Restart Update: Low Dose Clomid

[Xerxes]

Oh man, what a crazy few days. As you know I had been doing very well on the Clomid for the past month or two. Dr. Saya and I had our consult and decided with the positive subjective symptom relief to stay the course and get new bloods in 3 months.

Well, last week I started to lose some vigor and energy, which I thought was just the onset of a cold, and then as the week went on I progressively down and lethargic, and my libido plummeted to nil.

Then this weekend I had several bouts of crying and feel kind of depressed. Had to take Klonopin for the first time in a month and have has to take it daily last 4-5 days or so.

Luckily I had a pre-scheduled urology appointment on Friday and he drew blood) (in addition to writing my scripts for clomid and cialis). I was feeling "okay" on Friday when I saw him, but over the weekend WOW! did I take a turn for the worse.

I should have the blood work today and I will share to see what you guys think. (he pulled Total T, free T, SHBG, sensitive E2, LH and FSH)

Could be estrogen issues?

My wife and I are also considering maybe having me try SSRI again to see if that can help.

I don't want to abandon the Clomid if it's getting my natural production going. I just want to manage the side effects and maybe titrate down if the dose I am on is causing these intense emotional sides.

I wish I could bottle how I felt 2-3 weeks ago and live that way forever.

My wife and I certainly do not want me to go back on traditional TRT, though.....

We think this issues are mental health related and hopefully with natural productions back I can use SSRIs and therapy to help.

Thanks for letting me rant and ramble. I need the outlet.

 

[ERO]

With Clomid, it could easily be elevated E2. Hope your Urologist did the sensitive E2 test for you.

 

[Xerxes]

He did pull the sensitive E2 along with some other things I asked for (I updated previous post.) I'll share when I get them. Do guys use arimidex while on Clomid if they had been feeling well and E2 wrecks it? Hopefully I can make it through the three months Dr. Saya and I agreed to do with the 12.5mg. day Clomid....And if we have to manage E2 with more than DIM and Calcium D-Glucarate, I'm okay with that...

 

[ERO]

Yes, one can use an AI (other than DIM) while on Clomid if needed.

 

[CoastWatcher]

I'm sorry you encountered this disruption in your journe. Hold tight, this doesn't mean things are falling apart (even if they feel like they might be). Did you alert Dr. Saya to the problem?

 

[Xerxes]

Thanks for the support. I just heard from my uro and the blood work won't be back for another day or so, so I'll have to wait. I was going to wait to have bloodwork in hand to send to Defy, buy I think I'll alert them now anyway to keep them in the loop.

 

[Dr Justin Saya MD]

Noted Xerxes!

Be sure to forward my office the labs once results are in.

 

[Xerxes]

Thanks, Doc. Will do...I'm very curious to see what the numbers will show.

 

[Ty1on73]

Thanks for the support. I just heard from my uro and the blood work won't be back for another day or so, so I'll have to wait. I was going to wait to have bloodwork in hand to send to Defy, buy I think I'll alert them now anyway to keep them in the loop.

Good luck on your journey and remember to stay the course. If you or others reading this use LabCorp be sure to sign up with Lab Corp Beacon and you can get past and future labs in electronic format. Generally at the same time your docs do.

https://patient.labcorp.com/public/publicweb/patienthome.aspx

 

[Xerxes]

Got blood work back just now. Really makes no sense to me. This is now after 2 months daily clomid 12.5 day and DIM and Calcium D. Glucarate

Blood from Friday May 6 2015 Blood from March 28 2015
(about 2 months into clomid) (1 month into clomid)

Total Test. 386 (range 249-836) Total Test: 324 range: 160-853 (most recent test on 1/19/16 was 547)
E2 20.6 (range 10-40) E2 (sensitive) : 14 range <40 (most recent test was 19.18 range 7.02-49)
Free T 88.31 (range 30-150) Free Test: 6.6 range 3.4-15.5 (most recent test was 108, but no range given)
LH 4.3 (range 1.7-8.6) LH: 6.5 range 1.5-9.3 (my LH before TRT in May 2015 was 2.2 range 1.7-8.6)
FSH 5.5 (range 1.5-12.4) FSH: 8.1 range 1.4-18.1 (my FSH before TRT in May 2015 was 2.6 range 1.5-12.4)
SHBG 24 (range 10-57) SHBG: 29.8 range 10-57 (most recent test was 19 on same range from 1/19/16)

So it's clearly not an estrogen issue. Test only up a bit from a month ago. SHBG down, which normally doesn't happen with Clomid, I;ve read.

