Pre-Comiphene Lab Results - Help!

[james2012]

I went of all T for 14 days before these labs. On Clomiphene I am noticing my testicles are growing in size and texture but these lab results are just plain weird to me. I really want to understand the Iron (near high) and Ferritin levels (high) and their impact on any chances Clomiphene will do anything to me. Here are my labs:

TSH: 1.850 uIU/mL 0.450 ? 4.500
Thyroxine (T4): 7.6 ug/dL 4.5 ? 12.0
T3 Uptake: 33 % 24 ? 39
Free Thyroxine Index: 2.5 1.2 ? 4.9
Iron Bind.Cap.(TIBC): 381 ug/dL 250 ? 450
UIBC: 235 ug/dL 150 ? 375
Iron, Serum: 146 ug/dL 40 ? 155
Iron Saturation: 38 % 15 ? 55
Testosterone, Serum: 74 ng/dL 348 ? 1197
Testost., %F+W BounL: 20.8 % 9.0 ? 46.0
Testost., F+W Bound: 15.4 ng/dL 40.0 ? 250.0
Dihydrotestosterone: 15 ng/dL Adult Male: 30 ? 85
DHEA?Sulfate: 219.3 ug/dL 44.3 ? 331.0
DHEA, Serum: 188 ng/dL 31 ? 701
LH: 3.4 mIU/mL 1.7 ? 8.6
FSH: 5.3 mIU/mL 1.5 ? 12.4
Insulin?Like GF I: 90 ng/mL 64 ? 210
Calcitriol(1,25 di?OH Vit D): 99.3 pg/mL 10.0 ? 75.0
Vitamin D, 25?Hydroxy: 65.5 ng/mL 30.0 ? 100.0
Estradiol, Sensitive: 5 pg/mL 3 ? 70
Free Testosterone(Direct): 2.5 pg/mL 6.8 ? 21.5 02
Estrone, Serum: 40 pg/mL 12 ? 72
Ferritin, Serum: 532 ng/mL 30 ? 400
Sex Horm Binding Glob, Serum: 21.0 nmol/L 16.5 ? 55.9

I'm worried here!

 

[Donzi]

how long were u on Clomid when these were pulled.

 

[Michael Scally MD]

What do you mean by the following?

I went of all T for 14 days before these labs.

 

[james2012]

I stopped testim for 14 days in preparation for 25mg clomid daily for 10 days to be droppped to 12.5 EOD depending on results. This was all done prior to clomid therapy starting and after cessation of all Testim.

 

[Michael Scally MD]

I stopped testim for 14 days in preparation for 25mg clomid daily for 10 days to be droppped to 12.5 EOD depending on results. This was all done prior to clomid therapy starting and after cessation of all Testim.

A SERM challenge at this point is backwards. Start with a hCG challenge. Also, what are the baseline labs that ruled in hypogonadism. How long where you on TRT before stopping?

 

[Donzi]

I stopped testim for 14 days in preparation for 25mg clomid daily for 10 days to be droppped to 12.5 EOD depending on results. This was all done prior to clomid therapy starting and after cessation of all Testim.

idk
why these dr say start 25.
clomid for pct start high - low. ie / 100. 75. 50. then ur 25. had u done this u never would of felt the need to write this.

 

[james2012]

A SERM challenge at this point is backwards. Start with a hCG challenge. Also, what are the baseline labs that ruled in hypogonadism. How long where you on TRT before stopping?

Dr. Scally, you and I worked years ago in the past on this. I have done HCG within the past year and got a big boost in T levels (and E2!). I have been on T therapy for 15 years so this is going to take a loooong time to come back. I am attempting the Clomid T replacement with option to see if a restart is possible. 25mg/day is in a great deal of literature (some go as high as 50) with a backoff to sustaining doses of 25mg (or 12.5mg) EOD. This keeps T around 500 (in one study I recall) and 650 in another (I think the patient population was about 50). Backing down to 12.5mg EOD then stops the issue with desensitization and allows T levels to continue to increase and then plateau. I don't recall how long the plateau was held before an attempt was made to back down on the dose, but many patients who were idiopathic had a successful restart. When I did the restart with you many years back that was in the day when large dose HCG, along with Tamoxifen and large dose Clomid (I recall the tracers!) at 150mg/day. My levels went up to 550 then plummeted after. A number of docs have told me that the reason is that I did not have the building blocks to maintain T levels (whatever that means). They did check my iron to make sure that I was not so high I was damaging the boys.

