One month into Clomid treatment

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https://www.excelmale.com/forum/sho...about-two-months/page2&highlight=clomid+blood

See the link above for my original blood work and history...etc.

Well, I'm a month into the Clomid treatment (50 mg, Mon/Wed/Fri)...

At first, I wasn't really sure if there was a placebo effect going on, or if things were truly improving/changing. I'm quite sure now.

I have virtually NO drops in energy like I used to routinely get throughout the week. I'd have periods where I would feel like I didn't even have the motivation or energy to walk down the hallway, never mind go to the gym (I still did, it just sucked).

No more afternoon drowsiness, I'm actually fairly motivated to go to the gym when I get home. And at the gym itself, strength is solid, not steroid-benching-3 plates solid, but it's markedly improved. I used to finish just a couple sets and be completely gassed, just sitting there in a pile of unmotivated waste, and then still move on and struggle through the next set.

I think I look more muscular overall, and somewhat leaner. It's hard to tell as I'm not really actively trying to change my diet at all during the Clomid treatment. Until I know my testosterone is in check, I see no point in gaining weight (if it's low, I'll just put on fat not muscle), or losing weight (I'm more likely to just lose muscle). I keep track of measurements in detail, so I'll compare the before and after results in a month or so to see if there's a difference.

Sex drive is probably the least impacted. I am actually noticing women again (score!), and I've had more frequent morning erections. This difference is noticeable, but not appreciably so. We'll see in a month where I'm at, and also what my actual numbers are.

No real side effects to report...unless...you consider the fact I've developed mild to moderate OCD. I was diagnosed with generalized/performance anxiety 3.5 years ago, which has been well managed through meditation and public speaking classes. But I've now developed OCD and have started tackling this issue.

Now that I'm more aware of what the symptoms are, I realize that this started about two months ago, and this was before Clomid. It's hard to tell if the Clomid is making it worse, because the week or two leading up to beginning Clomid my OCD was off the charts. I specifically remember thinking, "Ok, before you head to a therapist for your anxiety, get your testosterone in check and go from there. This could be causing most of your issues." It's something I'll definitely bring up to my endocrinologist, I've thought about e-mailing him now to inform him, and see if he wants to see me sooner. But for now, I'll just wait the month.

I've reached out to a friend who has OCD, and have begun implementing CBT therapy on my own, and I am making my way through the OCD Workbook that he used. I'm also actively seeking out a psychiatrist/therapist who specializes in OCD/CBT to help coach me through it. I already saw one who was absolutely awful, and if the next one doesn't work I have a good recommendation I may try (out of network, so more expensive).

I do remember about 2 - 3 weeks into the Clomid, there were periods of feeling better than I've felt in years, longer than I can remember. Mood, energy...etc. I just felt great, but that was only for hours at a time, maybe the better part of an entire day. So who knows.
 
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You're moving in the right direction. I hope you connect with a good therapist. All the best.

Best wishes for you. Thank you for having the courage share your experience.

Wow, it sounds like it's working, I hope your awesome progress continues. :)

Thank you all for the kind words, simply reading them gives me even more motivation and encouragement. It's nice to know I'm not the only one who feels things are moving in the right direction (despite the OCD).

I will post the blood work results a month from today (I like to give it a good month to evaluate, as I realize patience is key with Clomid treatment), and then the results of my follow-up appointment a few days after the blood work.

Thanks again!
 
Two months into Clomid treatment. Symptom relief is more or less the same. Energy is still very good, but anxiety is also still quite moderate. I'm currently seeing a therapist/pyschiatrist for generalized anxiety/OCD. It feels like I'm on edge half the time, but it's still manageable and hasn't interfered with work/the gym/social life. But it definitely needs to be improved.

Sex drive has still only improved minimally.

Total testosterone did improve to 425, but Estradiol is incredibly low. SHBH/free T was not tested this time, bummer. There were some other blood tests done (WBC/RBC, enzymes/bilirubin) but these barely changed.

Any ideas what this blood work means? I've been on a 3x/week dose of 50 mg of Clomid for two months.

FSH 4.6 mIU/mL (range 2 - 12) not tested previously
LH 2.8 mIU/mL (range 2 - 10) was 3.7

Prolactin 6.0 ng/mL (range 4 - 15) was 4.9

Total testosterone 425 ng/dL (was 158)

Estradl <5 pg/mL, didn't give a specific number (range 8 - 45) not tested previously
 
Two months into Clomid treatment. Symptom relief is more or less the same. Energy is still very good, but anxiety is also still quite moderate. I'm currently seeing a therapist/pyschiatrist for generalized anxiety/OCD. It feels like I'm on edge half the time, but it's still manageable and hasn't interfered with work/the gym/social life. But it definitely needs to be improved.

Sex drive has still only improved minimally.

Total testosterone did improve to 425, but Estradiol is incredibly low. SHBH/free T was not tested this time, bummer. There were some other blood tests done (WBC/RBC, enzymes/bilirubin) but these barely changed.

Any ideas what this blood work means? I've been on a 3x/week dose of 50 mg of Clomid for two months.

