T Nation

What is Going On with Me? Low T/LH/FSH/Estrogen | Clomid 25mg/d


#1

Hi all,

I did some blood work a few months back and had low T. I tried a bunch of supplements and remedies to try and increase my T but was unable to. Tongkat Ali, heavy lifting, eating tons of eggs, shit like that. After being retested last week, my T slightly improved but Estrogen levels decreased. Doctor put me on 25mg/d of Clomid.

Here are my stats from 9/1/2015 (with my GP):
Testosterone 310ng/dl ---- 199-1586 ng/dl
Estradiol 23.9pg/ml ---- 25-74 pg/ml
LH 2.6miu/ml ---- 1.7-11.2 miu/ml
FSH 2.4miu/ml ---- 1.0-42.5 miu/ml

Stats from 2/4/2016 (with an Endo):
Testosterone 386.2ng/dl ---- 199-1586 ng/dl
Estradiol 11.8pg/ml ---- 25-74 pg/ml
LH 2.1miu/ml ---- 1.7-11.2 miu/ml
FSH 2.9miu/ml ---- 1.0-42.5 miu/ml
Prolactin, Total 4.95ng/mL ---- 2.10-17-70 ng/mL
ACTH 15.80pg/mL ---- 0-46 pg/mL
Testosterone, Free (Direct) 10.83pg/mL ---- 4.25-30.37 ng/mL
Testosterone, Bioavailable 25.37pg/mL ---- 10.10-71.20 ng/mL
DHEA Sulfate 456ug/dL ---- 80-560 ug/dL
IGF-1 131ng/mL ---- 115-307 ng/mL
TSH 1.16ulu/ml ----- .50-250 ulu/ml
Free T4 1.49ng/dL ---- .89-1.76 ng/dL
Total T3 .88ng/mL ---- .60-1.81 ng/mL

I hope this is enough to make sense of what is going on. My symptoms are basically low to nonexistent libido, E/D, fatigue, brain fog, generally lack of desire to do anything in life…I am a 31 year old male, I am not overweight, have always been active until recently because I am too weak/tired, I also eat clean organic foods and do not eat any crap.

I have been taking 25mg/d of Clomid for the past 2 weeks or so, despite being told to take 50mg/d, just due to some of the stuff I read about it being too strong. Haven’t really felt any side effects other than headaches and some more stable moods.
.
Any help and/or advice would greatly be appreciated, thanks in advance!!
Drew


#2

Please see instructions in your first thread - a lot of reading.

Too much SERM [Clomid, Nolvadex and others] can create LH/FSH levels that are too high and then T–>E2 inside the testes can be very high.

Your labs on SERM should be:
TT
FT
E2
LH/FSH to see if too high
CBC with hematocrit
prolactin [one time screening]
fasting glucose
fasting cholesterol [could be too low]
AM Cortisol [At 8AM please] [one time screening]

IGF-1 is way low for your age,
Have you had any blows to the head or whiplash?
Any reduction in width of peripheral vision? Should be ~180 degrees.

When did this problem seem to start?

Have you been using iodized salt? -timeline?
Feeling cold easier?
Outer eyebrows sparse?


#3

Thanks KSman,

I really appreciate the feedback. I am reading the stuff you posted before.

This problem started around March of last year. I went through some emotional trama in January and also was recently diagnosed with Crohn’s disease. Although I believe the Crohn’s was present way before that, most likely around the time my T started going lower.

I have not had any head trauma that I know of. I get migraines on a weekly basis and that is about it really.

I have read that there is a possible link between Crohn’s and low T but I don’t know…

Thanks again


#4

I have not been using Iodized salt. I am a health nut and use Himilayan Seasalt or Celtic Sea Salt, not sure if that is the same.

Yes, I do get cold easier than people that I am around. I also get hot flashes sometimes.

My eyebrows do not look that sparse, the outer eyebrow has the same density as the inner eyebrow. (Kind of fading out to the edge) I would say the hair is pretty evenly distributed from inner to outer eyebrow, if that makes sense.


