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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Why Clomid Fails: The Zuclomiphene Threshold
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<blockquote data-quote="Nelson Vergel" data-source="post: 47944" data-attributes="member: 3"><p><strong>Serum levels of enclomiphene and zuclomiphene in hypogonadal men on long-term clomiphene citrate treatment</strong></p><p>Helo, S., Mahon, J., Ellen, J., Wiehle, R., Fontenot, G., Hsu, K., Feustel, P., Welliver, C. and McCullough, A. (2016), Serum levels of enclomiphene and zuclomiphene in hypogonadal men on long-term clomiphene citrate treatment. BJU Int. Accepted Author Manuscript. </p><p></p><p></p><p></p><p></p><p>Abstract</p><p></p><p>Objectives</p><p></p><p>To determine the relative concentrations of enclomiphene (ENC) and zuclomiphene (ZUC) isomers in hypogonadal men (HM) on long-term clomiphene citrate (CC) therapy. To determine whether patient age, body mass index, or duration of therapy were predictive of relative concentrations of ENC and ZUC.</p><p>Patients and Methods</p><p></p><p>Men already on CC 25 mg daily therapy for secondary hypogonadism for a minimum of six weeks were recruited to have their ENC and ZUC levels assessed. Total testosterone (T), free testosterone, estradiol, follicle stimulating hormone (FSH), and luteinizing hormone (LH) prior to initiation of and while on CC therapy were recorded for all patients. Patient demographics including age, body mass index, and medical comorbidites were recorded. Serum samples were obtained at the time of enrollment to determine ENC and ZUC concentrations.</p><p>Results</p><p></p><p>A total of 15 men were enrolled from June 2015 to August 2015. Median patient age was 36 (range 22-70) years, median body mass index 32.0 (range 21.1-40.3)kg/m2, and median duration of treatment 25.9 (range 1.7-86.6) months. Baseline median total T, estradiol, and LH were 205.0 ng/dL, 17.0 pg/mL, and 4.0 mlU/mL, respectively. Post-treatment median total T, estradiol, and LH increased to 488.0 ng/dL 34.0 pg/mL, and 6.1 mIU/mL, respectively (all p<0.001). Median ENC and ZUC concentrations were 2.2 and 44.0 ng/mL, respectively. After at least six weeks of CC therapy median ZUC: ENC serum concentration ratio was 21.3. On linear regression analysis patient age, body mass index, duration of treatment and serum T levels were not predictive of ENC or ZUC concentrations.</p><p>Conclusions</p><p></p><p>Long-term CC therapy resulted in a significant alteration of ENC and ZUC concentrations, with ZUC as the predominant isomer. Given the vastly different biochemical and toxicological properties of ENC and ZUC, this study supports the need for development of a pure selective estrogen receptor antagonist for the treatment of HM.</p></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 47944, member: 3"] [b]Serum levels of enclomiphene and zuclomiphene in hypogonadal men on long-term clomiphene citrate treatment[/b] Helo, S., Mahon, J., Ellen, J., Wiehle, R., Fontenot, G., Hsu, K., Feustel, P., Welliver, C. and McCullough, A. (2016), Serum levels of enclomiphene and zuclomiphene in hypogonadal men on long-term clomiphene citrate treatment. BJU Int. Accepted Author Manuscript. Abstract Objectives To determine the relative concentrations of enclomiphene (ENC) and zuclomiphene (ZUC) isomers in hypogonadal men (HM) on long-term clomiphene citrate (CC) therapy. To determine whether patient age, body mass index, or duration of therapy were predictive of relative concentrations of ENC and ZUC. Patients and Methods Men already on CC 25 mg daily therapy for secondary hypogonadism for a minimum of six weeks were recruited to have their ENC and ZUC levels assessed. Total testosterone (T), free testosterone, estradiol, follicle stimulating hormone (FSH), and luteinizing hormone (LH) prior to initiation of and while on CC therapy were recorded for all patients. Patient demographics including age, body mass index, and medical comorbidites were recorded. Serum samples were obtained at the time of enrollment to determine ENC and ZUC concentrations. Results A total of 15 men were enrolled from June 2015 to August 2015. Median patient age was 36 (range 22-70) years, median body mass index 32.0 (range 21.1-40.3)kg/m2, and median duration of treatment 25.9 (range 1.7-86.6) months. Baseline median total T, estradiol, and LH were 205.0 ng/dL, 17.0 pg/mL, and 4.0 mlU/mL, respectively. Post-treatment median total T, estradiol, and LH increased to 488.0 ng/dL 34.0 pg/mL, and 6.1 mIU/mL, respectively (all p<0.001). Median ENC and ZUC concentrations were 2.2 and 44.0 ng/mL, respectively. After at least six weeks of CC therapy median ZUC: ENC serum concentration ratio was 21.3. On linear regression analysis patient age, body mass index, duration of treatment and serum T levels were not predictive of ENC or ZUC concentrations. Conclusions Long-term CC therapy resulted in a significant alteration of ENC and ZUC concentrations, with ZUC as the predominant isomer. Given the vastly different biochemical and toxicological properties of ENC and ZUC, this study supports the need for development of a pure selective estrogen receptor antagonist for the treatment of HM. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Why Clomid Fails: The Zuclomiphene Threshold
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