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Pre and Post Results from Clomid: Looking for Advice


#1

So I have low-T due to a medication I am on. I was hovering around Test Total LC/MS/MS of 250ng. I am young and want kids eventually, so my Dr. put me on 25mg of Clomid daily. After 6 weeks my Test Total LC/MS/MS went to a shocking 1,068, except my estradiol shot to 61, which my Dr thinks is pretty high. My LH is currently high at 9.8. See below for a more detailed before and after test results. My main question is, well, what should I do? Should I get off of Clomid and see what happens? Should I go on an Estradiol reducing drug (I'm a noob, so i think the drug starts with an A?)? My Dr. Doesn't seem to knowledgeable on this subject, so I am looking for a new one, but in the meantime I figured you guys/gals know best. Is 1,000ng/dl of total test going to give me any more gains in the gym than say, 500/600? Also, my libido is almost non-existent, even with the increased T.

EDIT: Test results now include ranges. The pre-test ranges are the exact same as the post test (I verified this directly from my labwork results)

Pre-Results:
TESTOSTERONE, TOTAL, LC/MS/MS: 271 ng/dl (RANGE: 250-1100 (ng/dL))

TESTOSTERONE, FREE: 29.1 ng/dl (RANGE: 46.0-224.0 (pg/mL) )

TESTOSTERONE,BIOAVAILABLE: 53.6 ng/dl (RANGE: 110.0-575.0 (ng/dL) )

ESTADIOL: 29 pg/mL (RANGE: < OR = 39 (pg/mL))

LH: 1.7 mIU/mL (RANGE: 1.5-9.3 (mIU/mL))

SEX HORMONE BINDING GLOBULIN: 41 nmol/L (RANGE: 10-50 (nmol/L) )

ALBUMIN,SERUM: 4.0 g/dl (RANGE: 3.6-5.1 (g/dL) )

PROLACTIN: 14.2 ng/ml (RANGE: 2.0-18.0 (ng/mL) )

TSH: 0.98 (RANGE: 0.40-4.50 (mIU/L) )

FSH: 2.5 (RANGE: 1.6-8.0 (mIU/mL) )

Post-Results:
TESTOSTERONE, TOTAL, LC/MS/MS: 1,068 ng/dl RANGE: 250-1100 (ng/dL))

TESTOSTERONE, FREE: 106.7 ng/dl (RANGE: 46.0-224.0 (pg/mL) )

TESTOSTERONE,BIOAVAILABLE: 196.2 ng/dl (RANGE: 110.0-575.0 (ng/dL))

ESTADIOL: 61 pg/mL (RANGE: < OR = 39 (pg/mL))

LH: 9.8 mIU/mL Range: 1.5-9.3 (mIU/mL) (RANGE: 1.5-9.3 (mIU/mL))

SEX HORMONE BINDING GLOBULIN: 56 nmol/L (RANGE: 10-50 (nmol/L) )

ALBUMIN,SERUM: 4.0 g/dl (RANGE: 3.6-5.1 (g/dL) )

PROLACTIN: 13.6 ng/ml (RANGE: 2.0-18.0 (ng/mL) )

TSH: 1.75 (RANGE: 0.40-4.50 (mIU/L) )

FSH: 7.6 (RANGE: 1.6-8.0 (mIU/mL) )


#2

You need to lower your estrogen if you remain on this protocol. That would involve arimadex/anastrozole. Based on your levels you could probably due 1mg a week. Divide the tab at least in half an take a half tab 3.5 days apart.


#3

Thanks for the reply. Can I just jump off clomid completey or do I need to ween? Only been on 25mg ED for 6 weeks? My Dr didn't mention anything about weening only for me to make a decision on whether I wanted to stay on and lower my clomid, stay on same dose and put me on a anti estrogen, or jump off completely. I said as of now I'd like to jump completely and he never mentioned a taper.

What would you guys do if you had my options? Is 1000ng of T going to make that much of a difference if I can naturally get myself back to 500-550ng if I go off the other medication causing low-t?


#4

We really need you to add lab ranges to the first post. There is a pencil icon for editing an existing post.

Are you feeling OK on clomid?

Clomid dose is too high for you and high LH is causing a lot of T-->E2 inside the testes and AI anastrozole is not effective inside the testes and will not work. It is the nature of a competitive drug faced with T levels inside the testes that are around 100 times higher than serum.

