T Nation

To KSMAN - Labs on Clomid 25mg EOD - Updated Labs (test & thyroid)


#1

New to the forum and would appreciate some input from KSMAN and any other informed users.
Quick Stats:
27yrs old
6’3"
250lbs (20ish% BF)

Been on Clomid (25mg ED) for a few months now and I think I could be feeling better. I had a suspicion that my E2 was high due to some anxiety and my absolute inability to lose any bodyfat (midsection, chest).
train 5 days a week including HIIT and steady state, diet is in check but still no weight loss. Also holding a fair amount of water it seems considering my intake vs output.

Latest Labs are as follows:
Hormones:
FSH 17.5 (1.5-168.8)
Estradiol 50.1 uL 0-56pg/ml
Progesterone II .7 (0-1.4)
LH2 7.9 (.5-68.7)
Prolactin 12.4 (4.1-28.9)
Testosterone 592 (199-1586)

Ferritin is High 118 (3.0-73)

These are the labs my doctor took last week. I realize that these may not be sufficent to give you the full hormonal picture but hopefully its a start.

As far as the E2 is concerned I’d like to be down in the low 20s and I have arimidex on hand.

I also feel like my testosterone should be much higher on 25mg per day…

Hoping somebody can shed some light on this situation - any input is appreciated.

Thanks


#2

Clomid is creating high LH/FSH leading to high T–>E2 inside the testes. This is why I suggest smaller amounts of SERMs.

Arimidex cannot control T–>E2 inside the testes, only in peripheral tissues. You can try it and it will have limited effects.

E2=22pg/ml is where you should be.

High LH also may desensitize the LH receptors.

Your [not tested] SHBG may be creating a lot of non-bioavailable SHBG+T. FT could tell a similar story but was not tested.

You are in a clomid trap, only way out probably involves lower T.

High ferritin:
Need hemoglobin, RBC, hematocrit.

Post other labs please.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#3

@KSman appreciate the quick response on my post. I will post additional labs for your review (including thyroid).

Being in a clomid trap seems less than ideal. Only way out is lower T? I’m already relatively low for my age? Could I change medications? Perhaps Nolvadex?


#4

@KSman
Additional Labs for review:
Thyroid
TSH 3.820 (.400-4.00)
Free T4 1.0 (.8-1.6)
TT3 1.0 (.8-1.6)

Blood Panel
RBC 5.32 (3.8-5.8)
HGB 16.6 (11.00-16.5) High
HCT 50.6 (35-50) High

Any advice on getting out of the clomid trap?

Thank you for your attention to this.


#5

@KSman
I will start taking my temperature 3 times daily tomorrow. If I’m low according to the thyroid sticky i will order Iodoral immediately.

Hoping to give you as much information as possible.

looking forward to hearing more.

Thanks!


#6

I’m in a very similar situation, but with higher LH and lower E2 and T. Like you since taking clomid my body fat % has been on lock down. No matter what I do I can’t move it and I’m following a very similar fitness plan. It’s very frustrating and discouraging. I was making great progress while on shots so I can only attribute the body fat issues as some reaction/resistance to clomid.

Also, on 25mg EOD my test is still low, barely mid range. However E2 was approaching the top limits and I started to not feel well. I have lowered my dose and am experiencing E2 symptom relief, but I can also feel my test dropping as I currently have no benefits of higher T that I experienced with injections.

Creating my own T was very attractive but in my case, and possibly yours, it’s just prolonging the inevitable of starting an injection protocol. For young guys I’ve read the primary concern of starting injections is the potential impact to fertility so just make sure you’re aware of the pros and cons and hopefully you can get this worked out.

Good luck.


#7

@azwildcats
Body fat on lockdown is an understatement doesn’t want to move at all! I think my issues may be two fold. The more I learn from this forum/the stickies the more Im noticing that my thyroid might be an issue also. Going to follow the protocol in the thyroid sticky to try and get a better idea (TSH is very high).

Thanks for your interest, hopefully we can both get everything figured out.


#8

@KSman

I began taking my temperature yesterday afternoon and I will continue to do so daily (morning and afternoon).

