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Author Topic: 31, Low Free T Since Accident, Starting Clomid 25mg  (Read 3139 times)

hockey21

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31, Low Free T Since Accident, Starting Clomid 25mg
« on: May 26, 2017, 11:18:58 am »
HI All -

I appreciate everyone taking the time to weigh in here. Around a year ago I was in a light whiplash accident - from two weeks on after that, everything seemed to start going 'downhill.' I developed chronic nerve type pain in my lower right leg and left shoulder blade. Without fail it has come on every day. I've had the whole run of MRIs, EMGs, etc. yet none of the results really pinpoint what's going on. I got on Gabapentin 300mg 2x/ day for about 3 months but felt like an utter zombie.

Symptoms related to Low T for me: extremely low libido, no morning erectors, chronic inflammation (high d-dimer blood tests yet not blood clots), loss of 'spunk' for most things in life, weight loss despite working out.

Finally, my GP decided to run some serious blood tests on me - turns on my T was very low. He sent me to a male hormone specialist who spent a ton of time with me, re-ran my numbers and these came back:

Testosterone: 364 (old blood tests of mine show levels around 510-650, those were taken about 18 months ago)
Free Testosterone (Direct): 5.0
LH: 2.2
FSH: 2.7
Prolactin: 5.2


The doctor has prescribed 25mg/ day of Clomid. Any thoughts on this? Sorry for the newbie vibe

Cataceous

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #1 on: May 26, 2017, 12:35:50 pm »
Do you have additional blood work? Usually it's good to look at thyroid numbers, SHBG, etc. Here's one of PeakT's articles on the subject: http://www.peaktestosterone.com/Testosterone_Tests.aspx

I'll give my usual thoughts on starting Clomid: 25 mg per day is about the most guys should be taking for this. Starting with this much is opposite the philosophy of low-and-slow espoused by Dr. Crisler and others. This approach is about starting with a very low dose and only increasing gradually if needed. The idea is to find the lowest effective dose. Various guys on here have found doses as low as 12.5 mg three times a week to work. A lower dose reduces the risk of side effects. Because Clomid has an estrogenic isomer with a long half life it is possible to get some unpleasant side effects that take a while to go away. Visual side effects can also occur, and are grounds for stopping immediately. Higher doses of Clomid may also result in lower levels of testosterone than lower doses, odd though that seems.
« Last Edit: May 26, 2017, 06:09:01 pm by Cataceous »
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 56, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 250 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #1 on: May 26, 2017, 12:35:50 pm »

Boxcar

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #2 on: May 26, 2017, 01:13:31 pm »
Ditto what Cataceous said.  I will also add that testosterone may help with nerve pain. That has been my experience, albeit with a very different type of nerve pain. This is really an under-explored treatment for pain (The only study using testosterone as a standalone treatment is actually for postmenopausal women  with fibromyalgia.).

Also, many of the antidepressants that boost norepinephrin have been found to work for nerve pain. I have had good results with low dose amitriptyline  (50 mg per day). It is one of the older drugs that is used for this, but it is the standard-setting treatment (I actually have zero side effects with it, unlike gabapentin, Lyrica and newer antidepressants like Effexor).
Age: 36
178 lbs 5'8''

Current Treatment: 50 mg testosterone cypionate IM, twice a week
Low T Symptoms: Chronic pelvic pain, and other neuropathic pain.  Mild anxiety, low energy and low motivation
Meds: Amitriptyline (for pain, not depression), Clonidine (for sleep, not blood pressure)

hockey21

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #3 on: May 27, 2017, 07:04:11 pm »
Wow, Both - thank you. I have some more feedback:

Blood - Metabolic/ Lipid :
Glucose: 94
A/g Ratio: 2.5 ("High")
Cholesterol: 204
HDL: 94
LDl: 99

Blood - Testosterone/ Thyroid:
SHBG: 66.6
Estradiol: Lower than 6
TSH: 3.02
T4: 1.1
TPO: 14


Nerve pain:
I am going to follow up on low dose, amitriptyline . Thank you!

Stats about me:
5' 10
144 lbs (I used to be 160 lbs prior to accident/ nerve pain/ dropping T levels)

Diet:
Gluten- free/ dairy-free, admittedly too low of a carb diet. Any thoughts on this?

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #3 on: May 27, 2017, 07:04:11 pm »


Boxcar

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #4 on: May 27, 2017, 09:23:48 pm »
Wow, Both - thank you. I have some more feedback:

Blood - Metabolic/ Lipid :
Glucose: 94
A/g Ratio: 2.5 ("High")
Cholesterol: 204
HDL: 94
LDl: 99

Blood - Testosterone/ Thyroid:
SHBG: 66.6
Estradiol: Lower than 6
TSH: 3.02
T4: 1.1
TPO: 14


Nerve pain:
I am going to follow up on low dose, amitriptyline . Thank you!

Stats about me:
5' 10
144 lbs (I used to be 160 lbs prior to accident/ nerve pain/ dropping T levels)

Diet:
Gluten- free/ dairy-free, admittedly too low of a carb diet. Any thoughts on this?

