My Chlomid Results so Far

[Haritec]

52 yr old male 5'08" 162 lbs - reasonable shape - about 12 % BF
Been struggling with low testosterone for several years trying to get the numbers higher. Tried many of the herbal approaches (longjack, maca powder, HCGenerate, PhytoTest, Sustain Alpha, etc). Nothing seemed to help much - in fact my SHBG went way up during this time outside of reference range. Before going on testosterone supplementation, I decided I wanted to try Chlomid to see if I could get the numbers to a better range without any more shutdown of the boys. Test results in three columns (in Canada so units are weird for those in the US), the last column is after six weeks or so of 25 mg Chlomid every other day.


Results.jpg

My thoughts on results

1) Pituitary seems to be working as the chlomid drove up LH and FH
2) Balls seem to be working as Testosterone and Free Testosterone went up 70 %
3) Estrogen getting pretty high
4) Thyroid is OK - actually getting better as tests proceed (added iodized salt back into diet and taking thyroid glandular)
5) Sudden sharp drop in AM cortisol is disconcerting - wonder if it was side effect of chlomid.

Next Steps (my plan so far)

1) Increase chlomid to 25 mg for three days - then one day off (works out to 37.5 mg EOD)
2) Go back to eating a lot of raw cruciferous veggies and take Dyindol Methane twice per day (reduce estrogen) (NOTE - this is what I was doing when my estrogen was 20 - it usually ran about 100 before that - at 20 I had morning wood issues )
3) Taking a stinging nettle / oat straw supplement to hopefully reduce SHBG

Note I could increase Chlomid more - but I want to take the minimum dose that gets me to where I would like the numbers to be.

Any thoughts / suggestions ?

[weekend]

Aromatase inhibitor.

[Jelisej]

Hormones should be fixed in this order:
Adrenal
Thyroid
Testosterone
Growth Hormone

To me it seems that after you stop clomid you'll be back to square one, if you continue than you'll "crash" as your cortisol levels are insufficent to sustain high levels of testosterone. With low cortisol your body is susceptible to infections and allergies etc... If it drops too low than you may start feeling very tired, sleepy, shaky, or even collapse.
Progesterone is too low as well so your E2 is free to rampage all over your body- overall you adrenals are not working well enough.
What I dont understand is your second bloodworks- it seems that adrenal hormones were topping up, you may be doing something right in between two blood tests.

Thyroid seems to be ok, but even there you've probably got problem as it seems that your T4-T3 conversion is not quite good it may be due to some illness. Other (very likely) option is that's happening because of poor adrenal output. So, you may still have hypothyroid symptoms.

SHBG- high SHBG tells you that you may have some other underlying problem as your SHBG was always wat too high, at the moment SERMS are raising SHBG levels so we cant pinpoint what is what there. Reducing SHBG by using any kind of supplements will not give you long term results.

Would be wise to go and see an endo, it seems to me that your clomid tratment will not give desired results.

[Haritec]

Just a brief update - been on Chlomid for over three months now. Somethings going very well - others need a bit of work yet. I have been avoiding adding an anti-aromatase but looks like I may not be able to get around it. Recent labs

Cortisol 688 (range 200- 690 nmol/L)

Way better than last test result - may have been an anomaly as is consistent with previous test from December.

Total Testosterone 28.3 (range 8.0 - 29.0 nmol/L) Well can't complain

Estradiol 184 (range 0 - 160 pmol/L ) This one I need to work on yet
Progesterone 3.7 (range 0 - 3.0 nmol/L)

Free Testosterone 451 (range 175 - 700 pmol/L) More than double the numbers I used to get
SHBG 60 (range 10 - 55 nmol/L) would love to see this down - but maybe because of high estrogen so anti-aromatase?
DHEA-S 8.4 (range 2.2 - 13.0 umol/L)
BioAvail Testosterone 9.2 (range 4.0 to 16.0) NICE- was below reference range in October

Both Bio Avail and Free Testosterone will of course improve if I can get SHBG down.

Here is a major problem - first time ever tested for Vit D and I take about 3000 IUs daily

Vitamin D 80.5 (range 80 - 200)

Maybe I am a poor absorber - have added a second source (pills in the morning - liquid Vit D in evening ) and taking 6-7000 IU and am going to see how it goes.

All in all - I am very pleased with being on Chlomid. I upped my dose in February from 25 mg EOD to 25 mg daily. I am going to cut back to 25 EOD again and see where I stabilize - figuring the lower dose rate will reduce side effects. Going to try some natural anti-aromatase first before trying other approaches.