FSH 4.6 mIU/mL (range 2 - 12) not tested previously
LH 2.8 mIU/mL (range 2 - 10) was 3.7

Prolactin 6.0 ng/mL (range 4 - 15) was 4.9

Total testosterone 425 ng/dL (was 158)

Estradl <5 pg/mL, didn't give a specific number (range 8 - 45) not tested previously

FSH was not tested prior to starting Clomid therapy? Based on the range provided, I would think your estradiol test was the standard, not the sensitive, one. For future reference you'll want the LC, MS/MS sensitive lab run.
 
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Nope, unfortunately it wasn't. FSH was tested back in the fall of 2008, and it was 4.9 then (range 1 - 12). With a total testosterone level of 627.

Would these (albeit somewhat incomplete) blood results indicate that the Clomid isn't working well for me? Isn't FSH and LH supposed to increase, and in the case of my LH, it actually decreased. Even FSH is about the same/slightly lower than 8 years ago, with a much lower total testosterone level.

I have my follow-up this week with both my primary and endo. I'll inquire about more blood work, including SHBG and the sensitive estradiol test.
 
Went to see my primary today for a physical, and had some more blood work.


Cholesterol is 233 mg/dL (range 0 - 199) not tested before Clomid


HDL is 94 mg/dL


CHOL/HD ratio is 2.5


SHBG is 68 nmol/L (range 14 to 48) was 56


Albumin is 4.5 g/dL (range 3.5 to 5.2) was 4.7


calc Free T is 52 pg/mL (range is 60 to 185) was 20


I also asked which test was done for Estradiol, and it was the sensitive test.
 
I met with the endocrinologist today.


With an increase in total testosterone, and a high SHBG and low estrogen number, he asked about my diet. He suggested I start eating more, as having low body fat can cause both of these numbers to skew high/low. This could allow my free T to increase, along with my estrogen, both of which will help increase my libido and help me feel better.


He's keeping me on a 3x/week Clomid dose, and I have a follow-up in three months. He said it's up to me if I want to eat more, and the it's choice between being lower body fat/thin, and possibly having an increased free T/estrogen number which will help me feel better.


I am quite lean, and have been for awhile now. This is definitely not where I sit naturally either, and it is entirely possibly a restrictive diet is still causing issues. My gut instinct at this point is to slowly raise calories/gain weight and see how I feel. I was suspicious this was the cause from the beginning, and questioned it six months ago.


The other option would be to get a second opinion, but at this point my other option would be injections. I don't want to move to injections if a simple adjustment of diet could boost free T at this point.

Thoughts?
 
Yeah...my 2-cents is you need a new doctor. If you are lean and at a healthy body-fat level, the advice to get fatter to feel better is ridicules. I mean, eating healthier is always a smart choice, including healthy fats, but just to 'eat more' is not really sound medical advice unless you are anorexically thin or something.
 
AlcahueteJ

How old are you?

In my opinion. Clomid is not bringing you up where you should be. Just to make sure: your dose is 50 mg three times per week?

Is there any reason (besides possibly age) that justified you being on Clomid?

Have you even tried an SSRI for your OCD? How bad does it get?

Do you have low appetite? Is that why you do not eat as much as your doctor is telling you should?
 
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Yeah...my 2-cents is you need a new doctor. If you are lean and at a healthy body-fat level, the advice to get fatter to feel better is ridicules. I mean, eating healthier is always a smart choice, including healthy fats, but just to 'eat more' is not really sound medical advice unless you are anorexically thin or something.

That was my initial thoughts months ago, because I'm not anorexic it may not be the cause. But I was also skeptical of years of a restrictive diet causing many of these issues.

Injections are still an option if I desire as well. It's up to me.

AlcahueteJ

How old are you?

In my opinion. Clomid is not bringing you up where you should be. Just to make sure: your dose is 50 mg three times per week?

Is there any reason (besides possibly age) that justified you being on Clomid?

Have you even tried an SSRI for your OCD? How bad does it get?

Do you have low appetite? Is that why you do not eat as much as your doctor is telling you should?

34 years old.

Yes, my dose is 50 mg 3x/week.

I was given the option of injections or Clomid, so, it was my choice. I wanted to take the conservative route first to see what happens, then weigh my options. Injections are still on the table if I want. I'd prefer not to if I don't have to, but I have no issue with them if that the best course of action. But if simply eating more can help alleviate these symptoms (entirely possible considering my SHBG, estradiol, insane appetite, constant cold body temperature, minimal libido), I'd hate to go on injections if I don't have to.

I have not, I can take one if I want to. I have had generalized anxiety for ~3.5 years, and have managed that well without an SSRI. I'm doing well with the OCD as well with therapy at the moment, and neither interfere with social life/work. I'm a mild-moderate case. I'm still highly functional, if that changes, I'd consider it. Also, SSRIs can kill libido, which is already quite low.

No, the opposite actually. I'm NEVER completely full, I haven't been in a long time. Even when I go on vacations and eat whatever I want, I can just...keep....eating. So my diet is admittedly restrictive, but I'm not currently losing weight. I'm ~2 lbs. less than this time last year.
 
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