T Nation

The Heart is Willing but the Nutsack is Weak


age: 39
height: 5’9"
waist: 37" (ouch, dreamer bulk?)
weight: 175lbs

describe body and facial hair:
blond, pattern 2, class 4. No changes lately.

describe where you carry fat and how changed,
Pretty even fat distribution with love handles. Contours on the muscle fairly nicely, I can’t complain.

health conditions, symptoms [history]
massive allergy to tree pollen. 4-5 months of misery a year.
Acne always, though it has calmed down in the past 10 years.

Rx and OTC drugs, any hair loss drugs or prostate drugs ever:
I did take propecia for about a year 10 years ago. It made me feel like a pussy, so I stopped taking it.
All sorts of antihistamines including zyrtec, allegra, and some first gen ones (effective, but sleep inducing).
Nicotine (ecig)

lab results with ranges:
e2 (estradiol): 21 (<63)
progesterone: 1.1 (0.15 - 1.15)
free t4: 0.83 (.73-1.95)
TSH 2.3 (.5-4.7)
DHEA sulfate: 220 (103-446) Dr said he wanted me closer to 400 (I take 25mg/day now)
Free T3: 3.3 (2.3-4.2)
pregnenolone 211 (23-173) (high) Dr said he wanted me closer to 100
TT (testosterone): 195 (300-1080) (low)
FT (calc free testosterone): 4.5 (4.8-25.7) (low)
SHBG: 24 (16.5-55.9)
Vitamin D 25OH: 38 (30-100) Dr said I need to take 5000 IU vitD, I comply
cholesterol: 158 (<200)
HDL cholesterol: 36 (>39) (low)
calculated ldl chol: 104 (<100) (high)
WBC: 5.8k/ul (4.0-11.0)
RBC: 5.06m/ul (4.1-5.7)
HEMOGLOBIN: 14.2g/dl (13.0-17.0)
hematocrit: 43.3% (37-49%)
MCV: 85.6fL (80.0-100.0)
MCH: 28…1pg (27.0-34.0)
MCHC: 32.8 g/dl (32.0-35.5)
RDW: 12.9% (11.0-15.0)
Neutrophils: 54% (40-74)
lymphocytes: 33% (19-48)
monocytes: 9% (4-13)
eosinophils: 4% (0-7)
basophils: 0% (0-2)
platelet count: 311 k/ul (130-400)

Follow up tests:
FSH: 2.5miu/ml (1.3 - 11.4)
LH: 1.4 miu/ml (1.2 - 7.8)
Prolactin: 5.7 ng/ml (3.0 - 30.0)

Tests after one month of clomid at 12.5mg ED.

E2: 32 (<=63) 52% increase
Testosterone: 575 (300-1080) _195% increase
SHBG: 30 (16.5 - 55.9) _25% increase
Free Test: 13.0 (4.8 - 25.7) _189% increase

November 2016 Tests on 6 months of clomid at 25mg ED and 1/10mg arimidex ED.

E2 24 (<=63)
Testosterone: 604 (300-1080)
SHBG: 36 (16.5 - 55.9)
Free Test: 12.4 (4.8 - 25.7)
Vitamin D: 70ng/ml (30-100)

WBC: 7.6k/ul (4.0-11.0)
RBC: 5.43m/ul (4.1-5.7)
HEMOGLOBIN: 15.5g/dl (13.0-17.0)
hematocrit: 47.2% (37-49%)
MCV: 86.9fL (80.0-100.0)
MCH: 28.5pg (27.0-34.0)
MCHC: 32.8 g/dl (32.0-35.5)
RDW: 12.0% (11.0-15.0)
Neutrophils: 64.8% (40-74)
lymphocytes: 24.0% (19-48)
monocytes: 9.4% (4-13)
eosinophils: 1.3% (0-7)
basophils: .5% (0-2)
platelet count: 264 k/ul (130-400)

describe diet [some create substantial damage with starvation diets]
No fast food, nothing fried. Some beef, maybe once a week. A lot of chicken. No junk food.
By today’s standards, I probably eat a lot of carbs. I’m going to have to break my morning bakery habit.
Lots of granola. I’m going to start eating more vegetables. A protien shake with creatine approx EOD.

