T Nation

First Few Weeks of TRT, Clomid?


#1

I'm 33, and a few weeks ago I had some blood work done and found my TT was 280, and FT was 48. I had suspected this and asked for the blood work, since i had been working out for several months and not gaining anywhere near what I used to gain in the same time, as well as generally feeling bad.

I was prescribed 1cc of 200mg/ml test cyp a week. Thankfully I had read just a little on this site beforehand, and I thought this seemed like a pretty high dose. I decided to try about 5/8 of a cc, or 125mg. I'm glad I did, because I woke up a few hours later with what had to be pretty high blood pressure- a new feeling for me, since mine is normally low/normal.

The next day I felt great. I've seen guys saying it can take time to work, but that wasn't the case for me. I'd forgotten what morning wood was- hadn't noticed it was gone, until it came back. Just feel much better in general. I decided to try a little less, maybe 3/8 a cc, or about 75mg or so, every 3 or 4 days, which has worked fine as far as BP. After four or five injections, it is working like I'd hoped.

However after some more reading, I'm starting to wonder if I shouldn't try clomid first instead. The injections are not easy for me, not because they hurt, but I just get really anxious and stressed over doing something wrong. The last one bled a lot but stopped within a few seconds, but I was all worried I'd injected into a vein, etc. It's just not easy for me at all.

But I could get through that easily if it wasn't for other doubts. The idea of shutting down my own production when it is not for sure necessary bothers me much worse. I don't have any kids but I plan to at some point, and I really don't want to create some kind of crazy rollercoaster of doc visits and tests for myself in the future if I don't have to.

So is clomid a viable alternative? I feel like I must be missing something, because if it was that simple, why is TRT so much more popular? Because it works faster and more effectively and in more cases I suppose? What else should I consider possibly?

Thanks for any help. I'm glad I found this forum. I can provide a lot more info if anybody wants to read it. I don't have detailed blood work- the only other measure in that part of the panel was SBHG, at 40 nmol/L. Everything else the doc ordered tested was pretty much mid-range, except very slightly elevated ALT/SGPT at 56 U/L and alkaline phosphatase at 158 U/L.

As for why this happened in the first place, I have a good guess- I have had several back surgeries after an accident and have been on a pretty small dose of opiates for about 10 years. That's all I can figure right now. My test was always towards the top end of the scale before a rapid falloff in the last year- I had hot flashes, and like I said about nothing doing at the gym, unlike every other time I got into lifting before. My doc is GP, not a specialist. Thanks for any help.


Low Testosterone, Medical Advice Needed
#2

More details-

I’m 33 years, 5’10 170. Waist is probably 32". Slightly thinning hair at the front, and normal, maybe a bit thin beard. Never carried much fat at all until this latest unsuccessful gym go round, where protein supps/ extra calories etc seemed to go straight to fat at my waist, which i’ve never seen before. That was my first real evidence something might be wrong, besides generally feeling bad. I’d always gained muscle easily, and couldn’t get fat if i tried. Suddenly it’s the opposite.

Diet I would rate as good/very good- semi vegetarian, just prefer it that way. A lot of tofu (which i’ve heard about its potential effects on T now), rice, vegetables, probably need more fruit though. Never eat fast food. Switched sugar for stevia in sweet tea this past summer (which is about the time this low T thing started i think), which I drink a lot of, and try to stay away from sugar generally. In the past, through my 20s, any time I’ve checked my T (which was only a handful of times) it was near the top of the listed range- I want to say 780ish, somewhere in there. Maybe over 800 in my early 20s. This past summer, before the symptoms started, it was 581. Then a couple weeks ago, 280.

This last time at the gym has been 5 or 6 months, 3 or 4 days a week. Nothing too extreme. Gains have been marginal at best. Before that I was pretty sedentary.

The other measure I have from a week before starting TRT-
Sodium- 135 (135-145)
Potassium- 4.4 (3.5-5.3)
Chloride- 100 (96-112)
CO2 28- (19-32)
Glucose- 94 (70-99)
BUN- 12 (6-23)
Creatinine- 1.06 (.5-1.35)
Bilirubin- .5 (.3-1.2)
Alk Phos- 158 (39-117)
AST/SGOT- 23 (0-37)
ALT/SGPT- 56 (0-53)
Total Protein- 7.4 (6-8.3)
Albumin- 5.1 (3.5-5.2)
Calcium- 9.9 (8.4-10.5)
Total T- 280
Free T- 48
SHBG- 40

WBC- 4.5 (4-10.5)
RBC- 5.03 (4.22-5.81)
Hemoglobin- 15.5 (13-17)
Hematocrit- 44.3% (39-52)
MCH- 30.8 (26-34)
MCV- 88 (78-100)
RDW- 14.4% (11.5-15.5)
MCHC- 35 (30-36)
Platelet count- 193 (150-400)

