T Nation

Low T After Testicular Cancer. Advice?

Hey guys, long time reader, first time poster. Just trying to get some second opinions on my labs and see if there is anything else I should be looking for. I am 24 years old, and had my right testicle removed in 2018 due to cancer. Did not need chemo or radiation but obviously removing a testicle has altered my T levels. I have been attempting Clomid Monotherapy (2nd go-around with it now), due to trying to retain fertility and not take the leap into injections. I get some classic side-effects from Clomid, such as headaches and mood swings.
I will most likely be stopping this protocol soon due to not seeing a big benefit. My typical low T symptoms include fatigue, low motivation, decreased sex drive, trouble building muscle.

Height - 6’1
Weight - 180lbs
Activity Level - Sedentary job but weight train 4x week and kickbox/muay thai 2x week.

11/21/2018 (8 a.m. test)
Total Testosterone – 446 ng/DL (250 - 1100)
Free Testosterone – 80.9 pg/mL (46.0 – 224.0)
Bioavailable Testosterone – 180.5 ng/dL (110.0 – 575.0)
SHBG – N/A
LH – 4.4 MIU/ML (1.5 – 9.3)
FSH – 10.5 MIU / ML (1.6 – 8.0)
E2 – N/A
Albumin – 5.1 G/DL (3.6 – 5.1)
Prolactin - 8.1 NG/ML (2.0-18.0)

5/20/2019 (8 a.m. test, 25 mg / EOD Clomid)
Total Testosterone – 639 ng/DL (250 - 1100)
Free Testosterone – 111.8 pg/mL (35.0 – 155.0)
Bioavailable Testosterone – N/A
LH – 10.1 MIU/ML (1.5 – 9.3)
FSH – 24.9 MIU / ML (1.6 – 8.0)
E2 – 37 pg/mL (< OR = 29)

8/07/2019 (9 a.m. test, 25 mg / EOD Clomid)
Total Testosterone – 591 ng/dL (250 – 1100)
Free Testosterone – 90.0 pg/mL (46.0 – 224.0)
Bioavailable - 193.0 ng/dL (110.0 – 575.0)
SHBG - 29 nmol/L (10-50)
LH - 7.2 MIU/ML (1.5 – 9.3)
FSH - 17.3 MIU/ML (1.6 - 8.0)
E2 – 36 pg/ML (< OR = 29)
Albumin – 4.7 g/dL (3.6 – 5.1)

Stopped taking 25 mg / EOD of Clomid on 11/15/2019

12/07/2019 (8 a.m. test)
Total Testosterone - 443 ng/dL (250 – 1100)
Free Testosterone - 69.1 pg/mL (46.0 – 224.0)
Bioavailable Testosterone - 142.1 ng/dL (110.0 – 575.0)
SHBG - 27 nmol/L (10.0 – 50.0)
LH - 5.5 MIU/ML (1.5 – 9.3)
FSH - 9.6 MIU/ML (1.6 – 8.0)
E2 - 31 pg/ML (< OR = 29)
Albumin - 4.5 g/dL (3.6 – 5.1)

5/06/2020 (10 a.m. test)
Total Testosterone – 407 ng/dL (250-1100)
Free Testosterone – 56.1 pg/mL (46.0 – 224.0)
Bioavailable Testosterone – 125.2 ng/dL (110.0 – 575.0)
SHBG – 30 nmol/L (10 – 50)
FSH – 13.2 MIU/ML (1.6 -8.0)
LH – 5.0 MIU/ML (1.5 – 9.3)
E2 – 27 pg/mL (< OR = 29)
Albumin – 4.9 g/dL (3.6 – 5.1)

So obviously taking Clomid has raised my T, but also increases E2 as expected. Is the increase in E2 canceling out any benefit of the increased T? Is Clomid even worth it for me? Considering my remaining testicle is working pretty efficiently, the problem is that I’m just down a man.

I appreciate all of the knowledge you guys have shared on here through out the last year and a half that I have been reading. It has helped me tremendously. Thank you.

You can take test and be fertile with the use of HCG (You can actually be fertile without HCG and on test as well, it depends on you). Less sides, easy administration. And sorry about the cancer. My brother-in-law just died from testicular cancer, I’m glad that you did not.

Very sorry to hear about your brother sir. I agree with your fertility comment, I know it is still very possible to be fertile. I guess one of my other biggest dilemmas has been the idea of needing TRT for the rest of my life once I start, considering I’m only 24.