No alcohol for the past 2 years.

describe training [some ruin there hormones by over training]
Modified stronglifts 5x5. I have never been able to go through 3 different lifts in one session, so I tend to do one lift or two per day. I thought I was a big pussy because I couldn’t get through it, so I adapted, I have a power rack in my house and would lift when I was feeling up for it. Rarely, if I spaced it out, I could do three lifts in one day.

My 5x5 maxes (don’t know what my 1rm are)
deadlift: 265lb
squat: 205lb
bench: 165lb
row: 147lb
overhead: 105lb

I completely lack energy and stamina.

I gain absolutely no muscle unless I’m eating like it’s my fucking job. I have actually put on some muscle and I’m the fattest I have ever been, but it’s still not too bad. When I cut, the muscle leaves me. I have cut down to 150lbs right after I quit drinking and still had damn love handles.

All my joints are extremely unhappy with lifting, my form must be perfect and even then my shoulders still bother me. My knees pop like I’m an old man doing squats.

I have never done steroids or any test boosters. Protien and creatine only.

testes ache, ever, with a fever?

how have morning wood and nocturnal erections changed
They have returned since taking clomid.

Body temperature in the morning was low, I took iodine, now morning temperature is 97.6.

I went to the Dr because I thought my feeling like shit was due to allergies and that I had them year round now. Thankfully he’s a general prac who specializes in endocrine and allergy stuff. He ordered the tests that uncovered my problem and figured this out.

Tests indicate secondary hypogonadism. I am taking clomid and supplements to treat.

Current supplements and meds:

1000mg fish oil
Vit-D3 5,000 iu
DHEA 25mg
Iodoral, one dose per day for 60 days
GNC Mega Multivitamin without Iron

Clomid 12.5 / day. Considering increasing the dose.
After ~1 month, I added arimidex. I have settled on .5mg /week with daily dosing.


[Would like to see these:
fasting cholesterol
fasting glucose
AM cortisol [at 8AM please]

Without LH/FSH we do not know what is going on. But if testes are small and scrotum up tight, then we can guess.

Cholesterol would be better nearer to 180.

Feed your hunger with protein shakes and avoiding carb might be easy.

TSH should be nearer to 1,0
T3, T4, fT3, fT4 should be midrange or a bit higher.
Your fT3 should support normal body temperatures. If body temps are low, we suspect that rT3 is blocking fT3. Your body temperatures are regulated by fT3 acting on the mitochondria to make ATP.

Low thyroid function leads to fat gain, low energy and sometimes low T.
Some will press ahead with training despite this and the stress can lead to adrenal fatigue.

5-alpha reductase inhibitors, Propecia, can damage hormone production by altering gene expression. This is well known in some circles, but most docs do not know because its not in the literature or told by the drug reps.

Please follow these links in the 2nd post of the f1st forum topic:

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

You doc seems decent, but may not be able to wrap his head around what is recommended here.

Check your oral body temps as per the thyroid sticky.

  • what is your history of [not]using iodized salt?
  • do you get cold easier now?
  • are your outer eyebrows sparse?

Your progesterone is quite strong and should be able to support cortisol production, if the adrenals are OK.


  • fish oil - take with a meal that has fats/oils and less fiber
  • Vit-D3 5,000 iu - take with a meal that has fats/oils and less fiber
  • DHEA 25mg - take with a meal that has fats/oils and less fiber
  • high potency b-complex multi-vits with trace elements including iodine+selenium
  • vit-C and other anti-oxidents

Your problems are low T and thyroid. Carefully read the thyroid sticky and get those oral body temps posted. Fixing these will restore energy and weight loss. Thyroid could be complicated by rT3.

