Posted on 08-19-2012
A Testosterone Therapy Alternative for Men with Low Testosterone Levels
Whether you are a 30, 50, 80 or even 110 year old man, having low testosterone levels (hypogonadism) is neither fun nor healthy. The symptoms of low testosterone in men range from lack of energy, depressed mood, loss of vitality, muscle atrophy (sarcopenia), muscles aches, low libido, erectile dysfunction, and weight gain...to bone loss (osteopenia), osteoporosis, mild anemia, increased risk of Alzheimer's, increased risk of high-grade prostate cancer, and increased risk of death due to all causes.1
As you may know, low testosterone in men may be caused by problems in the testes (or gonads). This is called primary hypogonadism and can be brought on by the mumps, testicular trauma, or testicular cancer, etc., and can only be treated with testosterone replacement therapy. However, the more common causes of low testosterone/hypogonadism result from problems in the pituitary gland and/or hypothalamus in a man's brain. Low testosterone levels caused by such "brain problems" are collectively described as secondary hypogonadism or hypogonadotropic hypogonadism and may result from depression/anxiety, head trauma, iron overload, anabolic steroid overdosing, diabetes, sleep deprivation, or some medications.
Traditionally, if low testosterone is diagnosed, testosterone replacement therapy is prescribed, and it most commonly comes in the form of a cream, gel, pellet, patch, and by injection. And although these types of therapy are effective, some methods are better than others, and there are side-effects with all of them. For example, testicular shrinkage, gynecomastia (breast enlargement), low sperm count/sterility, and polycythemia (overproduction of red blood cells) are common side-effects of testosterone replacement therapy (for many sufferers, these side-effects are mostly treatable or considered "worth it" by the patient).
However, specifically due to the sterility side-effect, such testosterone treatments aren't a good option for men who want to have children. In these (usually young) hypogonadal men, clomiphene citrate (CC pill, or Clomid) and/or human chorionic gonadotropin (HCG) have been used (by specialists) for decades to increase testosterone production, increase sperm production, and increase fertility. Both these therapies effectively help signal the testes to produce testosterone and thereby increase testosterone levels (assuming of course the cause of the initial problem is not in the testes' ability to make testosterone). See "David" below for an oversimplified diagram of how clomiphene, HCG, and testosterone work within the hypothalamic-pituitary-testicular axis.
In a healthy male, the pituitary gland in the brain releases luteinizing hormone (LH) into the blood stream, which signals the testes to “GO” and produce testosterone. After testosterone has been produced it naturally converts to some estrogen (yes, there’s estrogen in men too) and this estrogen acts as a “STOP” signal to the pituitary to stop making LH. It is a delicate system of checks and balances which I have simplified here for our purposes.
Clomid (clomiphene citrate, or CC pill) works by blocking estrogen at the pituitary and hypothalamus. Thus, the usual estrogen message to "STOP" production of LH is essentially silenced, and therefore the pituitary makes more LH and there is an increased "GO" signal to produce testosterone in the testes. HCG works by mimicking LH, which also increases the "GO" signal to produce more testosterone in the testes. Prescribing testosterone for a man, however, does the opposite of what clomiphene and HCG do.
With traditional testosterone replacement therapy, the brain (hypothalamus and pituitary) gets the message that there is plenty of testosterone being made in the testes, so much so that it doesn't need to make anymore. Subsequently, the pituitary stops producing LH, and the natural production of testosterone (and sperm) in the testes ceases, which is why traditional testosterone replacement results in testicular shrinkage and low sperm count...a man's testosterone and sperm manufacturing plant is essentially shut off.
Clomiphene citrate (CC pill) and/or HCG do not turn off the testosterone manufacturing plant but rather turn it back on or reboot it. While some hypogonadal men require continuous use of clomiphene, for others it can be used for a 3-6 month time period and then discontinued. And, the checks and balances system is not interrupted, so there aren't the testosterone replacement side-effects which occur due to intentional or unintentional testosterone overdosing. Most interestingly, although it used to be thought that clomiphene and/or HCG only worked on young men, in the past decade or so it has been used effectively in older men too.
