Clomid trial and other options??

[Complete novice]

Advice please??

Been on clomid, 50mg a day for three weeks now, but feel no different, just wondering if I should feel any different by now?

Had a group of blood tests before I started (which are getting posted to me) testosterone was 6.8. will post rest of results when I receive them.

I would really like to get to the bottom of my cause of low testosterone, but after having several different blood tests and clear MRI scan my endo has given me the option of either a low dose of testosterone, clomid or he will sign me off, any mention of HCG is not permitted.

I feel like i am at a stalemate and not sure which way to turn, so I have been taking the clomid on a trial basis but with no effect.

[jimmyinkedup]

You are really going to have to base your decisions off of blood work. Like what it was pre treatment, which it is while taking the clomid, etc. So you are saying you see no improvement in your quality of life at all yet? Depending on the cause or type of hypogonadism clomid therapy may not work for you and injections may be your answer.

[kelkel]

What were your pre-clomid LH and FSH values?
By chance your not primary hypogonadal are you?
Clomid is proven effective, but like any med it's not for everyone.
Pull some quick BW to see what's actually happening. It takes time to actually feel better. A few weeks is not much time really.

[Complete novice]

Thanks for the replys, i had a full blood count done a week before I started and am waiting on the results still, but will post them when I get them, I was thinking of having another basic blood test done at 4 weeks just to see where I'm at if any different!

I feel no different at all, just get dehydrated quicker and kinda feel like my eye sight is getting worse.

I'm not sure what my actual diagnosis is the doctor hasnt told me much, just that I've got low testosterone. I have developed high blood pressure recently and was also tested for my cholesterol which is high.

for that reason and to maintain a high sperm count, I have only been offered low doses of testosterone.

[Complete novice]

Got the letter from the doctors today, these are my pre clomid bloods, I will try and get another blood test next week to see how things are, but still no drive, no morning wood or any other time.

Bloods: (the letter has no ranges)

Testosterone: 8.0
SHBG: 18
Free testosterone: 211 pmol/L
Hba1c: 5.4%
Prolactin: 115
Tsh: 0.84
Free t4: 11.6
FSH: 6.5
LH: 2.2
Growth hormoans: <0.002
Igf1: 24.6

I don't have a clue what any of that means but hopefully will give an indication of my problems

[kelkel]

Put some ranges next to those numbers please.

[Complete novice]

Hi i`ve been searching the net for 3 hours now and am an ipad screen down as i threw the f`ing thing across the room. any ideas where i can find the ranges?

[Complete novice]

Testosterone: 8.0 (8.6–32 nmol/L)
SHBG: 18 (10-57 nmol/L)
Free testosterone: 211 pmol/L (174–729 pmol/L)
Hba1c: 5.4% (3.5–5.5mmol/l* before meals)
Prolactin: 115 (< 15 ng/mL)
Tsh: 0.84 (0.5 and 4.0 mIU/L)
Free t4: 11.6 (10-24)
FSH: 6.5 (1.5 - 12.4 mIU/ml)
LH: 2.2 (1.8 to 8.6 IU/L)
Growth hormone: <0.002 (< 5 ng/mL)
Igf1: 24.6 (69-226)

[kelkel]

Ok, these ranges correlate to your specific lab, right? As lab ranges are not all the same....

Assuming they are correct:

Your T is abysmal, both free and total
The most concerning thing to me is your prolactin level. If you are actually at 115 and the range is less than 15 all sorts of bells and whistles should be going off in your doctors head. That high a level in conjunction with low LH can be indicative of a pituitary adenoma. Which means you need to get an MRI done to rule this in or out asap.

[Complete novice]

I found an old blood test from same lab, with ranges next to them, I have had an mri which came back normal and with nothing found to be untoward.

I have had a two sperm analasys done, both results were high 240 million per ml, my doctor says everything must be working right. I just have low levels.

But surely I shouldn't feel like this.

[kelkel]

Odd. Well, many things can contribute to high prolactin like thyroid, liver issues, etc. which all can contribute to low T levels. Makes me curious what a trial run of a dopamine agonist like cabergoline would do for your symptoms. Low dose Caber would suppress your prolactin level. That said, it's still best to find the root cause and remedy it. It may take another doctor.

[Complete novice]

I have been to two different doctors here in the UK both of which know my condition needs addressing but both are only willing to give me testosterone.

Yes I am greatful that they have offered me testosterone, but I do feel like it's not a cure for the actual problem!

I do think you are on the money with the prolactin being so high, they haven't even mentioned it. All the doctors have said is my testosterone is low and I need to supplement it! I've never done a AS, haven't had any kind of testicular injury, and I have got a 9 year old. So things did work ok at one point but I seriously can't remember the last time I woke up with wood or any other time tbh, or had a drive or zest for life! Not in the last 5 years minimum anyway!

I train 4 days a week and have done over 10 years but have no definition in my body at all?

