# STEROIDS FORUM > HORMONE REPLACEMENT THERAPY- Low T, Anti-Aging >  Considering trying a Clomid restart prior to TRT

## DVC

Hi. First post and I've been reading the forums for a bit. 

I'm 46 and had my test levels tested in conjunction with my regular blood work.

My total T is low, free is in range but lower. Test results:

Testosterone , Serum 318 ng/dL [Low] range 348-1197
Free Testosterone(Direct) 8.3 pg/mL range 6.8-21.5
DHEA-Sulfate 112.6 ug/dL range 44.3-331.0
Estradiol 10.0 pg/mL range 7.6-42.6
TSH 2.980 uIU/mL range 0.450-4.500
Did not test LH and FSH.

I have BPH and a high PSA. Take Flomax daily for BPH. Just had a biopsy a month ago and it came back fine.

My symptoms are real, but not severe:
* Some brain fog,
* Some decreased libido, but not terrible.
* Some limited ED, but occasional only. Gets up fine, but doesn't stay occasionally.
* Some tiredness.
* I've retained my strength and body comp.
* Testes look full and don't hurt.


Saw my urologist today. BTW - I really like him and he is a top rated urologist. Of course that doesn't mean he's a top notch TRT guy.

He stated that he has prescribed TRT to many hundreds of patients. He, himself, is on Androgel . He was not concerned about my BPH while on Test. He told me that he's only taken one patient off of TRT because of increased BPH.

He is a fan of Androgel and does not prefer injections because of the hassle for patients. He does not prescribe HcG and only prescribes an AI when indicated.

He prescribed Androgel 1.62% at 3 pumps per day for me. I have a follow up scheduled in 3 months.

I'm considering trying a Clomid restart to see if I can avoid the long term commitment of TRT. Any thoughts appreciated.

I also would appreciate the protocol for a Clomid restart. I have found the protocol for PCT and wondering if it's any different for my purposes. Thanks.

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## Vettester

Thanks for the informative, well written first post! 

To help you, we really need the LH / FSH panels taken. This will help confirm if you are primary or secondary hypogonadal. Here's the deal, if you get on a Clomid protocol, then essentially what you're trying to accomplish is getting the HPTA functioning with LH & FSH production. In turn, that would trigger endogenous production with your testes. However, let's say your condition is primary, meaning failure at the testes level, then that would mean that your LH/FSH is more than likely elevated. It all works on a negative feedback loop. So, if your testes are not receptive to the LH signal at this time, adding a compound to produce more LH will just be redundant, and not healthy on a pituitary gland that might potentially already be overproducing these hormones.

At your age it's more than likely secondary, but I wouldn't speculate, I would find away to know for sure. E2 is definitely on the low side ... Any noticeable sides (fatigue, low libido, joints, ...)?

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## GotNoBlueMilk

I tried the Clomid thing. It worked ok while I took it. Took it for several months. The problem I had was 1) it was only good while I was on it and once I stopped my Test went back down; 2) it killed my libido! 

Some others in the past on this board have done the Clomid therapy w/o success. Not everyone has the libido issue from it, but many do. Something to consider.

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## zaggahamma

also think it was a great first post

symptoms sound like me at age 36 unfortunately and 7 years later no regrets being on a shot a week

i havent heard a lot of posts with ppl in their 40's trying to fully recover rather than going on trt nor would I consider it knowing what trt can/has done and how easy it is BUT it IS a personal decision

welcome and best of luck

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## DVC

Thanks for the replies and the welcome!

I am having my LH and FSH tested today and should have the results in a few days. Thanks.

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## DVC

> E2 is definitely on the low side ... Any noticeable sides (fatigue, low libido, joints, ...)?


Yes - all of the above but not too bad. Where I really see the fatigue is in my Muay Thai classes at the gym. They are very intense contact-based classes and we usually spar towards the end of class. That is where I have recently noticed my stamina is not what it used to be - and a bad time to run out of gas!

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## HRTstudent

> Hi. First post and I've been reading the forums for a bit. 
> 
> I'm 46 and had my test levels tested in conjunction with my regular blood work.
> 
> My total T is low, free is in range but lower. Test results:
> 
> Testosterone , Serum 318 ng/dL [Low] range 348-1197
> Free Testosterone(Direct) 8.3 pg/mL range 6.8-21.5
> DHEA-Sulfate 112.6 ug/dL range 44.3-331.0
> ...


If I could personally start over, I would do a clomid option before T. I actually did transdermal testosterone as well. Didn't go that well at all.