Transdermal T products seem to be poorly absorbed when their is low thyroid function. So T gels may not work for you. These are poor choice if you are going to sweat in the gym.


Response and relevant information incorporated into first post.


Running log for those interested in a real world account of taking clomid
There are no questions in this section, just my experiences and ponderings

Day one:

Earlier today (after three days or so of taking the multivitamins) I noticed that colors seem brighter and more vivid. We can probably add Vitamin A deficiency to my list.

I have wrapped my head around this enough to take my first 25mg clomid pill a few hours ago. I tend toward sensitivity to drugs, but damn. 3 hours in, I have a grin on my face that I haven’t felt in a very, very long time. The fog in my head isn’t gone, but it’s lifting, thoughts are more … fluid. I expected this to take weeks to feel any effects.

Day two:

I dosed all the vitamins listed earlier and another 25mg clomid. Today I seem more cold and calculating, and my grin is more devious today. I think I’m getting used to having more test back in my system.

The iodine pills arrived, I think I’m going to do one a day for 60 days instead of 4/day for two weeks.

Acne is returning, but I’m healing a LOT quicker now too. Might be a good tradeoff.

I think I’m going to lower my dose to 12.5mg/day. I may lower it further. The research doesn’t show any difference in T improvement between 50mgs and 25mgs, so both doses are likely fully saturating the receptors, leaving some to circulate in my system and cause other problems.

Day three:

I have reduced my dose to 12.5mgs clomid. I think my voice is getting deeper, I have always had a kinda high pitched squeaky voice, but I thought it was because of a regional accent that I grew up with.

I am having some strong DOMS, haven’t had that in a while. Might be because I haven’t lifted in about a week while I was in panic mode over my test results. Belt is starting to loosen, could be because of T or my dietary changes or both. My diet is pretty clean at this point, still need to add more vegetables in though.

Fatigue is pretty much gone. Yesterday I was actually able to do two lifts in a row. I think soon I’ll actually be able to do the three stronglifts lifts in one session. That was unthinkable a few weeks ago.

Need to do some more cardio, my stationary bike was broken for a few weeks, I repaired it, but I fell out of the habit.

Day four:

A very strange realization has come to me. I’m don’t think I’m getting any of the cognitive effects of the e-cig anymore. Apparently, the nicotine will help me focus if I’m in a foggy state, but if I’m feeling good and thinking clearly, it doesn’t seem to improve that further.

Day five:

Tired from lack of sleep, but libido is definitely up. I have broken through some plateus this week on OHP and Bench that have been dogging me for months. My shoulders also feel pretty damn good, I was having some amount of tendon pain. I also changed my grip to bulldog, that may have also helped with my shoulders. Most of my other lifts I just deloaded because I didn’t lift for almost two weeks. I’m pretty confident I’ll bust those plateus too. My pump is also much larger than before.

Part of me really thinks this is all in my head, but I have been eating allergy meds like candy for a year, I have had plenty of opportunity for (and would have welcomed) the placebo effect.

Skin is getting greasier and I’m breaking out like a teenager. That’s definitely not in my head.

Day Six:

For me, one week of lifting with clomid is greater than two months of lifting without. I have seen posts that clomid doesn’t help lifting, and that might be true if your T is normal, but it’s clearly not true in my case. So nice to finally see some strong gainz.

I am keeping on my conservative Stronglifts program and only raising 2.5# per session (instead of 5#), but I haven’t failed a lift yet. My stamina is getting better too, I just have to get into the habit of doing more lifts at once.

I may end up being able to squat three times a week like the program prescribes. That was absolutely unthinkable before.

Day six update, hubris hits. I have been feeling great, so I skipped my rest day. Failed my OHP. Turns out I’m not invincible… yet!

