loss.
Well over three months on Clomid 50mg MWF. Will ask for a second round of bloodwork, but I doubt anything has changed substantially. (After five weeks, T went from 265 to 697, E2 went from 28 to 38.) Feel no changes in symptoms at all. Apparently this happens often with Clomid. Side effects have been pretty minor: some temporary blurry vision and small amount of acne. No big deal.
My options now are:
A. Stay on the six month Clomid treatment, and see if the symptoms improve when I taper off. Clomid side effects can sometimes offset effect of T gains. Doctor says this is possible, but unlikely.
B. Stay on the six month Clomid treatment, and try to knock down the E2 with an AI to see if that is counteracting the effects of the rise in T. My guess is that this won?t do much?I raised my T to E ratio a lot, so you would think that would have some effect if the T to E ratio was the problem. I have also read that Estradiol works in a way that can make E2 levels misleading.
C. Try Hcg monotherapy. Am leaning towards this option.
I have been looking into related issues based on KSMan?s advice:
Iodine: Had low body temps (varied but generally around 97.6 midday) and always felt cold. Took about 700mg Iodoral over a period of time. Body temps went up to around 98.1 midday. Now have been at maintenance dose of 12.5 mg/wk. Body temps seem to have slipped a bit?back to 97.8 or so.
Adrenals: I am almost certain that I have adrenal fatigue. Spent years working in extreme high stress job with long hours. Used to pull all-nighters on regular basis. Terrible nutrition, no exercise, stress from personal issues. I came close to having a nervous breakdown. Eventually made a lot of changes starting about 9 months ago. No longer feel awful, just kind of ?.blank.
I have read Wilson?s book, and tried the pupil dilation test, which showed I have adrenal fatigue.
Well over three months on Clomid 50mg MWF. Will ask for a second round of bloodwork, but I doubt anything has changed substantially. (After five weeks, T went from 265 to 697, E2 went from 28 to 38.) Feel no changes in symptoms at all. Apparently this happens often with Clomid. Side effects have been pretty minor: some temporary blurry vision and small amount of acne. No big deal.
My options now are:
A. Stay on the six month Clomid treatment, and see if the symptoms improve when I taper off. Clomid side effects can sometimes offset effect of T gains. Doctor says this is possible, but unlikely.
A. Stay on the six month Clomid treatment, and try to knock down the E2 with an AI to see if that is counteracting the effects of the rise in T. My guess is that this won’t do muchâ?¦I raised my T to E ratio a lot, so you would think that would have some effect if the T to E ratio was the problem. I have also read that Estradiol works in a way that can make E2 levels misleading.
C. Try Hcg monotherapy. Am leaning towards this option.
I have been looking into related issues based on KSMans advice:
Iodine: Had low body temps (varied but generally around 97.6 midday) and always felt cold. Took about 700mg Iodoral over a period of time. Body temps went up to around 98.1 midday. Now have been at maintenance dose of 12.5 mg/wk. Body temps seem to have slipped a bitâ?¦back to 97.8 or so.
Adrenals: I am almost certain that I have adrenal fatigue. Spent years working in extreme high stress job with long hours. Used to pull all-nighters on regular basis. Terrible nutrition, no exercise, stress from personal issues. I came close to having a nervous breakdown. Eventually made a lot of changes starting about 9 months ago. No longer feel awful, just kind of â?¦.blank.
I have read Wilsonâ??s book, and tried the pupil dilation test, which showed I have adrenal fatigue.