However, fertility is important to me and that's a big reason I would prefer something like clomid or an AI. At 46, and if you don't want kids in the future, then testosterone would be your best bet, but that doesn't mean it's the only thing that will give you good results - just on average. 

Testosterone is a far more cumbersome commitment, however, like you stated. You must see a physician yearly, must get a schedule 3 drug, must get a good doctor to work with you, must apply daily or inject regularly. With clomid, it's as easy as taking a vitamin.

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## DVC

> If I could personally start over, I would do a clomid option before T. 
> However, fertility is important to me and that's a big reason I would prefer something like clomid or an AI. At 46, and if you don't want kids in the future, then testosterone would be your best bet, but that doesn't mean it's the only thing that will give you good results - just on average.


Thanks for you reply HRTstudent. At 46, I have two great kids and fertility is something that no longer matters for me. Two kids are enough to have to put through college!

I should have my LH and FSH tests back hopefully by week's end. If those are low, my plan is definitely to try a clomid restart. If they are not low, I will be back asking more questions regarding whether a clomid restart is worthwhile trying. 

I'm currently trying to figure out what protocol to use for a clomid restart in my situation. There's plenty of data for clomid protocol for PCT for guys ending an AAS cycle. Based on some of my reading, I don't think I need such high levels of clomid for my purposes but looking for advice on that protocol. 

Any thoughts on that clomid protocol? Thanks.

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## kelkel

Also talk to your doc about your tsh level. It's high. New standards are .3 - 3.0, not what is still on a lot of blood results. Do you have T3 and T4? Hypothyroidism can put you at risk of low test. Also take a look into Cialis for daily use to help with BPH. It has a lot of other benefits also. Read the below:

http://www.fda.gov/NewsEvents/Newsro.../ucm274642.htm

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## DVC

> Also talk to your doc about your tsh level. It's high. New standards are .3 - 3.0, not what is still on a lot of blood results. Do you have T3 and T4? Hypothyroidism can put you at risk of low test.


Thanks Kelkel. I will ask my doc about the TSH. Based on the new scale, I'm not technically high, but right there. If high, wouldn't I have hyperthyroidism (as opposed to hypo) - or do I have it reversed. Thanks.

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## DVC

Wow - got my test results back in one day.

FSH 3.2 mIU/mL normal range 1.5-12.4 MB
LH 4.0 mIU/mL normal range 1.7-8.6 MB

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## kelkel

If T4 & T3 are low the pituitary will produce more TSH in effort to normalize your system. Read this excerpt:

Diagnosing all types of hypothyroidism is important, because treatment with thyroid hormone will improve symptoms in patients with hypothyroidism, but is unlikely to help those who do not have hypothyroidism. In primary hypothyroidism, the thyroid gland, located in the neck, is less able to produce the thyroid hormones, T4 and T3. The pituitary gland, located in the head, responds to this deficiency by secreting more TSH. Thus, in more mild cases of primary hypothyroidism, T4 and T3 levels are normal, but the TSH is high. In more severe cases, T4 and T3 levels drop. Although the normal range for TSH is often between 0.5 and 5 mU/mL, values at the high end of the normal range may be abnormal. T3 is the more bioactive hormone compared to T4, but T4 is more stable in the circulation.

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## HRTstudent

> Wow - got my test results back in one day.
> 
> FSH 3.2 mIU/mL normal range 1.5-12.4 MB
> LH 4.0 mIU/mL normal range 1.7-8.6 MB





> Thanks for you reply HRTstudent. At 46, I have two great kids and fertility is something that no longer matters for me. Two kids are enough to have to put through college!
> 
> I should have my LH and FSH tests back hopefully by week's end. If those are low, my plan is definitely to try a clomid restart. If they are not low, I will be back asking more questions regarding whether a clomid restart is worthwhile trying. 
> 
> I'm currently trying to figure out what protocol to use for a clomid restart in my situation. There's plenty of data for clomid protocol for PCT for guys ending an AAS cycle. Based on some of my reading, I don't think I need such high levels of clomid for my purposes but looking for advice on that protocol. 
> 
> Any thoughts on that clomid protocol? Thanks.


There is someone who is using the nolvadex /tamxifen restart with really good results. They just posted a couple weeks ago. It's similar to clomid.

The dosing of clomid is probably far less than what you read about on "steroid " forums. I tend to tell people to just ignore what they read there - it's far more likely to confuse you than help you. They also have far different goals than people on TRT - purely physique/strength vs quality of life.

If you would update us on your protocol I think it would be useful for many people here. 