I remembered to take my temperature again this morning. 97.6 with the ceiling fan on blast. Seems that the iodine is doing its job.

Two weeks

I haven’t updated for a while.

My testicles are now nearly a handful, they weren’t before.
I have had some piercing pain in my testicles, enough to grit my teeth, not enough to drop me to the floor. It lasts about 2-5 seconds then passes. Perhaps it’s growing pains… Either way, it doesn’t concern me much.

Libido is still improving. I’m a fairly horny SOB now.

Still making good gains at the gym.

Sleep has become much better. I now sleep like a stone and I sleep to my alarm or 15 minutes before. If I wake in the middle of the night, I can return to sleep. This is a great change.

I’m noticing more vascularity. Could be from muscle gains or the T. Scale doesn’t show much change, but I’m not pushing myself to lose weight or gain. I’m trying for a little while to chase the fabled, legendary recomp. We’ll see how that goes. I really cannot stand the thought of getting fatter, but dammit I’m finally getting some gains!

I have felt some nipple itch at night, but I don’t see any gyno. I also don’t have the emotional E related sides that others have experienced.

update: Ok, my recovery time is bordering on amazing. I failed on my third set of BP two days ago. I stripped 10# off the bar and finished my 5 sets. Two days later I tried again at the higher weight and made it through the full 5x5. This is completely unheard of for me.

I’m starting to feel like the clomid poster-boy.

Squats have always been the bane of my lifting. They have always felt heavy, and the most disheartening thing was even after I would deload 10-20% the weight never felt any lighter. Yesterday, however, I did my squats (only 5# off my 5x5 pr) and they felt… almost light. The progress keeps coming!!

Three weeks

Family has visited for the past week. I gained some weight entertaining. It is time to go on a light cut.

I am at or exceeding my previous PRs for all lifts except squat.

Last night I noticed my vision has become slightly sharper. Again, this could be the vitamin-a supplementation.

Four weeks

I have lowered my caloric intake. I don’t count, I just eat like I’m not on a bulk and go to bed slightly hungry. Unfortunately, when I cut calories, I have a tendency to hurt myself lifting. This time is no exception.

I screwed up my shoulder pretty good. I felt something coming on but I thought I would be ok to do squats, but nope, that made it much worse… I’m fortunate (unfortunate?) in that before I do any serious damage, my body will scream out in pain as a warning. So I doubt I have done any lasting damage, but I’m taking it easy this week. I’m only doing some rotator cuff accessory work with a resistance band. It seems to be helping and my shoulders are feeling fuller.

Otherwise, my mood is great, I still have lots of energy and motivation. Sleep is still good.

My voice has definitely become deeper, there’s no question now. My working hypothesis is that I have always been lower half to lower quartile in testosterone, but the really bad effects have only kicked in when I have been extremely low. My T is now probably higher than it has ever been as evidenced by my voice.


I have been having some itchy nipples for maybe two weeks. Not much, and mostly at night, I figured it was all in my head. It’s getting worse and starting to ache. I have scheduled a follow up appointment with the doc. Feeling really tired today, but mood is still upbeat.

I just got back from the Dr. I have a script for an AI and they pulled blood to test for T and estrogen (I assume e2). I favor treating symptoms, but it will be interesting to see the results.

Yet another update:

I took 1mg arimidex earlier today. Dr said take 1mg to start and 1mg/week divided in two doses. 1mg is clearly too high a dose for me, I’m dizzy, have chest tightness, short of breath and nausea. Nipples were itchy eariler, expecting it to continue, but the other stuff seems to overshadow itchyness.

Started lifting, after a few sets had a feeling that I might drop the bar on myself, no more for now.

My go forward plan is to reduce dose to .5mg/week by dissolving a 1mg pill in 14ml water and take 1ml per day. This should give me a more consistent dose without a big peak which I clearly cannot handle.

