T Nation

Read My Labs? Clomid Only - Urologist Suggested

Hi guys,

I’ve been lurking here for a few months and have appreciated the information I’ve read. I have some new test results from this week that I’m unsure how to read but want to be ready before I meet with my doc next week.
My stats
30 years old
195 lbs
17% BF
I just discovered that I have low testosterone (labs below) with 2 tests showing total T around 190. I went to a doctor and then a urologist and he prescribed me Clomid since my wife and I aren’t done having kids yet. I’ve been taking 50mg EOD. My total T went up over 1000 and all other data points are up. I have no clue what to do from here. Any advice or recommendations? I’ve included my old and new tests (taken 2 months apart). I’ve been on Clomid for 4 weeks.

Clomid is usually used for a short time to restart the HPTA and get your testicles producing testosterone again and isn’t going to make you feel your best. Lots of men on TRT having babies simply stopping TRT and starting clomid to restart the natural process again or staying on TRT and adding HCG and FSH injections. TRT suppresses FSH so injecting FSH increases sperm while on TRT when TRT+HCG isn’t enough.

Surely your urologist should have spoken to you about it. Beware most sick care (insurance based) doctors aren’t well versed in sex hormone therapies and those that do are in the private anti-aging and or sports medicine clinics.

Your urologist’s lack of testing shows they do not specialize in sex hormones, most do not. There is no Free T testing or SHBG which binds testosterone and estrogen and is the balance between Total T and Free T, Free T was never tested and is troubling. Free T is bioavailable to your body’s tissues, Total T is bound to SHBG and not bioavailable.

So what we don’t know is how much of your testosterone is available to your bodies tissues. Also note if SHBG was already high pre clomid, clomid will only increase SHBG further handcuffing your Free T and increasing Total T.

I’m assuming those second set of labs are your pre-clomid labs, LH being almost midrange should be seeing testosterone about mid-range as well. Normally LH is low and testosterone also low.

Maybe some testicle dysfunction, would have like to see a thyroid panel.

I’d cut the clomid back to say 25mg. 50 is a lot. You must tolerate it well. Sure looks like your balls are working fine do you think your doc will take a closer look at your pituitary gland.
I am amazed with a TT of over a 1000 your HCT is so low. I guess natural T does not thicken the blood to dangerous levels like TRT does. Also your E2 is staying range amazing. I want natural T damit.

I had my TSH with Reflex Free T4 came back at 2.06 on a scale of 0.27-4.20. Also Vit D and B12 checked. The tests you’re seeing are the ones I ordered myself. My insurance sucks so I wanted to do it on my own versus paying my doctor. He’s certainly no expert in TRT. It seems like I’ll need to get off Clomid at some point since it isn’t a long term solution.

There are no T4 receptors in the body, only T3 receptors and Free T3 is the only free thyroid hormone, it speeds up every cell in the body, Free T3 (not TSH or Free T4) increases body temperatures and increases metabolism.

Most so called thyroid doctors get this wrong, most doctors were not taught properly in medical school. Only those doctors interested in reeducation and staying up to date on current medical studies and modern treatment protocols are able to effectively help people.

HMO’s are useless for TRT and thyroid problems and only good if you have broken bones, are very sick or need surgeries. If you have hormonal problems which require critical thinking and analytical thought, if you can’t afford private care, you’re screwed.

If you’re doctor is very skilled, thorough he/she is very likely intelligent and doesn’t need to be working in the sick care system being told what to do by insurance companies, he/she can run their own show and start their own private clinic.

This is exactly what Dr. Saya did years ago, left the sick care system and started his own private clinic which doesn’t take insurance.

I would ask real doctors about that and not take advice from randoms here about Clomid.
You can always go on TRT after you and your wife are done with children. Best of luck to you both.

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When you say he should ask real doctors advice about clomid, are you referring to the doctors that have failed at the most basic level by not testing SHBG and the free portion of testosterone?

That plan doesn’t fill me with much confidence.

It would be pure luck if the OP feels good and levels are in a health range.

Right, it’s not a long term solution if long term means permanent. Guys have stayed on Clomid for years without difficulty though. That statement does not mean it is for everyone.

To me, it looks as though you are doing well (how are you feeling?) right now. I would not change anything.

The clomid was prescribed by my urologist. I’m meeting with him Monday. I just know there is a lot of knowledge on this board and I want to have as much info as I can before I meet with the doc again. It seems he may be uneducated in TRT.

Thanks man!

I’m telling him to not listen to you. You would have everyone 15 and older shooting T daily regardless of their wishes or plans.

I agree the tricky part is finding the good advice and ignoring the not so good.

You have shown time and time again you can’t be reasoned with by your irrational and outlandish posts.

A perfect example of outlandish remarks that doesn’t pertain to this thread, it almost seems like you are just venting your daily frustrations on other members who give good advice. If you feel inadequate which I know you do, that’s your problem and is easily correctable if you have an open mind.

However if a guys SHBG is <10 I will recommend what I think based of credible information is the best course of action.

Honestly, I’m feeling close to the same as I was before any treatment. No increase in mood or libido. So that’s a bummer but I don’t feel “bad” just bleh. But I felt that before I started Clomid too so that’s nothing to me. But if my T is where it’s supposed to be (or higher) and other markers are appropriate, I may stay on Clomid until we’re done with kids (end of this year) then see what happens.

What led you to, at age 30, have your testosterone level checked?

Low libido, Lethargic 24/7, irritable (which is unusual). I spoke to my training partner (a very smart pharmacist) after 6 months of heavy lifting and clean eating I was gaining fat I have an alarm in case. After all that, I decided to Google it and see what happens. Then I decided to do a cheap blood test and that started it all. Even on Clomid I still feel somewhat lethargic and my libido have an increased noticeably. But it might testosterone is notably hire that should help with the body recomposition. Which is pretty important to me.

That will take some time, usually about six months. Regardless, given your fertility situation your other options are testosterone with hCG and/or FSH.

There was a study while back of two groups low T men, men in group A were not given TRT and were given a diet and weight program, men in group B were given TRT and did not to do any exercising.

Men in group A didn’t lose any weight or gain any muscle, in fact some men gained weight, men in group B lost weight doing no exercise at all, waist decreased in size and they gained muscle.

When your hormones are optimal, so are your results.