#5

You are iodine deficient. See the thyroid basics sticky and post body temperatures.
Please review my posts to not miss any points.

Where are you located?
This also affects what sources of iodine you have.

How long have you not been using iodized salt? -time line?
These “natural salts” cause so much damage and doctors never think to ask.


#6

I currently live in California. I have not been using iodized salt since I can remember. I primarily make my own food and try not to eat out very much so I do not have much exposure to Iodized salt. This has been going on for the past few years at least.

Now that you mention it, I crave salt like crazy. Is that a common symptom?

It is difficult in pin pointing stuff because of the Crohn’s Diagnosis. Low T and Crohn’s have very similar symptoms (other than the obvious intestinal stuff).

I will continue to read the stickies so that I am more educated on these topics.


#7

Have you had an occult blood stool test?

Do you eat enough healthy fats?

You will need to supplement iodine; iodine replenishment. You also MUST have an identifiable source of selenium!

Most restaurants do not use iodized salt. Ditto for prepared foods/snacks. So your salt shaker is your primary source of iodine. Sea food is helpful.

Body temperatures will tell us how bad this is.


#8

My fats are primarily from meat (I eat turkey and fish), I also take a high quality fish oil supplement, Avocado everyday as well as cooking my foods in coconut oil.

I was eating a few brazil nuts a day for selenium but the problem is that I can’t handle them anymore with the Crohn’s…

Never had an occult blood stool test…Would you recommend taking that with the above suggested tests?

Not sure what you mean by body temperatures but I am reading the stickies now and I am sure they will explain.

Where would you recommend I get some iodized salt? What about Nacent Iodine supplements?

Thanks again


#9

Google Iodoral for iodine source.

Thyroid hormone fT3 regulates body temperatures and basic metabolic rate by regulating metabolic rate of mitochondria in your cells that create ATP. You know what that is?

Body temperature is the bottom line for overall thyroid function.

Do you get a lot of sun exposure?
You may find 5,000iu Vit-D3 helpful, tiny oil caps.
You can test Vit-D25

Your nutrient and mineral absorption could be compromised.

List all medications, Rx and OTC.
List everything that you take for migraines!


#10

I usually get a lot of Sun exposure. My Vitamin D was recently tested and was fine, although back in May of last year I was deficient. I now take 10,000iu before bed. Will scale back down to 5,000iu in the summer.

I do not know what ATP is but I will read about it.

Yes my minteral and nutrient absorption is compromised because my small bowel (where nutrients are absorbed) is inflammed due to crohn’s. However, I just had bloodwork done and all of my nutrient/vitamin levels are back in normal range. I personally feel it is due to taking gluten and dairy out of my diet, which are know Crohn’s offenders.

I currently take nothing for Crohn’s or Migraines. Like I said I try to keep things all natural. The Clomid I take was purely out of desperation as I have been unable to perform in bed with my Girlfriend for the last 9 months.

I did start recently taking Low Dose Naltrexone 4.5mg at night - this is an alternative therapy for different auto-immune diseases. Not sure if that is helping or not at this point but we will see. The common dose is 50mg so this is very low.

Supplements I take:
Vitamin D 5-10kiu everyday
Vitamin b12 spray - 1 spray in morning
L-Glutamine 1000mg in the morning - supposed to help repair gut lining
Aloe vera juice in the morning 1/4 cup - gut lining

That is it for the most part. I stopped taking a lot of the supplements that I used to take because I wasn’t absorbing anything. But now that it seems the absorption problem is getting better, I am open to try new things.

Thx


#11

Are you absorbing magnesium OK?
http://www.lifeextension.com/magazine/2008/5/magnesium-widespread-deficiency-with-deadly-consequences/page-01

You can load up on magnesium and see if that makes a difference.
Another sign of low magnesium is muscles cramps.

Crohn’s may also be reducing your absorption of iodine.


#12

I will try the Iodine as well as magnesium and report back to you.

It would be nice if the doctor’s tested for this stuff so that we wouldn’t have to experiment on ourselves.