Good luck with the amitriptyline. A couple of things:

-Many people do have side effects. Sleepiness is the most common (so it is generally taken at night). There are many similar drugs, if the amitriptyline does not quite agree with you.

-The pain killing effect takes time. At first, I thought I had just improved on my own. It took stopping the drug several times, before I concluded that it was a really strong painkiller (even if you do not feel it like Advil or Vicodin).
Age: 36
178 lbs 5'8''

Current Treatment: 50 mg testosterone cypionate IM, twice a week
Low T Symptoms: Chronic pelvic pain, and other neuropathic pain.  Mild anxiety, low energy and low motivation
Meds: Amitriptyline (for pain, not depression), Clonidine (for sleep, not blood pressure)

ghce

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #5 on: May 27, 2017, 10:32:37 pm »
Wow, Both - thank you. I have some more feedback:

Blood - Metabolic/ Lipid :
Glucose: 94
A/g Ratio: 2.5 ("High")
Cholesterol: 204
HDL: 94
LDl: 99

Blood - Testosterone/ Thyroid:
SHBG: 66.6
Estradiol: Lower than 6
TSH: 3.02
T4: 1.1
TPO: 14


Nerve pain:
I am going to follow up on low dose, amitriptyline . Thank you!

Stats about me:
5' 10
144 lbs (I used to be 160 lbs prior to accident/ nerve pain/ dropping T levels)

Diet:
Gluten- free/ dairy-free, admittedly too low of a carb diet. Any thoughts on this?

That Estradiol is very worrying, with levels that low you are likely to experience bone loss and I would expect a lot of joint pain, perhaps your nerve pain is actually a symptom of the low Estradiol.

Clomid would be I suspect your friend as it raises both T and Estradiol.

Low Estradiol will also very badly effect your libido and all things sexual.
Were it me I would be starting a clomid based protocol.
Age:56, Height 6' 3" weight 92.5KG
2014 Androderm Patches
2014-2016 Andriol 160mg
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 

Reference Range Adult males  1000-6000 pmol/L

hockey21

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #6 on: May 27, 2017, 10:50:55 pm »
Thank you for the continued responses. You're right about the low Estradiol (being that it could be causing the nerve pain or at least the nerve that is NOT healing)

To be extremely thorough (and sorry if I am deviating a bit), here a few levels from a test I had during a route physical in December of 2015 (as a reminder, my issues began in late May of 2016)

TSH - 2.13
SHBG - 30.3
Testosterone - 642
Free Testosterone, Index - 73.5

And from my physical in November of 2016 (so, post accident, nerve pain had been ongoing for around 5 months at this point)
TSH - 2.76
Tesosterone, total - 500
D-Dimer (inflammation) .52


It sounds like Clomid 25mg a day may help. I have been keeping a pain journal this whole time so when should I maybe be looking for improvements on this protocol? Random question but do you recommend any type of nutrition/ supplementation during Clomid?

I am so grateful I found this forum.

ghce

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #7 on: May 27, 2017, 11:02:42 pm »
25mg a day is quite a strong starting dose, many people including myself found 12.5 eod (every other day) to be more than enough though in your case  Estradiol is pretty low.

My basic daily supplementation is Vit B complex (50 or 100mg) Vit D 5,000 iu magnesium 500mg and Zinc 15 mg (elemental value) and 1000mg calcium. You will find many other taking a similar basic regime, there are quite a few added wrinkles to it that may be added but with this I feel quite good.
Age:56, Height 6' 3" weight 92.5KG
2014 Androderm Patches
2014-2016 Andriol 160mg
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 

Reference Range Adult males  1000-6000 pmol/L

Cataceous

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #8 on: May 28, 2017, 06:00:12 am »
If it's accurate, that SHBG measurement of 66.6 nmol/L is troubling; it will greatly suppress your free testosterone. You should read PeakT's article on high SHBG. The fact that you had a previous value less than half that suggests a retest might be desirable.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 56, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 250 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

hockey21

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #9 on: May 28, 2017, 07:52:24 am »
I'll have my estradiol retested and make sure to post the numbers ASAP.

Vitamin B supplementation is something I also have - I receive an injection once a month to being borderline anemic. See my numbers below BEFORE I began injections. It's interesting how much of this seems to stem from these low numbers (like T, etc)

Iron, TIBC - 255
UIBC - 153
Serum - 102
Saturation - 40
Vitamin B12 - 351
Ferritin - 155

If anyone is interested, I keep all my health records digitally and can always share them confidentially (I read the rules on that before)


**I I forgot to mention to those answering me - my nerve pain is unilateral (left side up top), right side (on bottom). Can that be from estradiol being so low or does the fact it is unilateral mean it's more of a injury from the accident (I take full understanding here that no one is examining me here in person and it's infinitely more hard). Just more curious about low T/ nerve healing taking longer, exacerbating nerve pain, etc.

Boxcar

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #10 on: May 28, 2017, 01:13:59 pm »
I'll have my estradiol retested and make sure to post the numbers ASAP.

