My Bloodwork pre/post Clomid **Labs after 3months of treatment @ bottom**

Member Stories Lab Tests
#1

My full history is posted in the Members Stories section. I’ve copied and pasted the following info on my bloodwork from 2 months ago & progress at 6 weeks, and subsequent increased meds. Since discovering this site and seeing that so many of us have had a lot of similar treatment approaches, I decided to book a follow-up appointment with Dr. G. in 2 weeks. I want to discuss my bloodwork in greater depth, as well as different options for treatment.

My question is, what do you make of these levels? What appears off other than the ridiculously low T and DHT? Based on these results, should I ask to get other markers tested?

Bloodwork ordered by Dr. Irwin Goldstein (San Diego Sexual Medicine at Alvarado Hospital) prior to meeting with him in November of 2009:
DHT 17
T 335
TSH 1.41
E2 30
FSH 3.0
LH 3.9
PROLACTIN 5.2
SHBG 13

After 6 weeks of Clomid (2x a week, 50mg), my Testosterone was in the 600 range, DHT was doubled. Dr. G. said DHT was still very low and that we needed to get T to 1000. He upped my dosage of Clomid to 3x a week and added ½ tube of topical Testim 1% (50mg) gel (Testosterone).

Quick Update (full story at end): after just a few weeks of Clomid, I felt much more upbeat & energetic. 2 months later, I’m far more motivated to workout, run, and do simple things like empty the dishwasher which used to feel like a monumental task. I realized just how damn exhausted and out of it I’d been in the last couple of years pre-treatment. I’ve always been horny: pre, during and post fin. I’ve “just” suffered E.D., lack of energy/depression/melancholy. Meaning, even though erections are difficult to initiate, I’ve never stopped wanting sex or masturbating. Just avoiding situations due to performance anxiety, etc. Nevertheless, 2 months later, I’m starting to feel a little hornier, I’m masturbating slightly more. Also getting regular morning erections (but not completely full). Still not recovered, by any means, but this is what I’ve noticed and I’m trying to keep track as I notice changes.

Any advice on bloodwork or specific questions to ask Dr. G.? I want to go into my next appointment more informed, I’ve just begun looking at this board nightly in hopes of educating myself. Thank you for your help!

#2

Post RANGES beside each blood result so we can assess properly. Without ranges, results are useless.

#3

Here is the bloodwork I’ve had done. I’m going to see my doc for a follow-up in 2 weeks. Any observations? Any suggestions for additional things to test for before my visit, or things to discuss getting tested?

I want to discuss as many potential “leads” for “cures” or parameters to test with Dr. Goldstein. If you can arm me with your best stuff, treatments that have worked, or specific theories on markers that need to be tested for, levels that you find off in my testing, anything…I’ll discuss with the doc and report back. Be as specific as you can, I’m new on this site, and I don’t have all the science and jargon down yet. And I want to obviously help my condition, but also help raise awareness for what’s being observed and theorized, what’s worked and not worked from the experiences of members on this forum with the doctor(s) to hopefully come up with some strategies that can help everybody’s cause.

10-26-09 test results:
Testosterone, Serum: 335ng/dL range: 241 - 827
DHT: 17ng/dL range: 30 - 85
LH, S: 3.9 mIU/mL range: 1.5 - 9.3
FSH, Serum: 3.0 mIU/ml range: 1.4 - 18.1
Estradiol: 30 pg/mL range: 0 - 53 <54
SHBG, Serum: 13 nmol/L Range: 13 - 71

TSH: 1.410 uIU/ml range: 0.450 - 4.500
Prostate-Specific Ag, Serum: 0.3 ng/mL range: 0.0 - 4.0
Prolactin: 5.2 ng/mL range: 2.1 - 17.7

12-14-09 test results (after 6 weeks of Clomid 50mg, 2x week)
Testosterone, Serum: 670 ng/dL range: 280 - 800
DHT: 28 ng/dL range: 30 - 85
LH: 7.9 mIU/ml range: 1.7 -8.6 (lab papers said to note the reference interval change)
FSH: 5.1 range: 1.5 -12.4 (lab papers said to note the reference interval change)
Estradiol (Roche ECLIA methodology): 39.5 pg/ml range: 7.6 - 42.6
SHBG, Serum: 21.4 nmol/L range: 14.5 - 48.4 (lab papers said to note the reference interval change)

I guess the doctor didn’t feel the need to test for TSH, Prostate-Specific Ag or Prolactin. (Thoughts?)

