Are Clomid side effects worth it?

[phalloguy100]

Hey there!

I've been on TRT for a while due to secondary hypogonadism. Due to moving / no job, I was off TRT for 2-3 years and my levels dropped to "normal" which for me is <200 total T. Started seeing a new PCP last year who ran 2 morning T tests, both came back low, so he started me on Androgel again.
Recently I had the misfortune of having to see an endo (due to diabetes diagnosis), who just like the previous 2 endos, basically wanted to get me off TRT to "prove" I don't need it. He started me on Clomid 25mg daily and said to lower Androgel to 1 pump per day. Two months later, I was feeling absolutely horrible with hot flashes, depression, fatigue, and E.D. I re-did labs and it showed LH, FSH, Free Test and Estradiol all elevated, while total T in the 700's. I stopped it clomid, restarted androgel just 1 pump per day, and one month later tested with low-normal LH+FSH (which was normal for me), but free T even higher at 150 and total T higher still in the 900's... along with Estradial super high at 75. Endo wants me to stop androgel again, stay on clomid but decrease to 25mg three times per week. He refused to prescribe anastrazole until we re-do labs in 3 months at this new Clomid dose. All the previous symtoms are there again - hot floshes, no erections, etc.

I've been reading posts here that Clomid works, but it takes time and men too often give up too quickly. I guess I wonder if it's worth staying on Clomid another 3 months with all the nasty side effects, especially if the endo won't even prescribe anastrazole in the meantime.

I have an appointment scheduled at Defy for a second opinion, but it's a month away.

Thoughts?

 

[sammmy]

Fire the endo and get another that will prescribe Androgel, which you know works for you.

Do not fall for "you have to give Clomid time" or "it gets worse before it gets better" stupidity.
Most experiences that I have seen here are that Clomid works only on paper - gets your levels high as a kite but you feel nothing positive.

Anastrozole has nasty side effects and you should stick to a regimen that doesn't require aromatase inhibitors.

 

[Systemlord]

Started seeing a new PCP last year who ran 2 morning T tests, both came back low, so he started me on Androgel again.

Low-T increases your risk of developing type 2 diabetes. So stopping TRT may have been unwise the first time around. TRT has the potential to cure, reverse the type 2 diabetes, so it’s alarming that your endo felt the need to pull you off of it.

Recently I had the misfortune of having to see an endo (due to diabetes diagnosis), who just like the previous 2 endos, basically wanted to get me off TRT to "prove" I don't need it.

I agree with @sammy, fire your endo. The two tests <200 and the type 2 diabetes diagnosis prove you need TRT as low-T is a risk factor for T2D.

Testosterone level and risk of type 2 diabetes in men: a systematic review and meta-analysis - PMC

Type 2 diabetes is a risk factor for testosterone deficiency and impaired sex steroid status. Some studies also investigated the association of testosterone level with diabetes risk in men, but reported controversial findings. To clarify this issue, ...

www.ncbi.nlm.nih.gov

As for whether or not clomid is worth continuing, it has a bad side effects profile. If you’re feeling bad now it’s not likely to get better, in fact it may get worse over time.

Defy Medical is an excellent choice, I’m a patient as well, only not for my TRT. I’ve used them on and off for years.

 

[aneuman]

Since the purpose of this forum is to help each other, and not simply show off how much we "appear" to know (although sometimes is confusing) I going to post an anecdote of someone I know who's using Clomid and very happy with it

This is a guy half my age that started off with Total T=125 ng/dL, SHBG=16 nmol/L and E2=27 pg/ml. He was feeling like shit as you may imagine. I suggested he went to the same famous andrologist I was going and ended up with a prescription of Enclomiphene Citrate, 12.5mg/day, just like me.

After 3 months, his numbers were a little better with total T=350ng/dL which his doctor consider a success. He was not happy, did not "feel" anything thing and because of the treatment failure, he thought he was hopeless.

After I changed urologist, he asked me for the name of the new Dr, which gave to him, he went to visit and he put him on Clomid, 50mg/day for 3 months. I cautioned him given everything I've heard on this forum, to watch out for floaters, clomid crazies, and all that stuff. We spoke about the difference between enclomiphene and zuclomiphene and how given his experience with enclomiphene, clomid was unlikely to do anything.

And here's the punchline: after 3-4 months, he had his bloodwork. TT=580 ng/dL, SHBG=22, E2=33, FT=110pg/ml. He feels much better, have more energy and initiative, and claims his sex life is better. Time will tell if this is a viable long term, but within the same timeframe, the difference between clomid and enclomiphene -for him- were night and day.

Moral of the story, not everything works the same for everyone. TRT is not a religion or a political ideology. Most of the time doctors know what they are doing (although I'm as frustrated as many of you are with many of them) and who knows, Clomid may work.

Blanket statements are very dangerous, particularly from people armed only with anecdotes and not medical or scientific training. My barber is very good at solving problems, everything is easy for him. While he cuts my hair, he solves world hunger, ends wars around the world, brings the country out of recession, cures cancer, yet, after 20 years, he's still cutting my hair and selling AmAway.

