T Nation

High T with Low T Symptoms? Previously Had Low T


#1

I’ve tried to search this subject, but typing “high t with low t symptoms” usually comes up with TRT and the symptoms of low T

I used to have low T. before i started using Clomid, my T levels were in the 400’s. Clomid, 50mg every other day, boosted this level to 700 for my next test at 6 months after. Since then, I haven’t been able to find a doctor that will prescribe this (i moved). I had a lapse of a few months. So, I ordered some generic clomid online. I just had my blood test and my T is 1232 with free at 166.5. I am using the same 50mb every other day, though there is no way to tell if this is actually how much is in the stuff i ordered.

Either way, I am still tired, no muscle gain, no sex drive, etc… basically all the symptoms of low T.

Am i missing something?


#2

1232 ng/dl TT only on clomid?
if so, without aromatase inhibitor your estradiol must be sky high, a possible factor for your symptoms.


#3

Yes, thats what i was wondering. I was very surprised to see my results this time around. When i went from 400 to 700, i was like “ok that makes sense”… but now im pretty impressed with the numbers, but not the results. I think i need to add this in to my treatment. Is there one that is generally recommended?

By the way, I am 28 and otherwise healthy. My biggest complaint is the sex drive… i mean, i can get turned on but quickly lose it during sex… that shouldnt be.

The only thing odd on my labs was “high” test, a slightly high Creatinine (possibly due to all the ibuprofin i take), and HDL Cholesterol at 33, a bit low


#4

popular solution for lowering estrogens is arimidex/anastrozole.
but first you should do E2 labs.


#5

Yes, i am trying to get the doctor to add this test. They just ran mine a few days ago, so hopefully they can run with the sample they have. Whoa, why is anastozole 9 dollars a pill online?!


#6

i don’t know about the price, but usually a pill is more than enough for a week


#7

Can you post labs with ranges ? Especially FT. Clomid can raise shbg and this can inflate TT. FT is what matters for symptomatic relief. If the range is what I think it is for your FT, it indicates high SHBG. There’s a reason one does not self medicate. Just hopping on clomid is not treatment.


#8

Testosterone, TOTAL, LC/MS/MS 1233, range 250-1100 ng/dL
Testosterone, Free 166.5, range 35-155 pg/mL


#9

The range is age adjusted or generally low for the particular lab. We see a range upto 300 in most labs. With a TT so high, FT should be more. Considering this is on clomid, LH FSH and TT will all drop after a high dose SERM and it will leave you with low FT. I suspect that this was the case with your last run of clomid as well. You should also test e2 and use anastrozole if necessary. The thing about this is, clomid can distort your baseline numbers, sometimes it works, most time it does not. When numbers are inflated from baseline but one doesn’t feel better, the doctor does not know what is wrong as he doesnot know your baseline numbers.

If suspicion is true, you might have hampered chances for a good treatment. I estimate your current shbg to be in range of 70-80 (15-48 as the range). Did you know your LH FSH before you ran clomid. Clomid use would have only made sense if LH FSH were low. If mid range or higher, they tend to do nothing but make recovery harder.


#10

I am new to this, so you’re going to have to explain a bit. I do not know what LH FSH is, or SERM.

If i understand what you’re saying, the levels could be artificially inflated for the lab tests, and my actual levels might not be as high as these tests suggest. We also are considering that the clomid increased my E2, which could have side effects as well.

Either way, I will probably need to seek DIY treatment, even if its injections. Doctors are not friendly about this stuff.

The clomid was originally prescribed. My levels at 4 something weren’t anything that the doctor was going to do TRT with. After the second set of labs came back with 700, they decided the treatment was successful. And toa degree, i think it did something, as I was no longer falling asleep at the gym. When i moved, the doctor would not even consider continuing clomid because it was an “off label” use. In order to continue treatment, i got it online.


#11

anastrozole was 20$ for 30 pills at costco pharmacy. I’m sure they aren’t that cheap, but pretty close at alldaychemist.