8/1 Afternoon (3 hours Post heavy workout) - 97.1
8/2 Morning - (5:45 am) 96.4 - retest (7:00am) 96.9 / Afternoon to follow

I fully understand these numbers could be an outlier and I will continue to log my temperatures for the next week.

As far as the Clomid goes, should I discuss a possible switch to Nolvadex? Your opinion is welcome and valuable.

Appreciate any input.


#9

@KSman

Bit of a delay but I figure its worth updating the log.

After taking my temp each morning and afternoon for a week I’ve found that I have a pretty severe sub temperature.

96.4-96.6 first thing in the morning upon waking
97.0-97.4 in the afternoon

I introduced selenium and iodine (50mg per day) for a week and my temps havent changed much if any.

I’m concerned about my gut health if I continue the high dose of iodine. Is it safe to assume there is another reason for my high TSH (3.82)?

I need more comprehensive thyroid labs but I’m assuming my T3 is less than stellar at this point.

Any thoughts are greatly appreciated.

Thanks!


#10

I’m in the same boat here on Clomid 25mg EOD. Test came up to 573 and estrogen came up as well to 46.2. I actually packed on some water and fat in the first two weeks I started taking the clomid (15 lbs gained of both, probably half of each).

I’m on arimidex now to see if it helps at all, but I’ve heard mixed opinions on that helping with clomid, so we’ll see next week when I get my labs back.

The TSH is definitely on the high end at 3.82. I’d get it retested to verify and also make sure you get another FT4 and FT3. I had one TSH number at 3.786 or something, but the rest of them have come in around 1.1-2.6.


#11

@KSman @texas2006

updated comprehensive labs. Looking for some insight.

Currently on 25mg of Clomid EOD and .5mg of arimidex twice per week. Doctor prescribed Armour Thyroid today…

Labs are as follows:

Test 442.9 (199-1586)
Free Test 93.1 (46-224)
FSH 10 (1.5-168.8)
LH2 3.4 (0.5-68.7)
Estradiol 36.2 (40.7-424.6)
DHEA-S 318.6 (40.8-222)
SHBG 16.3 (19.3-76.4)

Thyroid
TSH 3.722 (.4-4.0)
Free T4 1.2 (.8-1.6)
TT3 1.0 (.8-1.6)
T4 6.4 (4.5-12)
T3 Uptake 36.4 (22-35)
FT3 3.21 (2.3-4.2)

Cant lose weight (yet to start taking Armour).
I feel like my test should be higher. I really dont know where to go from here.

Any insight is greatly appreciated!


#12

@KSman @texas2006 @azwildcats

Hoping for some feedback on the new labs if anybody has a second.

Thanks!


#13

There are so many variables that impact labs such as timing of the day, when you took the meds etc., so it’s really hard to get a clear picture. With that said here are some thoughts:

  • Test and Free Test do appear to be on the low side of normal. My results were similar on 25mg EOD but then doubled after dropping the dose to 12.5mg EOD. It not intuitive to drop the dose and experience an increase, but it happened for me and many other guys.

  • Based on the ranges both FSH and LH appear to be low. This may indicate that Clomid may not be your best treatment option, and you may want to think about switching to injections. My thinking is if the HPTA is firing on all cylinders with Clomid, or barely getting jump started, continuing with Clomid most likely won’t produce better results.

  • Estradiol is below normal, but this is really hard to gauge while on Clomid. It’s also difficult to guage as we don’t know which test was run, sensitive vs non sensitive, or which lab you used as methodologies are different at different places. Based purely on the numbers your AI dose may be a bit too high and you may want to chat with your Dr. about potentially adjusting it based on how you feel.

I too struggled with weight loss, but the harder I workout, nail my diet, slowly but surely I’m seeing progress. Diet is really the main thing and if you want to drop some pounds there are a ton of great resources here to help you along the way.

Can’t speak to the Thyroid labs, but TSH appears high which is probably why you got the new meds. Hopefully they work well for you and you get the benefits you deserve.


#14

Really appreciate the response!