Judging by those numbers, if I was in your position I would be trying the clomid for a few months and take it from there.

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## DVC

> If you would update us on your protocol I think it would be useful for many people here. 
> 
> Judging by those numbers, if I was in your position I would be trying the clomid for a few months and take it from there.


I am looking for advice on the clomid protocol. Here's what I'm thinking about. Looking for comments: three months on clomid: first two weeks at 50 mg per day, thereafter 25 mg per day.

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## kelkel

Good advice above. Take a look at this and see if you can glean some info from it that will help your particular case:

http://forums.steroid.com/showthread...Which-for-what

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## Vettester

> Wow - got my test results back in one day.
> 
> FSH 3.2 mIU/mL normal range 1.5-12.4 MB
> LH 4.0 mIU/mL normal range 1.7-8.6 MB


Hmmm, I don't know ... Your LH isn't all that bad IMO. Truthfully, based on the testosterone serum score you provided, I would have expected the LH to be in the low 2's, maybe high 1's. The whole point of Clomid is to restart a suppressed HPTA. It's just my opinion (for whatever that's worth), but I don't view your HPTA to be suppressed, at least to the point of needing Clomid therapy. I've seen guys with similar LH scores having 500+ serum scores. 

This isn't to say that maybe your LH couldn't be a point or two higher, and things would be more optimal. However, I'm not convinced that part of your condition might also be testicular related (or at least partially), and truthfully I just don't see Clomid therapy doing anything miraculous to your HPTA that's going to increase and sustain endogenous production to a level that will be appreciated, especially considering you are 46yo. Don't feel bad, I'm 45 and was out of the game around 40.

That's just my .02, so if you can somehow get Clomid to give you a total test serum level of 600 or more, then all the power to it! If so, take labs right after the protocol, then again after another 6 to 8 weeks after being off of Clomid.

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## DVC

Thanks kekel. That thread contained this study: Clomid raises test in hypogonadism men by 146%: [apparently I can't put links in my post because I'm a new member with <25 posts. Sorry]

Which also lead me to a more recent, similar study: Clomiphene citrate is safe and effective for long-term management of hypogonadism: [apparently I can't put links in my post because I'm a new member with <25 posts. Sorry]

It looks like 25 mg is the base line used. Something that's not addressed is the effect on natty test if the patient stops taking clomid.

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## DVC

> Hmmm, I don't know ... Your LH isn't all that bad IMO. Truthfully, based on the testosterone serum score you provided, I would have expected the LH to be in the low 2's, maybe high 1's. The whole point of Clomid is to restart a suppressed HPTA. It's just my opinion (for whatever that's worth), but I don't view your HPTA to be suppressed, at least to the point of needing Clomid therapy. I've seen guys with similar LH scores having 500+ serum scores.


I'd take 500+! Interesting that the LH level are pretty OK. 

I might try 25 mg of clomid for 6 weeks and get a reading. Four - six weeks was the initial eval period when T was remeasured in the first study cited in my post. 

QUESTION: is the liquid clomid offered by the research companies (such as forum advertiser ar-r ) effective as the pill form? If not any suggestions appreciated (I don't want to run afoul of any "no source checks" rules, etc).

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## Vettester

> I'd take 500+! Interesting that the LH level are pretty OK. 
> 
> I might try 25 mg of clomid for 6 weeks and get a reading. Four - six weeks was the initial eval period when T was remeasured in the first study cited in my post. 
> 
> QUESTION: is the liquid clomid offered by the research companies (such as forum advertiser ar-r) effective as the pill form? If not any suggestions appreciated (I don't want to run afoul of any "no source checks" rules, etc).


First, I'll vouch for AR-R and their products. Although, I've never used their Clomid, I've read plenty of threads over the years where it was tremendously successful. I've used several of their other products, it's the real deal! Take that to the bank!

If you go with the clomid, then definitely take the labs (LH/FSH, total & free test), but go back again two months after that and see if it's sustained. 

Another thought ... Take this information to a good HRT doctor (A4M) and have him/her interpret this to you. Plenty of these doctors will go the Clomid route if they believe it will work. So, their experiences will probably be able to advise you if this is the correct path to take, and/or what success ratio you probably have.

I'm pulling for you, but considering everything presented, I just don't have the faith as others do in the Clomid therapy. IMO, I think you will be looking at HRT if you want to sustain serum levels above 500, but again, that's just my .02 amongst many knowledgeable members. Do as much research as you can ...

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## kelkel

Well said Vette!