Cholesterol- 137 (0-200)
Triglyceride- 65 (<150)
HDL- 52 (>39)
Total chol/HDL ratio- 2.6
VLDL chol- 13 (0-40)
LDL chol- 72 (0-99)

TSH- 2.483 (.35-4.5)
Free T4- 1.22 (.8-1.8)
Vitamin D- 44 (30-89)

My TSH was .440 last summer, and I started taking a sea kelp supp. It’s nearer the middle of the normal range so I guess it is working, though I really don’t know much about it all. I know for a fact it helps with this skin irritation thing i get on my face sometimes, a little redness in different places. Taking that stuff knocked it out in a couple days. It comes back if I don’t take the kelp, then goes away in a day if I do. I pretty much never get sick, haven’t in years. This past summer however I developed some kind of persistent eyelash infection. It never goes away. I also take fish oil and lecithin, which seem to help the eyelashes thing, but it never goes away. Been taking both of those for about 4 or 5 months. Tried several topical antibiotics, steroids, etc, nothing helps. I also take 5k or 10k IUs of vitamin D whenever I think of it, a couple times a week. I don’t know how long morning wood has been nonexistent, but it’s been several months at least. I didn’t notice it was gone until it came back within a day or two of my first TRT injection. I’ve been taking melatonin to sleep after quitting ambien a few months ago, and it works. Can be sluggish when I wake up, but it seems like I’ve always been that way, ambien, melatonin, or nothing at all. I wish I could find out why.

Thanks for reading and for any advice. These first couple weeks of TRT I had several days where I felt better than I have in years, and I wish I could keep doing it without being anxious about long term effects. I am using 21 gauge to draw and 25 gauge 1 inch to inject in alternating quads. Haven’t tried glutes, I just don’t like the idea of not being able to see what I’m doing so well. I get a little soreness from the injections but not too bad. Only this last one really bled- very dark colored blood welling more than I thought was possible from such a tiny needle. Not a big deal at all i don’t think, but I stress a little too hard about hitting veins or just messing something up in general- just uncomfortable with it. Thanks again.


#3

Based on this thread, it sounds like I need to ask for clomid and aromasin? At what dosages? Do I have this right? If anybody has an idea, I’ll be glad to hear it and thanks.


#4

I’m 31 and had FT bouncing between 160-220 for the few years. I’m on my 5th specialist and I think I’ve finally got one that knows her shit. I’ve used this forum and other resources to educate myself and I wanted to bring my levels up without risking my fertility. Ironically, by the time I got a physician that knew the answers to my questions I’m done having children.

I wanted to try clomid before trt and had trouble finding a knowledgeable doctor.

The first endo told me since I had facial hair I was good

The next was a urologist who fought me on clomid for several meetings despite the stack of medical journal articles I brought in. Finally he acquiesced, but only 12.5 mg every other day. Brought my FT up to about 250. This doc swore there was no risk to fertility no matter how many articles and statements from the major urology associations. I didn’t trust him as he didn’t even know what to test for in blood tests.

The next urologist was a total fail and didn’t believe in prescribing trt to young men. Told me to go on a diet.

Next was another urologist who was much more knowledgeable but pretty apprehensive about trt. He knew a lot more about risks and treatment options as well as what to test for. My wife had just become pregnant but we wanted to get a little farther along before starting trt so we went with clomid again. 50mg every other day brought me into the mid 300s but I didn’t feel any better. I also had occasional stomach cramps and anal leakage once in a while every time I started the clomid.

Finally I decided I wanted to rule out pituitary problems and waited 8 months to get into a highly rated endo. She asked all the right questions and asked for the full blood work up to rule out cancer, tumors, etc. She wants to manage all my levels, not just test. She offered clomid, but I no longer care about fertility and we’re jumping right into trt.

She’s asked me to try Axiron first instead of the injection I requested. She wasn’t pushy, but indicated that there is a lower chance of affecting my body’s own production with this compared to injections. Her POV was let’s try this as it’s easier and if you don’t like it in a few months we’ll try injections.

I’m 6’2" 300 pounds (the main reason I’m seeking trt) and when I get down to 220 (trt, exercise, whole30 diet) I’m coming off the trt. She has indicated that coming off axiron is easier in terms of my body’s own production, but if I do injections we can use clomid after to transition.

That was a very long post but my point is that it took me years to find a doctor willing to go the clomid route and while it did bring my numbers up a little, I didn’t feel any better and it did have some side affects. When you decide to have children you can go off the trt and perhaps even use clomid to boost your fertility (it improves fertility).


