T Nation

Lab Results after 4 Weeks on Clomid

I’m receiving treatment from Defy Medical. I’ve been on Clomid for the last 5 weeks. The doctor started me on 12.5 Clomid EOD, and .125 Anastrozole 3x per week + a variety of over the counter supplemetns. 2.5 weeks in, talking with one of the nurses at Defy Medical aboutmy low e2 reading, and symptoms, she told me to drop the Anastozole.

I continued on just clomid and other OTC supplements that were recommended to me by the original trt doc I spoke with (iodine, selenium vit d3,vit k2, dhea, stinging nettle root). I have my blood tested 4 weeks from the start of my treatment (2.5 weeks Clomid/Anastozole/OTC stuff. 1.5 Weeks just clomid/OTC). Below are my previous lab results, and current lab results, with standard ranges in parenthesis.

Total test 579 (264-916)

Free test 10.9 (8.7-25.1)

LH – 2.7 (1.7-8.6)

Estradiol Senitive – 7.4 (8-35)

SHBG 58.6 (16.5 – 55.9)

TSH 2.090 uIU/mL 0.450 - 4.500 01

Thyroxine (T4) 5.4 ug/dL 4.5 - 12.0 01

Triiodothyronine (T3) 81 ng/dL 71 - 180 01

Triiodothyronine (T3), Free 2.4 pg/mL 2.0 - 4.4 01

T4,Free(Direct) 1.23 ng/dL 0.82 - 1.77 01

Reverse T3, Serum A 13.8 ng/dL 9.2 - 24.1 01

Thyroid Peroxidase (TPO) Ab 18 IU/mL 0 - 34 01

Thyroglobulin Antibody <1.0 IU/mL 0.0 -0.9

-----New labs taken 4/1/19--------
Total test 656 (264-916)

Free test 15.9 (8.7-25.1)

LH – 3.9 (1.7-8.6)

Estradiol Senitive – 12.6 (8-35)

SHBG not tested

Thyroid not tested

I have my follow up consultation scheduled with Dr. Caulkins from Defy later this week. I’m sure he will address many questions I have and provide recommendations. However, I wanted to share it here for comments or insight from the above.

My questions:

I’m currently 5 weeks in. I feel no relief in my symptoms, yet. Still stubborn weight hanging around, despite very calculated/tracked diet & exercise. Still low libido. Urination incredibly frequent, and always cracking joints. I do see improvement in lab results. Should I expect this to continue to improve and thus feel relief in my symptoms moving forward?

Would there be anything else you would suggest tested? Thyroid? SHBG? The above is what was tested, along with CBC and Hemoglobin. This was Defy medical who said these were the necessary labs to order. My SHBG was high in the previous lab. I was curious to what this would come in at. I’ve heard that if LH is tested, that could be a big enough indicator where SHBG isn’t needed?

Does anyone have experience with Dr. Calkins? I know Dr. Saya from Defy is very highly regarded. However, he was booked up for at least a couple weeks. I paid extra to get a consultation from one of the doctors instead of one of the assistants. I hope to get my stuff figured out and have the best plan moving forward.

Estradiol is still crashed. That is not good and causes symptoms.

Can you take another estradiol test? Make sure it’s going up.

Your thyroid labs should be repeated. They indicate a possible problem. Low Free t3 and t4.

When we’re the B4 labs taken?

Defy again starting people on an ai. Not good! They crashed you!

Curious also what otc supps did they tell you to take?

How old are you?

Your T3 is low and almost bottomed out, normal is midrange and optimal is high normal. It doesn’t sound like clomid is a long term solution, it rarely is because men feel no different even though levels are perfect, quite common.

Clomid will increase SHBG and probably why it wasn’t tested the second time around, it’s expected to be elevated.

I wouldn’t say estrogen is crashed, nothing a dosage adjust won’t fix. Anastrozole is almost always needed when on clomid since it possess dual actions as an estrogen agonist and an estrogen antagonist.

It’s time for TRT, two injections per week should do nicely.

Bull shit.

Oh really. How old is op? Does he want a baby soon? Wtf
Did he ever get thorough labs ?

Tell them they owe you for keeping you e2 very low.
Surprised they did not check fsh which is more stable than LH. This good idea to gauge if clomid is working and if necessary diagnose primary or secondary hypogonadism

Care to explain what you meant by bullshit? Crashed estrogen is 0, his is low and a simply dosage adjustment is all that needed.

Tons of men having babies on TRT when HCG and FSH injections are added to a TRT protocol.

Close to crash. Just as horrible.

The BS was for almost everyone needing an AI on clomid (he’s taking 12.5 eod)

I’m 33. I may want children in the future. The over the counter supplements they had me on (in addition to the clomid_ were: iodine, selenium vit d3,vit k2, dhea, stinging nettle root. The first labs taken were 2/11/19. I began treatment on 3/4/19. Second labs were on 4/1/19 (4 weeks later)

I will be talking with Dr. Calkins from Defy Medical this week to see where to go from here. No one with insight on him?

Is there an ideal range for free test to total test ratio? I hear 3%?

My thoughts from what I gather is that They started me on Clomid and Anastrozole. The Anastozole supressed my already low E2 for the first 2.5 weeks. Once I stopped teh Anastrozole, my E2 began to rise a bit, for the next 1.5 weeks. I wonder if I continued just ataking clomid if my T would continue to raise, while my E2 raised to a normal level?

Dr. Calkins is well regarded and you will be hard pressed to find such a doctor in sick care.

Clomid half life very long. You would need to take it for at least 2 months to see what you settle at.

Weight? Your pre treatment numbers MAY come up with diet, exercise, supps.

Are you taking any medications?

Did you ever check lipid panel, ferritin, metabolic panel, prolactin, glucose, a1c if your glucose is high?

It does not matter how good the doctors are you need to research, ask questions and be your own advocate.

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These were my complete blood labs taken on 2/11/19. Before treatment. I really don’t know what to make of it all. Any insight is appreciated.