All seems odd and the only explaination I get is I'm getting old!

Sory, thanks for your advice and is there anything else I could say or suggest to the doctor? UK waiting times are a joke, 6 months between appointments! And as I don't want to have testosterone the endo I was seeing has signed me off and said he can't offer anything else.

[kelkel]

Waiting times like that would seriously piss me off. An option would be to try some liquid Prami (dopamine agonist) yourself and see what happens. Site sponsor sells it. Then if you can get BW on your own to check progress it would be awesome.

[Complete novice]

Hey Kellet, thanks again for the help, done 28 days of 50mg everyday of the clomid now and feel no different so I'm going to give them up. Rang for a blood test at my doctors but can't have one until I've seen a gp, which will be next week!

Seems like everything is against me. I do have an appointment with the urologist in the next two weeks tho, as I was referred to him regarding my inability to get wood.

Was thinking of asking him about the prolactin levels and getting his opinion and confirmation of the issue.

What do you think??

[kelkel]

Go over everything with the uro. Write down your questions so you don't forget any! As stated, if you're at 115 and the range is "less than 15" then there's an issue. Prolactin can crush libido. Definitely talk to him about it.

Are you taking any other prescription meds? BP or dopamine blockers of any type?

Clomid treatment as well as HCG mono works for some but the subjective benefits just don't seem to be the same as with T therapy.

[Complete novice]

Yeah that's what I was thinking, tbh I don't really have a good relationship with my endo at all! So will be interesting to get a different slant on the situation.

Is there anything else I should ask? I will obviously mention all my problems, but anything else I should add?

I'm not on any medication and haven't had any before. Don't know if it's relavent but I don't smoke, hardly ever drink (maybe once a month if that) and haven't used any type of recreational drugs for almost 10 years, never used AS.

Probably not doing my sanity any favours but the more I research high prolactin, the more it points to my symptoms.

[kelkel]

Tell him just what you said in your first post, "you want to get to the bottom of the cause for your low T," not just band aid it unless absolutely necessary.

[Complete novice]

Finally seen the urologist today, talking to him compared to my endo was like night and day!

Told him my worries and he took it all on board! The prolactin range I had been given was incorrect and it is in fact fine, yet all the others are correct! He said it was the first thing he checked.

He explained the he finds it very strange why everything is low and my sperm count is so high, after a physical exam he became more confused as he stated my testes are as they should be. He honestly seamed very confused with it all.

After discussing, my issues he discussed an injection for ED but I wasn't to keen on that so we agreed I try a low dose of cialis Every day. I am having a scan to rule anything out and he is going to contact my endo and discuss my bloods in depth.

I feel it was a very positive meeting, although I'm none the wiser, I am hopefully getting a bit of help in the mean time.

[kelkel]

Sounds like a positive interaction. I prefer uro's over endo's in this field. Confusion is easy as it's not always easy to pinpoint an issue. Hopefully he digs in and investigates.
Scan? You mean MRI?
Low dose cialis is simply a great thing. I've taken it for years, 5mg twice per day. For an added benefit ask him about adding low dose Doxazosin with it at 1mg twice per day. It's a smooth muscle relaxer (penis) and will help you as well with erection quality. The injection he's referring to is Trimix. It's painless and works incredibly. Fun stuff.

[Complete novice]

Thanks again for your input

Yeah I couldn't have really been treat any better, he did make aware it isn't his area of expertise. But at the same time made it clear he wanted to help.

I think the scan is for my testes, as I do have what he describes as micro calcification which he wants to keep an eye on.

Not sure what the next step is to be honest. But hopefully he will do his best to help. I am seeing him again in 6 weeks and will ask about doxazosin when I do.

He was really trying to get me to try the penis injection, and is referring me to an ED specialist to discuss further.

Guess it's just a waiting game now to see what he comes back with.

[Joco71]

Your a good man Kelkel. Not everybody is willing to help others like that.

[bullshark99]

^^^^agree, as always, thanks for sharing your wisdom and experience Kel!

[kelkel]

Thanks again for your input

Yeah I couldn't have really been treat any better, he did make aware it isn't his area of expertise. But at the same time made it clear he wanted to help.

I think the scan is for my testes, as I do have what he describes as micro calcification which he wants to keep an eye on.

Not sure what the next step is to be honest. But hopefully he will do his best to help. I am seeing him again in 6 weeks and will ask about doxazosin when I do.

He was really trying to get me to try the penis injection, and is referring me to an ED specialist to discuss further.

Guess it's just a waiting game now to see what he comes back with.

Ok, not a varicocele but a calcification?
I would recommend you try the Trimix. It's painless as it's injected into the upper part and it works unbelievably. It can change your life if having issues there and if not, it's simply fun stuff when you really want to "have at it." I always have some on hand just for the fun of it.

And thanks guys. It is appreciated.