Clomid study discussion

[Jelisej]

My fate, and probably for most of us here will be same as Burly's I'm afraid.
There is this Jack Kruse who has some strange and some good ideas as well- one of his better ideas (IMO) ideas is to live life as closest to life of our ancestors, he has point there but for most of us thats impossible.
Anyway- some researchers have said that till modern times men had double TT levels compared to men today.
Their lifestyle was completely different- in summer they were exposed to sun (natural vitamin D), in winter they ate lot of stored nutty products. Lot of good stuff in diet. Lot of rest. Interestingly- in Europe because of "industralisation" poor diet, hard labour and not enough rest- average height has been reduced by inch or so in last 200 years. That speaks for itself.

[h2s]

I've heard it as 200x more suppressive (for estrogen), but I really don't have any idea. It's all just a guessing game until someone publishes a study (for finds one published).

I agree with your apparent assertion that a good lifestyle/diet can maintain higher test levels. We can't all be farmers in aussieland. Look at burly, the dude probably has crazy stress levels, has used roids in the past when he was younger, probably sleeps way less than most of us (i mean, he almost certainly does) and odds are his nutrition reflects his lifestyle, in that he probably eats not so great foods due to limited time. It's no wonder his T levels are low, right? Not to single you out Burly, it's just that that's how most of society is. We're running around trying to beat everyone else, while those farmers chill out and eat their organic foods that they grow themselves.

I have no idea on the 200x or 20x or 100x etc, but by it's nature as part of the negative feedback loop, it would be a very strong part in the process of suppression.

My fate, and probably for most of us here will be same as Burly's I'm afraid.
There is this Jack Kruse who has some strange and some good ideas as well- one of his better ideas (IMO) ideas is to live life as closest to life of our ancestors, he has point there but for most of us thats impossible.
Anyway- some researchers have said that till modern times men had double TT levels compared to men today.
Their lifestyle was completely different- in summer they were exposed to sun (natural vitamin D), in winter they ate lot of stored nutty products. Lot of good stuff in diet. Lot of rest. Interestingly- in Europe because of "industralisation" poor diet, hard labour and not enough rest- average height has been reduced by inch or so in last 200 years. That speaks for itself.

Yeah, to be honest though, I have always planned that at a certain age I will seek TRT. I tend not to bring this up, as any other time I have it has lead to arguments between those that oppose TRT and I. There is a natural decline to ideal hormone composition as one ages. The impact this has on one's life can be anywhere from mild to very significant, but none the less will always impact it in some regard. I very much take a life extensionist view towards TRT. This is of course at an appropriate age and I am not advocated every 20 and 30 year old use this thought as a means to justify their abuse.

[burlyman30]

Look at burly, the dude probably has crazy stress levels, has used roids in the past when he was younger, probably sleeps way less than most of us (i mean, he almost certainly does) and odds are his nutrition reflects his lifestyle, in that he probably eats not so great foods due to limited time. It's no wonder his T levels are low, right? Not to single you out Burly, it's just that that's how most of society is. We're running around trying to beat everyone else, while those farmers chill out and eat their organic foods that they grow themselves.

You are right on many counts regarding my lifestyle. I operate in a chronic state of stress because of business/investment situations and the economic climate has been a major factor. However, I likely handle it better than most would. If you guys only knew what I went through on any given month... lol.

My diet, like most of us, could be better. However, I'd have to say that I am probably miles ahead of the average American. I eat no sweets. Never have. No cookies, candy, ice cream, etc. I rarely eat snack foods like french fries, chips, etc. I have cut down my starchy carbs to almost nil, but will imbibe on occasion. I eat a lot of hamburger and eggs. My downfall would be fast food burgers, sometimes 2 or 3 in a day when I am at my busiest in the summer. As you surmised, my busy lifestyle dictates eating on the run.

I sleep 4-6 hours routinely, but during the slower work season I am more likely to be in the 5-7 hour range.

So yes, I have my part to play. Exogenous hormones may or may not have had a major part to play in all of this. Hard to say. I was never a heavy user, but it's hard to say who's body can take how much.