One day later:

Itchy nipples gone. There was some nipple swelling, it’s almost gone too. Feeling better than yesterday, but I have some brain fog today. I am considering dosing .25/week of armidex. Labs results should be back Monday or Tuesday.

Five Weeks:

Lab results back from before arimidex:

E2: 32 (<=63) 52% increase
Testosterone: 575 (300-1080) 195% increase
SHBG: 30 (16.5 - 55.9) 25% increase
Free Test: 13.0 (4.8 - 25.7) 189% increase

I’m now on about .5mg/week arimidex divided in daily doses. I’m apparently very sensitive to E2 because I was getting sides from E2 at 32, which most would consider low.

I’m surprised that my test is still that low, it does confirm that I have been low T pretty much my whole life. After I figure out my dosing on arimidex, I may take my clomid dose higher.

At the moment, I feel pretty darn good. I have been trying to make sure I get enough protien more than I have been trying to go on a caloric deficit, I am definitely putting on more muscle.


Over the past maybe week, I have been noticing trouble focusing and reading small print. I was hoping it was in my head and not a side effect from the clomid. Last night I had a hunch, took my contacts out early, and I now see better without my contacts than with them. My vision was never bad (20/35 uncorrected) , and my presciption has barely changed over the past 20 years.

I strongly suspect that my vision is improving. I’m going to wait at least a few months before going in to the eye doc so I can see if things stabilize…

Week Six

Vision improvements from last week are gone, it’s possible my blood pressure was raised, increasing ocular pressure and causing my eyes to become more rounded.

Shoulders still bothering me. I was perhaps overzealous with my working out. I have stopped all stronglifts excercises except squats and bench press. I have also stopped my shoulder work with the resistance bands. Time to get in some isolation work! Curls and calf raises until the shoulders can take the compound lifts again.

Nipples ache slightly. I upped my dose of arimidex today by about 30%. Will tune as needed.

I can easily see people going off their therapy because of side effects. This is something that needs to be actively managed and tuned.

Week Seven

Shoulders are almost better, I have discovered I have a rhomboid strain/tear that I’m working through. I think I pulled it swinging an axe (pioneer workout!) a few weeks ago. Still no core lifts, doing a lot of curls and wrist curls (grip!) instead. Added shoulder stretching as shown in Alan Thrall’s utube video, seems to be really helping my posture.

Mood is still upbeat. It’s interesting getting used to having highs and lows again instead of a steady state of feeling crappy all the time. The bad days now are still lots better than before.

I have upped my arimidex dose to .625mg/week in divided daily doses.

My appetite is through the roof. I want to eat everything in sight.

So far so good!

Week Eight

I have adjusted my arimidex back down to .5mg/week.

Shoulders are still bothering me, I feel like such a slug, I really want to get back to my lifts. More curls in the power rack, oh the shame (at home, no one can see you doing curls in the squat rack). Still working on mobility stretches…

Libido still up. Mood upbeat.

This week I should finish my course of iodine and I’ll be back to maintainence doses via my multivitamin.

Update: Temperature this morning was 97.8. Looks to be back in the expected range.

Week Nine

Facial hair has filled in to the point where I could actually grow a beard if I were so inclined. Libido is very strong, it’s almost too much. I’m gaining muscle at a rate I did not believe was possible outside of going on a cycle (which I never have). I’m still managing my shoulder, but after a steep deload, I’m doing ok. Motivation is great.

Things seem to be stabilizing, I’m going to suspend my blow-by-blow clomid log. I’ll update with new bloodwork when I get it (probably 3-6 months after start) but I’m not in a rush to do so. The numbers don’t matter all that much to me, it’s just a curiosity at this point.

Thank you to all who post here and especially KSMan.

Almost 3 months

Ok, strange update here. I was a bit lazy this week, didn’t shave my head as often as I usually do. The wife pointed out that my hair is actually growing back from where it was receeding. While I don’t have a full head of hair yet, it’s almost to the point where I would be comfortable having hair again if that’s what I wanted (I don’t). I did some research, apparently, low T results in elevated DHT which results in baldness. That’s yet another sign that I have always been low T and low T has affected almost all areas of my health.