My only concern with switching to injections is fertility. I’m 27 and I’d like to have children at some point. Any ideas on how to better preserve fertility?

Additionally switching to clomid 12.5mg EOD is definitely counter intuitive. How much did your test/free test increase?

Thanks!


#15

Got it on the injections. There are options like HCG to keep your testes working, but I believe Clomid is most likely the best route to preserve fertility.

Cutting the dose in half doubled my Test. Read up on it or talk to your Dr. about it, it’s definitely a common occurrence and one to consider. My assumption is the lower dose may help find the FSH/LH sweetspot stimulating your body to produce your max potential T. Also, since lowering the dose I have had zero negative symptoms. May not work for you, but it worked for me.


#16

HCG monotherapy is not my favorite for most guys but you may benefit from it. I’m going to recommend the opposite of AZWildcats and recommend trying 25 ED to try and get your LH/FSH up… it really needs to be up higher to stimulate any testosterone. Here’s my recommended order of everything:

  1. Your TSH is too high and your FT3 could use a boost. Stick with your 25mg EOD clomid and start taking the Armour. Go retest in a month.

  2. Once your TSH is more normal or you get your FT3 to 3.7 - 4.2 range, start jacking with the testosterone again. I’d do the following on testosterone, systematically.
    -25 ED Clomid with the anastrazole. Retest 3 weeks after starting that.
    -If after 25 ED Clomid, consider going to 50 mg ED clomid. If you are having side effects from it that you aren’t a fan of, consider switching to HCG monotherapy and give that a try. After all that, come back and likely will recommend Test Cyp injections if your labs still suck.


#17

Thanks for the response on this, I’ve been really trying to wrap my head around the options and I appreciate the input.

I have been on 50mg ED of clomid before and it gave me horrible (and I mean HORRIBLE) anxiety. Never had anxiety before that, thought I was having a heart attack.
Needless to say I’ll be avoiding that dose but I would consider 25mg ED after I have my next thyroid evaluation.

My Armour script is only for 1 30mg tab per day, which from research seems low but I guess bloodwork tells all.

Any experience with Armour? I was hoping for more of a T3 boost to help with fat loss but that might be me just being a bit greedy ha.

Thanks for the interest in my case


#18

Please fix ranges if not correct.
E2 ng/ml or pmol/L?

fT3 is mid-range but body temps are low. This suggested high tRT blocking actions of fT3. Please see thyroid basics sticky referencing terms: stress, over-training, infections, adrenal fatigue and Wilson’s book.


#19

Ranges are correct

FSH and LH2 are measured in mlU/mL

Estradiol is measured in uL, so 36.2 (40.7-424.6 uL)
Estradiol in males 0 to 56 pg/ml

I don’t have a grasp on the unit conversions, can you shed some light on that?

As for thyroid, doctor started me on Armour at 30mg per day, seems low to me.

DHEA-S is 318.6 (40.8-222) uL any ideas on why this is so high??

Thanks for any input!

@texas2006 @KSman


#20

E2=36 is a problem, too high. Anastrozole help reduce T–>E2 in peripheral tissue but cannot control T–>E2 that occurs in the tests which can be high with higher doses of SERMs.

FSH is often a better indicator of LH status than LH itself as LH moves a lot.

Some concern that FSH is so much higher than LH=3.4 which might be from testicular cancer which is a young man’s disease. Any aching in your testes? You can get screened.

DHEA can be high at your age, no problem.

HTC, do not be dehydrated for lab work. Men do not need any supplements that have any iron unless there is a GI blood loss.

Clomid simply makes some feel horrible and Nolvadex does not do that. Docs do not understand.

Inability to loose fat is thyroid and E2 contributes to adverse fat patterns, and low libido and perhaps bitching or intolerance.

Your elevated E2 suggests lower E2 clearance by your liver.

Get fasting glucose tested and/or A1C as insulin resistance can explain lower SHBG some times.

Armour is T4 with some T3, often useful. But when there is a rT3 problem, more T4 means more T4–>fT3 instead of T4–>fT3 and then things can get worse. Do not expect to find a doc that understands.