Starting Clomid

[hva]

TL;DR...hit my head in 2013, testosterone is in the tank, starting clomid hoping for a restart.

I had my consult with Dr. Saya last week. I'm 44 y.o. and have had two tests showing very low testosterone. My symptoms began in 2013 after a cycling incident. I was traveling down a 10ft wide cycling/walking trail. As I was passing some walkers their dog walked right into my path. As I veered to avoid the dog my wheels dropped off the trail and this sent me off the bike at around 12 to 15mph head first into the pavement. I hit might right temple first and my helmet broke like it was supposed to. If not for my helmet, I'm fairly certain this would have gone from a concussion to a more severe TBI. The combination of my wheels getting trapped on the edge of the pavement and being clipped into my pedals probably caused me to land head first. Trails are dangerous, I'd rather ride on the open road.

I recovered from the concussion in a few weeks but noticed a gradual downward spiral in my overall mood and sense of well being. At first I was thinking this must be some sort of mid life crisis. However, as the months/years went by I kept noticing I didn't feel right.

In May of 2016 I visited my dr and told him I suspected my testosterone levels may be off. He ordered a total T and TSH test. The next day his nurse called and said my T level was fine so I didn't think much about it. A few months later I obtained my medical records from this doctor, for other reasons, and noticed the lab results. The testosterone was 149ng/dl with a lab reference range of 132 - 820! Obviously, my testosterone was "in range" so everything was deemed to be ok by my doctor.

I have Clomid in route as of today and will be starting it this week. I hope it can restart my natural testosterone production. I'm unsure if Clomid is a long term solution, assuming I'm still capable of producing testosterone, but I'm willing to be a forum unicorn.

I guess my main question is, will Clomid still stimulate natural testosterone even if there is some sort of disconnect between the hypothalamus/pituitary axis? At first I was under the impression that Clomid is an analog to LH, but after some reading I'm not sure if that's the case.

 

[green2145]

You've got nothing to lose by doing a trial run.I'm a week in to clomid 12.5 daily.Everything is up,literally,libido,energy,etc.

 

[hva]

That's good to hear. My pharma package is currently out for delivery so I'll be starting it today.

 

[Vince]

That's good to hear. My pharma package is currently out for delivery so I'll be starting it today.

Dr Says is great TRT doctor, so I know you're in good hands, keep us updated.

 

[hva]

This morning I took my third 12.5mg dose of Clomid. I'm really trying to avoid any thoughts of placebo but I honestly feel like some of the brain fog has lifted ever so slightly. Dr. Saya also prescribed 30mg DHEA and I've noted much deeper sleep after taking it an hour before bed.

 

[CoastWatcher]

This morning I took my third 12.5mg dose of Clomid. I'm really trying to avoid any thoughts of placebo but I honestly feel like some of the brain fog has lifted ever so slightly. Dr. Saya also prescribed 30mg DHEA and I've noted much deeper sleep after taking it an hour before bed.

To hear you're feeling better is great news, but keep your focus on the long term. Almost all of us, be it Clomid or traditional TRT, experience ups and downs (sometimes significant ones) as the journey unfolds. All the best.

 

[hva]

At this point it's probably the better sleep more than anything. I've had this vicious cycle of low T, poor sleep, brain fog, extreme mental fatigue followed by more poor sleep.

 

[hva]

Morning wood is making an appearance. I'm starting to notice my forehead and shoulders are oily like they used to be. I've had unusually dry skin for the past two or three years. Honestly, I think this is working. If I had some spare time I would get some blood work done right now just out of curiosity.

 

[hva]

It's been a little over a week with 12.5mg ED Clomid. I'm half way through my third pill. Subjectively, my low T symptoms have vanished and I feel like I did 20 years ago. My wife can objectively say things have improved. I honestly didn't think this would have much of an improvement in a week.

 

[Dr Justin Saya MD]

It's been a little over a week with 12.5mg ED Clomid. I'm half way through my third pill. Subjectively, my low T symptoms have vanished and I feel like I did 20 years ago. My wife can objectively say things have improved. I honestly didn't think this would have much of an improvement in a week.

A great and encouraging response thus far.

Will be very interested to see first round of follow-up labs which will offer more insight, keeping in mind the longterm goal.

 

[johndoesmith]

A great and encouraging response thus far.

Will be very interested to see first round of follow-up labs which will offer more insight, keeping in mind the longterm goal.