#5

Thanks man. From what i’ve gathered it seems it is not good at all to be on TRT but not HCG. I guess i’ll deal with that first. Hopefully it doesn’t turn into a carousel ride of docs like it did for you.


#6

Got a script for HCG and arimidex from a different doc. After reading more, i held off on the last couple weeks for TRT in order to redo some more applicable lab work with this other doc and kinda start over. I think I did four injections totalling about 300mg over two weeks, ending the 12th, 10 days ago.

I wonder how long I would need to wait to get more accurate numbers on everything. Which ones would still be compromised right now? LH/FSH i guess? Do I really care if I’m pretty to very sure of the cause of all this?


#7

Oh boy. I just read in another thread that soy lecithin doesn’t help anything with this stuff. I’ve been taking it for this eyelash condition for like 8 months. A lot of it. It does help the eyes but it sounds like it is just an aggravation to the cause of the eye condition, which i think is somehow related to low T. All this stuff is confusing. What a trickbag. Now i’ve got to figure where to get some HCG. Should have this latest lab back in the next couple of days. This is really stressing me out bad, or maybe i’m just too girly now to manage, heh.


#8

Ok, I did 4 injections totaling about 300mg T cyp over two weeks, then read some here and began to think I needed a new doctor. The last one was may 12. On the 24th I saw the new doc, got a script for HCG and arimidex, and did some blood work, knowing that LH and FSH at the least would still be messed up, but wanting to at least check PSA, since my first doc didn’t even do that much. It might be useful to somebody as far as how fast some things do or don’t normalize after a small round of T, even without baseline data, so here are the results.

cortisol =15.5 (2.3-19.4ug/ml)
prolactin = 4.9 (4-15.2ng/ml)
estradiol =11.6 (7.6-42.6pg/ml)
ferritin = 85 (30-400ng/ml)
CBC- = all normal
LH = <.2 (1.7-8.6)
FSH = <.2 (1.5-12.4)
Total T = 304
Free T = 4.1 (8.7-25.1pg/ml)
PSA = .3 (0-4ng/ml)

Metabolic panel was all normal except ALT was just over normal. Any ideas on anything appreciated. I’m still waiting for the insurance company to talk to the doc for authorizing payment for novarel.


#9

Ok, had a change of plans. I went back to the doc and told her I wanted to try Clomid instead. I’ve been taking only Clomid, at 12.5mg ED for almost two weeks now. I began to feel better a few days ago. It’s working, for now. I haven’t really had any side effects to this point at all. Gonna go get some blood work pretty soon and check it out.


#10

Make sure you test for total t, free t and E2. Would be good to test for DHEA-s


#11

Hey RedandBlack,
I had a question on one of your other threads http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/low_testosterone_medical_advice_needed?

Can you take a look?

How have your eyes been?


#12

At about 3 weeks of clomid 12.5mg ED, I’m already over the hill and starting to feel worse. Morning wood came back and then went again a few days ago. I’m not familiar enough with the feelings to know but maybe it’s high e2. Gonna check Wednesday. I’ve got some arimidex at the pharmacy I might go get.

One thing I’ve noticed in a lot of threads, is that clomid seems to get a bad rap. Guys say “I was on 100mg of T for 2 years, then I switched to clomid and it just made me feel terrible”. It is quitting the T that makes you feel the worst, i’d bet. After only a couple weeks of TRT I felt horrible when I stopped, then much better for a while when I started clomid a few weeks later.


#13

[quote]dhickey wrote:
Make sure you test for total t, free t and E2. Would be good to test for DHEA-s[/quote]

Went to a different doc for a different reason and asked for a T bloodwork while I was there. Just got the results, unfortunately it is a single webpage saying my total T was 491 on the regular ~200-800 scale.

If there’s not some other kind of a results, what a ridiculous lab they are running. I know i specifically asked for SHBG and E2 to be tested, and they drew 3 tubes for it. Maybe it will come through later.

Anyway, that means 12.5 ED of clomid is having some effect. The gap where i felt worse for a few days was actually when i skipped a couple days, trying to go towards something more like 12.5mg 3x a week instead of every day. I felt worse right away. Sticking with every day has been good. There is a world of difference between the low and middle range in the way i feel, that’s for sure.


#14

It’s almost certainly your e2. I did the same thing, tried clomid only, and my e2 shot through the roof after having a few days, maybe even a couple weeks of feeling great. Could tell it was working because my nipples became very sensitive … which also means my e2 was likely rising.

$100 says you’ll feel better once you throw in an AI.