Try 12.5mg clomid and redo labs in 3 weeks.

Read these stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

What meds, Rx and OTC are you taking? Maybe we can find alternatives that are not endocrine disruptive.

Your first labs with low T and E2=29 suggest that your liver is not clearing estrogens properly and some medications can do that by making demands on the same enzyme pathways that clear estrogens. Also, labs for AST/ALT might show some elevations. Do not do any training for 3-4 days prior.

TSH increased? Should be nearer to 1.0
This might be from switching iodized salt to sea salt etc.

TT=1068 is not a problem. However, high E2 will increase SHBG produced in the liver and then more T is bound and non-bioavailable as T+SHBG and that inflates TT. We really need the FT range as lab ranges are wildly different from one lab to another.

Please post more lab work, we are concerned with the whole package and do not have T-tunnel vision.

Where are you located? Affects your therapeutic and diagnostic options.

More T is better for muscle development. But it has to be the right T and E2 opposes effects of T. High E2 reduces energy, mood, libido, initiative and makes guys moody and intolerant.


#5

Wow, what a wealth of information, truly fascinating that you know more than my Dr, but in his defense he is a urologist, I should really be seeing an Andrologist.

But anyway, my Dr and I have decided to drop the medication that was causing the Low-T in the first place (opiate-based medication for chronic pain) and to stop the Clomid completely. Wait 12-16 weeks, get some blood work done and see where I stand naturally. A few years ago I believe I had a baseline of around 550ng of total test without any medication, which I'm hoping I can get back to without the opiates messing with my test.

Are there any issues with the above plan? Should I still be using Aromasin to get my E2 down even though I am stopping Clomid, or will just stopping the Clomid lower that on its own in a hopefully timely fashion? My Dr. believes the latter to be true (no Aromasin necessary and stopping Clomid cold turkey as I was only on it for 6 weeks). Would really love to hear your thoughts, as I am most worried about Gyno at this point.

I'll be going through opiate withdrawal by going off the opiates, but the Dr's have provided ample legal medication to combat the symptoms. I just want my F'ing libido back already. I'd rather be in pain and horny than not in pain at this point.


#6

Glad you are getting off the Clomid. That is nasty shit and kills libido - not to mention comes with a host of other unwanted sides. The Estrogen will definitely fall as the testosterone drops. If it was me- I would take some aromasin -12.5 mg eod for a week or so to kick start things. You will notice a spike in libido almost immediately as estrogen goes down. Aromasin provides a bit of kick and also has other properties that help when coming off. I would also take some products to help with the Cortisol that will no doubt be pumping out like crazy as you come off the opiates. Rhodiola Roseate helps with this if you want to stay natural or you can get a peptide like Cardarine


#7

CThanks for the tips! If I don't go on an Aromasin like drug am I at risk for gyno? Or do you think 6 weeks of clomid and at max 6 weeks of high estradiol shouldn't be a problem for gyno if I stop the clomid? My dr really doesn't want to give me the Aromasin due to potential side effects. Would love some advice. Thanks.


#8

The bottom line is you need to get off Clomid while having a protocol so you don't crash your T but also get your E down So, You still need a Serm (Like a Nolvadex) until you get this squared away plus an AI. If it were me - I would switch to Nolvadex asap - this is best for stopping / reversing gyno while also improving the LH (i.e. Will increase your Test but without the sides of Clomid). I would also take an AI - you need to lower your E a bit (it will come down on its own if your T levels drop
From coming off the Clomid). I would take 12.5 mg of Aromasin eod for a total of 4-6 doses to knock down the E a bit. It works well with the Nolvadex. Rather than stop the Serms cold turkey I would try 10 mg/day Nolvadex for a week right after stopping the Clomid then 10 eod for two weeks. If your doc won't script you these you can check out some peptide sites that sell SARMs (not to be confused with Serms) or get it from a Canadian pharmacy.

.


#9

Wow, sounds like I'm kinda f'ed if I don't buy those drugs, or is this in a perfect world scenario? Let's say I don't go on anything and stay off clomid, what am I looking at? I'm more of a take less of something if able to kind of guy.