Is it even plausible that benefits are felt from the increase in testosterone that fast? From my understanding, most of the major effects are genomic actions which generally take weeks to maybe 2 months to reach a noticable, perceivable level. There are the non-genomic effects though, such as those mediated via GPR30, so it could be that.

Either way, OP congrats on feeling better!

 

[Dr Justin Saya MD]

Is it even plausible that benefits are felt from the increase in testosterone that fast? From my understanding, most of the major effects are genomic actions which generally take weeks to maybe 2 months to reach a noticable, perceivable level. There are the non-genomic effects though, such as those mediated via GPR30, so it could be that.

Either way, OP congrats on feeling better!

Most subjective results indeed take time, however many men do seem to notice subjective changes (sometimes positive, sometimes negative) sooner than expected...and the incidence of this is much higher than can likely be explained by placebo effect.

For Clomid specifically we can think of possible peripheral/central actions (known and unknown) of the gonadotropins (LH/FSH) and for both Clomid/TRT we can think of possible areas such as endorphin release, nitric oxide production, up/down receptor regulation, neurotransmitter balancing, etc. Again, most generally take some time, but the human body is an amazing specimen.

 

[johndoesmith]

Most subjective results indeed take time, however many men do seem to notice subjective changes (sometimes positive, sometimes negative) sooner than expected...and the incidence of this is much higher than can likely be explained by placebo effect.

For Clomid specifically we can think of possible peripheral/central actions (known and unknown) of the gonadotropins (LH/FSH) and for both Clomid/TRT we can think of possible areas such as endorphin release, nitric oxide production, up/down receptor regulation, neurotransmitter balancing, etc. Again, most generally take some time, but the human body is an amazing specimen.

There is so much I don't know. I didn't even consider the LH/FSH effects.

What about the estrogen agonism of zuclomiphene? If OP was low E2, that could have an effect that's positive.

I often think about the estrogen antagonism causing some of the negative effects of clomid.

You most certainly have a point, that the incidence of people reporting effects quickly is too high to be placebo, but some part of me just finds it to be incorrect, I can't exactly articulate a scientific reason(other than what I stated) so it might just be "broscience". I digress.

 

[hva]

My E2 was on the low side as well as DHEA. I started taking some OTC DHEA the same day as my consult and it was about a week before the Clomid arrived.

I've been mindful of the potential placebo effect. However, the onset of oily skin and even some acne are two things I know cannot be anything other than a return to normal for me and they came back very soon.

I should also mention I've struggled with keeping hypertension under control and it's been much more difficult to keep within range after the low T symptoms began. The day after my consult with Dr Saya I saw my PCP and he started me on 12.5mg Atonolol ED. This definitely has had a calming effect and brought me back down to 125/75. It is also keeping my resting heart rate at around 70 and not 90 like before.

 

[hva]

So last Saturday I was a greasy mess. I haven't had so much oil on my face since I was a teenager. I even had to pop a whitehead. I've noticed some acne showing up in the usual places like along the crease of my nose and forehead. Fortunately this has subsided a bit in the last couple of days but my skin just feels "age appropriate" now, for lack of a better term. I've always had very oily skin and this is a family trait. I had problems with acne until I was in my early 30's.

Before I had my cycling incident I was starting to lose my hair in the normal MPB areas. My hair was thinning at a rate to where I should be mostly bald on top by now. Before I ever thought about testosterone I noticed this thinning had stopped and my hair was becoming more dry and brittle. I always had very oily hair and needed to wash it every morning. It had become so dry I was considering using conditioner; unthinkable in the past.

So it would appear this lack of normal sebum production, cessation of hair thinning, and a host of other symptoms were due to the lack of testosterone. If I'm reading things correctly the body converts testosterone to DHT which is responsible for sebum production as well as male pattern baldness.

To begin this week I think I've ended my honeymoon period and things are just returning to normal for me. My moods are even, I'm able to concentrate on my job, which had suffered greatly over the past four years, and I'm finding I have the ability once again to not give a shit about small things. My mind does not dwell on issues that I cannot control and the mental fog, confusion, and constant fatigue have lifted. Honestly, I feel like I've come out of a four year coma.

