On Clomid - Want To Change And Need Advice

[xren]

I am currently on Clomid.
My pre-Clomid labs:

FSH 2.34 mIU/ml (1.5 -12.4) N
LH 2.28 mIU/ml (1.7 – 8.6) N
TT 596.8 ng/dl (249 – 836) N
FT 17.21 pg/ml (1 – 28.28) N
Estradiol 15.2 pg/ml (11.3 – 43.2) N
Prolactin 10.1 ng/ml (4.04 -15.2) N
SHBG 44 nmol/l (18.3 – 54.1) N
PSA 0.971 ng/ml (0 – 4) N

After 3 weeks on Clomid (1 week 25, 2 weeks 50):
FSH 6.21 mIU/ml (1.5 - 12,4) N
LH 7.82 mIU/ml (1.7 - 8.6) N
Estradiol 65.7 pg/ml (11.3 – 43.2) H
TT 13.1 ng/ml (2.49 – 8.36) H
SHBG 42.9 nmol/l (18.3 – 54.1) N
DHT 775 ng/l (219 – 1080) N

After 2 more weeks on Clomid (lower dose again 25):
Estradiol 72 pg/ml (11.3 – 43.2) H
TT 9.98 ng/ml (2.49 – 8.36) H
FT41.98 pg/ml (1 – 28.28) H

I feel like crap even though my TT is above range on Clomid. I think of switching to Nolvadex + Proviron and would welcome any advice as to dosage and whether asking doc for this switch is a good idea?

 

[xren]

The above is the short version of a longer story with some more labs (below)
Part1:
Currently I am on Clomid treatment (I think the doc meant it to be a Clomid trial to see if he can restart my T production).

I am 37, currently 84 kg, 176 cm. For the past ten years I’ve been experiencing varying levels of fatigue, generally increasing. No morning wood, or very rare (sth like 1 in 2 weeks) with very short periods of it happening more often (difficult to say what influenced it – tried tracking it).
My libido has also decreased significantly and became very low. Since starting Clomid it’s become non existent.
A few years ago hair on my hands and legs decreased. (I never had coarse bodyhair I see other guys have but I definitely had more hair.) Around that time my testicles also kind of shrunk. And my semen volume decreased and it got more see-thru. Since then my testicles got a bit bigger but that’s about it. Semen colour got whiter on Clomid but not more volume.
I feel tired and sleepy a lot of the time and have much less energy than other men I know my age. I just try to survive each day.

The first labs I had taken a few years ago showed
total testosterone of about 420 ng/dl (range 249 – 836)
free testosterone was 8,3 pg/ml (range 8,8 – 38,8) – below range
I felt bad then but doc said I was fine.
Also got my thyroid tested and tried dialing that in in hopes of getting more energy. But nope.

(I have a slightly underactive thyroid and diagnosis of Hashimoto’s. Doctor started treating me with T4 only medication (it’s called Letrox) almost 2 years ago. I read of conversion issues and guys restoring their T levels and energy when on thyroid medication. Nothing like this happened and doc tried raising the dosage and even got me on a T4+T3 medication a few months back. Upping doses and changing to T4+T3 made me only get some hyper symptoms and almost undetectable TSH with fT3 above range but didn’t make me feel better. Since then I am back to T4 only medication as it seems my body converts well and I don’t need the extra T3. The only change I noticed after starting thyroid treatment is that my memory got a bit better.)

Since then I tried dieting under dietician’s and personal trainer’s supervision, generally eat a cleaner diet, practically don’t eat gluten and dairy (am lactose-intolerant), work out with a personal trainer a couple times a week, supplement vit D and zinc and selenium. Plus varying supplements depending on trainer’s advice. Those changes made my TT rise a bit but it varies within 480 – 590 ng/dl after these changes. It didn’t make me feel much difference in my energy levels or libido. There were a few bursts of energy I got shortly after training sometimes and that made me think it could still be sth to do with free T maybe.

Finally when the thyroid doc said nothing more can be done about thyroid I tried another doc who suggested taking Clomid cause my body might need more testosterone than I was then producing. Doctor suggested that my SHBG is high for my age but that not much can be done about that and that it influences my free T.

