Looking for guidance on next steps (TRT or Clomid)

[Alexman]

I'm new to the excelmale but have been lurking a a little bit. As a background I've been suffering with the symptoms of low T for a while now and have been meaning to check it out, but had a very busy life in my 20's. Lately, I've been feeling worse with the symptoms of brain fog, weight gain around the waist/butt/chest but not arms, tired and fatigue all the time and a down mood. I decided to test myself out and requested an initial hormone test including for fertility since I'm recently married and want to try for kids. My first lab I took in the evening at labcorps and it came back with the following result:

Total Test: 230 ng/dL (264-916)
Free Test: 7.9 pg/mL (8.7-25.1)
Prolactin 20ng/mL
FSH: 3.0
LH: 7.0

So my primary care provider decided to refer me to a endocrinologist and he decided I should test again this time in the morning. The second results were taken at labcorp and they are below with the reference ranges:

TSH: 1.310 ulU/mL (0.450-4.500)
T4: 1.12 ng/dL (0.82-1.77)
Total Test: 380 ng/dL (264-916)
Free Test: 10 pg/mL (8.7-25.1)
Prolactin: 13 mg/mL (4.0-15.2)
SBHG: 32 nmol/L (16.5-55.9)


As for my person stats, I'm 5'7 and weight 220 pounds. My doctor states that these numbers are in normal range and doesn't recommend anything other than maybe clomid at 12.5 EOD if I want to improve testosterone. I also had a semen analysis done and the normals were normal except for my total sperm count on the lower end at 18 million with the lowest normal range for men being 20 million. Do these numbers speak primary/secondary hypogandism or should I give clomid a shot? Other suggestions?

 

[Systemlord]

You're doctors an idiot and needs a cold wet fish across his face. I hear stories like this every day, most endo's are clueless and has to do with the fact that TRT for most is like a side job to what they really do, diabetes and thyroid disorders. Some guy comes in needing TRT and his ill equipped to deal with it and he doesn't know anything about male hormones.

There's evidence that testosterone levels below 440 ng/dL is there are diseases associated below this point, diabetes, heart diseases and cardiovascular diseases. I cringe every time I read stories like yours because you're not normal, our president has higher T (446) than you do and he is 71 years old! You're already running on an empty tank if you make a simple comparison.

Your below the threshold for what's considered low and still your doctor doesn't get it, I'm not even sure he could tie his own shoelaces.

 

[Alexman]

You're doctors an idiot and needs a cold wet fish across his face. I hear stories like this every day, most endo's are clueless and has to do with the fact that TRT for most is like a side job to what they really do, diabetes and thyroid disorders. Some guy comes in needing TRT and his ill equipped to deal with it and he doesn't know anything about male hormones.

There's evidence that testosterone levels below 440 ng/dL is there are diseases associated below this point, diabetes, heart diseases and cardiovascular diseases. I cringe every time I read stories like yours because you're not normal, our president has higher T (446) than you do and he is 71 years old! You're already running on an empty tank if you make a simple comparison.

Your below the threshold for what's considered low and still your doctor doesn't get it, I'm not even sure he could tie his own shoelaces.

I currently do not have any diagnosed diseases at this point in my life, but your right my endo doesn't seem to understand men's hormones based on what I read here and I'll need to search for another one that understands andrology better. I had to request clomid on my own otherwise he just said "good luck, try antidepressants maybe to help with the symptoms".

I've read that clomid is usually the first try for people on here to "restart" their testosterone, is that a good move?

 

[ZoomyR6]

Yes, Clomid is definitely a good move. T is a last resort. You are a young man that should exhaust all other options..

 

[Alexman]

What would be the recommended starting dose for Clomid? 12.5mg EOD or 25mg EOD?

 

[ZoomyR6]

12.5 ED but a lot of docs, including the one that had me try it first, had me at 25ED

 

[Alexman]

To update, it looks like Clomid 12.5 EOD might have mad a small difference..new numbers below.

Total Test: 419 ng/dL (264-916)
Free Test: 15.9 pg/mL (8.7-25.1)
Prolactin 9.0 ng/mL
Estradiol: 39.0 pg/mL
Sperm Count: 80 Million

I noticed my estradoil shot way up from 19 before I started taking clomid to 39. I also gained another 10-12 pounds as well. So does this mean I should just jump to hgh or TRT? I was planning on having kids so I didn't want to take the risks yet until that was finished, it looks like the clomid at least increased my sperm count 4x and raised my free test.

 

[Vince Carter]

I'd go 25 EOD I think thats been more of the sweet spot for guys before you give up on it, make sure that you're taking it (if due) the morning of your labs, don't skip it and take if after you have labs. Clomid is also a bit notorious for Estrogen so that's usually were the balancing act teeters for dosing. 25mg/D is typically too much.

 

[Alexman]

I'd go 25 EOD I think thats been more of the sweet spot for guys before you give up on it, make sure that you're taking it (if due) the morning of your labs, don't skip it and take if after you have labs. Clomid is also a bit notorious for Estrogen so that's usually were the balancing act teeters for dosing. 25mg/D is typically too much.

Hey Vince, sorry I wasn't clear I was taking Clomid EOD since the original post up top in November of last year. I was wondering if based on the results from my blood and semen labs if I should continue Clomid and consider options for lowering estrogen or move to hgc or T shots.

It looks like my Total T improved but not significantly, maybe my weight? Free T looks double compared to my original post.

 

[Vince Carter]

If you're considering HCG mono therapy it wouldn't be useful if you're primary Hypo (problem is the testes) which this, tells me that you're Primary and HCG wouldn't do much at all for you:

FSH: 3.0
LH: 7.0