Vitamin B supplementation is something I also have - I receive an injection once a month to being borderline anemic. See my numbers below BEFORE I began injections. It's interesting how much of this seems to stem from these low numbers (like T, etc)

Iron, TIBC - 255
UIBC - 153
Serum - 102
Saturation - 40
Vitamin B12 - 351
Ferritin - 155

If anyone is interested, I keep all my health records digitally and can always share them confidentially (I read the rules on that before)


**I I forgot to mention to those answering me - my nerve pain is unilateral (left side up top), right side (on bottom). Can that be from estradiol being so low or does the fact it is unilateral mean it's more of a injury from the accident (I take full understanding here that no one is examining me here in person and it's infinitely more hard). Just more curious about low T/ nerve healing taking longer, exacerbating nerve pain, etc.

Testosterone raises your pain threshold by increasing endorphins.  The theory is that this happens through aromatization of testosterone into estradiol in the CNS. Estradiol production is part of this, but having enough testosterone is more important  (and is thought to be why women have much higher levels of certain types of neuropathic pain, such as fibromyalgia).

To answer your question on nutrition, did anything change after your accident?  That is where I would start. If you are getting out less, low vitamin D has been found to lower testosterone. Not getting enough calories or sleep (potential issues, with chronic pain) are big issues also. It is also importent to get enough carbs, fats (especially saturated and monounsaturated) and zinc. Before I went on TRT, I found d that extra virgin olive oil raised my testosterone, so that was probably the monounsaturated fat. All of this stuff will continue to be important, while you are on clomid, since hour body is still making its own testosterone.

How long have you been taking Clomid now?
Age: 36
178 lbs 5'8''

Current Treatment: 50 mg testosterone cypionate IM, twice a week
Low T Symptoms: Chronic pelvic pain, and other neuropathic pain.  Mild anxiety, low energy and low motivation
Meds: Amitriptyline (for pain, not depression), Clonidine (for sleep, not blood pressure)

Boxcar

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #11 on: May 28, 2017, 01:51:29 pm »
Wow, Both - thank you. I have some more feedback:

Blood - Metabolic/ Lipid :
Glucose: 94
A/g Ratio: 2.5 ("High")
Cholesterol: 204
HDL: 94
LDl: 99

Blood - Testosterone/ Thyroid:
SHBG: 66.6
Estradiol: Lower than 6
TSH: 3.02
T4: 1.1
TPO: 14


Nerve pain:
I am going to follow up on low dose, amitriptyline . Thank you!

Stats about me:
5' 10
144 lbs (I used to be 160 lbs prior to accident/ nerve pain/ dropping T levels)

Diet:
Gluten- free/ dairy-free, admittedly too low of a carb diet. Any thoughts on this?

It looks like reduced calorie and carb intake could help explain your drop in testosterone. Significant caloric deficits are especially well documented for lowering testosterone. A recent weight loss study on 20-30 year old men, showed that the average testosterone level was miserably low (around 200, as I recall), at the end of the study. So even just this one thing could account to for your drop in testosterone.

On the flip side, accumulating body fat will also lower testosterone (and be much more difficult to reverse).

How is your sleep? I know that can also be a struggle, with chronic pain., and that is another well-documented testosterone-killer.
Age: 36
178 lbs 5'8''

Current Treatment: 50 mg testosterone cypionate IM, twice a week
Low T Symptoms: Chronic pelvic pain, and other neuropathic pain.  Mild anxiety, low energy and low motivation
Meds: Amitriptyline (for pain, not depression), Clonidine (for sleep, not blood pressure)

hockey21

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #12 on: May 28, 2017, 03:50:39 pm »
Some answers to questions you all posed (and I am loving all this feedback)

Sleep: I sleep very well, on average 7-8 hours a night. I recently started adding magnesium in to my supplementation to help keep me asleep.

Diet: I think I have cut back on carbs too much. I am now adding them back in and not just in the form of sugar.

After my accident I would just say was a cascading amount of random injuries (nerve pain in leg & foot and then the left medial shoulder blade pain that has persisted around 12 months). Since I had those injuries and lifting exacerbates it (which I was doing a ton before the accident) I went to more intense interval training.

At times the nerve pain seems largely linked to items I eat (high fat meals).

I just got the Zinc supplementation that PT website recommended (the Zinc challenge one)

Oddly (or not so much it seems), on days where I do have libido, my pain is much lower.

Also, I start Clomid this week: my prescription will be available on Tuesday!

hockey21

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #13 on: May 29, 2017, 07:10:04 pm »
Any final feedback?

Thanks again and Happy Memorial Day to everyone

ghce

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Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #14 on: May 29, 2017, 07:44:30 pm »
Give it a couple of weeks and report back here.
Age:56, Height 6' 3" weight 92.5KG
2014 Androderm Patches
2014-2016 Andriol 160mg
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 

Reference Range Adult males  1000-6000 pmol/L

Peak Testosterone Forum

Re: 31, Low Free T Since Accident, Starting Clomid 25mg
« Reply #14 on: May 29, 2017, 07:44:30 pm »