I also have to admit that I am a chronic coffee drinker and water avoider (my mouth is always dry). I was also on three months of doxycycline prior to the above labs (for acne). The acne appeared to be T related, but when I switched to Axiron and my levels dropped the acne stayed. When I went back on Testim it stayed (levels increased from 400mg/dl to 600mg/dl when I did the switch). When I stopped all T the acne also stayed so DHT levels (which went from above normal to high to very, very low) have nothing to do with the acne. The thinking now is systemic inflammation. I need to check my hsCRP. The doxy could be the culprit for some of the numbers I am seeing as far as ferritin. The 1,25 D is due to chronic inflammation or doxy as before the doxy it was 1:1 with D25 at around 70.

Clomid is working. Testes in five days have went from raisins (felt like lumps of collagen) to about twice the size of an almond and are much harder. After 10 days I will get tested again.

I think I am on the right track, and I feel better about the numbers. I'll know more and post back when my new results come in. I also have erections and libido again so there is definitely something going on and it is not placebo as I was under the impression Clomid killed libido and expected to have experience. Perhaps it is the low dose.

I am hearing long term low dose for T therapy with possibility of full recovery as long as dose is kept low. Is this not the current thinking?

 

[Michael Scally MD]

https://thinksteroids.com/community/threads/134313294

 

[toolman]

idk
why these dr say start 25.
clomid for pct start high - low. ie / 100. 75. 50. then ur 25. had u done this u never would of felt the need to write this.

THey say it because it works Donzi. THe frontloading you mentio is what all the AAS sights say to use. I was on 25mgs EOD and within a couple weeks the balls were cranking. More is quite often not better.

 

[toolman]

How is your libido on it? It killed mine.

 

[james2012]

How is your libido on it? It killed mine.

Bad at first, but after four days it is back. Should see improvement when I go to 12.5mg EOD if 25mg is working. It is now looking like high Ferritin is due to chronic inflammation due to illness or 3 months of doxy use. Should see that come down. Right now I am backing off of liver tabs and red meat and drinking lots of water and taking a very powerful probiotic from innate response (powerful stuff!). Feeling better every day but last night I suddenly became very tired around 9:00pm and had to go to bed. That is a first since starting four days ago, but as the body is coming into a new homeostatic state who knows what the heck is going on with all the other systems.

The low IGF-1 is from my very low T. While on Testim I was in the 50-75 percentile range. The 1,25 D is high also due to inflammation and/or doxy use. Stopping D until that number drops and getting my inflammation markers measured. I know that statins work because they lower hsCRP, not because they lower cholesterol. My cardiologist told me that and there is a paradigm shift coming. People with normal cholesterol have heart attacks with low or normal cholesterol. It's all about the inflammation. I quit taking statins (still on Tricor for triglycerides) because my LDLs lowered below my HDLs and that is dangerous if left for extended periods of time. However, if my hsCRP is high I may go back on the statin drug to lower it unless there is a natural way to do it. I know vitamin D can help, but too much can also lead to a pro-inflammatory situation. I have advanced heart disease and right when the cardiologists figured out having vitamin D25 around 70 was good, they also figured out that in some patients it was bad - it depends on the ratio of D 1,25 to D25. So depending on the patient high dose Vitamin D can help a great deal or it can hurt you.

My libido coming back may reverse itself. I recall going on the shots and getting serous wood and libido and then 1 month later just dropping off. So if I started at 70 and am picking up again it could be a dopergenic response which will die off while at the same time my E2 and Estrone will tick up. That may kill my libido. Right now I am enjoying the feeling.

Do you do cardio?