Three Months

I started taking 25mg clomid ED a few weeks back. I bumped up the AI slightly too. Muscle tone is improving, my lifts are still improving and my nagging shoulder injury is almost gone. Voice has become deeper to where others have noticed it. It is very easy to put on muscle mass now, it’s almost that just touching makes me grow now, whereas before I’d have to take myself to the absolute limit to trigger any growth. I have added some accessory work in, lat pulldowns, incline press and a lift to target my rhomboids.

So far so good!

Ongoing research and questions:

How does the HPT axis influence the hypothalamic-pituitary-gonadal axis (HPG axis)? Are there any feedback mechanisms here? Is cellular metabolism the feedback mechanism?

When is one expected to reach peak plasma SERM levels? The calculations are making my head spin. Given a daily dosage schedule and a half life of 5 days… I have figured this out, when I get an hour, I’m going to write up how to do the calculations.

What is your suspision regarding the fasting cholesterol, fasting glucose and AM cortisol tests? I’ll ask for those at my next appointment, but he’s going to ask “why?” and I’m don’t want to give him a blank look. Have I overlooked a sticky, I didn’t see these tests mentioned anywhere.

Many thanks in advance for any comments.

Clomid Monotherapy
Appointment with the Endourologist, but I have Concerns

Thanks for linking this in the other thread @gonadthebarbarian , a very interesting read!

How have your temps been since adding the Iodoral? Are your tabs 12.5mg? Also, are you taking Selenium with the Iodine?


I should check that again. Yeah, I have been using the 12.5mg pills. I set aside 60 pills and I’m more than halfway through the course (12.5/ed). There is selenium in my multivitamin.

How Long Should I Wait?

Cholesterol is the base for your steroid hormone cascade. Low cholesterol can lead to problems.

Low energy can be, in part, from low cortisol.

Much of what you feel is also the effect of newness and accelerating T levels. You reaction will settle down.

Be careful with your workouts. You can gain muscle strength. But connective tissue is very slow to catch up. You could tear something. Watch your form.

Hypothalamus sees estrogens and T as a feedback signal.

Clomid Therapy Current Lab Results
Clomid Only Cycle? Other Questions
25 and Low T, What to Do?

So, new labs in. I have added them here, but I also added them to my first post. I’m somewhat surprised, though I increased my dose from 12.5mg ED to 25mgED, my T levels have barely changed (and SHBG is up and Free T is down). I am cutting now at a rate of a little more than a pound a week, would cutting really reduce my T like this? Or have I maxed out what I can achieve with clomid?

I may increase my arimidex slightly to push it slightly more towards my original test of 21.

Is there anything else I should be looking at?

E2 24 (<=63)
Testosterone: 604 (300-1080)
SHBG: 36 (16.5 - 55.9)
Free Test: 12.4 (4.8 - 25.7)
Vitamin D: 70ng/ml (30-100)

WBC: 7.6k/ul (4.0-11.0)
RBC: 5.43m/ul (4.1-5.7)
HEMOGLOBIN: 15.5g/dl (13.0-17.0)
hematocrit: 47.2% (37-49%)
MCV: 86.9fL (80.0-100.0)
MCH: 28.5pg (27.0-34.0)
MCHC: 32.8 g/dl (32.0-35.5)
RDW: 12.0% (11.0-15.0)
Neutrophils: 64.8% (40-74)
lymphocytes: 24.0% (19-48)
monocytes: 9.4% (4-13)
eosinophils: 1.3% (0-7)
basophils: .5% (0-2)
platelet count: 264 k/ul (130-400)


When evaluating how a SERM is working, you should be checking LH/FSH.

See the HPTA restart sticky for context.