Low T, Clomid works wonders but won't reset permanently

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jackjam2

New Member
This is my first post on ExcelMale and I'm hoping I've finally found the best resource.

My basic problem: I'm 25 and have low T < 250 ng/dl. Clomid works wonders as my T will soar to over 1,000 ng/dl with a 25 mg per dose. However, when my levels have spiked, I've had prostate issues and after waining off clomid I'm back in the same situation.

For the details: I've always been very skinny, had very little muscle mass, and limited facial/body hair. I turned 21 in 2010 and began to party a lot harder since I was of age and in college. My diet changed but I was still 5'11" / 160 lbs and somewhat in shape. In October 2011, I was enjoying life and wanted to start working out for the first time in 3-4 years. A friend of mine who was into body building suggested I take creatine and a supplement he took that he said would increase recovery and endurance. I look the "supplement" for almost 10 months. While I didn't realize it at the time, this must have been some sort of oral steroid. My muscle mass exploded, I was sleeping better, I had more energy, and my confidence soared. Life was great. However, after about a month I noticed that my libido was decreasing, my skin was a lot drier, and my acne cleared up. About 8 months in, or June of 2012, I noticed that shortly after taking the "supplement" I would feel my prostate area and would experience a pain in my urethra. I kept taking the "supplement" for a couple more months in lower doses. By September of 2012, I had quit taking the "supplement" as I had graduated college and joined the working world. I put on a substantial amount of weight from June-October 2012 and weighed almost 200 lbs. At the time, I chalked this up to a more sedentary lifestyle and being able to afford more of the high quality beers. That same September, I experienced a case of acute prostatis. I had the same pains as before in my prostate / uretha, however they were 10 times worse. I finally went to a urologist and they prescribed an anti-inflammatory and instructed me to cut out alcohol for a while. I obliged and my symptoms went away. During my follow up visit my doctor ran a few tests and we were alerted as my PSA levels were so high (14) and my testosterone levels were low (180 ng/dl). My PSA levels eventually subsided when the prostatis symptoms disappeared. The doctor prescribed clomid and my levels soared to over 1000 ng/dl. My confidence, muscle mass, and quality of sleeping were back. However, my libido never returned. For the next 2 years I worked with the doctor to vary my clomid does to a point where I was getting the benefits of the increased testosterone. This was largely offset by the back and forth battle with an irritable prostate. In July of 2014, I had a varicocelectomy as my doctor had indicated I had a significant varicocele and this may help blood flow. The varicocelectomy was successful but the vein is still there. In order to try and reduce prostate problems, I started wearing loose clothing, stopped clomid, and changed my diet. My prostate no longer bothers me on a daily basis and I have lost 20 lbs. The only problem is my testosterone has plummeted back down to the 200-300 ng/dl level. My libido is still next to 0, my muscle mass has shrunk, I am up multiple times during the night and sleep poorly, my endurance when I do feel like having sex is abysmal, and I don't remember the last time I woke up with an erection.

I've skimmed the forum pretty well and have been reading about HPTA dysfunction for a while. I've been to 2 urologist and neither will prescribe and formal TRT, primarily due to my age, and the fact that Clomid works on paper. I'm out of ideas but my quality of life is no where near the level it should be. Can someone provide any advice on how I can reset my HPTA?

Thanks,

Jay
 
Defy Medical TRT clinic doctor
You may want to try

Clomid 50mg/tamoxifen 20mg once per day x 30 days
Plus/minus DHEA based on labs
Then test: total/free testosterone, estradiol, LH/FSH 6 weeks later

If total T under 500 ng/dL --> pituitary MRI warranted to rule out pituitary lesion. If MRI positive -> treatment through endocrinologist. If MRI negative, then likely hypothalamus issue and can try HCG 350iu QOD (to test testicular response) then TRT if HCG ineffective.

If total T over 500 ng/dL -> then HPTA intact, but suppressed for some reason. Mitigate potential contributing factors. Suggest HCG to augment testicular T production at 350 UI every other day. May continue clomid 50mg qMWF to augment gonadotropins. If still suboptimal results and total T < 500, may consider TRT.
 
Thanks for the reply Nelson. I'm having a tough time finding a doctor that will prescribe tamoxifen. I recently went to a different Endo and they ran a full hormone profile. The Endo wants to watch me for 3 months with no clomid, etc. This is certainly frustrating to me as I've been waiting 2 years. The full hormone profile is below. Should I be worried about the high AST levels. Could this be a side of the clomid?

Updated Panel:
Total T: 368 ng/dl - Range: 348-1197 ng/dl
Free T: 8.7 pg/ml - Range: 9.3 - 26.5 pg/ml
SHBG: 34 nmol/L - Range: 16.5 - 55.9 pg/ml
Estradiol: 6 pg/ml - Range: 3-70 ng/ml
FSH: 3.7 mIU/ml - Range: 1.7 - 8.6 mIU/ml
LH: 4.6 MIU/ml - Range: 1.5 - 12.4 mIU/ml
Prolactin: 7.3 ng/ml - Range: 4.0 - 15.2 ng/ml
 
jackmam2

I am sorry about your frustration. I encounter that a lot on new members here that are having access issues with TRT, HCG and PCT.

AST can increase with weight training and certain supplements. Are you taking any?

Email Jasen Bruce about their HPTA program at [email protected]
 
Beyond Testosterone Book by Nelson Vergel
Thanks Nelson! I recently found a doctor to prescribe HCG. No luck with Tamoxifen. The doc wants to run HCG w/ Clomid for 6 weeks and monitor. Do you think the clomid is necessary? I've been worried that the clomid might desensitize the pituitary (i've always been very sensitive to stimulants and medication).
Thanks!
 
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