Testosterone only 400 after 4 weeks of Nolvadex!!

[endo518]

Hi guys, I want to make this short so basically I feel that my levels were pretty much low my whole life. I have never had a "good" sex drive and have ALWAYS had very weak erections. I am 20 years and my total testosterone was 119 like 5 or 6 weeks ago. My doc is basically a body-builder and he knows a ton of literature that gets thrown around on this site. He has said to me that at 20 years old, my testosterone should be in the 800-1000 range. Basically our plan was to try 20mg of Nolvadex everyday for 4 weeks, then get retested and see where my levels were. If they were still low he said he would put me on hormone replacement therapy with ai if needed and definitely HCG to keep me fertile. Well 4 weeks go by, the nolvadex has done nothing for my sex drive, if anything it made it worse. So I get retested 1 week after I ended it, and my levels just came back at 400. The nurse called to tell me this and said everything was okay and I could make another appointment at my digression. Well now I left wondering if I should? I do not want to waste my time with him back tracking and saying "well, you ARE in the normal range, there's really nothing I can do". I basically just want to clarify with you guys, that I should definitely make an appointment and try to get on testosterone right? I will basically be like, "well my levels were only raised by not even 300 points, what's stopping them from plummeting right back down after the nolva leaves my system? the half life is like 2 weeks you know?"

Also, MRI came back normal+have not used steroids ever.

Edit: Edit: my LH and FSH were both 1.0 when my testosterone was 119. I do not know what they were after the nolvadex yet, but I assume they were well above 1.0, which probably means I am primary?)

[endo518]

Just thought of another question: I have noticed every lab has different ranges. Would my 119 be the same on another lab with different ranges? Because I find it odd that my doctor told me I should be in the 800-1000 range yet the lab he uses for blood work has a range of (estimating from memory here) like 150-700. I know labcorp has a range from 348 - 1197 which sounds more in line with what he was talking about. Using that range, we can tell that my 400 on the nolva is just barely in range. So is that 400 which was taken from Sun Rise Medical Labs the same on Lab Corps range? I have heard that labs garner their ranges based on the average of everyone who gets blood done there. So one lab may have a bunch of old people with low testosterone skewing the ranges a bit to be lower than normal. Correct me if I'm wrong here.

[The Deadlifting Dog]

Would my 119 be the same on another lab with different ranges? ......So is that 400 which was taken from Sun Rise Medical Labs the same on Lab Corps range?

I am no expert but I have been told by others on this site that:
You would be 119 at whichever lab you get tested.
Different ranges come from different groups of people being tested and from different ways of calculating an average.

[HRTstudent]

Just thought of another question: I have noticed every lab has different ranges. Would my 119 be the same on another lab with different ranges? Because I find it odd that my doctor told me I should be in the 800-1000 range yet the lab he uses for blood work has a range of (estimating from memory here) like 150-700. I know labcorp has a range from 348 - 1197 which sounds more in line with what he was talking about. Using that range, we can tell that my 400 on the nolva is just barely in range. So is that 400 which was taken from Sun Rise Medical Labs the same on Lab Corps range? I have heard that labs garner their ranges based on the average of everyone who gets blood done there. So one lab may have a bunch of old people with low testosterone skewing the ranges a bit to be lower than normal. Correct me if I'm wrong here.

The labs all have their own way of doing things. Generally, if you're low on one you'll be low on the other, but that doesn't mean your absolute level would be the same. What if the test they use is more sensitive? What if there is more "contamination" from other substances in the body, etc etc. The key is to use what test is the best available to you and use it every time to monitor changes and relate them to your life.

Regardless, it's really not that important at this point because your T was low. At this point, whether or not you go to the doc is up to you. But a good doctor for HRT primarily focuses on YOUR quality of life. That's why all these men are going on TRT. It's not because with a T level of 200 we are doing to die in three years, but rather, our quality of life suffers. TRT is a quality of life treatment by and large.

Does your doctor care about your symptoms?

Are you willing to try clomid? What about sticking with the nolvadex for another 4 weeks? (You haven't really been on nolvadex very long, HRT takes time.)

As an aside, are you primarily going on HRT because a lack of sex drive? What brought you to the doctor in the first place?

Are you on other drugs, prescription or otherwise? Alcohol?

[AD]

if 4wks of nolva raised your test by more than 300%, i would say its almost a success. you should definitely feel the difference compared to when your test was 100+. however, it may be the nolva itself that may be causing your low libido. you could try switching to clomid and see how it goes. but try starting at a very low dose, and go a longer duration. maybe 25mg ed for 3months.

either way, whether clomid or nolva, i think the treatment is lifelong. you're right, soon as you stop, most likely your test would return to baseline.

[HRTstudent]

Id just like to mention that 25mg of clomid daily is probably closer to a higher dose than a low dose. 12.5mg ED and even EOD seems to mitigate the side effects while still providing the T boost.

[AD]

Id just like to mention that 25mg of clomid daily is probably closer to a higher dose than a low dose. 12.5mg ED and even EOD seems to mitigate the side effects while still providing the T boost.

ooops... lol

[AD]

http://www.ncbi.nlm.nih.gov/pubmed/22044663

maybe this is where i got the misconception. this study started with 25mg eod and went up to 50mg eod if the lower dose failed. in the end, 70% of the subjects managed to stay with 25mg eod and 30% needed 50mg eod.

better to start of with a lower dose.

[endo518]

Ehh, I've already run Toremifene before for 3 months 60mg ED from a research lab and it didn't do much to be honest. I didn't do labs afterwards, but I pretty much expected my levels to still be pretty low after the nolvadex run because of this. Hopefully he puts me on replacement therapy like he said he would. I've got an appointment later today, and thanks for the replies guys.

[endo518]

Okay, just got back from doctor. Here is my actually blood work after the nolvadex :

Total testosterone : 482(160-726)
IGF-1: 268(127-424)
LH: 3.1(1-8)
FSH: 6.6(1-11)

Well my numbers look good and he said to get blood work again in 2 weeks to see if they stay or go down again. I kind of got into an argument with him because he said if I'm low again we can try HCG monotherapy and that it would be better to do that instead of straight testosterone. I definitely do not want to do that and if he doesn't give me the option then I will be forced to find a new doctor. Are there any good arguments against HCG mono for life? Assuming my testosterone comes back low of course.

[HRTstudent]

Why don't you want to try HCG mono?

I think it's a reasonable thing to try if you do it right (namely avoid large shots).

Tamoxifen lowers IGF1 so, I'm not sure why you got that lab done exactly, but you could expect it to raise. Frankly, I would be more concerned with estradiol, DHEAs, and thyroid well before I was worrying about IGF1.

I'm not saying stick with this doctor, but I will say that trialing HCG monotherapy is acceptable, and it's reasonable to expect it might help you. Given your age, the doctor probably wants to see your body produce what it can.

What's your bodyfat?

Did they ever do a pituitary MRI?

Did they ever talk to you about why you, a youthful 20 year old, are running into such dramatic testosterone problems?

[M302_Imola]

Id just like to mention that 25mg of clomid daily is probably closer to a higher dose than a low dose. 12.5mg ED and even EOD seems to mitigate the side effects while still providing the T boost.

Yep, to many people overdue their clomid dosage and end up with some nasty sides. I personally wouldn't go above 50mg of pharma grade clomid, but in most cases 25mg is plenty.

OP, your doc should have started you on clomid instead of nolva. Clomid has a much better track record of raising endogenous test levels. If I were you I would ask your doc to try clomid at 25mg ed for 6 weeks and then retest. If your levels aren't raised then trt might be the only way to go.