My temporary recovery via clomid...

Kazman, are you saying that by taking a cream containing cortisol that you actually reduced your cortisol levels a.m.?
(I’m paranoid about taking any cortisol due to the wasting effect on muscle, also my DHEA levels were high)

To.robin,

I hope to soon start a separate thread that covers the cortisol treatment I underwent last year for adrenal fatigue, as I have had numerous private messages asking about it. In my case I had above normal morning cortisol that would be well below normal at noon and also low at around 4 pm. By taking low dose cortisol one dose in the morning and a second at noon, I was able to “even out” my cortisol profile.

I have been off low dose topical cortisol treatments for about a year. While on clomiphene citrate during 2009 about half my 8 AM serum cortisol levels have been above normal but symptoms haven’t been too bad.

The latest T reading is 1010, quite high but estradiol is up into the mid 30s (ng/dL i think) while low/mid 20s is thought to be desirable. It had previously been below 15 . . . so yes I had a very good few weeks function/frequency wise during the change between ~15 and mid 30’s.

kazman

adrenal fatigue is something i am looking into for my own condition , my brain fog and fatigue definately get worse with stress.i am sleeping ok though so that is counter intuitive.

what i can’t figure out is if my problem is the liver then why is it taking so long to improve , the liver is supposed to be good at regenerating itself correct? must be other issues here.i will order saliva test next month when more cash comes through.

Am way overdue in updating this thread, thanks all of you for your PMs asking for updates and inquiring as to how I’m doing.

To answer an old question. prior to going on topical TRT in 2007-mid 2008 I had LH levels of less than 1 to about 1.5, and FSH readings in the 2-3 range (multiple tests), so definitely secondary hypogonadal according to two different board certified endos and one other doc doing bioidentical hormone replacement. My total serum T was in the 180 to 300 range when not on TRT. The topicals (tried two different ones) could get me to around 500 maximum. Found I always had to keep tweaking the dose higher, and although it helped functioning in the bedroom it did nothing for anorgasmia, which has slowly, steadily been getting worse since I quit fin (on fin for several months back in 2002)

To recap on the clomiphene, on 75 mg/week in 3 divided doses my T rose from the 250-300 range to the 700 range after about 3 months. These were peak values; typically I would take the clomiphene before bedtime then get drawn for T and E at around 7:30 AM the next morning. After three months I took a 24 hr urinary steroid profile. The T (testosterone) showed as below the normal range despite the upper range serum T. The doctor explained that the T in the urinary profile is either bioavailable or free, can not recall which he said it was. Bioavailable includes free and albumin (weakly) bound. Also, my FSH really had not budged, so he increased the dose to 100 mg/week.

When I last reported out, my T levels were supraphysiological, in the 900 to 1050 ng/dL range. This happened by upping my dose from 75 mg/week to 100 mg/week (divided doses). Note this is still much less than the 150 mg/week Dr. Andre Guay has used (see the linked article in an earlier post of mine). This period basically corresponded to the month of June. And what a month it was. Felt great, sense of humor returned, just felt good all around. Not since before fin have I been able to have intercourse every two days or so, and even when not actually in the act I had that low buzz of libido just being around her (and, to a lesser extent, around any attractive females)… Got to the point where she was actually shooing me away, quite a change from the less than once a month and only early in the morning thing I experienced while off of TRT in the second half of 2008, as well as before my hypogonadism was diagnosed. Also, finally, FSH rose to the 4 range.

Please do not for a moment think this somehow cured me. Anorgasmia was and still is extremely prevalent, with almost no sensation down there, and only very minor feelings in the brain, at climax. Function was excellent, easily aroused, but the reward at the end was a low fizzle. Still, I felt al around much better

Clomiphene is serious medication; the liver is taxed to eliminate it. The drug consists of two isomers, zuclomiphene and enclomiphene. The drug is mostly used for short runs of several days to help women ovulate and get pregnant. In this application I have read that the zuclomiphene is the more active portion (will try to update this post with a reference). In men the enclomiphene is the active portion, blocking hypothalamic receptors and making the hypothalamus secrete GnRH, thereby signally the pituitary to release LH (and hopefully, for us, FSH). There is a small pharmaceutical company, Repros Therapeutics, that is developing pure enclomiphene (called Androxal), Unfortunately, it may never come to market as one of their other drugs got turned down by the FDA in July and their stock price has plummeted. The zuclomiphene just acts as a synthetic estrogen in males, and is undesirable, I think this is why the bodybuilders get emotional when they take walloping doses of it to try restart their HPTA after a steroid cycle – they take 100 or 150 mg clomiphene and then load their systems up with synthetic estrogen none of us need. Maybe some wealthy secondary hypo or post fin sufferer will help the Repros company out and make enclomiphene a reality.