Always remember to take my advice: don't take advice from me.

 

[sammmy]

In the long run, Clomid has a much broader side effect profile than exogenous testosterone. Putting someone on Clomid, when testosterone works, just to "prove that he doesn't need testosterone" and because "clomid is more natural than testosterone" (laughable!) is a clear sign of incompetent and negligent doctor.

The OP has an anecdote that adding Clomid to his Androgel was a train wreck for him. His personal "anecdote" trumps any other personal anecdotes. The question of this thread is not whether clomid works for someone else, but whether it works for him and that question is already answered by his own experience for 2 months.

 

[phalloguy100]

Thank you everyone for the thoughtful comments and anecdotes. It is all very helpful.

Yes, I'm definitely firing the endocrinologist. I am hopeful it will go better with Defy. My PCP was not comfortable prescribing Androgel without the endo to manage TRT long term, which is too bad because all meds with Defy are out of pocket while my insurance was already paying for Androgel.

I was hopeful that perhaps Clomid would start to work better with no side effects, but it sounds like people either have a good or bad experience from the get go, and mine hasn't been great.

 

[VacationMan]

Thank you everyone for the thoughtful comments and anecdotes. It is all very helpful.

Yes, I'm definitely firing the endocrinologist. I am hopeful it will go better with Defy. My PCP was not comfortable prescribing Androgel without the endo to manage TRT long term, which is too bad because all meds with Defy are out of pocket while my insurance was already paying for Androgel.

I was hopeful that perhaps Clomid would start to work better with no side effects, but it sounds like people either have a good or bad experience from the get go, and mine hasn't been great.

Do know that Defy can and will write or call-in prescriptions to a local pharmacy. Then you can use your insurance to pay for those medications. Defy does charge a call-in fee though. Haven't priced Androgel (never tried it myself), so unsure if there would be significant cost savings taking this approach.

Also, I have Defy list out all the labs they need - just the list. If you can get the test codes and the CPT codes too, that's even better. I take this list to my PCP and his nurse orders all my labs. Nurse loves me because I have all the codes for her to use. My insurance covers all my labs at 100%.

I do order my testosterone and a few other meds from Defy, but the rest are taken care of by my PCP (thyroid, BP, etc.).

For me though, I do have E2 issues that require medication to control. It took -forever- to find the frequency and dose of Anastrazole to get me to that E2 happy place. Anastrazole comes in 1 mg tablets...tiny tablets. My former urologist (who is an idiot and I subsequently kicked to the curb as a result) had me taking 1 mg of Anastrazole per week. Boy did that help <NOT>. It was -way- too much. He crashed my E2 and I felt like crap!

What I did instead? I got a 20 ml dropper bottle from a pharmacy. I fill it with 16 cc of quality vodka then pop 4 Anastrazole tablets in there and shake the daylights out of it until the tablets dissolve. Doing the arithmetic here - 1 cc of this solution would be 0.25 mg of Anastrazole. I can micro-dose it! Turns out that I only need like 0.20 cc of this solution once per week and it keeps my E2 right where it needs to be (so yeah, like 0.05 mg once per week is all I need).

In my early 60s and I feel like I'm in my 20s again. Although there are times when the mind says "I can do that job" but my body says "I don't think so Scooter!". That's another story to itself though.

 

[phalloguy100]

Hmmm interesting. Yeah if Defy can send prescriptions to my state, that would certainly save me a ton of money (assuming they can also do the prior authorization work if needed). Androgel for example is only $10 with my insurance… vs $79 with goodrx or $140 for compounded cream from Empower.

Now, they did email me a prescription for labs so I could get them done locally at an in-network lab. It looks like the insurance claim is pending so I’m not sure yet if insurance will pay for those labs, but I hope so! That would save me a ton as well.

Yeah, I’m really looking forward to my appointment at Defy. It can’t come soon enough!

 

[phalloguy100]

Finally, some relief - the endo who sees me for the weight loss program (different hospital than the one that put me in clomid) agreed to take over my hormone and diabetes care. This new endo was very concerned about the increased depression from Clomid, so I was told to stop it and will be put back on Androgel. Still no arimidex though - that will be discussed after labs at my next appointment. This new endo wants to figure out what's causing my secondary hypogonadism in the first place, so we're also going to discuss pituitary MRI and other tests at the appointment.

I am still going to have the consultation with Defy though. I want to see what their thoughts are. Plus, I want to get their advice on cjc/ipramorelin to help with energy and weight loss.

 

[Systemlord]

This new endo wants to figure out what's causing my secondary hypogonadism in the first place, so we're also going to discuss pituitary MRI and other tests at the appointment.

Most cases of secondary hypogonadism are of an unknown cause, a very small percentage have pituitary tumors and testicular failure. The majority of the time, regardless of the cause, there’s little you can do to cure it.

 

[phalloguy100]

That’s kind of why I thought a clomid “restart” was pretty ridiculous in the first place… because even if it raised T levels, thy would only last as long as I continued taking it.