The 5 Main Reasons Clomiphene Citrate (CC pill, or Clomid) May be a Good Alternative to Testosterone Replacement Therapy in Men with Low Testosterone Due to Secondary Hypogonadism:
1. Clomiphene citrate (CC pill) stimulates the body's own production of testosterone
2. Clomiphene citrate (CC pill) doesn't interfere with the body's checks and balances of testosterone
3. Clomiphene citrate (CC pill) comes as a pill easily administered by mouth
4. Clomiphene citrate (CC pill) is generic and very cheap2
5. Clomiphene citrate (CC pill) has little side-effects and low risk of developing these side-effects3
The 5 Main Reasons Clomiphene Citrate (CC pill, or Clomid) is Not Usually Prescribed to Men with Low Testosterone Due to Secondary Hypogonadism:
1. Most doctors aren't aware of the efficacy and safety of clomiphene use in men
2. Most doctors think of Clomid as a "women's drug" to increase fertility
3. Clomid is FDA approved only for use in women
4. Clomid use in men is considered "off label"
5. Clomiphene citrate (CC pill) is now generic and really inexpensive so it's not advertised very much
Note: HCG is more commonly known and prescribed for secondary hypogonadism in men but it involves injection and is expensive, so if clomiphene works alone I think that is preferred.
The 4 Main Risks of Using Clomiphene Citrate (CC pill, or Clomid) in Men with Low Testosterone Due to Secondary Hypogonadism:
1. Very rarely, visual changes may occur which are reversible with discontinuation
2. In older men, there is a reported increased risk of pyospermia (a noninfectious increase in white blood cells in semen, with unseen detriment)
3. Clomiphene citrate (CC pill) is a drug which is not bioidentical. This means it's molecular structure doesn't mimic a compound naturally found in the human body. And, correspondingly, clomiphene citrate (CC pill) doesn't have a known natural function in the human body and thus may at some point manifest a currently unknown side-effect in men. This latter, however, is a theoretical risk because for more than 40 years clomiphene use in men has only shown the risks above.
4. Clomiphene may not work...especially in older men who in addition to secondary hypogonadism may also have primary hypogonadism; or in men with an unresolved chronic disease4
In conclusion, in the appropriate male patient, clomiphene citrate (CC pill, or Clomid) may be a good alternative to both short and long-term testosterone replacement therapy. Regardless, just like testosterone replacement, clomiphene citrate (CC pill) must be administered and monitored by a competent physician. If you are interested in becoming a patient, click here for more info.
I look forward to meeting you in consultation.
Dr. Shira Miller
p.s. Thank you for all your questions and comments. I apologize but I cannot give personal medical advice. The most common questions in this blog will be answered in my upcoming book. SM
What do you think of D Aspartic Acid? This study showed a one third increase in testosterone. http://www.ncbi.nlm.nih.gov/pubmed/19860889; Since it's a naturally occurring amino acid, do you think it might be safer than Clomid? Dr. Miller: thank you and yes
Shafique Ahmed said:
if work good but need more clical trial on man. I am one of the candidate...thank you so much..
Dr. Jayanta Kumar Chattopadhyay said:
Thank You So Much For Your Best Teaching & Informatics. I Would Be Pleased Enough If You Kindly Send More Information s Re. Causes of Male/Female Low Libido Within The Age Of Couple Eligibility, In their Middle Age & Before their Age Of >50yrs & It's Management Done Now-a-Days World-wide Without Any Drug Used For ED e.g.Sildenafil etc.
In September 2012, my total T level was 125, and that was while I was on T injections. In October my Dr put me on Clomid (50mg) and as of March 2013, my total T level is 831. That is a 706 point increase in 6 months. What a difference clomid has made in my life...I feel like a new man! Why do you think you see so many low T commercials on TV now days...they know low T is a problem in older men and they want to sell you their product which makes them millions and once you are on the cream or injections, they have got you and you have to keep using it just to feel normal.Find a Dr that thinks outside the box and does not care about making the drug companies richer like I did.
KINDLY LET ME KNOW THE DOSAGE. THANK YOU. Dr. Miller: I'm sorry but I cannot give personal medical advice here.
Hi If a man stops clomephene after a course of three months, will the increased testosterone stick? What are the results from study revealing ? What has been your experience? What are the possible factors that could help with sustaining the higher testosterone? Dr. Miller: It depends. Primary cause of secondary hypogonadism needs to be addressed and fixed if possible. Also, age is a factor. If a man is young, and cause of secondary hypogonadism has been treated effectively, then yes the testosterone levels may remain elevated after discontinuing clomiphene.
