T Nation

Taking Clomid, Still Losing Muscle Mass


#1

I have a propblem with my hypothalimus/pituitary axis. Untreated, my Free T was zero. My Total T was 25. With Clomid, my Free T is 35 and my Total T is about 500. My Endo is happy. But, although I work out with a trainer, take protien suppliments, and pre workout.

A prior Endo had me on Androgel. I gained strength reasonably well. I move to another city and my new Endo prescibed Clomiphene Citrate 50mg. I immediately started losing strength, and had my blood work done. My T was low again. He upped the does and now my T is now at the 500 range I mentioned above. Over a couple of months I made up lost ground, but lately I have been actually losing strength again…

Everything my Endo checks “looks good” to him. He is both unaware why I am losing strength and muscle, and unconcerned. I, on the other hand, and very frustrated. This guy is the only Endo in town.

Advice?


#2

What was your total T on the androgel?


#3

There’s is something you should know about endo’s, they go by labs and if the labs look good they are not concerned even though you tell them you feel terrible.

Androgel is the least successful version of TRT, injections is 100 percent absorbed. The real problem is the majority of doctors and so call specialists have no idea how to design a proper TRT protocol, if you want to feel good on TRT you have to go private.

Defy Medical is a telemedicine clinic that knows no borders, everything is mailed to me, consults are over the phone.

Free T at 35 doesn’t mean anything without labs ranges, but I suspect you may have high SHBG and if that’s the case Clomid isn’t recommended for high SHBG men.


#4

On Androgel Total T = 241 reference range 170-780
On Clomid Total T = 430 reference range 170-780


#5

I have looked through all of my labs. I don’t see where SHBG has been tested.


#6

If your SHBG is high, a 500 total testosterone would put your free testosterone below ranges and you would lose muscle mass as a result.


#7

Latest Lab results in.

Total T= 458 ng/dl ref range 250-1200
Free T = 40.8 pg/ml Reference range 35-150
Estradiol = 34 pg/ml Ref range >40

He didn’t test for SHBG.

Everything is within the reference ranges. Total T is not “bad”, but Free T is near the bottom. Still, since it is within reference range, my current Endo will not change anything. Is there a good “Sports Endocrinologist” that can help?


#8

You’re on Clomid in an attempt to restart your HPTA, clomid is a short term solution that is stopped after months to see if your HPTA starts to produce enough LH on own.

If your levels drop low again after stopping clomid, it’s time for TRT. Increasing clomid will raise SHBG even more and free T will may be even lower.


#9

No, I am on Clomid because my Pituitary/Hypothalimus has (since birth) not made near enough LH. I didn’t start puberty without intervention. It is a rare genetic disorder (about 1 in 300,000).

Anyway, there is no reason to think that my pituitary/hypothalimus is going to start making LH. Whatever I am looking for, it is long term treatment. I am not trying to reset. The Clomid (I am told) substitutes for GnRH and then my testes make testosterone.

I think I should be ona combination of hCG and GnRH injections, but my Endo disagrees (without explanation). I think it is a lot more expensive, and my insurance company prefers the cheaper Clomid, or even Androgel.


#10

My advice is find a doctor that know what in the hell he’s doing, this one doesn’t and neither do the majority as this is a new field of medicine.

Any hormone doctor not testing sex hormone binding globulin is an idiot.

Endo’s and urologist are typically ignorant in sex hormones.