Up until my accident I followed a very predicable pattern of heightened aggression for a day or two followed by a mellowing and calmness. This, I believe, was my mental response to the normal hormonal cycle and feedback working as nature intended. Post accident, I began a sliding decent of similar to a bearish stock chart with lower highs and lower lows. In the last year or two my highs were only as good as my former lows, and my lows were becoming a state of despair. Like a bullish stock chart, I'm making higher highs and higher lows now.

 

[BryanW]

Great news, thanks for sharing. I hope things continue to go well for you!

 

[hva]

About 2.5 weeks into taking 12.5mg Clomid ED. Libido seems to be in retreat and morning wood has been MIA. I had a few days of unstoppable wood but now...meh. I still feel like I'm functioning as a normal human being instead of the undead, but if this is a good as it gets with regards to libido then I'm not sure it's a long term solution. For the past few years I've had a frustrating lack of penile sensitivity and inability to orgasm like normal. It happens every now and then, but not without a lot of time and effort. I failed to mention this during my first consult with Dr. Saya, mainly because at the time I was more interested in becoming a productive member of society than worrying about finishing sex. More often than not I can get real close then nothing happens like dry firing a pistol. For the first week or so with Clomid this stopped but I'm afraid it has returned again.

My skin is still producing oil but not prodigiously as it was in the first couple of weeks.

 

[CoastWatcher]

About 2.5 weeks into taking 12.5mg Clomid ED. Libido seems to be in retreat and morning wood has been MIA. I had a few days of unstoppable wood but now...meh. I still feel like I'm functioning as a normal human being instead of the undead, but if this is a good as it gets with regards to libido then I'm not sure it's a long term solution. For the past few years I've had a frustrating lack of penile sensitivity and inability to orgasm like normal. It happens every now and then, but not without a lot of time and effort. I failed to mention this during my first consult with Dr. Saya, mainly because at the time I was more interested in becoming a productive member of society than worrying about finishing sex. More often than not I can get real close then nothing happens like dry firing a pistol. For the first week or so with Clomid this stopped but I'm afraid it has returned again.

My skin is still producing oil but not prodigiously as it was in the first couple of weeks.

It's still only been a few weeks - almost no time in the world of androgen replacement. Had you started injecting testosterone a few weeks ago you would almost certainly be working to balance and dial things in. Stay the course and remember your medical care is first-rate. All the best.

 

[hva]

It's still only been a few weeks - almost no time in thenworldmof androgen replacement. Had you started injecting testosterone a few weeks ago you would almost certainly be working to balance and dial things in. Stay the course and remember your medical care is first-rate. All the best.

I hear you. I'm still extremely happy to be functioning like my normal self in most regards and that is the most important thing at this point. TBH, I think I was down for so long that I really felt an initial boost out of the brain fog and depression and now things are just settling in for me. I'm looking forward to the follow up labs to see where things changed and by how much.

 

[hva]

Today is the 1st day of week four. I've started lifting weights and doing high intensity cardio workouts this week. I'm intentionally hitting the muscles in the shoulder girdle since these are supposed to be the most receptive to androgens. I've always been frustrated at my lack of ability to gain any appreciable mass in these muscles. Not only was I an avid cyclist, but I had the typical cyclist physique as well. Post accident my Tour de France physique transformed into a dad body and that's simply unacceptable; but I suffered from a severe lack of motivation to do anything about it for the past four years. Next week I'm going to start hitting the squat rack and deadlifts. When I was in really great shape I could do eight or nine deadhang pullups, right now I can do about half of one. How pathetic.

I've been pretty sore, as expected, but I do notice the soreness is confined to typical DOMS and recovery is much faster. My pants are noticeably looser around the waist and I've lost about three honest pounds since Feb 1. I've discontinued the use of prescription diuretics as water retention does not seem to be a problem at this time. I should be wearing a size 34 waist at most but right now the size 36 is a little tight. I've been down this road before with body transformation from couch potato to fitness freak. I'm feeling the motivation and some initial results. I know from past experience this can accelerate rapidly if I keep my diet in check and keep punishing myself with workouts. Anyone who's ever been into cycling knows we are a masochistic lot when it comes to suffering in the saddle. I haven't thought much about riding again yet but I'm starting to have thoughts about putting the hammer down in the big ring with a 20mph tailwind...

Maybe it's the combination of lifting and testosterone, but I'm not really dealing with anyone's shit. I'm finding it much easier to either speak my mind or just STFU. My wife has referred to Clomid as my ******* pills and that's a good thing.