Low dose Clomid for Low T, and bloodwork

[nwolfe88]

I have been on 12.5mg ED of Clomid the last few weeks. My Total T is 556 now, but my Estradiol (ultra-sensitive) is 55 on a scale of <=29. Would low dose Anastrozle help with this? I am assuming my Total T would be even higher if my estradiol was in the 20's.

I have an appointment in a couple hours with my doc.

Here are some other blood results (below). Also, should I take more D3? I already take 5,000iu per day but my blood levels are only 49.

[TD="align: left"]Prostate Specific Antigen (PSA) on 09/27/2017 Normal [/TD]

[TD="colspan: 2, align: left"]Details [/TD]

[TD="align: left"]PSA, TOTAL - 0.5 Range: < OR = 4.0 - ng/mL [/TD]

[TD="align: left"]- FSH and LH on 09/27/2017 Normal [/TD]

[TD="colspan: 2, align: left"]Details [/TD]

[TD="align: left"]LH - 3.0 Range: 1.5-9.3 - mIU/mL [/TD]

[TD="align: left"]FSH - 1.6 Range: 1.6-8.0 - mIU/mL [/TD]

[TD="align: left"]Ferritin on 09/27/2017 Normal [/TD]

[TD="colspan: 2, align: left"]Details [/TD]

[TD="align: left"]FERRITIN - 233 Range: 20-345 - ng/mL [/TD]

[TD="align: left"]- Comprehensive Metabolic Panel on 09/27/2017 Normal [/TD]

[TD="colspan: 2, align: left"]Details [/TD]

[TD="align: left"]eGFR NON-AFR. AMERICAN - 93 Range: > OR = 60 - mL/min/1.73m2 [/TD]

[TD="align: left"]eGFR AFRICAN AMERICAN - 108 Range: > OR = 60 - mL/min/1.73m2 [/TD]

[TD="align: left"]BUN/CREATININE RATIO - 19 Range: 6-22 - (calc) [/TD]

[TD="align: left"]GLOBULIN - 2.4 Range: 1.9-3.7 - g/dL (calc) [/TD]

[TD="align: left"]ALBUMIN/GLOBULIN RATIO - 1.9 Range: 1.0-2.5 - (calc) [/TD]

[TD="align: left"]Sodium - 141 Range: 135-146 - mmol/L [/TD]

[TD="align: left"]Potassium - 4.8 Range: 3.5-5.3 - mmol/L [/TD]

[TD="align: left"]Chloride - 106 Range: 98-110 - mmol/L [/TD]

[TD="align: left"]Total Protein - 7.0 Range: 6.1-8.1 - g/dL [/TD]

[TD="align: left"]Albumin - 4.6 Range: 3.6-5.1 - g/dL [/TD]

[TD="align: left"]Calcium - 9.3 Range: 8.6-10.3 - mg/dL [/TD]

[TD="align: left"]Alkphos - 69 Range: 40-115 - U/L [/TD]

[TD="align: left"]TBilli - 1.0 Range: 0.2-1.2 - mg/dL [/TD]

[TD="align: left"]AST ( SGOT) - 18 Range: 10-40 - U/L [/TD]

[TD="align: left"]BUN - 20 Range: 7-25 - mg/dL [/TD]

[TD="align: left"]Glucose - 98 Range: 65-99 - mg/dL [/TD]

[TD="align: left"]CREAT - 1.07 Range: 0.60-1.35 - mg/dL [/TD]

[TD="align: left"]ALT (SGPT) - 15 Range: 9-46 - U/L [/TD]

[TD="align: left"]Bicarb - 27 Range: 20-31 - mmol/L [/TD]

[TD="align: left"]- Testosterone, Total on 09/27/2017 Normal [/TD]

[TD="colspan: 2, align: left"]Details [/TD]

[TD="align: left"]TESTOSTERONE,TOTAL - 556 Range: 250-827 - ng/dL [/TD]

[TD="align: left"]- VITAMIN D, 25-HYDROXY on 09/27/2017 Normal [/TD]

[TD="colspan: 2, align: left"]Details [/TD]

[TD="align: left"]VITAMIN D, 25-OH, TOTAL - 49 Range: 30-100 - ng/mL [/TD]

[TD="align: left"]- ESTRADIOL, (male) LC/MS/MS on 09/27/2017 high [/TD]

[TD="colspan: 2, align: left"]Details [/TD]

[TD="align: left"]ESTRADIOL, ULTRASENSITIVE LC/MS/MS - 55 Range: < OR = 29 - pg/mL Flag: H [/TD]

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[JPB]

I would probably try 12.5 mg Clomid eod and see if that helps.

 

[nwolfe88]

I would probably try 12.5 mg Clomid eod and see if that helps.

My problem is that my Total T would probably drop into the high 300's or 400's. What could be the cause of the that high of Estradiol reading? 550's total test isn't even that high.

 

[nwolfe88]

Just got back from the doc. Apparently 55 on a scale of <=29 isn't enough to warrant Anastrozle. Checking bloods again in 1 month to see if it's still elevated. Question - at what blood level should I be worried about Estradiol affecting breast tissue, etc.?

 

[ERO]

Better docs go by how you feel more than by test numbers alone. As long as you are not experiencing high E2 symptoms then your E2 levels of 55 are not a problem as your doc indicated. Clomid often raises E2 so its not surprising to see your E2 at 55.