I feel better - am more positive, good morning wood, can concentrate better and am seeing some body recomposition that is favorable. So far - the experiment for me has been a success - your mileage may vary. I figure for a 53 yr old guy to get his total T up to 800 with just a SERM is pretty good results.

[Grape Ape]

It's more about where it stays after the serm is discontinued, but I am glad you are feeeling better. That is the important part.

Keep the updates coming.

[Haritec]

I am not sure about going off Chlomid permanently - ever. It is reported to have low sides - and more and more studies are pointing to it as an effective long term treatment for hypogonadism.

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

Moskovic DJ, Katz DJ, Akhavan A, Park K, Mulhall JP.


Source

Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.


Abstract


OBJECTIVE:

To assess the efficacy and safety of long-term clomiphene citrate (CC) therapy in symptomatic patients with hypogonadism (HG).

PATIENTS AND METHODS:

Serum T, oestradiol and luteinizing hormone (LH) were measured in patients who were treated with CC for over 12 months. Additionally, bone densitometry (BD) results were collected for all patients. Demographic, comorbidity, treatment and Androgen Deficiency in Aging Men (ADAM) score data were also recorded. Comparison was made between baseline and post-treatment variables, and multivariable analysis was conducted to define predictors of successful response to CC. The main outcome measures were predictors of response and long-term results with long-term CC therapy in hypogonadal patients.

RESULTS:

The 46 patients (mean age 44 years) had baseline serum testosterone (T) levels of 228 ng/dL. Follow-up T levels were 612 ng/dL at 1 year, 562 ng/dL at 2 years, and 582 ng/dL at 3 years (P < 0.001). Mean femoral neck and lumbar spine BD scores improved significantly. ADAM scores (and responses) fell from a baseline of 7 to a nadir of 3 after 1 year. No adverse events were reported by any patients.

CONCLUSIONS:

Clomiphene citrate is an effective long-term therapy for HG in appropriate patients. The drug raises T levels substantially in addition to improving other manifestations of HG such as osteopenia/osteoporosis and ADAM symptoms.

[pman42]

1) Watch the ocular toxicity of clomid. you may wish to supplement with some eye-specific antioxidants
2) Your vitamin D level is pretty normal for a Canadian at the end of winter, even given your 3000 IU. I would do a couple days of 50,000 IU then go to 25x your bodyweight in lbs as an approximate dosage. I do around 30-35x my bodyweight, plus a few days I've done the 50,000 IU thing, and my blood levels are not in the upper part of the range
3) look at adding a low-dosed aromatase inhibitor if you're worried about E2. DIM and I3C won't cut it

[O_RYAN_007]

What's a eye specific antioxidant?

[Haritec]

Thanks for the feedback PMAN. I will definitely crank up the vitamin D and monitor to see effects.

In regards to occular toxicity - I thought the research showed that Chlomid had far less occular issues as compared to tamoxifen. Also - a lot of the occular issues occured with high doses like 100 to 150 mg daily chlomid. THe recent research seems to show that lower doses are as effective or even more so - with some people getting good results (testosterone increase wise) on 12.5 mg EOD. Personally, I think that 25 mg every day is too much for me - and will go back to 25 mg EOD - and may reduce further from there in the future if my numbers stay good.

In regards to occular specific anti-oxidants - I think that increasing glutathione levels is the most important thing. Glutathione is a powerful whole body anti-oxidant but especially important to the eyes. It is not adsorbed well orally - so the best ways to increase it seem to be to take N-Acetyl Cysteine with Vitamin C and/or to take SAM-e.

I don't know whether to be worried about the higher E2 levels or not - I don't feel emotional (feel more testosterone effects - dominance etc) , have good libido, nocturnal erections, no gyno signs, so no outward signs of problems with E2. My only worry is that it is outside normal range and that may be driving my SHBG higher which in turn lowers my free testosterone. If I could get free test up to 90% or so of the reference range - I would be satisfied I have hit my goal from a hormonal perspective. The online pharmacy my lab rat uses doesnt seem to sell exemestane - but from what I have read that seems to be the approach I would like him to take. It seems better for his lipid profiles and actually increase IGF-1 while reducing estrogen. Lab Rat has had some issues with ordering from other online pharmacies and never getting the product.

[Rodja]

Elevating SHBG and estradiol is how Clomid works. It's part of the negative feedback loop that sends the signal for the HPTA to produce more testosterone. I would NOT add in something to lower SHBG without an AI as SHBG also binds up E2 and doing so without an AI will only increase the amount of circulating E2.