T Nation

TRT, Clomid, Feel like Crap, No Sex Drive

Its been about a year now that i was first ‘diagnosed’ with low T. I’m 23 years old and my tests over the past year had been coming back Total Test 200-400 range. Was on TRT from July 2009-September 2009 (injections) And I didn’t feel any better, so he checked my thyroid levels and they were almost 5x too high.

After 3 months they normalized themselves without me doing any treatment. So then we went back to testing my Test because I have low energy, poor mood/sense of well being, low sex drive and erectile dysfunction 99% of the time. Cant build muscle, can only maintain what I have and when I increase my calorie intake it goes to fat instead of muscle.

SO my endo has me doing 50mg of clomid EOD for a month (which i did) then it didnt help so he currently has me bumped up to 50mg clomid every day and I’ve been doing this for about a month, SLIGHT improvements, but still my main concern at this point is low sex drive and erectile problems. Blood test today came back:
Total Test 949 ng/dl (250-1100) normal
Free Test 129.5 pg/ml (35-155) normal
%free test 1.35 (1.5-2.2) so this is low

does my low %free test mean anything since my total test and free test are both normal?
Anyone have any clue what could be causing my low sex drive and erectile problems?
Also, I’d assume I wont be taking the clomid for much longer, so when I stop taking it wont my testosterone levels fall back down?

Clomid can cause these problems

Clomid also acts as an estradiol receptor agonist in some tissues (brain), which will kill you libido. I would expect your libido to increase after stopping the clomid. Give it a few weeks maybe even a little more than a month.

Retest your T levels a few months after stopping the clomid to see if the T levels stick. If they do, then test every once in a while to make sure that the result is truly permanent.

If you slide back again, you might need another course of clomid, or you can go on TRT.

You have secondary hypogonadism. Sometimes a course of clomid can reverse the condition!

Good luck!

[quote]chemman wrote:
Clomid also acts as an estradiol receptor agonist in some tissues (brain), which will kill you libido. I would expect your libido to increase after stopping the clomid. Give it a few weeks maybe even a little more than a month.

Retest your T levels a few months after stopping the clomid to see if the T levels stick. If they do, then test every once in a while to make sure that the result is truly permanent.

If you slide back again, you might need another course of clomid, or you can go on TRT.

You have secondary hypogonadism. Sometimes a course of clomid can reverse the condition!

Good luck![/quote]

I be curious at looking at other factors that can make the signal from LH to testicles work more effectively. I would like to see an cortisol saliva test, indept thyroid panel, iodine urine sample, and also your eating pattern, sleep hygiene, current daily stress, supplements taking. Being on clomid to long can cause eye issues such as floater and problems with visions. I like to see guys on clomid for 8-10 weeks with proper support for thyroid and adrenals plus knowing what things you are deficient in that are necessary to make hormones. I have seen alot of guy you when tested lack the proper fats and in the wrong ratio preventing hormone production. I see alot pepole taking huge dosages of fish oisl thinking it is good for them but it can actually slow your thyroid and lower testosterone production. As you can see there is alot that goes into this to get the right clincal response that is desire. If a person responds to clomid and every thing else is in check and then crash then HCG is the next step …people that start hcg and adrenal are not supported may have a bad reaction such as axniety and low cortisol symptoms because it stimulate many enzymatic pathways.

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well my sleep is in great order. 8-9 hours every night. Ive drank alcohol maybe 5 times this entire year so far so I dont think its an alcohol related problem. My diet consists of lean protein sources (300-400g/day, I am 6’4" 210 lbs). Protein is pretty evenly spread out throughout the day.

I load up on good quality carbs (oats, 100% whole grain whole wheat bread, 50% whole grain pasta, etc.) and taper my carbs off to where my meal at about 6pm consists of 30-50 g of carbs and then no more carbs the rest of the night. Fats I don’t monitor too closely, I avoid as much saturated/trans fats as I can.

Eat a serving of almonds every day, use flax seed on most days, fish 2-3 times per week. Eat lots of veggies like spinach, broccoli and every day i make myself a smoothie consisting of blueberries, banana, strawberries, milk, strawberry protein.

Supplements: vitamin b6, b12, one-a-day mens pro edge multivitamin, and thats it. No creatine or NO products or anything like that as I have found them to be a waste of money throughout my life. I drink coffee in the morning.

So as a few of you said, clomid has been known to cause libido problems even though my testosterone is actually pretty high in the normal range. So when I stop clomid, wait a month or so and my libido is still missing … what would you guys recommend be my next course of action (i.e. what should I try to get my endo to put me on).

ALso, my low %free testosterone doesnt really matter? Like I said my TT is normal and my FT is normal, but the ratio between the 2 is low.

Thanks for all of your help!

Sincerely,

The 23 year old who cant get a boner.

I walked around for about a year and a half feeling like absolute shit before I was diagnosed with hypogonadism. I too was first treated with 25 mg clomid everyday, which tripled my testosterone in one month. However, I was worried that my libido would NEVER return to normal.