So what happened to me? All this time on clomiphene my estradiol slowly crept up, as was SHBG. In July function remained but the desire (libido) dropped. Did not pick up on the estradiol issue right away as I had mostly been running the ultrasensitive test. There are indications from the regular secondary hypogonadism, non post fin sufferers that this ultrasensitive test is not very accurate while on clomiphene. My doc is even starting to think the ultrasensitive is of little value at least for clomiphene treated patients. I had two readings in a week, one ultrasensitive, and one not, that differed greatly (mid 20s on ultrasensitive yet high 40s on regular). Anyway, even the ultrasensitive E was showing a steady increase over the months.

I was tempted to take nettle root to control the rising SHBG, which had gotten up to about the average of a man in his 70s. However, careful research of this supplement revealed it to also be a 5 alpha reductase type 2 inhibitor as well (under the impression that it is not as strong as saw palmetto). It is also very difficult to find hydromethanolic or methanolic extracts of nettle, which are the ones you need for SHBG control (ethanol extracts do not work according to at least one paper).

My doc decided to take me off clomiphene for a month to clear everything out, and start at a new, lower dose. Coming off clomiphene was much nicer than halting topical TRT. For the later (middle of last year) I felt like utter crap for a few weeks, sweats, fatigue etc. was glad I decided to stop during a vacation, and then the hypogonadal symptoms of course persisted. Clomiphene has a half life of about 5 to 7 days, and takes a few weeks to be processed out completely. This resulted in a much slower, gentler ramp down off the higher testosterone levels, only a few rounds of minor sweats. No, I did not restart my HPTA (will type about restarts another time) as T dropped to 500 over a couple of weeks (E to mid 20s, perfect), then T to a little over 300 in another couple of weeks. I added another week and a half, even though I felt very low on energy, so that I could take Adiol-G with nothing in my system, to get a baseline value. See the Adiol-G thread in the Stickied Blood and Hormone testing section. Felt a little short tempered and crabby during the last couple of weeks of the 5 week break.

Back on at a lower dose taken twice a week, after several weeks T has popped back up to 700, but E has risen also into the mid 40s (too high, bodybuilders suggest 20 to 25 is ideal with 18 being the lower limit to prevent osteoperosis. Will see the doc in November; great deal to talk about given the very low Adiol-G and low 5 alpha/5 beta urinary ratios.

Based purely on my own experience, do not overdue this drug, more is not better. Look at Voice’s thread, he tried as little as 10 mg. Best to take it only 3 or so times a week to give your liver a break, and to prevent blocking the hypothalamic receptors responsible for sexual stimulation. Still seems to be the most natural way to correct low LH, as clomiphene results in pulsatile LH and FSH (and thus pulsatile testosterone) secretion, rather than a gradual absorption you get from topical T (or huge sudden burst from an enthanate shot). .This is all my opinion and my own experience with my own physiology, I am not an MD and would recommend using clomiphene only under the care of a doctor (they need to check liver enzymes periodically).

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Nice infor about clomid treatment. Are you still taking clomid? if so how much is your dose and how long you are planning to take. I assume it has been already 4 months.
Your pre clomid values are very low, 180 to 300 so did you notice ball shrinkage?
while I was reading DavidZ’ primer on HCG, I learned that it took him pretty good time to get his Testicles functioning again. So what do you think if you add little HCG to your current regimen. would not that be a good idea? I think you can do it now while being on clomid cause HCG alone is supressive to HPTA.

these are my thoughts of course you and your Doctors know better.

Hey did anyone recover with Clomid??

I have a bit milder symptoms , mild ED and loss of libido

Do you think i can make a full recovery with it??

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It’s worth getting a hormone blood panel to see if you have an imbalance. If so, you might be treatable from hormone replacement therapy. I tried clomid and it slightly improved things for a couple weeks but the results weren’t lasting.

Yeah same question here.

Just got labs done that stated everything was normal except very low FSH. Clomid does not seem worth trying from everything I’m reading. Does anyone think I should address this with any kind of medication?

Possibly starting a second clomid treatment after 5 years of the first one where recent tests came with low LH, low-normal Testosterone…

What was your LH and T levels? How low? @needacure

What was your FSH levels? And what is your age? What made you think Clomid does not worth trying, just asking?