 

[xren]

Part2:
My labs before taking Clomid were (May 18th 2018):
FSH 2.34 mIU/ml (1.5 -12.4) N
LH 2.28 mIU/ml (1.7 – 8.6) N
TT 596.8 ng/dl (249 – 836) N
FT 17.21 pg/ml (1 – 28.28) N
Estradiol 15.2 pg/ml (11.3 – 43.2) N
Prolactin 10.1 ng/ml (4.04 -15.2) N
SHBG 44 nmol/l (18.3 – 54.1) N
PSA 0.971 ng/ml (0 – 4) N

Total cholesterol 224 mg/dl (115 – 190) H
Cholesterol HDL 44 mg/dl (>40) N
Cholesterol non-HDL 180 mg/dl
Cholesterol LDL 140.2 mg/dl (0 – 130)H
Triglicerides 199 mg/d ( 0 – 150)H
Cortisol 18.9 µg/dl (7:00 - 10:00am – 6.2 – 19.4 µg/dl)
Vit D25 37 90 ng/ml (30 – 50 optimal)

I also tested insulin and glucose levels (July 5th 2018):
Glucose tolerance test (75 g) Fasting glucose 85 mg/dl (70 – 99)
Glucose after 1 h 185 mg/dl
Glucose after 2 h 141 mg/dl
Insulin after giving glucose (75 g glucose 0,1,2)
Insulin before glucose 11.9 µIU/ml (2,6 - 24,9)
Insulin after glucose (pkt 1) 125 µIU/ml
Insulin after glucose (pkt 2) 101 µIU/ml
I was suggested this indicates insulin resistance and I’ve cut out sweets since then. I do have cravings for sweets.

I waited a bit since May and started taking Clomid in early July cause the doc told me to switch from T4+T3 (Novothyral) medication and I felt horribly tired switching and didn’t want to change two things at the same time so waited until things somehow normalised and then started off with Clomid.

After 3 weeks on Clomid (1 week of Clomid 25 once a day + 2 weeks on Clomid 50 once a day) my results were:
(July 27th 2018)
FSH 6.21 mIU/ml (1.5 - 12,4) N
LH 7.82 mIU/ml (1.7 - 8.6) N
(July 25th 2018)
Estradiol 65.7 pg/ml (11.3 – 43.2) H
TT 13.1 ng/ml (2.49 – 8.36) H
SHBG 42.9 nmol/l (18.3 – 54.1) N
DHT 775 ng/l (219 – 1080) N

I experienced some Clomid side effects – visual and heat waves and excessive sweating and decreased it to 25 once a day. After 2 more weeks the results were (August 10th 2018):
Estradiol 72 pg/ml (11.3 – 43.2) H
TT 9.98 ng/ml (2.49 – 8.36) H
FT41.98 pg/ml (1 – 28.28) H

I still didn’t feel too well. Non-existent libido, low energy, but got some morning wood for about a week. Cut down on Clomid 25 every second day. Morning wood much rarer. Still very low libido, but maybe a little bit better.

 

[xren]

Tomorrow I’m going to see a new doctor (had to travel far to see the Clomid doc) and want to ask him to switch me from Clomid to Nolvadex and Proviron as I had this suggested by a personal trainer that it might help with my issues and lower SHBG. I did some reading and it seems that I might be not be experiencing the benefits or raised testosterone on Clomid due to estradiol going above range and my SHBG being too high for my age.

Is it a good idea to switch to Nolvadex + Proviron? And if so what dosage should I think about? The suggestion I got from that guy was of 20 Nolvadex once a day and 12.5 or 25 Proviron every 12h.
I really want to finally experience some energy and libido increase.

We’re planning to start trying for a baby with my wife soon so I am still looking at the medication before classic TRT option cause I want to be fertile.

English is my second language but I tried my best.
Any advice would be greatly appreciated.

 

[xren]

I realise now I probably posted in the wrong forum subsection - if it's possible I'd like it to be moved to the Clomid section. Thank you.

 

[xren]

Hi - any advice? Anyone? Please and thanks.