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## DVC

Gents - I sincerely appreciate your thoughts and help. 

I have decided to give the clomid restart a try. If it's not successful, I will take the next step into TRT.

As soon as I get the clomid, I'll report and track my progress in this thread.

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## kelkel

Please keep this thread alive. Very relevant!

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## Blergs

> First,* I'll vouch for AR-R and their products*. Although, I've never used their Clomid, I've read plenty of threads over the years where it was tremendously successful. I've used several of their other products, it's the real deal! Take that to the bank!
> 
> If you go with the clomid, then definitely take the labs (LH/FSH, total & free test), but go back again two months after that and see if it's sustained. 
> 
> Another thought ... Take this information to a good HRT doctor (A4M) and have him/her interpret this to you. Plenty of these doctors will go the Clomid route if they believe it will work. So, their experiences will probably be able to advise you if this is the correct path to take, and/or what success ratio you probably have.
> 
> I'm pulling for you, but considering everything presented, I just don't have the faith as others do in the Clomid therapy. IMO, I think you will be looking at HRT if you want to sustain serum levels above 500, but again, that's just my .02 amongst many knowledgeable members. Do as much research as you can ...


Agreed same here, No issues over the year’s only smiles.

Deff talk to a doc though!

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## DVC

Thanks for the replies.

I'm trying to get up to 25 posts so I can post links for some clomid studies. Absent the ability to post a link, here's the summary on a study on long term Clomid therapy:

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

Daniel J. Moskovic,
Darren J. Katz,
Ardavan Akhavan,
Kelly Park,
John P. Mulhall*

Article first published online: 28 MAR 2012

DOI: 10.1111/j.1464-410X.2012.10968.x

What's known on the subject? and What does the study add?

Clomiphene citrate (CC) has previously been documented to be efficacious in the treatment of hypogonadism. However little is known about the long term efficacy and safety of CC. Our study demonstrates that CC is efficacious after 3 years of therapy. Testosterone levels and bone mineral density measurement improved significantly and were sustained over this prolonged period. Subjective improvements were also demonstrated. No adverse events were reported.
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.

Patients were commenced on CC 25 mg every other day and were titrated to 50 mg every other day based on the treatment serum T level. The target total T level was arbitrarily set at 550 +/- 50 ng/dL.

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.*

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## DVC

Update - started clomid two days ago at 25 mg ED. I will get blood work done somewhere in the 4-6 week range.

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## Renholder

> Update - started clomid two days ago at 25 mg ED. I will get blood work done somewhere in the 4-6 week range.


I think it`s smart to give it a shot and see if it works.

I also did a trial with 25 mg per day and initially I got a great boost, but the bloodwork indicated that my free testosterone had not really increased by much because of increased SHBG, so I wonder if it may have been placebo. Who knows.

I`ve read a lot of mixed results about clomiphene therapy, but there are quite a few success stories and also several successful clinical trials where it stood side by side with exogenous testosterone. Some smart doctors also use it to diagnose whether you are primary or secondary.

Good luck!

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## kelkel

Re your SHBG, add Vit D as well as stinging nettle root or avenacosides to help reduce it. Most people are low on D so make sure you get it tested on your next BW. Mine runs high to and it's what I'm doing. Will be testing soon to check progress.

http://www.ncbi.nlm.nih.gov/pubmed/20050857

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## Simon1972

hey dvc , pm me a message, i cant send you a message because your account setings, id like to keep in touch im going thru the exaact situation as you and would love to find out how it progresses with you.

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## HRTstudent

Nice study DVC....

some related study that is very pertinent:

*Clomiphene citrate and testosterone gel repla***ent therapy for male hypogonadism: efficacy and treatment cost.* 
http://www.ncbi.nlm.nih.gov/pubmed/19694928

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 repla***ent 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.



and



*Outcomes of clomiphene citrate treatment in young hypogonadal men.*
http://www.ncbi.nlm.nih.gov/pubmed/22044663

Abstract

Study Type - Therapy (case series) Level of Evidence 4 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 efficacious drug to use as an alternative to exogenous testosterone. Not only have we validated previous findings of other papers but have proven our findings 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.
OBJECTIVE:

•  To prospectively assess the andrological outcomes of long-term clomiphene citrate (CC) treatment in hypogonadal men.
PATIENTS AND METHODS:

•  We prospectively evaluated 86 men with hypogonadism (HG) as confirmed by two consecutive early morning testosterone measurements <300 ng/dL. •  The cohort included all men with HG presenting to our clinic between 2002 and 2006 who, after an informed discussion, elected to have CC therapy. CC was commenced at 25 mg every other day and titrated to 50 mg every other day. The target testosterone level was 550 ± 50 ng/dL. •  Testosterone (free and total), sex hormone binding globulin, oestradiol, luteinizing hormone and follicle stimulating hormone were measured at baseline and during treatment on all patients. Once the desired testosterone level was achieved, testosterone/gonadotropin levels were measured twice per year. •  To assess subjective response to treatment, the androgen deficiency in aging males (ADAM) questionnaire was administered before treatment and during follow-up.
RESULTS:

•  Patients' mean (standard deviation [sd]; range) age was 29 (3; 22-37) years. Infertility was the most common reason (64%) for seeking treatment. The mean (sd) duration of CC treatment was 19 (14) months. •  At the last evaluation, 70% of men were using 25 mg CC every other day, and the remainder were using 50 mg every other day. •  All mean testosterone and gonadotropin measurements significantly increased during treatment. •  Subjectively, there was an improvement in all questions (except loss of height) on the ADAM questionnaire. More than half the patients had an improvement in at least three symptoms. •  There were no major side effects recorded and the presence of a varicocele did not have an impact on the response to CC.
CONCLUSION:

•  Long-term follow-up of CC treatment for HG shows that it appears to be an effective and safe alternative to testosterone supplementation in men wishing to preserve their fertility.

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## DVC

> hey dvc , pm me a message, i cant send you a message because your account setings, id like to keep in touch im going thru the exaact situation as you and would love to find out how it progresses with you.


Sounds good. I will change my account settings. I could not PM you for some reason.

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## DVC

Update: I have been on CC for just over two weeks.

Sides: It has killed my libido. I am also emotional. I was fighting back tears watching the end of The Blind Side yesterday  :Aajack:  Also feel generally "down." I cut the dose from 25 mg ED to 12.5 mg ED (cutting the pills in half). The decrease helped the sides but didn't remove them. I need to be a little careful in drawing conclusions because I've also had a cold and cough for the last week. 

I will continue on 12.5 and have blood test in a week or so.

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## Simon1972

keep the feedback coming, im very interested

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## DVC

I lifted for the first time since having my cold/cough today. I thought I would be weak, but actually felt strong. Completely anecdotal of course . . .

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## Renholder

I would give it some time.

Personally, I had no side effects on 25 mg per day, but I`ve heard of guys who could not do more than 12,5 per day and even EOD. 

For me, libido actually improved some and my body felt stronger, not strange since it was very low before starting, but the libido issue is not rare with guys using clomid.

If you respond positively, i.e., increased testosterone levels , but still do not feel good on clomid, you`re probably a good candidate for HCG which you may respond differently to.

Keep us updated.  :Smilie:

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## Simon1972

> I would give it some time.
> 
> Personally, I had no side effects on 25 mg per day, but I`ve heard of guys who could not do more than 12,5 per day and even EOD. 
> 
> For me, libido actually improved some and my body felt stronger, not strange since it was very low before starting, but the libido issue is not rare with guys using clomid.
> 
> If you respond positively, i.e., increased testosterone levels , but still do not feel good on clomid, you`re probably a good candidate for HCG which you may respond differently to.
> 
> Keep us updated.


hey ren, what was your experience with clomid- was it as a hpta restart? what was your protocol and did the results stick after you completed your cycle
DVC stick with 12.5mg, crysler uses that amount and it should take a week before the initial 25 mg wears out

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## Renholder

> hey ren, what was your experience with clomid- was it as a hpta restart? what was your protocol and did the results stick after you completed your cycle
> DVC stick with 12.5mg, crysler uses that amount and it should take a week before the initial 25 mg wears out


After reading some PUBMED articles, I convinced my doctor to let me try 25 mg clomiphene per day, since my LH/FSH was low in addition to low testosterone . It was the first time she ever heard of the treatment and here in Norway it is only known as fertility medicine for women.

Testosterone rose from 13,0 to 17,6, which is still not very high. I felt much better for a while, even though the bloodwork showed that free testosterone was pretty much unchanged because of increased SHBG. Eventually, the effects seemed to wear off and my doctor did not want to renew my prescription having read that there was a risk of ovarian cancer with women using it long-term. I did not argue, since I did not feel much better at that point.

Tried it one more time this year along with DHEA, but did not feel any better after 2 weeks, even worse, so I just quit. My blood work responded MUCH better to HCG .

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## HRTstudent

us guys need to watch out for that ovarian cancer!

but seriously, thanks for sharing your experience. I'd like to see more on the clomid stand-alones.