My husband just started a course of clomid after we found out the testosterone he was on for over 2 years made his sperm count lower to zero. His urologist put him on clomid in the hopes that it would raise his LH and FSH enough so that he will start producing again. Is there a study that shows this is actually possible? I wish we had known about all this before his endocrinologist put him on the testosterone in the first place. I am just questioning whether or not clomid works once a course of testosterone treatment has already been administered. What are the statistics that once men have been on testosterone and their count lowers to zero, that anything can be done to reverse this? He is still young, mid 20s, and he had a tumor on his pituitary removed 3 years ago that dropped all his hormones and they stopped producing naturally. He is also on prednisone, although his is on a course right now and is tapering off slowly, desmopressin, and synthroid. Dr. Miller: I'm sorry you guys are having to go through all that at such a young age. There are studies showing clomiphene citrate restarts hypothalamic-pituitary-testicular axis and restarts sperm production. Whether or not it will work on him just depends on what caused his hypogonadism (low T) in the first place, and whether that has been treated. See my article about it in the blog section.
Dr, l am grateful if practitioners like you are in our part of the world. I will not suffer like this. I pray that my problem is over.
I am a 44 year old man in Holland and have low T (250) diagnosed by a doc. I have been described clomid 25mg ed for a min of 3 months. - What dosage do you recommend? - What about the lower IGF-1 levels with clomid use? This is researched in women. - I have use letrozole before and it brought my T to 800. However I suffered pain in knees and loss of libido! Energy was great. T dropped after discontinuiing to 250 again. - What do you think of Triptorelin 100 mcg injection? Thank you very much for your response. Dr.Miller: I'm sorry but I cannot give personal medical advice here. I have not seen clomiphene cause low IGF-1 in men.
Chris P. said:
Radical prostatectomy done, now on Lupron. Doc said testosterone replacement would bring cancer back (PSA near zero for 2 years). Would I be a Clomid candidate? Dr. Miller: Chris, testosterone replacement is not absolutely contraindicated after prostate cancer. Whether or not clomiphene would work largely depends on blood work results.
Barefoot Kowboy said:
I have been taking Test years. Four years ago my wife and I wanted to have a baby and my Endo MD prescribed an injectable drug called Novarel 3x a week. I had a zero sperm count (less than 1%). After a month of shots we were pregnant! This was after my urologist told me it was impossible to bring back my sperm count due to the length of time I had been on testosterone.
Dear Doctor, I've been on testosterone injections as well as HCG injections. I've been diagnosed with hypogonadotropic hypogonadism. The testosterone injections did not work so well to elevate the T levels but the HCG injections did work well. Ive been off the HCG injections now for about 2 months and the T levels have started to drop off again. Will beginning treatment with Clomid help my situation even though I have been on the testosterone and HCG before? Many thanks for your help. Dr. Miller: Yes, Clomid can help, even in men who have used testosterone or HCG in the past. Good luck!
Ray A. said:
Dear Dr. I have done the injections and my test. will not increase higher than 165. My dr. will not put me back on because my prostate in somewhat increased and my psa is 5.25 due to risk of cancer. He took samples from my prostate and found no cancer. Will clomid get my test. by to normal.......help. Dr. Miller: Hi Ray, Yes, Clomid may increase your testosterone, it depends on other blood testing. Your would need to monitor for change in PSA. Please email me if you would like to become a patient.
I`m very interested in your product. I was a pro bodybuilder for many years and now suffer from low T. Any help will be welcomed. Dr. Miller: Hi Casey, If you are interested in becoming a patient, please email me.
Dear Dr. Miller, My T was 50.6nmol/L in 2010 and 10.9 nmol/L now , had couple of injection 2yrs ago. don't know whats the cause of low T,though have low libido.I am 47 not on any regular medication ( occasional Aspirin),can I take Clomid to raise T level and how long should I continue. please tell if any interrupted or short (on and off)course of clomid. thanks. Dr. Miller: You have to find out if low T is due to primary or secondary. I cannot give personal advice here.