Testosterone & DHT went up, but not enough according to doc, according to the normal ranges. DHT, in particular, was still below the lowest number in the range. So he upped Clomid to 3x a week of 50mg as well as Testim 1% topical.

Quick update: since beginning treatment about a couple months ago, energy & mood = significantly up. Urinating control is vastly improved (starting easily, stopping after done, not squirting more). Hives I’d get all over my body = gone. More morning wood, still 60-85% of full capacity. Still have E.D. Desire/lust is there, I just have a disconnect between the brain & penis. Only by jerking it can I get hard.

Again, any interpretations of my results? Advice?

Thank you in advance for your help!

#4

Estradiol needs to be managed. Discuss further with doc about ways to bring it down (possibly Arimidex?).

#5

The first day I met with the doc, he gave me the Clomid prescription along with a prescription for Arimidex to “put in my wallet” in case I needed it. He told me we’d have to watch the Estrogen level as T rose.

After the 2nd round of tests, however, at the 6wk mark posted above, he didn’t raise the issue. And upped my meds. Which so far I’ve tolerated well, and have made me feel better.

Where do you think Estradiol should be? Any other stuff you think I should look into? I’ve read some threads on DHT/5ar/Adiol G. Haven’t connected all the dots yet. Thoughts?

#6

I believe Dr Shippen likes to keep it between 15-25, with 20 being the sweet spot for most men… but I could be wrong.

I’m not an expert so best to discuss with doc. Just noticed your Estradiol was going up since your “before” test.

#7

Just got my latest lab results, going in to see the doctor this afternoon.

Testosterone, Serum: 938 ng/dL range: 280 - 800
DHT: 78 ng/dL range: 30 - 85
LH: 4.1 mIU/ml range: 1.7 -8.6
FSH: 4.3 range: 1.5 -12.4
Estradiol (Roche ECLIA methodology): 91.4 pg/ml range: 7.6 - 42.6
SHBG, Serum: 22.5nmol/L range: 14.5 - 48.4

Obviously, Testosterone, DHT are way up…but no improvement in E.D.

Estradiol skyrocketed. [note: I screwed up when initially transcribing these #'s. I updated the correct levels. Estradiol is 91.4!!]

It’s now been 2 1/2 months of Clomid treatment, a little over a month of upped Clomid dosage and 1/2 tube of 50mg Testim daily.

I’m guessing the doc will have me fill the prescription for Arimidex he handed me when I first met him. Not sure if other levels indicate anything? Anyone? Would lowering Estradiol with the levels I have, possibly help E.D.?

#8

My guess is yes. I’d say that’s your biggest concern at this point. Elevated estrogens can kill sex drive and erections in men, and yours is near top of range.

#9

What about the other levels, SHBG. Normal? Or do you think they’ll need to be tweaked?

If anyone’s taken arimidex, or specifically dealt w/ lowering Estrogen, what were your results like? Did any other levels fluctuate in turn? Anything else added to the medication cocktail?

Thanks

#10

…as noted in my corrected recent lab results…my Estradiol escalated to well above “normal” range…to 91.4 (range: 7.6 - 42.6) !!!

LH, FSH went down a little.

SHBG was ever so slightly more, about the same, really.

So T, DHT look to be high and in a good relative place, unsure of how tweaking the other levels would affect me, other than the clear red flag of high Estradiol.

Hoping this is good news, but it still doesn’t work down there.

Complete labwork history (latest results at bottom):
10-26-09 test results:

Testosterone, Serum: 335ng/dL range: 241 - 827
DHT: 17ng/dL range: 30 - 85
LH, S: 3.9 mIU/mL range: 1.5 - 9.3
FSH, Serum: 3.0 mIU/ml range: 1.4 - 18.1
Estradiol: 30 pg/mL range: 0 - 53 <54
SHBG, Serum: 13 nmol/L Range: 13 - 71

TSH: 1.410 uIU/ml range: 0.450 - 4.500
Prostate-Specific Ag, Serum: 0.3 ng/mL range: 0.0 - 4.0
Prolactin: 5.2 ng/mL range: 2.1 - 17.7

