5 week Clomid Results with Primary Hypogonadism Diagnosis

[kramesh]

Hello Forum!

I hope some of you may be able to help me with my situation.

I am 35yr old male - pretty healthy (slightly overweight) - 6'1" 220 pounds. (20-25 pounds overweight)

In Feb 2015 - I went to the urologist to get my ED situation checked. He checked my testosterone levels - and I had results of 224ng/dL (range 348-1197) [LOW]

I went back a week later to have them rechecked - tests were
Total T = 164ng/dL;
FSH = 19.2 (HIGH);
LH - 6.0 (Higher end)
Prolactin = 13.2 (Higher End)

He said I likely have Primary Hypogonadism and before putting me on testosterone replacement, we can check if Clomid works... chances are it will not. Lets.

5 weeks later at 25mg ED Clomid

Testosterone = 466 ng/dL (Range 348-1197)
Free Testosterone = 12.9 (Range 8.7-25.1)
SHBG = 21.8nmol (Range 16.5-55.9)
Prolactin = 6.7 (Range 4.0 - 15.2)
LH = 13.4 [HIGH] (Range 1.7 - 8.6)
FSH = 31.0 [HIGH] (Range 1.5 - 12.4)
Cortisol = 29.6 (HIGH) (Range 2.3 - 19.4)
ACTH, Plasma = 22.6pg/mL (Range 7.2 - 63.3)
TSH = 2.56 (0.45 - 4.5)

So my testosterone is up by almost 300 points.. but so is my FSH and LH. If I had primary hypogonadism - then Clomid should not work right???

Any theories as to what is going on?

Any help?

 

[ERO]

Normally e[FONT=Verdana, Helvetica, Arial, sans-serif]levated LH and FSH with low testosterone = primary hypogonadism, but at total T of 466 you are above the usual cut off point of 300 used to diagnose Low T so I am hoping that someone more experienced will weigh-in on this as well.

Do you feel any better? Did your Doc test your E2 levels as well?[/FONT]

 

[kramesh]

Hi Ero

Thank you for your response

I honestly do feel better... I actually look forward to going to the gym and have actually lost about 8 pounds in 5 weeks.

I am having a sleep study and ultrasound done in the next few weeks

I have a theory - initially in Feb, while my FSH was elevated (19), my LH was not as elevated.. So perhaps it isn't primary and in some loopy way - secondary

I haven't had my estrogen or E2 levels pulled... What would the indicate?

 

[ERO]

I am glad that you are feeling better! I mentioned the E2 test because for some guys, Clomid can raise estrogen too high so even if they have higher T levels from the Clomid, they still don't feel good. Plus, it is the sign of a good TRT doctor to be checking total T, free T and E2 levels all together.

 

[kramesh]

I am glad that you are feeling better! I mentioned the E2 test because for some guys, Clomid can raise estrogen too high so even if they have higher T levels from the Clomid, they still don't feel good. Plus, it is the sign of a good TRT doctor to be checking total T, free T and E2 levels all together.

ERO - I will def get my E2 levels checked in the next round of tests.

Question:

- Is e2 the same as estrogen?
- what are some of the side effects i would be facing if my e2 levels were elevated?

 

[kramesh]

GENERAL QUESTION - I am also hoping to get the attention of NELSON.

After 5 weeks on Clomid @25mg ED -

1) my testosterone levels increased from 164 ng/dL to 466 ng/dL. Now, this is not a huge increase as I have seen people report on the 25mg.

2) My LH levels increased from 6 to 13.4

3) My FSH levels increased from 19 to 31.

ERO - you said that this may not be Primary as the threshold is 300 in testosterone... however, the increase at the same time is not as dramatic as I have seen in others.

Question

- Should I get an MRI done? Is this an indication of a Pituatary Lesion?

- Seems to be something going on with the LH or the testes? Any theories?

 

[kramesh]

First Glance - Primary Hypo.. but Not Really?

Hello Forum!

I hope some of you may be able to help me with my situation.