You have a great result on clomid. Haven’t seen anyone report T that high on clomid.

Clomid doesn’t increase E2. Increased levels of T are converted to E2 by your body.

You also need to find a new doctor, someone with familiarity with T issues.


#12

Nice. 28 pills for $60. What kind of dosage? someone here mentioned 1 pill/wk… so i assume 1mg a week… online, i am getting people saying .5-1mg per DAY


#13

No!

I run about .5mg/week. I dissolve 1mg in 14ml of water, and then I dose a touch more than 1ml a day.

Based on your E2 number and your symptoms, I’d tune it from there. I had easy to identify and unambigious symptoms (wanted to scratch my nipples off) so it was easy for me to get it dialed in.

Those who pin often take a larger dose twice a week, but IMHO with clomid, you are better off taking smaller daily or EOD dosing.


#15

I have requested all the tested listed above and will probably go for bloodwork tomorrow or the following day


#16

Good deal. Emphasise your symptoms, your E2 may come back well within “the range”, as mine did, but if you have symptoms, it’s harder to argue with.


#17

Okay I’ll explain, LH and FSH are hormones secreted by the pituitary gland to signal the testes to make testosterone and other androgens. When these hormones are not being produced, testes don’t get the signal and they don’t produce T. There are two types of hypogonadism, one where these signalling hormones are not made by the brain, and other where the signalling hormones are made but the testes don’t respond to these hormones.

Clomid can be used when the brain is not making LH and FSH as clomid tricks the pituitary to make them. If ones LH and FSH were okay in the first place, that means testes were not fully receptive to the signal. Using clomid then, increases LH and FSH to where they’re not sustainable and will drop back down after discontinuation of the drug.

Clomid is half estrogen. 25mg of the 50mg is an estrogen in itself, it does not “increase” estrogen it is one itself. The increased LH and T increases E2 in the blood. Now when T is not being produced efficiently, and we administer an estrogen through a drug, SHBG increases in some men. This is a protein secreted by the liver and testes in response to estrogens and external thyroid hormones. Higher shbg “artificially” inflates TT measurement. Testosterone bound to shbg carries no biological significance. FT is what we are looking to increase. Shbg is also increased due to testes inability to produce adequate T in response to LH and estrogen load. T decreases shbg and estrogens increase it.

With your high total T but modest FT, it is my suspicion that clomid has soared your shbg very high and when you get off clomid, shbg will remain elevated and your LH FSH will drop from the aforementioned unsustainable position. This will lead to some drop in total testosterone and a bigger drop in free testosterone. Essentially, even with high TT numbers, it wouldn’t be biologically active and we face hypogonadism symptoms. Now a doctor doesn’t know your history and will wave his hand when you ask for treatment at a high total T.

This is my theory of your problems! You’re free to disregard. I’m trying to help. If you want to confirm or rule out my theory, you can get blood tests for LH fsh, shbg among others to see if that’s a problem.


#18

Thanks for the input! I just got back from the lab getting those tests you recommended. I should have answers on friday.

Thanks again


#19

Did you get TT with LH/FSH and SHBG? Also get E2. These labs should be done together!

I am worried that you may not get appropriate treatment now, that’s why i do not advise people to run clomid without established baselines with doctors.Doctors are particularly ignorant about Testosterone/ sex hormone problems and 99% still only look at TT despite huge evidence pointing to the contrary now.Do you have all previous blood tests before clomid? Please keep them in hand if my theory is true and you need a doctor. Finding a doc would be more difficult then and you would need to assert that you had been prescribed clomid from a doc when you had low T and it hasn’t helped with symptoms. Where are you located?


#20

I got LH/FSH SHGB, E2 … not TT cause that was done last week.

Im in east ohio


#21

I have requested all blood tests i’ve had since college. I have only ever taken 4 tests. The one in college is pre everything. Hopefully, they will send those.

let me add that i was literally falling asleep in the gym before the clomid. That is no longer happening. But the sex drive is low and all that… same with muscle mass, has been the same since college and i work out regularly.