12-14-09 test results
(after 6 weeks of Clomid 50mg, 2x week)

Testosterone, Serum: 670 ng/dL range: 280 - 800
DHT: 28 ng/dL range: 30 - 85
LH: 7.9 mIU/ml range: 1.7 -8.6 (lab papers said to note the reference interval change)
FSH: 5.1 range: 1.5 -12.4 (lab papers said to note the reference interval change)
Estradiol (Roche ECLIA methodology): 39.5 pg/ml range: 7.6 - 42.6
SHBG, Serum: 21.4 nmol/L range: 14.5 - 48.4 (lab papers said to note the reference interval change)

1-18-2010
(Clomid upped to 3x/wk from 12-14-09, ½ daily Testim)

Testosterone, Serum: 938 ng/dL range: 280 - 800
DHT: 78 ng/dL range: 30 - 85
LH: 4.1 mIU/ml range: 1.7 -8.6
FSH: 4.3 range: 1.5 -12.4
Estradiol (Roche ECLIA methodology): 91.4 pg/ml range: 7.6 - 42.6
SHBG, Serum: 22.5nmol/L range: 14.5 - 48.4

#11

Why do you think estradiol went up so high? Is that a consequence of taking Clomid/Testim? If so does anyone know what in particular as i have started 25mg Clomid daily…

I don’t want estrogen going up that eff high…

#12

Yes, it was to be expected. T converts to Estrogen. The goal was to get my T high enough to get DHT in the right range, and then regulate E down to where it needs to be.

I met with Dr. G. today and we talked for a while. He prescribed Arimidex 1mg, 3x a week, to be taken along with the Clomid and Testim. He believes that once I get E under control, I should see improvement…but there’s another possibility which I’ll get to in a few paragraphs…

I shared with him various theories and lines of thinking from this board, he was very interested in my printouts and studies, etc. Took home some reading.

Apparently, he’s working with a few of you from this board. I emphasized how many of us there are on here, and how we have profiles with bloodwork, etc.

One thing he wanted me to share was a theory that there is redundancy in systems in nature, in our bodies. We have 2 kidneys, whereas we only need 1/2 of one to function. Two vascular passages in the penis. Two balls, etc. In other words, when our systems are compromised, the body usually is able/tries to compensate somehow. (I hope I’m not butchering his concept–I probably am)…

Dr. G. said that in brainstorming with others, he wonders why some people are affected by fin and other not. He hypothesizes that we have some pre-existing condition that is only brought to light once we are affected by this drug. And possibly compounded by the drug. I know that this idea in and of itself is not that revolutionary, but I wonder how many of you have had comprehensive physical testing (doppler ultrasound, DIC, etc) to rule out physical roots for E.D. ? I know some of you have found that you have minor blockages. These could be the result of childhood injuries: falling on a bike, a fence, etc, etc. It could be that you would have had a decrease in ability anyway, and then fin stripped you of the hormonal component.

The doc said that we should monitor progress after getting E under control, and at some point, I may want to visit addressing the blockage if all basic levels are normal.

#13

Whats your 3-Adiol G reading?

This is important…

#14

holy shit dawg

that’s some massive amount of arimidex to take i know your value is high but still…

get prepared to lose wood again;)

#15

I can’t speak for everyone but in my case so many things were affected that physical damage doesn’t make sense. I mean my skin, changed, my eyes changed, my scent changed, I stopped losing hair, I was highly fatigued. Damage to the junk doesn’t make sense. + I get flashes of 100% where everything works normally a few times a year. It’s fin and it fucked with our internal systems IMO.

#16

But what made the estrogen high, was it the from the Testim or Clomid??

A far as the physical nature of this is concerned, I appreciate the insight but cannot fathom how that might be the problem. I’m sure many of us have taken a ball to the nuts or fell on the horizontal bar on our bikes…

All of this for me happened while on propecia and then while off of it…

#17

To be clear, the doctor is not suggesting that we’re not suffering side effects from propecia at all. He’s well aware of that. For me, most of my side effects have subsided since treatment, with the obvious big one, E.D., still present. I have more energy now, dont’ get random hive outbreaks, my urinary control is far improved (staring/stopping), etc.

He’s supposing, that once basic hormonal values are stabilized, addressing my blockage issue may be the next step. But hopefully meds will be enough.

