Clomid success but incredible fatigue and hunger

[GeauxBears]

I have been on clomid 12.5 E3D for several months now with great success, Total T in the upper 900s. The one issue is the E2, which when tested with the sensitive test, comes in in the upper 80s, despite increasing doses of Arimidex, now up to 0.25mg twice a week, pending another assessment next week.

Recently, I have weirdly gained 10 lbs out of nowhere, I am hungry constantly for terrible foods, and have incredible fatigue throughout the day, particularly a couple of hours after lunch when I want to sleep at my desk.

Any thoughts as to what is going on? Is it the E2? If it is, what's weird is that it just recently started, and my E2 has been high since we started.

 

[ERO]

Is your doc up for you maybe going with 0.5mg twice a week instead of the 0.25mg on the Arimidex? I don't know for sure if it is the E2 since you say that you have had higher E2 all along. I do know that some guys feel "off" on Clomid. Other than the weight gain and fatigue, how do you feel?

 

[Nelson Vergel]

Why are you using Clomid?

 

[GeauxBears]

29 years old. Low LH/FSH/TSH due to pituitary adenoma. Before I started my T levels were consistently in the 200s.

Mentally I feel really good on clomid. I don't seem to have the emotional issues I hear people talk about. Also, no side effects that I can tell.

My libido is terrible and morning erections while better than pre-treatment, still spotty and infrequent. My doc and I don't want to write off the clomid until we can get the E2 under control, but these new symptoms are a bit troubling.

Yes, I think he is comfortable doing what is necessary. He's a start low go slow type of guy, which is good.

 

[CoastWatcher]

Is your doc up for you maybe going with 0.5mg twice a week instead of the 0.25mg on the Arimidex? I don't know for sure if it is the E2 since you say that you have had higher E2 all along. I do know that some guys feel "off" on Clomid. Other than the weight gain and fatigue, how do you feel?

What was your E2 (sensitive) prior to the Clomid?

 

[Nelson Vergel]

How are you sleeping? Extreme hunger could be caused by high cortisol, so it would be something to check with a 4 sample salivary test.

 

[GeauxBears]

E2 prior to therapy was 20.5 with a testosterone level of 282.

Sleep is so-so but I've noticed it's gotten worse along with theseother symptoms. I've noticed this because I take Ambien every night and I've had trouble initiating sleep for the first time in a while.

I also am very jittery and nervous. We thought it was from too much Wellbutrin at 450mg, so we reduced to 300mg, but I'm thinking there's something else going on with the presence of all of these things.

Latest labs on 12.5 MWF clomid and 0.25 an anastrozole twice weekly. Started at 25 ED but tapering due to high E2 and LH but tapering doesn't seem to be dropping those numbers. Weirdly, they have gone up over time, despite the lowering of dose.

Total T: 1194 (348-1197)
Free T: 27.7 (9.3 - 26.5)
E2-Sens: 78.1 (8-35)
LH: 26.8 (1.7 - 8.6)
FSH: 22.5 (1.5 - 12.4)
SHBG: 34.6

 

[Nelson Vergel]

I wonder why it takes people two to three posts to provide the whole pic. The two factors you mentioned could be the cause of your fatigue.

Wellbutrin is well known to disrupt sleep since it is an stimulant. That is why you use Ambien. Have you tried non stimulant antidepressants? Poor sleep quality and wellbutrin induced anxiety can have additive effects. Your increased T level could also add to the stimulant effect while on wellbutrin.

Your issues are most likely not related to your hormone issues (although I would increase the anastrozole dose to .5 mg twice per week to see how you feel).

 

[GeauxBears]

Nelson, thank you for your responses and I apologize for not summarizing better up front. I've been on Wellbutrin so long (years) I guess it just slipped my mind.

Two quick questions:

- do I need to be worried about the LH/FSH levels being so high? Are there any downstream effects of these hormones being high? I couldn't find much researching online.

- what antidepressants would you recommend I take a look at? I have tried to avoid the SSRIs (anything affecting serotonin) because of the horror stories about the sexual side effects, but interestingly my doc is of the mind that my libido issues may be helped by increased serotonin or perhaps an anti-anxiety.

I have the MTHFR mutation A/C so I am at risk for depression anyway.

 

[Nelson Vergel]

I would not worry about your high LH and FSH induced by Clomid.

Talk to your doctor about combining your wellbutrin with buspirone (Buspar). It may improve sex drive and decrease anxiety.

Show him page 112: http://www.researchgate.net/profile...er/links/0c960533596d4e6378000000.pdf#page=15

[h=2]Effect of Buspirone on Sexual Dysfunction in Depressed Patients Treated With Selective Serotonin Reuptake Inhibitors[/b]
This newer antidepressant may also have lower issues with sexual dysfunction and stimulation:
https://en.wikipedia.org/wiki/Vilazodone