#15

Ok it has been close to 6 weeks of clomid 12.5mg every day. Feeling good, total T tested at 490 a couple weeks ago. I haven’t had any of the E2 symptoms at all, no sensitivity in nipple area whatsoever, and none of the moodiness. Do some people just not have problems with E2, or it just takes longer to develop for some people I guess?

The only thing i’ve noticed is some irregular heartbeat kind of stuff. I don’t really notice it until I’m falling asleep, so i don’t know whether it’s going on all day or what. But i get a rapid breathing kind of feeling, and not a rapid heartbeat but just a weird feeling heartbeat. Don’t know.


#16

[quote]dhickey wrote:
Make sure you test for total t, free t and E2. Would be good to test for DHEA-s[/quote]

Finally got the rest of the results. These numbers are a little more than 2 weeks old now.

E2 was 30 with a range of < or = 29. Yea, that’s how it was presented on the web page. Free estradiol was .78 with a range of < or = .45.

SHBG was 53 nmol/L with a range of 10-50.

I stopped the clomid a few days ago, after the heartbeat thing got a little creepier. For three nights in a row i could feel a fluttery unevenness to it. This wasn’t the first time i’d noticed it, but it was the first time it was this persistent. One day off clomid and it went back to normal. I’m gonna stay off everything a little while and go get a lab and see if i keep up the T myself. That would be nice.


#17

Took a few days off, then tried to ease into maybe 12.5 mg clomid two or three times a week. It’s not gonna work. I took some today and I’m trying to go to sleep right now but my heart is beating funny and actually hurts, and i have heart burn, which never happens to me. I guess my levels are already low again because my eyes are itching too. If somebody has any idea please help. What other options are there? I may have no choice but to do TRT but i really wish there was another way.


#18

Red. You really need to read the stickies. You seem to be floundering with issue that you could easily understand.

If you test LH/FSH after you start TRT, you should get zero’s a waste of time and money and your doc should have known better.

Read these stickies:

  • advice for new guys
  • thyroid basics [TSH should be near 1.0, not mid range]. Are you using sea salt? [BAD!] READ CAREFULLY
    – check body temperatures
  • protocol for injections, you could have been injecting with 29 gauge insulin syringes

You would also have seen that some guys feel terrible with Clomid and that does not happen with Nolvadex.

T dose was to low:
Total T 304
Free T 4.1 (8.7-25.1pg/ml)

TSH=2.5
Free T 4.1 (8.7-25.1pg/ml)
This should be mid range. This data [please check that you typed it right] indicates that <<>>. 8.7-15.5?


#19

[quote]KSman wrote:
Red. You really need to read the stickies. You seem to be floundering with issue that you could easily understand.

If you test LH/FSH after you start TRT, you should get zero’s a waste of time and money and your doc should have known better.

Read these stickies:

  • advice for new guys
  • thyroid basics [TSH should be near 1.0, not mid range]. Are you using sea salt? [BAD!] READ CAREFULLY
    – check body temperatures
  • protocol for injections, you could have been injecting with 29 gauge insulin syringes

You would also have seen that some guys feel terrible with Clomid and that does not happen with Nolvadex.

T dose was to low:
Total T 304
Free T 4.1 (8.7-25.1pg/ml)

TSH=2.5
Free T 4.1 (8.7-25.1pg/ml)
This should be mid range. This data [please check that you typed it right] indicates that <<>>. 8.7-15.5?

Thanks for the response. This thread is probably hard to follow because it’s turned into a journal for me at this point, where I can keep track of which dates I’ve done what.

That total T = 304 was two weeks after I my last injection, and before I started clomid. I noted I knew the LH and FSH would probably still be bottomed out but I had them added to the other tests anyway, just out of curiosity. My insurance pays for it so it doesn’t matter to me if adding the FSH LH test meant they have to fill an extra tube.

The thyroid number of 2.483 is correct. This time last year I tested it and it was .445, just enough to show up as low on the normal range they use, of .5 to 4.5. I started taking sea kelp a few months later. Then this latest test showed 2.483.

Now I see what has happened. That’s Free T = 4.1 pg/nl (8.7-25.1 pg/nl); not Free T4, but free testosterone. Sorry about that, I’ll type the next one more clearly.

I just had another bloodwork done this past week. Body temp was 98.2. We’ll see what it all looks like on there. Hopefully the TSH number is closer to 1.0 like you say.

I think my next move will be trying testim for a bit. Maybe I’ll try a few months of that, and then take a few weeks off and use nolvadex or clomid, if I can stand it, then back to T. Or maybe I’ll man up and just do it right, inject T and HCG.

Thanks again.


#20

You can edit your posts to correct the lab results. See [edit] at bottom RH corner of the posts.

Don’t go by temperatures taken at Doc’s office for your thyroid body temp testing.