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## Renholder

> us guys need to watch out for that ovarian cancer!
> 
> but seriously, thanks for sharing your experience. I'd like to see more on the clomid stand-alones.


I considered telling her that I don`t think I have ovaries, but I figured she probably knew that. Then again, this is the same female doctor who googled "testosterone " in front of my very eyes telling me she does not know much about that stuff.

There is a reason we don`t hear that much about clomid and I think it`s called money. I`ve read quite a few promising studies and anecdotal reports on the internet, but consensus from users experience is that it is typically a hit or miss. Some feel great, but experience zero libido.




> Clomifene citrate has been found very effective in the treatment of secondary male hypogonadism in many cases.[3] This has shown to be a much more attractive option than testosterone repla***ent therapy (TRT) in many cases because of the reduced cost and convenience of taking a pill as opposed to testosterone injections or gels.[4] Unlike traditional TRT it also does not shrink the testes and as a result can enhance fertility. Traditional TRT can render a man sterile (although with careful monitoring and low-dose hCG as an adjunct, this is both preventable and reversible for most men).[5] Because clomifene citrate has not been FDA approved for use in males it is prescribed off-label. According to Professor Craig Niederberger, because this drug is now generic, no drug company would pursue FDA approval for use in men now because of limited profit incentive, mostly due to the relatively small market potential.[6] However, the single isomer of clomifene "enclomiphene" under the brand name Androxal is currently under phase 2 trials for use in men.[7][8]

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## HRTstudent

> I considered telling her that I don`t think I have ovaries, but I figured she probably knew that. Then again, this is the same female doctor who googled "testosterone " in front of my very eyes telling me she does not know much about that stuff.
> 
> There is a reason we don`t hear that much about clomid and I think it`s called money. I`ve read quite a few promising studies and anecdotal reports on the internet, but consensus from users experience is that it is typically a hit or miss. Some feel great, but experience zero libido.


LOL... I wouldn't even go back to that doctor and I'm being 100% serious. That's bad news... are you going to trust her medical expertise if something goes slightly off (and it's more than likely to happen!)?

Also, you are right about clomid... no money. Meanwhile, there is a new androgel (or other gel) study coming out regularly just in time when the old patents are about to expire!

Pretty sad, but you're right in that there are some seriously good studies pointing to the efficacy of clomiphene citrate solo. It sure would be nice to simply pop some clomid EOD than go through all the baggage that comes with Testosterone...

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## Renholder

> LOL... I wouldn't even go back to that doctor and I'm being 100% serious. That's bad news... are you going to trust her medical expertise if something goes slightly off (and it's more than likely to happen!)?
> 
> Also, you are right about clomid... no money. Meanwhile, there is a new androgel (or other gel) study coming out regularly just in time when the old patents are about to expire!
> 
> Pretty sad, but you're right in that there are some seriously good studies pointing to the efficacy of clomiphene citrate solo. It sure would be nice to simply pop some clomid EOD than go through all the baggage that comes with Testosterone...


Well, at least she admitted that she lacked knowledge in that area, unlike my arrogant prior GP who told me everything was "normal" and that I should calm down. The same doctor that told me I had no reason to worry about bottom-range LH because that is a ladies hormone. 

I then called a specialist in the private sector (we have public health care in Norway) who was supposed to be good, but he pretty much simply mocked me and said I should stop feeling inferior in the gym, because all of those guys are probably on steroids anyway. And that was without me even mentioning anything about the gym. His advice: Move to the city and have more girls in my daily life. That should do it.

My current GP, while liberal, is also pretty much clueless, with claims about exogenous testosterone being able to fire up my own production and so on. I have not been to an endocrinologist yet, but from what I`ve heard, most of them are just the same. So, I`m essentially self-medicating myself and persuading the doctor in my desired direction. Not ideal, but it`s all I got for now.

Did you never try clomiphene citrate? Androxal might be interesting when (if) it comes out.

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## Simon1972

try going to an endo ren. ive been researching aromasin instead of clomid and from what i read its a better drug- less sides and more positive results- im leaning towards aromasin now.

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## DVC

> try going to an endo ren. ive been researching aromasin instead of clomid and from what i read its a better drug- less sides and more positive results- im leaning towards aromasin now.


Better as far as a restart "sticking" - or long term, low dose use?

Please share some specifics on your research. Thanks!