#10

You can definitely just come off. 6 weeks isn't that long in the grand scheme of things. I was just recommending what I would do - but coming off is fine. You should get bloods done again after a month to see how you feel.


#11

You think my changes of gyno are small at this point without AI?


#13

Thanks for the reply and advice. What's this Canadian pharmacy you speak of?


#14

With your high E2, if you stop Clomid suddenly, your HPTA will then see the E2 and shutdown hard. Please see the HPTA restart sticky for ideas.


#16

Guys/Gals, sorry to beat a dead horse here. Let me elaborate a little more on my situation.

I'm not a power lifter, or really a body-builder by any means. I lift casually 3-5 times a week depending on my work schedule. I like to stay in somewhat decent shape, i.e., no flab and some chest and back definition (still working on getting myself into a leg day routine, I know, kill me). Will going off Clomid and not on an AI be detrimental long term for me? Or after a few weeks (4-6) will I be hopefully back to where I was pre-clomid?

If I'm in some serious trouble, I'll keep hounding my Dr., but he doesn't seem too concerned about the E2 considering I'm stopping the clomid completely, but everyone here does. Again, my Dr. doesn't appear to be the most knowledgeable in regards to andrology in general, but I'm sure he is a good Urologist. I think he specializes in kidney stones, but he was the only Dr I could get an apt. with in the city I was working in at the time.

I'm back working in New York City now, so if anyone has a great doctor that takes insurance PLEASE LET ME KNOW

EDIT: Just an update on my Dr, he called me back. I expressed my deep concern about the E2, and he said it's out of his field of expertise (who prescribes a medication and then can't deal with the side-effects of said medication, pretty poor judgement IMO, right?), but he apparently consulted an andrologist and they both agree that going off Clomid and NOT going on an AI or any other med is the way to go. I'm calling my general doctor (GP) tomorrow to see what his thoughts are, as he is pretty well versed in all aspects of medicine.


#17

Please see the HPTA restart sticky.


#18

I was prescribed Anastrozole 1mg ED. That is my only medication. My T is at 1,200 with E2 at 57. My new doc wants to bring my E2 down and then take a lab in a few weeks. He doesn't think my T will drop much as it hasn't in the 2-3 weeks off Clomid, and believes all my symptoms, including fatigue and zero libido are due to the high E2 (what you all have been telling me since I first posted, lol). After reading the HPTA restart sticky, 1mg of Anastrozole ED is a very high dose. I am interested in the solution dosing method,but have no idea really how to even begin dissolving this stuff in a measurable way, so if I can't figure that out I will probably stick to 1/2mg EOD. Is this a decent/safe dose? All suggestions are appreciated!


#19

25mg of Clomid ED seems like a lot. I just followed the restart sticky as my first attempt at a reasonable protocol (not the one my Dr. prescribed).

Yes, 1mg ED of ADEX would crash your E2 and cause your more issues. Again, I looked to the restart sticky as a reasonable place to start.

First, go to the pharmacy at the supermarket. Get a couple of oral syringes they give out for children's medicine. It should be a 1ml oral syringe. Next, I took an old small ibuprofen bottle (I've since upgraded to a 4ml glass bottle I found on ebay so I can see the solution) and I dissolved 1 mg pill with 1 ml of vodka. That way for example, .2 ml =.2 mg of ADEX. You can do more at a time, I drop 3 pills in 3ml vodka last time I did it. Just shake it before drawing the syringe.

I recommend .2 mg Adex EOD, then retest after 6 weeks.


#20

Thanks for the reply! I'll take you advice on the .2mg EOD of ADEX. I made the mistake of trusting the Dr after filling the script so I have taken 1mg yesterday, do you recommend I wait a week before continuing on the lower dose?


#21

I think I read that ADEX has a 2 day half life in your system. Yes, I would wait a week.
Then after you retest labs, you can use KSman's formula for dialing in adex to desired E2 levels. Just be consistent with Adex and Clomid until retested.


#22

I am completely off of the Clomid, been so for almost 3 weeks now. The only active ingredients, outside of food that are going into my body at the moment are ADEX 1mg (took the whole dose yesterday, so I will re-test labs in a week to see where I am at, then adjust dose accordingly), Vitamin D3 2,000IU and acetaminophen PRN for chronic pain, not to exceed 2,000mg per day. I am forbidden from taking ibuprofen due to the illness.