[Haritec]

I have a few full papers on Clomid and treating low testosterone. Tried to add them as attachments but the form doesnt let me attach files > 20K ?? Anyways, in regards to symptoms and the effects Clomid has on them, this was the discussion in:

Outcomes of clomiphene citrate treatment in young hypogonadal men
Darren J. Katz , Omar Nabulsi , Raanan Tal and John P. Mulhall
Male Sexual and Reproductive Medicine Programme, Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA


ADAM QUESTIONNAIRE AND SAFETY OUTCOMES

Table 2 shows the results of the ADAM questionnaire. Overall, for all questions except loss of height, there was an
improvement in the symptoms of HG. At baseline, the median number of ‘ yes ’ responses was 5 (interquartile range 2 – 7) and this dropped to 2 (interquartile range 1 – 4) after treatment. There was a significant improvement in fi ve of the 10 variables (before vs after treatment): decreased libido (72% vs 32%), lack of energy (65% vs 40%), decreased life enjoyment (85% vs 40%), sad/ grumpy (60% vs 30%), and decreased sports performance (55% vs 25%). Table 3 showsthe proportion of patients with varying degrees of symptom improvement. More than half the patients had a subjective improvement in at least three symptoms but 10% experienced no improvement. There was no difference in response to CC in patients with or without a varicocele ( P = 0.46). There were no major side effects recorded from CC during the course of follow-up and no patient ceased CC treatment because of adverse events


And their Summary stated this

What ’ s known on the subject? and What does the study add?
Hypogonadism is a prevalent problem, increasing in frequency as men age. It is most
commonly treated by testosterone supplementation therapy but in younger patients
this can lead to testicular atrophy with subsequent exogenous testosterone
dependency and may impair spermatogenesis. Clomiphene citrate (CC) may be used as
an alternative treatment in these patients with hypogonadism when maintenance of
fertility is desired.
This study shows that CC is a safe and effi cacious drug to use as an alternative to
exogenous testosterone. Not only have we validated previous fi ndings of other papers
but have proven our fi ndings over a much longer period (mean duration of treatment
19 months). This prospective study is the largest to date assessing both the objective
hormone response to CC therapy as well as the subjective response based on a
validated questionnaire.

If anyone wants the papers leave me a private message with an email addie and I willl send to you.

[Haritec]

This study is online and has impressive results

Chlomiphene Increases Testosterone

This study looks at Testosterone / Estrogen Ratios

Ratios


And this study looks at 3 yrs of treatment on Chlomiphene - long term study found safe

Clomiphene citrate is safe and effective for long-term management of hypogonadism

Releavant Abstract to the Discussion

J Sex Med. 2010 Jan;7(1 Pt 1):269-76. Epub 2009 Aug 17.

Clomiphene citrate and testosterone gel replacement therapy for male hypogonadism: efficacy and treatment cost.

Taylor F, Levine L.


Source

Rush University Medical Center-Department of Urology, Chicago, IL, USA. frederick_taylor@rush.edu


Abstract

INTRODUCTION:

The efficacy of oral clomiphene citrate (CC) in the treatment of male hypogonadism and male infertility (MI) with low serum testosterone and normal gonadotropin levels has been reported.

AIM:

The aim of this article is to evaluate CC and testosterone gel replacement therapy (TGRT) with regard to biochemical and clinical efficacy and cost.

MAIN OUTCOME MEASURES:

The main outcome measures were change in serum testosterone with CC and TGRT therapy, and change in the androgen deficiency in aging male (ADAM) questionnaire scores with CC therapy.

METHODS:

Men receiving CC or TGRT with either Androgel 1% or Testim 1% for hypogonadism (defined as testosterone < 300 ng/mL) or MI were included. Serum values were collected 1-2 months after treatment initiation and semi-annually thereafter. Retrospective data collection was performed via chart review. Subjective follow up of patients receiving CC was performed via telephone interview using the ADAM questionnaire.