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## HRTstudent

> try going to an endo ren. ive been researching aromasin instead of clomid and from what i read its a better drug- less sides and more positive results- im leaning towards aromasin now.


they are a different type of drug so... you could certainly try one and if it doesn't work try the other. plenty of people use both, but clomid is probably just the most studied in men because it's been used in fertility for a while now.

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## HRTstudent

> Better as far as a restart "sticking" - or long term, low dose use?
> 
> Please share some specifics on your research. Thanks!


I was reading something the other day from a urologist and he said the max he uses clomid I believe is 3 years. we don't have the long term safety studies, and also, the primary reason is to conceive so you would obviously know if clomid works in that time frame.

there are some long term sides of clomid that we can't just brush over that we actually know about - like eye floaters.

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## Simon1972

> Better as far as a restart "sticking" - or long term, low dose use?
> 
> Please share some specifics on your research. Thanks!


Pharmacokinetics and Dose Finding of a Potent Aromatase Inhibitor, Aromasin (Exemestane), in Young Males 

Nelly Mauras, John Lima, Deval Patel, Annie Rini, Enrico di Salle, Ambrose Kwok and Barbara Lippe 

Nemours Children’s Clinic and Research Programs (N.M., J.L., A.R.), Jacksonville, Florida 32207; and University of Florida Health Sciences Center (D.P.) and Amersham Pharmacia Biotech (E.d.S., A.K., B.L.), Peapack, New Jersey 07977 


Suppression of estrogen, via estrogen receptor or aromatase blockade, is being investigated in the treatment of different conditions. Exemestane (Aromasin) is a potent and selective irreversible aromatase inhibitor. To characterize its suppression of estrogen and its pharmacokinetic (PK) properties in males, healthy eugonadal subjects (14–26 yr of age) were recruited. In a cross-over study, 12 were randomly assigned to 25 and 50 mg exemestane daily, orally, for 10 d with a 14-d washout period. Blood was withdrawn before and 24 h after the last dose of each treatment period. A PK study was performed (n = 10) using a 25-mg dose. Exemestane suppressed plasma estradiol comparably with either dose [25 mg, 38% (P 0.002); 50 mg, 32% (P 0.008)], *with a reciprocal increase in testosterone concentrations (60% and 56%; P 0.003 for both)*. *Plasma lipids and IGF-I concentrations were unaffected by treatment.* The PK properties of the 25-mg dose showed the highest exemestane concentrations 1 h after administration, indicating rapid absorption. The terminal half-life was 8.9 h.* Maximal estradiol suppression of 62 ± 14% was observed* at 12 h. The drug was well tolerated. In conclusion, exemestane is a potent aromatase inhibitor in men and an alternative to the choice of available inhibitors. Long-term efficacy and safety will need further study. 


Abbreviations: AUC, Area under the curve; CBC, cell blood count; HDL, high density lipoprotein; LDL, low density lipoprotein; PK, pharmacokinetic.

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## DVC

Simon1972 

What are your E2 levels?

Mine were pretty low before I started the clomid: Estradiol 10.0 pg/mL range 7.6-42.6

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## Simon1972

> Simon1972 
> 
> What are your E2 levels?
> 
> Mine were pretty low before I started the clomid: Estradiol 10.0 pg/mL range 7.6-42.6


OESTRADIOL-----------96pmol/L---------<150

translates to 26.10 pg/mol ----range less than 40

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## DVC

Getting blood work tomorrow - TT, FT, E2, FSH, LH, DHEA (just cuz it came with the package) and shbg. I'll post when I get the results.

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## DVC

Blood work results - been on clomid for approx 3 weeks.

Protocol: 25 mg ED for one week (felt like hell) - switched to 12.5 mg ed (still having sides)

Test, Serum 585 (previous 318) ng/dL range 348-1197
Free Testosterone (Direct) 16.8 (previous 8.3) pg/mL range 6.8-21.5
DHEA-Sulfate 183.4 (previous 112.6) ug/dL range 44.3-331.0
Estradiol 30.7 (previous 10.0) pg/mL range 7.6-42.6
FSH 4.4 (previous 3.2) mIU/mL normal range 1.5-12.4 MB
LH 6.4 (previous 4.0) mIU/mL normal range 1.7-8.6 MB
SHBG 33.2 (not previously tested) range – 16.5 – 55.9

So, what can I/we glean from this data?
* I'm secondary instead of primary.
* A relatively small dose increased my free test by 2x and total T by over 267 points.
* E2 tripled. 
* Even at this low dose, I still feel generally bad, not myself and low libido. I can't stand how cloimd makes me feel. Wife thinks I don't like her anymore.
* Big question: how much longer on clomid and will it "stick"?