Had I never been exposed to fin, perhaps my blockage issue would not have been exposed, or worsened. It’s unclear.

But I know I’m not the only one who has found other reasons. You have to treat the hormonal stuff first. But it doesn’t mean that there aren’t other issues, especially if T therapy helps all the other issues. Yes, a lot of us have gotten kicked in the nuts badly…and that can and does end up affecting people much later in life. I saw a panel of patients including one person that had scarring from a soccer accident. Took years to make the connection, he had surgery, he’s fine now. Now, imagine you have such an injury, and then you take a drug that screws up your hormones, and then in turn potentially further damages your tissue composition, or whatever. Hey, I don’t have the answer, but you have to isolate every variable. When doctors prescribe Viagra or Cialis, they don’t always know what the root cause of the E.D. is. But it works as a good enough bandaid solution for many.

Now as far as arimidix making me lose erections: I don’t have them now, so I’m not really afraid of what substantially lowering Estradiol would do. Doc says that the high levels of T and DHT I have now cannot be taken advantage due to the E level. I hope the strategy works, what can I say?

#18

Let us know how that strategy works with armidex

#19

Well, just got labs back from my PCP. I will scan and post the full report next week, but I thought I’d share a quick summary.

I did a CBC, Urinalyis, Cortisol, Thyroid Cascade Profile, Comprehensive Metabolic Panel, Lipid Panel, Estradiol, Vitamin D, T, DHT, E.

I threw in T, DHT, E, just to check in on my E level since taking Arimidex. I thought I wasn’t gonna be that low, so I didn’t throw in LH, FSH and SHBG at this juncture (although now I wish I had), thinking I’m due to retest in a month or so, at which point I’m going to open up hormonal testing more with Dr. G.

Anyways, most everything checked out well: liver, cholesterol, thyroid, etc. My platelet count was on the low side, but that’s traditionally been the case with me. Of note:

Vitamin D, 25-Hydroxy: 21.8 ng/mL Range: 32.0-100
Cortisol: 28.2 ug/dl Range: 2.3-19.4 ug/mL

Testosterone: 889 Range: 280-800 ng/dL
DHT: 68 ng/dL Range: 30-85
Estradiol: 19.9 pg/mL Range:7.6-42.6

I completely expected my Cortisol to be high and Vitamin D low (even though I live in California). So I’m off to the store to pick up Vitamin D. I’ve read that 2,000 ius daily is what you need, my multivitamin only provides 400ius. For reference on the importance of Vitamin D (although there is no emphasis on sexual function):
bu.edu/bostonia/winter-spring10/vitamin-d/

I’ve got to read up more on Cortisol. I don’t know if this is representative of something worse (adrenals–and what to test/treat), or just a reflection of the stress I feel from this situation and dealing with work minutia, etc.

I didn’t expect E to get knocked down from 90 so quickly, that was a pleasant surprise. It looks like it’s in the “sweet spot” right now, after being on Arimidex since the end of January.

I’m due to see Dr. G. in a few weeks, at which point I’m going to discuss adding this stuff to the labwork: Androstenedione
Androstenediol, DHEA-s, Aldosterone, Progesterone, Pregnenolone, 17-OH Progesterone , 17-OH Pregnenolone, Androsterone glucuronid, 3alpha-diol G

If everything checks out, revascularization is where I think I’m heading as far as curing the E.D. (my only persisting symptom). I do get upto 75% nocturnals / morning erections (they come and go as I’m snoozing in the morning, not even brought on my conscious fantasizing). More on that & please take this poll if you’re reading this thread:
propeciahelp.com/forum/viewtopic.php?t=3427

Thoughts on Cortisol? Additional hormonal testing to do? Thanks.

#20

I thought you werent suppose to take notice to estradiol levels whilst on clomid or other serms? You may have high estradiol on them but since you are using a serm they wont get to the receptor as they normally would?

Clomid raises T by tricking the brain into thinking theres not enough estrogen going around so the body tries to make T wich converts to estrogens. If your body was stimulated by the 91.4 e2 value then your T wouldent be that high cause it would have stopped sending the message to increase Testosterone. But it dident since your T is still high and your only on small amount of T-gel so its still your testicles producing the T.

I dont think this matter tho but id rather do less drugs than more.

Am i comletely wrong? whats your docs take on this?

Gl, glad you are feeling better!