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Clomid and Testosterone

Sometimes the best offense is a good defense.  This applies to the world of hormones at times as well. For example, the most obvious way to solve low testosterone, or hypogonadism, is to add testosterone, right? Well, there's another way:  add a SERM such as Clomid (clomiphene citrate) instead. In other words, lower estrogen and you'll naturally get more testosterone due to the body's feedback mechanisms.

What is a SERM?  It means that it will in some tissues act as an estrogen and in others block estrogen. However, the bottom line is that in males it generally works its hormonal magic by blocking or inhibiting estrogen at the hypothalamus which, in turn, stimulates GnRH and, further downstream, LH (leutinizing hormone) in the pituitary.  Males can see their low testosterone levels double or more, especially if you have secondary hypogonadism.

Some decent research and years of clinical practice have born this out. For example, one study put 36 men with average total testosterone of 248 ng/dl on 25 mg/day of Clomid and after 4-6 weeks the men's average testosterone was a hefty 610 ng/dl. [1] This is a nice boost indeed, especially for what is considered a relatively low dose of Clomid.  The authors also point out that the all-important testosterone to estrogen ratio was raised from 8.7 to 14.2.

We have had a couple of Peak Testosterone Forum member who were enthusiastic Clomid users.  Look at what this guy wrote:

"Yep, seems like i 'passed' the Clomid challenge. February i had a reading of total T at 270 ng/dl. Today's results, after 5 1/2 weeks on Clomid: 627 ng/dl!! Wow, so that was really good news..." [3]

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Clomid also has certain advantages over standard testosterone therapy.  HRT requires shots or topicals that require time and potential risks.  It's nice just to take a simple pill, as is the case with Clomid. And the good news is that Clomid seems to generally raise testosterone in the younger men who try it, which is still more evidence that the great majority of men have tertiary hypogonadism.  Also, it is worth pointing out that a significant percentage of men have what I would call an "HRT-like" experience from Clomid, i.e. it improves libido and erectile strength and they feel better as well. 

However, many have th opposite experience where their testosterone increases but they get no increase in libido.  We have had men shoot up into the 800's  or higher on Clomid and yet have absolutely no increase in sexual desire.  This shows just how Clomid can negatively impact the male brain due to its sometimes estrogenic qualities.  And there is simply no way to know if you will be one of the lucky or unlucky ones.

So how safe is this convenient Clomid?  In the short term, Clomid seems quite safe and that is one reason that some doctors are increasingly prescribing it for hypogonadism. Clomid has been taken for years by males as a fertility treatment due to its FSH-stimulating powers. So it has a reasonable track record considering that it has been out for awhile.

One other crowd that has used Clomid for an extended period of time are steroid users and certain athletes.  Steroid men will use Clomid to get their testosterone back, a common issue with steroid abuse. It is commonly used upon completion of a steroid cycle to "jump start" testosterone.  Often testosterone will collapse after steroid use and Clomid is the only thing that will bring back testosterone and estrogen within normal physiological ranges.  This was documented when one study discussed Clomid's effective use to do just this with a "steroid abuser". [2]

The bottom line is that Clomid has been used extensively by several off label and even non-legal users and all have found it to be reasonably well-tolerated with low side effects for short term use.  NOTE: Clomid does not always work. If you are primary hypogonadal, for example, Clomid will do nothing for you. And the same is true if you have pituitary damage..

CAUTION:  Many men now want to use Clomid long term.  Talk to your doctor, but I think this is unwise for a variety of reasons that I go into detail about in my link on Your Risks with Long Term Clomid Usage.  Below I give a quick summary, though, of the issues involved:

1) Vision.  A surprisingly common side effect of Clomid is blurred vision.  Is this drug doing some kind of subtle long term damage within the eye that we do not understand yet?  We just don't know.  However, cases of spontaneous retinal thrombosis (clotting), spasms and detachment have been reported.  . Is this really safe to use long term for men? That’s a good question. Some pretty smart doctors believe it is safe long term if it is used a) low dose and b) no side effects are experienced. I certainly do not have a crystal ball myself however. This is such a potentially major long term issue that I have created a page called Clomid and the Risk to Your Long Term Vision on the subject.

2) Moodiness and Estrogen. Clomid is actually estrogenic in some cases and  moodiness and mood swings are fairly commonly reported.  The bottom line is that Clomid's effects are poorly understood and likely vary from individual to individual.

3) Thyroid.  Some of Clomid's common side effects match up quite well with those encountered during various thyroid issues.  This has some wondering if Clomid does subtely affect thyroid function in some way.

4) Nausea or Headache. These are fairly common side effects with Clomid.  Again, one can't help but ask what it is doing long term. 

5) Peripheral Neuropathy and Paresthesia.  One commonly reported side effect of clomid are the symptoms of nerve damage, such as tingling, numbness, burning, itsching, etc.  This usually discontinues several months after stopping the drug, but one can't help but wonder how much damage has been done. 

6) Clomid. Clomid raises SHBG enough to where it could be an issue for some men. As SHBG rises, the percentage of free testosterone can fall. Ideally, you want this range to be 1.5-2.5 percent of total testosterone. See this link on High SHBG for more information.

Other Articles You May Be Interested In:

  • Check Out This Multi-Step Testosterone Program
  • How Does Low Testosterone Effect Erectile Strength?
  • What Are Normal Testosterone Levels By Age For Us Men?
  • Double or Triple Testosterone With Weight Loss

    1) J Sex Med, 2005 Sep, 2(5):716-21, "Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism"

    2) Fertility and Sterility, Jan 2003, 79(1):203-205, "Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse"


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