RESULTS:

A hundred and four men (65 CC and 39 TGRT) were identified who began CC (50 mg every other day) or TGRT (5 g). Average age (years) was 42(CC) vs. 57 (TGRT). Average follow up was 23 months (CC, range 8-40 months) vs. 46 months (TGRT, range 6-149 months). Average posttreatment testosterone was 573 ng/dL in the CC group and 553 ng/dL in the TGRT group (P value < 0.001). The monthly cost of Testim 1% (5 gm daily) is $270, Androgel 1% (5 gm daily) is $265, and CC (50 mg every other day) is $83. Among CC patients, the average pretreatment ADAM score was 4.9 vs. 2.1 at follow up (P < 0.05). Average pretreatment ADAM sexual function domain score was 0.76 vs. 0.23 at follow up (P < 0.05). There were no adverse events reported.

CONCLUSION:

CC represents a treatment option for men with hypogonadism, demonstrating biochemical and clinical efficacy with few side effects and lower cost as compared with TGRT.

[Haritec]

So - now my question - what about doing both ? Could somene who has low Test ( ~ 300 ng/dl) use Clomid at a moderate dosage (say 25 mg EOD ) use Clomid to stimulate the boys and get themselves up to say ~ 500 ng/dl - then use a small amount of exogenous T cream to get up to 700 - and still not shut oneself down ? What causes shutdown from exogenous T - is it only if you take too much ?

[nate3993]

So - now my question - what about doing both ? Could somene who has low Test ( ~ 300 ng/dl) use Clomid at a moderate dosage (say 25 mg EOD ) use Clomid to stimulate the boys and get themselves up to say ~ 500 ng/dl - then use a small amount of exogenous T cream to get up to 700 - and still not shut oneself down ? What causes shutdown from exogenous T - is it only if you take too much ?

any exogenous hormone causes shutdown. you body sees there's hormones in the blood and tells the testis no need to produce anymore cuz there's already hormones in the body.of course depending on what you're taking and how long will dictate what kind of shut down, but that wouldn't work. either your boosting you t, or your supplementing with exogenous. it's like taking a test booster while on steroids. sounds good in theory, but a complete waste. now, hcg is good for cycles to keep the testis from completely and utterly being shut down, but taking clomid and then taking test would be counter productive.

[BBG]

So - now my question - what about doing both ? Could somene who has low Test ( ~ 300 ng/dl) use Clomid at a moderate dosage (say 25 mg EOD ) use Clomid to stimulate the boys and get themselves up to say ~ 500 ng/dl - then use a small amount of exogenous T cream to get up to 700 - and still not shut oneself down ? What causes shutdown from exogenous T - is it only if you take too much ?

Your body just sense that there is too many sex hormones and stops your body from producing them. It could be estrogen, dht or testosterone. Everyone's body is different.

You could theoretically supplement with a little bit of hormones each day and not cause shutdown, but it probably wouldn't really do much in the short term. Over a long period of time you may see better results than if you didn't use a little hormone each day.

[Jelisej]

OK, first clomid part- body has its own way of controling estrogen and when estrogen is low (if HPTA is not shut) it sends more LH to raise estrogen levels (as all estrogen in men comes from testosterone)- so what clomid does is it blocks estrogen in some receptors so brain thinks there is not enough estrogen so it raises LH- so basically we trick body.
Problem with clomid is it blocks estrogen in some tissues but there can be build up in other- and for majority, not just estrogen, SHBG and DHT can be all over the place. And to make thing more difficult- when on clomid we cannot measure E2.
So basically Clomid is good for restart "protocols" and PCT but for majority is not good as TRT protocol.
Other weakness of clomid is it raises testosterone, but if adrenals and/or thyroid is malfunctioning it cant help there, and raising TT for someone who has adrenal fatigue can theoretically be fatal.

As for adding hormones- "end of the line" hormones (estrogen, DHT..) are supressive, but for example pregnenolone itself is not really supressive (as far as I know) and in theory you could top up all other hormones with adding pregnenolone, (altough in practice it rarely works that way) when E2 starts to raise that will cause shutdown for sure. Also what happens when supplementing pregnenolone and DHEA as well I think- as you raise dosage your liver enzymes raise- so it goes to "drain".

adding exogenous testosterone will definitely shut you down, eventually- practically lot of guys get shut after first shot, but also there were few guys on T shots and still had some LH after few weeks, I dont know why or how- but even they get shutdown eventually.

[josh]

If anyone wants the papers leave me a private message with an email addie and I willl send to you.

PM sent. Thanks



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