It's very curious that my LH and FSH went down from a month ago. I was shut down before starting the Clomid, si I thought it was a good sign that the LH and FH had come up. Not sure what it means that they went down over the last month.

Could this mean I need a higher dose of Clomid? Or what? I am forwarding the results to Defy to see if they have any suggestions.

 

[Dr Justin Saya MD]

Yes, based on these results, especially LH/FSH, an increase in Clomid dosage would be in store given your preference against TRT.

 

[Xerxes]

Thanks, Doc. That kind of makes sense to me. I'll start doing 25mg/day until our next follow up consult/bloods in 2.5 months. My wife and I have also decided I really need to give an SSRI a try again to see if it could alleviate some of the depression, etc. Thanks for you time, expertise, and availability to your patients. You truly care and want to see your patients get better.

I sent the actual blood work to your office for my chart.

I'll report back any subjective changes as I increase the dose. I will also stay on the DIM and Calcium D-Glucarate.

 

[Dr Justin Saya MD]

Thanks for sending!

That's the plan, look forward to our next chat.

 

[Xerxes]

Excellent. Thanks again for all your help. My wife and I are incredibly impressed with your level of care, sympathy, and attention. Thank you!

 

[Xerxes]

Just a quick question: Can Clomid cause depression even without elevated E2 levels?

Have a appt with psych next week b/c my wife and I feel an SSRI or another med (again!) might help with this.

Normally I suffer from anxiety, but not really depression. The anxiety has actually not been bad, but the depression is pretty rough.

Been on 25mg up from 12.5 mg/day for a few days now. Not much change either way.

Very little energy to go to gym.

 

[skycop00]

I'm 5 weeks into my restart. Dr Crisler has me on 12.5mg Clomid and I added in 5mg DHEA and 3mg Pregnenolone. I have been in clomid 3 weeks with Defy and w weeks on my own for a total of 5 weeks. All was well until about a week ago. The last few days have been aweful. Tired, some cramping in my neck and posterior chain, just aweful. I took 0.75mg arimidex and that did help slightly, nothing dramatic. I had to experience ot for myself....and it's not been fun....lol

 

[Dr Justin Saya MD]

Just a quick question: Can Clomid cause depression even without elevated E2 levels?

Have a appt with psych next week b/c my wife and I feel an SSRI or another med (again!) might help with this.

Normally I suffer from anxiety, but not really depression. The anxiety has actually not been bad, but the depression is pretty rough.

Been on 25mg up from 12.5 mg/day for a few days now. Not much change either way.

Very little energy to go to gym.

Your testosterone level still being in the 300's is far more likely as a culprit for depression than any Clomid effect. With THAT said, there are many possible causes of depression that fall far outside of even hormonal influence.

If the trial of higher dose Clomid doesn't achieve adequate T levels (with adequate LH), then despite both of our best efforts you may end up being stuck with TRT (or nothing) as the only option. A little more time will tell.

 

[Dr Justin Saya MD]

some cramping in my neck and posterior chain, just aweful

Skycop - that is most certainly NOT from the Clomid. Something else is going on there.

Also, taking 0.75mg of anastrozole (blindly) in a single dose will likely only cause more issues unless you had labs checked prior showing a VERY high E2 reading.

 

[skycop00]

Not sure Doc, going for labs at 1230.

 

[skycop00]

Cramps almost gone..half life of arimidex?

Took 2g Taurine and cramps almost gone, much improved. Now to figure half life of arimidex 0.75mg that I took Wed night to reconcile labs today.