I was 23 years old at the time. Eventually it came back - AND HOW SO! As I said in another thread, my libido and orgasms are INSANE now. (I DON’T say this to be some vulgar attention whore a la regular SAMA posters. I say it to show that normal sexual function has returned.)

You MIGHT or MIGHT NOT have any other problems now. It’s just that it may take some time to feel good again. That’s what my doc told me in my first visit. He even gave me some Viagra and said, “I’ll give you some of this to help with your erections for the meantime; it might take some time to function better again.”

[quote]cosmok wrote:

The 23 year old who cant get a boner.[/quote]

Dude, I was completely impotent for over a year - COMPLETELY!

so when exactly did you start feeling better? After you stopped taking clomid? and if so how long after. If you could give me a timetable of exactly what your dosages of clomid or w/e doc gave you were and how long you were on them and what not thatd be great… thanks!

Clomid can really mess some guys up. It can make some guys cry watching chick-flicks… that is not a joke.

Drop the clomid and inject 250iu hCG SC EOD. If your T levels are not acceptable after that, inject T to achieve high-normal levels.

Clomid may be pushing LH too high leading to too much E2 generation in the testes. Just as too much hCG will.

Use anastrozole to get close to E2=22pg/ml

Read the stickies and all shall be revealed.

T+AI+hCG

[quote]cosmok wrote:
so when exactly did you start feeling better? After you stopped taking clomid? and if so how long after. If you could give me a timetable of exactly what your dosages of clomid or w/e doc gave you were and how long you were on them and what not thatd be great… thanks![/quote]

He gave me three options when I first met him: 1) clomid, 2) HCG, or 3) Androgel. He said he doesn’t use clomid on a long term basis.

I said to him, “Eh, I don’t feel like being bothered with a gel or injections. So I’ll go with the clomid.”

He prescribed 25 mg clomid everyday and it made my T go from 240 to 790 - all from HALF a tab!

I felt good in a month, but my sex drive wasn’t quite where it used to be. He said, “Alright, you can try Androgel if you want. It’s what I’m going to give you eventually anyway, because I don’t use clomid for more than six months at a time.”

I’ve used 7.5 to 10 grams of Androgel since - for the past 8 years, except for another 1 month stint on clomid when my T value–for some unknown reason–jacked up to 1500 and my LH and FSH values were shot!

So it’s been 8 yrs aside from two months of clomid use in total.

As people on here know, I DON’T use anything but Androgel and I “feel like a million bucks”.

It took 1 month to feel better/OK; 6 months to feel like I used to; and a year for my sex drive to return to the level I had beforehand.

[quote]Bricknyce wrote:

[quote]cosmok wrote:
so when exactly did you start feeling better? After you stopped taking clomid? and if so how long after. If you could give me a timetable of exactly what your dosages of clomid or w/e doc gave you were and how long you were on them and what not thatd be great… thanks![/quote]

He gave me three options when I first met him: 1) clomid, 2) HCG, or 3) Androgel. He said he doesn’t use clomid on a long term basis.

I said to him, “Eh, I don’t feel like being bothered with a gel or injections. So I’ll go with the clomid.”

He prescribed 25 mg clomid everyday and it made my T go from 240 to 790 - all from HALF a tab!

I felt good in a month, but my sex drive wasn’t quite where it used to be. He said, “Alright, you can try Androgel if you want. It’s what I’m going to give you eventually anyway, because I don’t use clomid for more than six months at a time.”

I’ve used 7.5 to 10 grams of Androgel since - for the past 8 years, except for another 1 month stint on clomid when my T value–for some unknown reason–jacked up to 1500 and my LH and FSH values were shot!

So it’s been 8 yrs aside from two months of clomid use in total.

As people on here know, I DON’T use anything but Androgel and I “feel like a million bucks”.

It took 1 month to feel better/OK; 6 months to feel like I used to; and a year for my sex drive to return to the level I had beforehand. [/quote]

Once hormones balance is properly reached then it takes 6 months to year to repair tissue at the cellular level. I try to tell peoplel this time and time again but they want results and want it now. since they do not get results they thing something else is wrong and want to try something new and this puts them back to ground zero again. We also use viagra or cilas as a temporary bridge to optimal levels are reach then only use it when necessary if needed. Majority of the guys are able to get back but we have had some cases that it take over 1 year to finally get their body back to balance functioning normal. You can not repair the damage done in months when it has been several years or even decades in some instances.

Once hormones balance is properly reached then it takes 6 months to year to repair tissue at the cellular level. I try to tell peoplel this time and time again but they want results and want it now. since they do not get results they thing something else is wrong and want to try something new and this puts them back to ground zero again.

Sorry to bump an old post but was Googling. This such good information / advice and I wanted to call it out again. Thanks for this. Its something I really need to remember. And it gives me hope.