#13

Should I continue taking the Clomid?


#14

Yes and get the labs that I suggested when taking Clomid.

Doctors really do not typically understand much of this.
The idea of the [sticky] links is so you can know more than most doctors and take control of your own health care. The major problem is the doctors.


#15

Can the thyroid effect the production of LH/FSH? Or maybe I should get tested for Pituitary Adenoma?

That is where part of the confusion comes from, is it my thyroid that is causing the issues, or is it my pituitary gland?

Also, wouldn’t I have signs of goiter if I was iodine deficient? I read that Himalayan salt has iodine in it which is what I always use…So not sure if I need more.

Thanks again

ps - I received my iodoral and have taken it two days in a row now. Will see if symptoms improve.


#16

Himalayan salt does not have iodine in it. Yes its there, but too tiny to matter. Same for sea salt. You can find iodized sea salt if you look for it.

Yes, thyroid can affect every organ in your body, and LH/FSH can be affected.

We see a lot of thyroid/iodine issues with low-T here.

When you do the labs and we see LH/FSH; if low, one can suspect a pituitary defect. If high and T is not, the problem would be the testes. Elevated prolactin can indicate an adinoma and lower LH/FSH. When you do the labs, keep taking the same dose of clomid and be stead on that so we know what the labs represent.

With Crohn’s, you need more/stronger supplements to compensate not less.

http://umm.edu/health/medical/altmed/condition/migraine-headache

“”"
Supplements5-hydroxytryptophan (5-HTP).

Your body makes the amino acid 5-HTP and converts it into serotonin, an
important brain chemical. Researchers think abnormal serotonin function
in blood vessels may be related to migraines, and some of the drugs
used to treat migraines work by affecting serotonin. Several studies
indicate that 5-HTP may be as effective as some prescription migraine
medications at reducing the intensity and frequency of attacks. But not
all studies agree. One study found that 5-HTP was less effective than
the beta-blocker Inderal. More studies are needed to be sure that 5-HTP
is helpful in treating migraines. If you have a history of psychiatric
illness, take an antidepressant, or supplements such as St. John’s wort
or SAMe, you should not take 5-HTP except under your doctor’s
supervision. If you are pregnant or breastfeeding, do not take 5-HTP
without first asking your doctor.

Magnesium.
People with migraines often have lower levels of magnesium than people
who do not have migraines, and several studies suggest that magnesium
may reduce the frequency of migraine attacks in people with low levels
of magnesium. In one study, people who took magnesium reduce the
frequency of attacks by 41.6%, compared to 15.8% in those who took
placebo. Some studies also suggest that magnesium may help women whose
migraines are triggered by their periods. Side effects from magnesium
can include lower blood pressure and diarrhea. Magnesium can interact
with medications, including heart medications, diuretics or water pills,
some antibiotics, and muscle relaxers.

Vitamin B2 (riboflavin).
A few studies indicate that riboflavin may reduce the frequency and
duration of migraines. In one study, people who took riboflavin had more
than a 50% decrease in the number of attacks. Not all studies have
found riboflavin to be effective, however. More research is needed.
Riboflavin can interact with some medications, including tricyclic
antidepressants, medications called anticholinergic drugs that are used
to treat a variety of conditions, the antiseizure drug phenobarbital,
and probenecid, used to treat gout.
"""


#17

I am taking 2 x pills of Iodoral per day (25mg total) - would you recommend this as being a good amount?


#18

Hey KSman,

Wanted to check in with you before my appointment with my doctor tomorrow. I will definitely ask for the following samples on my follow-up blood work:
TT
FT
E2
LH/FSH to see if too high
CBC with hematocrit
prolactin [one time screening]
fasting glucose
fasting cholesterol [could be too low]
AM Cortisol [At 8AM please] [one time screening]

I have noticed an improvement in my libido since starting the clomid, but I am literally going fucking crazy with anger. I am not even an angry person. Have you had experience with this?

Also, anything else you recommend I do when I go see the doc tomorrow?

Thanks man!