5 week Clomid Results with Initial Primary Hypogonadism Diagnosis

[kramesh]

Hello Forum! I have been perusing for the last few weeks.

I hope some of you may be able to help me with my situation.

I am in my early 30s - pretty healthy (slightly overweight) - 6'1" 220 pounds. (20-25 pounds overweight)

In Feb 2015 - I went to the urologist to get my ED situation checked. He checked my testosterone levels - and I had results of 224ng/dL (range 348-1197) [LOW]

I went back a week later to have them rechecked - tests were
Total T = 164ng/dL;
FSH = 19.2 (HIGH);
LH - 6.0 (Higher end)
Prolactin = 13.2 (Higher End)

He said I likely have Primary Hypogonadism and before putting me on testosterone replacement , we can check if Clomid works... chances are it will not. Lets.

5 weeks later at 25mg ED Clomid

Testosterone = 466 ng/dL (Range 348-1197)
Free Testosterone = 12.9 (Range 8.7-25.1)
SHBG = 21.8nmol (Range 16.5-55.9)
Prolactin = 6.7 (Range 4.0 - 15.2)
LH = 13.4 [HIGH] (Range 1.7 - 8.6)
FSH = 31.0 [HIGH] (Range 1.5 - 12.4)
Cortisol = 29.6 (HIGH) (Range 2.3 - 19.4)
ACTH, Plasma = 22.6pg/mL (Range 7.2 - 63.3)
TSH = 2.56 (0.45 - 4.5)

So my testosterone is up by almost 300 points.. but so is my FSH and LH. If I had primary hypogonadism - then Clomid should not work... however, it seems to be working, albeit not as effectively as others (as I have on the forum).

Most of the people seem to have Low LH and Low FSH - secondary...

Any theories as to what is going on?

Any help?

[solesrch]

Not sure what is going on, but welcome to the forum. I am sure you will find some answers here.

[kramesh]

thank you solesrch!

Would appreciate anyones help.

Other stuff -

1) I do have Low Vitamin D - my levels are pretty low - I am now taking 50,000 IU Vitamin D once a week

2) I have never calculated by Body Fat Percentage - but I am ~20 pounds overweight with a BMI of 28.6.

3) I also snore a lot - so I have enrolled in an overnight sleep study to check for Apnea. Will know more about this next week


Does this help with any answers?

[kelkel]

Welcome Kramesh. I'll get this moved to the HRT Forum for comments. This is just for intro's.

[FakeLove]

How do you feel on that level? What did the doc say?

The results mean that it's the maximum level your testicles are able to produce T when fully stimulated. That's not so much to be honest and from my point of view (just another primary patient, not a doc) it could indicate a primary hypogonadism. Many secondaries that do the clomid trial get almost double the amount of T in comparison to you while on it.

I'm a primary case too with naturally high (top end of the range) LH. I got pretty much the same maximum level with clomid / nolva trial that you did. On that level I still had the symptoms of low T that now have fully disappeared while on T replacement and when staying in between 1100 ng/dL to 650 ng/dL.

While this said, there's still some variables that needs to be taken into account. Your baseline Cortisol apparently was not known? When it's high it can lower the T figures of yours. I'm not sure if there's clinical studies available how much it decreases T, but it's well known that it does that. So it could very well be that by bringing Cortisol in range it could improve the T figures. How significant the effect would be? Hard to tell.

Also good to see that your prolactin came down too. High prolactin also decreases T.

[kelkel]

Did your doc examine your testicals for a possible varicocele? If not, I'd ask him about possibly getting an ultrasound done.