It can become an issue when Clomid therapy doesn't raise your T levels far enough or it raises your T levels but you still feel like you have Low T. At that point switching to T injections is likely your best option.

 

[nwolfe88]

So latest bloodwork on 12.5mg Clomid per day. Doc adding 1mg Adex per week (.5mg twice per week). Anything stand out here with any of these numbers? Hoping the Adex lowers the shgb and raises the free test numbers. Not sure what's up with TSH, it's never that high. Doc also said we could try HCG+Adex too. Anyone think that'd be a better route?

Total T: 657 (264-916)
Free T: 142 (52-280)
% Free T: 2.1 (1.5-3.2)
LH: 3.3 (1.7-8.6)
FSH: 2.2 (1.5-12.4)
Estradiol (sensitive): 31 (8-35)
Estrone: 95 (12-72)
SHGB: 41 (16.5-55.9)
TSH: 3.35 (getting more in depth bloodwork because of this, it’s usually 1.5/1.6. Can Clomid affect?)
Free T3: 3.3 (2-4.4)
Free T4: 1.12 (.82-1.77)
AM Cortisol: 22 (6.2-19.4)
Prolactin: 4.7 (4-15.2)
IGF-1: 171 (98-282)
DHEA Sulfate: 347 (138-475)
DHT: 52 (30-85)
B12: 779 (211-946)
Magnesium: 2.1 (1.6-2.3)
Insulin resistance score: 60 (<=45)

 

[DaveK22]

Just my 2 cents...E2 is 31 and the Doc is putting you on 1mg adex per week? Not sure about that one

 

[nwolfe88]

Estrone is high so I guess that's why. Should I try .5mg/week instead? Or would HCG mono therapy be better altogether?

 

[CoastWatcher]

Why was estrone tested at all? The two major biologically active estrogens in men and non-pregnant women are estrone (E1) and estradiol (E2). A third bioactive estrogen, estriol (E3), is the main pregnancy estrogen, but plays no significant role in non-pregnant women or men. E2 demonstrates 1.25 to 5 times the biological potency of E1 and thus is of genuine significance in the evaluation of male hypogonadism. An estrone level yields no information that a clinician or patient can act on. It does seem to be associated with higher rates of diabetes in some men, but I'm not sure of the strength of that association. You can't dose an AI off estrone...unless you want a ticket to hormone hell.

 

[nwolfe88]

Would HCG mono be a better option?

 

[CoastWatcher]

Would HCG mono be a better option?

In regard to...? I'm not be snide, it's a genuine question. Unless I missed it, your posts focus totally on numbers, test results. That's admirable, but how do you feel? After two months, I believe, how do you feel?

 

[nwolfe88]

In regards to long term use, side effects, etc. rather than Clomid plus adex. I just started Adex so I will have to wait and see how I feel on this protocol.

 

[nwolfe88]

Anyways, how's my bloodwork look overall? Total T/Free T ratio, etc.

Is AM Cortisol being slightly high a big deal?

 

[CoastWatcher]

Your numbers look reasonable, not that different from what many men on Clomid are able to post. Your total testosterone is still below what you'd achieve on TRT, but what is your subjective response to the value you have now? Do you feel this is working? Are the issues that caused you to seek treatment moderating? Those are the questions that will ultimately determine whether Clomid has made a difference. You are right to wonder about the TSH. Finally, it does surprise me that an AI is being added when you sit at a comfortable level without one.

 

[nwolfe88]

Your numbers look reasonable, not that different from what many men on Clomid are able to post. Your total testosterone is still below what you'd achieve on TRT, but what is your subjective response to the value you have now? Do you feel this is working? Are the issues that caused you to seek treatment moderating? Those are the questions that will ultimately determine whether Clomid has made a difference. You are right to wonder about the TSH. Finally, it does surprise me that an AI is being added when you sit at a comfortable level without one.

I feel pretty decent, better than before. But I don't know if I would even know what amazing! felt like since I don't think I've ever really felt that way. Libido is a bit low. Still hard to lose weight.

I did test 55 on a scale of <=39 for the Quest estradiol, ultra-sensitive test on 10/6/17 so I'm assuming my levels are usually a tad high and nothing less. I will only take .5mg/week and see where it gets me. Bloodwork in 6 weeks and I will report back.

 

[CoastWatcher]

I feel pretty decent, better than before. But I don't know if I would even know what amazing! felt like since I don't think I've ever really felt that way. Libido is a bit low. Still hard to lose weight.

I did test 55 on a scale of <=39 for the Quest estradiol, ultra-sensitive test on 10/6/17 so I'm assuming my levels are usually a tad high and nothing less. I will only take .5mg/week and see where it gets me. Bloodwork in 6 weeks and I will report back.

So this value that you quoted in your most recent labs Estradiol (sensitive): 31 (8-35) was obtained while on an AI?

 

[nwolfe88]

So this value that you quoted in your most recent labs Estradiol (sensitive): 31 (8-35) was obtained while on an AI?

It was not.

 

[CoastWatcher]

Be careful with an AI. If it is prescribed...start low and go slow.

 

[nwolfe88]

Be careful with an AI. If it is prescribed...start low and go slow.

Yep. Doing .25mg 2x per week on Monday morning and Thursday evening. Sound good?

 

[CoastWatcher]

Yep. Doing .25mg 2x per week on Monday morning and Thursday evening. Sound good?

That is certainly a moderate dose. No question.