Are there any causes of secondary hypogonadism that can be cured?

 

[Systemlord]

That’s kind of why I thought a clomid “restart” was pretty ridiculous in the first place…

The concept is insane to me. People that believe clomid is like hitting the reset button and start over with high testosterone is ridiculous.

It’s a failure to accept reality, they’re fighting the truth.

Also, your endo wanting to find the cause of your low-T, while it’s nice to see, but since when do doctors care about finding the cause of depression?

They just give you the mind altering drugs, and the dangers, no need to prove you need treatment.

 

[VacationMan]

Finally, some relief - the endo who sees me for the weight loss program (different hospital than the one that put me in clomid) agreed to take over my hormone and diabetes care. This new endo was very concerned about the increased depression from Clomid, so I was told to stop it and will be put back on Androgel. Still no arimidex though - that will be discussed after labs at my next appointment. This new endo wants to figure out what's causing my secondary hypogonadism in the first place, so we're also going to discuss pituitary MRI and other tests at the appointment.

I am still going to have the consultation with Defy though. I want to see what their thoughts are. Plus, I want to get their advice on cjc/ipramorelin to help with energy and weight loss.

Look into semaglutide for weight loss. Defy prescribed it for me. I dumped 30 lbs in about 6 months on it. Now back into a normal BMI.

 

[Systemlord]

Look into semaglutide for weight loss.

I just watched an episode on Megyn Kelly where a doctor was warning people about these injectable medication’s for weight loss, saying they cause you to lose weight, except you get fatter in the process, because you’re also losing more mass than actual fat.

 

[VacationMan]

I just watched an episode on Megyn Kelly where a doctor was warning people about these injectable medication’s for weight loss, saying they cause you to lose weight, except you get fatter in the process, because you’re also losing more mass than actual fat.

Not sure what they mean by "getting fatter in the process". In my experience with semaglutide, I not only lost weight but my waist got smaller, my "dad bod" belly melted away, and it helped reduce my blood pressure (due to the weight loss). I didn't lose any muscle mass or strength. For me, it was mostly appetite suppression. Even lowered my A1c as well as fasting glucose.

Everyone is different, so...standard disclaimers apply (batteries not included, some assembly required, etc.).

 

[Systemlord]

Not sure what they mean by "getting fatter in the process". In my experience with semaglutide

They never mentioned the brand of the injectable weight loss medication.

 

[FunkOdyssey]

Since the purpose of this forum is to help each other, and not simply show off how much we "appear" to know (although sometimes is confusing) I going to post an anecdote of someone I know who's using Clomid and very happy with it

This is a guy half my age that started off with Total T=125 ng/dL, SHBG=16 nmol/L and E2=27 pg/ml. He was feeling like shit as you may imagine. I suggested he went to the same famous andrologist I was going and ended up with a prescription of Enclomiphene Citrate, 12.5mg/day, just like me.

After 3 months, his numbers were a little better with total T=350ng/dL which his doctor consider a success. He was not happy, did not "feel" anything thing and because of the treatment failure, he thought he was hopeless.

After I changed urologist, he asked me for the name of the new Dr, which gave to him, he went to visit and he put him on Clomid, 50mg/day for 3 months. I cautioned him given everything I've heard on this forum, to watch out for floaters, clomid crazies, and all that stuff. We spoke about the difference between enclomiphene and zuclomiphene and how given his experience with enclomiphene, clomid was unlikely to do anything.

And here's the punchline: after 3-4 months, he had his bloodwork. TT=580 ng/dL, SHBG=22, E2=33, FT=110pg/ml. He feels much better, have more energy and initiative, and claims his sex life is better. Time will tell if this is a viable long term, but within the same timeframe, the difference between clomid and enclomiphene -for him- were night and day.

The 50 my clomiphene regimen that is working so well for your friend contains 25 mg enclomiphene, versus the 12.5 mg dose of enclomiphene that failed. Did he ever just try taking more enclomiphene? I don't think zuclomiphene adds much to the experience besides eye floaters and crying at Hallmark movies.

 

[phalloguy100]

I am already on Ozempic (semaglitude), to help control hunger and lower glucose. Doctor wanted to switch me to something better, Mounjaro, but it’s almost impossible to get insurance approval because it’s so expensive.

 

[aneuman]

The 50 my clomiphene regimen that is working so well for your friend contains 25 mg enclomiphene, versus the 12.5 mg dose of enclomiphene that failed. Did he ever just try taking more enclomiphene? I don't think zuclomiphene adds much to the experience besides eye floaters and crying at Hallmark movies.

Not that I know of, I can ask him but I'm pretty sure, since we were both seeing the same urologist and used to share treatment options.

By the way, I mentioned to him that those two were side effects to watch out for, he claims he'd had none of it.

 

[Guided_by_Voices]

In my first foray into self-managing my hormones I used 12.5 mg clomid every other day for about 18 months and it was an improvement with no sides, but injectable test works better for me. I think low dose clomid is a good place to start for many people, but I also see people start at doses which would be way too high for me and that gives it a worse reputation than it deserves, IMO.