Your thoughts please . . .

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## ecdysone

The irony, heh? On paper your levels are near perfect, yet you don't feel good.

Can't say I haven't heard it before: for some reason clomid/HCG therapy often does not produce a good feeling even though
otherwise everything looks great.

Were it me, I would try three things: (1) give it more time; (2) think about reducing the dose slightly, and (3) remember to get some labs in a couple of months to see if your elevated test levels hold.

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## DVC

> The irony, heh? On paper your levels are near perfect, yet you don't feel good.
> 
> Can't say I haven't heard it before: for some reason clomid/HCG therapy often does not produce a good feeling even though
> otherwise everything looks great.


Agreed - and feeling bad is OK if this actually restarts my hpta. If it doesn't "stick" then I guess I know I'm secondary - for whatever that's worth . . .

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## ecdysone

Oh sorry, I missed the part about you doing a "restart." I just assumed you were anticipating staying on the clomid for good.

My point about checking the test levels in a couple of months was also assuming you would still be using clomid. For some guys, the test levels will drop even though they are still taking clomid and/or HCG .

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## DVC

> Oh sorry, I missed the part about you doing a "restart." I just assumed you were anticipating staying on the clomid for good.


No way is that going to happen!! I hate this stuff.

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## Simon1972

> No way is that going to happen!! I hate this stuff.


looks like estro has risen a fair bit.

clomid wont lower estrogen in your body, aromastase still occurs, it just prevents it from binding with receptors in the Hypathalamus.

aromasin is different, it prevents estrogen being manufactured in your body in the first place, aromasin does this by binding with the aromatase enzyme preventing estrogen being made.

if you are suffering major sides with clomid- i would say aromasin would be a better way of restarting. clomid is an old drug, aromasin is newer and has hardly any sides- cut your loses and but the liquid stane ( exemestane / aromasin) take it at 25mg or 12.5 mg a day depending how you feel.

i just ordered a bottle and hopefully get it in a week or so. and will wait until july to try it ( dont want to do anything before i see my endocrinologist in case it interferes with my test results)

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## Facecrash

Any update on this DVC?

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## DVC

Update:

I've been off of clomid for 9 weeks and had my Test tested.

# are in this order: (1) Pre-Clomid, (2) 3 weeks into Clomid, (3) 9 weeks post Clomid, and Normal Range


Test - total 318 585 499 348-1197
Test - free 8.3 16.8 13.6 6.8-21.5
E2 10.0 30.7 22.3 7.6-42.6



I feel good. Test is not as high as I'd like it to be, but not too bad. I'd like to be 550 +. I get this # from this article: http://www.lef.org/magazine/mag2012/...roversy_01.htm

Any general thoughts welcomed. 

Could the Clomid still be effecting my Test levels?

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## bass

not after 9 weeks, but your levels will go down as you age anyway, in other words they won't go higher, only lower. glad you're feeling good. keep us posted.

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## louie2400

Any updates DVC? I just started clomid yesterday (25 mg EOD) and am interested where you are at right now regarding levels and how you are feeling.

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## DVC

> Any updates DVC? I just started clomid yesterday (25 mg EOD) and am interested where you are at right now regarding levels and how you are feeling.


I actually started TRT about 5 weeks ago and feel awesome. A cardiac surgeon in my area recently started a side practice in the TRT area. He's very knowledgeable IMO. http://www.agewellmensinstitute.com/index.php

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## louie2400

DVC-
Great to hear that you are feeling awesome! What did you and your doctor decide on as far as TRT?

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## DVC

> DVC-
> Great to hear that you are feeling awesome! What did you and your doctor decide on as far as TRT?


Test Cyp, HCG and an AI - once per week.

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## jasondd1

I'm curious I am starting week 3 of 25 mg clomid eod. Did compounding test cream for 3 months and went from 323-409. Joints ached estradiol super low at 8 but actually felt better. Feel pretty good but have noticed my libido less and difficult to cum, not get hard just climax. My question is is there any benefit in adding in nolva, HCG , or aromasin ? I am going to retest in another 3-4 weeks but was curious if a combo would be beneficial or ever detrimental? I tried Cabergoline for cumming and it seemed to do nothing, does ths need to be taken for a while to be effective. I had heard it did not and after taking it one day I quit.

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## louie2400

@DVC- I now see what you mean by hating the sides of clomid. I too stopped taking it. It made me feel way too depressed. How is the androgel working out? How many pumps are you on?

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## powerlifterty16

any update

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