T Nation

New Treatment Plan - Clomid & Armour thyroid (vs. HCG/Armour?)

Symptoms - Weight gain/inability to lose weight despite tracking all calories & exercising 6 days a week, low libido, frequent urination, always cracking joints.

I’ve posted my pre-treatment labs. To summarize:
Low T & Free T, Low e2, Low LH, High SHBG, low Thyroid T3 free

The doc put me on 12.5 Clomid EOD, .125 Anastrozole 3x/week, iodine, selenium vit d3,vit k2, dhea, stinging nettle root. After 2.5 weeks, I spoke with the doc’s assistant about my low e2. She said to drop the Anastrozole and take ad needed (I’m not sure why the doctor put my on the AI in the first place with such low e2).

The next set of labs are 4 weeks into this treatment. I have no improvements on symptoms. The inability to lose weight despite very tracked diet/exercise is the most present symptom, but other symptoms haven’t improved. The doctor from Defy I spoke to today said he thinks my thyroid needs to be improved. Therefore, he added Armour Thyroid to my treatment, and increased Clomid dosage.

The new doc changed my treatment to 25mg clomid daily, 30mg armour thyroid iodine, selenium, vit d3,vit k2, dhea, stinging nettle root. He suggested if symptoms don’t imrprove after 1.5 weeks, up armour dosage to 60mg, 1.5 weeks later to 90mg, and 1.5 weeks later to 120mg if symptoms still do not improve.

Since staying fertile is important to me, he didn’t want to suggest testosterone yet. He mentioned HCG instead of clomid as a possible treatment, and kind of asked me what I would prefer. I said I’m deferring to him since he’s a reputable doctor, as I’m open to whatever helps. He went with the increased clomid option. I’m not sure what the difference would be outside of what he said of Clomid also raises SHBG. He acknowleged SHBG was previously high, but wanted to try increased clomid dosage for the next weeks, and have this retested. I feel like if I suggested I’d prefer HCG, he would’ve been fine prescribing that, but again - I don’t know what’s best, and wanted to leave it to his judgement rather than swaying him one way or the other.

What do you guys think of my labs and the new proposed treatment plan? Does anyone have experience with Armour Thyroid they can share? What to expect on how to feel? My labs are below are it should be noted I began the first treatment on 3/4/19, so the second labs are taken exactly 4 weeks of that treatment plan. Are the slight improvement on numbers about what
should be expected?

Input is appreciated.

Thyroid is suboptimal, Free T3 needs to be at least midrange or preferably higher, Reverse T3 is good, iodine is essential for your thyroid. Armour Thyroid is the preferred thyroid medicine, though no personal experience.

TRT, HCG and when not enough, FSH does wonders for sperm production. Consider freezing sperm before TRT is considered.

Defy has excellent doctors.

@systemlord I know you’ve stated before that Clomid raises SHBG, which defy did acknowlege. From my understanding HCG gets the testes to begin producing more T, and does not have the SHBG increase. The doc entertained both the idea of increased clomid dosage or switch to just HCG. I’m hoping I’m not back to the drawing board after another 6 weeks of Clomid & now thyroid meds. I’m guessing just HCG would be the next step.

Any thoughts on the increase in free T as far as if this is a smaller than expected increase in a 4 week period, or about right? I’m guessing this will begin to rise more rapidly with going from 12.5mg clomid EOD to 25mg everyday. Should I be concerned with the SHBG rising rapidly as well?

With the e2, I read people here saying their sweet spot is 20-35. With my first reading being 7.4, and this next one showing slight increase of 12.6, I’m wondering how I’ll feel when I reach 20-25. The doctor told me to keep the AI and have ready to use in case I feel any high e2 symptoms, with the increased Clomid dosage. Is there a “rule of thumb” ratio of clomid to Anastrozole to counter high e2?

Thanks for any advice.

UPDATE: I’m going on week 4 of Armour thyroid treatment and increased clomid dosage. My body weight is still not changing with disciplined diet and exercise. I really haven’t seen any increased libido. The only thing I can say has changed is I sleep much deeper (DHEA im guessing?). I’ve began taking my body temperature in the morning and it’s always under 97 degrees (96.3-97 degrees).

From what I’ve read, it could take 12-16 weeks before body composition begins making changes. But I thought I would at least begin to see SOME progress. I’m only 10 weeks total into T treatment, and only 3 weeks in thyroid treatment. Is this just a matter of waiting for hormone balance to see results, or should I be on a different treatment?

In addition, I read that an increase in libido should be noticed in a matter of 3 weeks. I can say that I have not noticed this. All my parts are working, but the desire itself is not super present.