I am 35yr old male - pretty healthy (slightly overweight) - 6'1" 220 pounds. (20-25 pounds overweight)

In Feb 2015 - I went to the urologist to get my ED situation checked. He checked my testosterone levels - and I had results of 224ng/dL (range 348-1197) [LOW]

I went back a week later to have them rechecked - tests were
Total T = 164ng/dL;
FSH = 19.2 (HIGH);
LH - 6.0 (Higher end)
Prolactin = 13.2 (Higher End)

He said I likely have Primary Hypogonadism and before putting me on testosterone replacement, we can check if Clomid works... chances are it will not. Lets.

5 weeks later at 25mg ED Clomid

Testosterone = 466 ng/dL (Range 348-1197)
Free Testosterone = 12.9 (Range 8.7-25.1)
SHBG = 21.8nmol (Range 16.5-55.9)
Prolactin = 6.7 (Range 4.0 - 15.2)
LH = 13.4 [HIGH] (Range 1.7 - 8.6)
FSH = 31.0 [HIGH] (Range 1.5 - 12.4)
Cortisol = 29.6 (HIGH) (Range 2.3 - 19.4)
ACTH, Plasma = 22.6pg/mL (Range 7.2 - 63.3)
TSH = 2.56 (0.45 - 4.5)

So my testosterone is up by almost 300 points.. but so is my FSH and LH. If I had primary hypogonadism - then Clomid should not work right???

Any theories as to what is going on?

Any help?

 

[Vettester Chris]

Unfortunately, I only have a few seconds to post here, can maybe comment more later ... Why the heck would any physician put you on Clomid or any SERM, when your LH value is sitting at 6??? In a nutshell, Clomid is designed to stimulate LH/FSH production in the pituitary. Great option for a secondary symptoms, where gonadotropin is suppressed. Oh wait, your LH is in the upper end, and FSH is elevated. So your doctor is giving you a compound to increase LH & FSH?? Seriously, are some of these physicians really that bad?!?!

 

[kramesh]

Unfortunately, I only have a few seconds to post here, can maybe comment more later ... Why the heck would any physician put you on Clomid or any SERM, when your LH value is sitting at 6??? In a nutshell, Clomid is designed to stimulate LH/FSH production in the pituitary. Great option for a secondary symptoms, where gonadotropin is suppressed. Oh wait, your LH is in the upper end, and FSH is elevated. So your doctor is giving you a compound to increase LH & FSH?? Seriously, are some of these physicians really that bad?!?!

Thank you for your response Chris!

I'm not sure - but perhaps the thought was to see if I am Primary or Secondary... The urologist did state that perhaps Clomid will not work because of my elevated levels - which would mean I am primary for sure.

However, in my case, the Testosterone has increased, albeit, not as much as I have seen in others on 25 Clomid ED. The increase is about 300 points.

My problem is - what does that mean?

There is LH and FSH being produced.. from what I understand, LH triggers testosterone. If there is no/less testosterone, the pituatary would make more LH. In my case my pre-treatment LH was ~6 - which is on the higher end. But my FSH was 19 - which is very high. Should my LH not be higher??? with a testosterone ~165 ng/dL?

Is this still secondary?

 

[kramesh]

GENERAL QUESTION - I am also hoping to get the attention of NELSON.

After 5 weeks on Clomid @25mg ED -

1) my testosterone levels increased from 164 ng/dL to 466 ng/dL. Now, this is not a huge increase as I have seen people report on the 25mg.

2) My LH levels increased from 6 to 13.4

3) My FSH levels increased from 19 to 31.

ERO - you said that this may not be Primary as the threshold is 300 in testosterone... however, the increase at the same time is not as dramatic as I have seen in others.

Question

- Should I get an MRI done? Is this an indication of a Pituatary Lesion?

- Seems to be something going on with the LH or the testes? Any theories?

If it helps any

1) I do have Low Vitamin D - my levels are pretty low - I am now taking 50,000 IU Vitamin D once a week

2) I have never calculated by Body Fat Percentage - but I am ~20 pounds overweight with a BMI of 28.6. I am working on reducing that... already lost about 8 pounds in 5 weeks.

3) I also snore a lot - so I have enrolled in an overnight sleep study to check for Apnea. Will know more about this next week

 

[Vettester Chris]

Why is there a duplicate thread with this same question? Do you want people to come to this thread, or to that thread?