I am male of 28 having primary hypogonadism & want a baby so what would you suggest please? can we take Novarel 3x ? Dr. Miller: You should see a urologist and/or fertility expert.
Chef Art said:
Hi. I am a 62 yr old male who works out with weights 3-4 times a week. Gaining strength and muscle mass is my main desire. Haven't had my testerone tested.
Like to know more about this. Thanks. Dr. Miller: Just email me!
Jay V. said:
Hi im a 29 year old male suffering from low T. I was first diagnosed by my urologist after I realised I was having getting an erection or maintaining one,My endocrinologist did a full physiological check blood tests MRI etc and concluded that I was perfectly healthy except that my T levels were in the lower ranges, avergaing 4.46 ng/ml he in fact told me that the relationship i was going through was the cause and it was all due to stress(I was in a relationship that ended badly) was nearing depression. Since then i have been very lazy and tired most days, have lost significant strength in training and still having problems having an erection(I have never had such a problem before that) It now been two years since diagnosed with low T. My question is what should be the range for a healthy male at my age and if using clomiphene could raise my test levels, and also could my erectile dysfunction be as a result of the low T that I am experiencing? I am patiently awaiting your reply,sincerely Jay. Dr. Miller: Jay, yes definitely low T can cause erectile dysfunction. Yes, clomiphene could help. I don't focus on a specific testosterone level, but in general try to be in top 30% of range of normal, or according to symptoms. Hope this helps.
CHRIS W. said:
I have been on Clomiphene Citrate for 4 weeks, and recently had my Testosterone levels checked again. They started out at 194 and with in 2 weeks of taking 25mg per day they have increased to 271. I was wanting to know when will it level off? Dr. Miller: 6-8 weeks.
Dr. Miller, I just completed a six month Androxal Trial. My test levels were below 300 ng/dl to get into the study. The last blood test I had was 895 on the drug. They did 2 more blood test over the next 2 months off the drug and they went down to 495 the 1st month and 415 at the end of the second month. I would like to continue with clomid. I had no adverse health affects from the drug. I am also on drugs for ED, Hypertension, Statin and T2D. I would like to keep my T levels over 800 ng/dl. Could you help me do that? Are you in the Tricare Prime network as a PCM? Dr. Miller: Yes, I can help, however I don't take insurance. Email me for more info.
Second, should TRT be discontinued if clomid is used to increase T levels? Dr. Miller: Generally, if it works, then yes.
Me and my partner have been trying over 3 years now, I have children from a previous relationship, I have had checks and I am fine and very fertile no problems. My partner on the other hand has no previous children, I'm pretty sure he has a low sperm count, doctors won't help us because I have children from a previous relationship. Please help us, I would be forever grateful. We are willing to try anything. Thank you. Dr. Miller: Sorry about your situation, Rochelle. I would be happy to help. Please email me through my website for more information about how to get started.
Jay V. said:
Dr Miller, do u deal with international patients? Dr. Miller: Yes, please email me.
l have been experiencing this pains in my testes over a decade now before I married. I have consulted doctors while they blamed it for wearing tight things. And I have for months now stopped wearing even pants, but to no avail. The pains is still there and I have been unable to reproduce. I was recently diagnosed that I'm having a lower sperm count. Less than seven million. Please doctor what can do. Help please. Dr. Miller: Sorry about your situation. I would need to see you in consultation to be able to help you. Please email me to schedule an appointment.
Clomid is essentially hCG. Leydig cells in the testicles will die over time. So with the use of either hCG or clomid you are not looking at long term benefits. As the leydig cells die, so does your ability to produce testosterone. This is a temporary fix at best. Dr. Miller: Clomid is nothing like hCG, however it does stimulate LH which is similar to hCG. Although it is true that Leydig cells do decline in function with the aging process, in many elderly men they function without problem. In fact, a very common cause of low testosterone in aging men is actually Secondary Hypogonadism, not primary hypogonadism, meaning that the Leydig cells which produce testosterone are functioning well. In conclusion, I would say that although HCG or Clomid treatments may be temporary, "temporary" in these situations often means 10-50 years, depending on when treatment is initiated. Not a treatment window to dismiss or belittle.
Ralph F. said:
I had a doctor in Philadelphia who prescribed Clomid and vitamin D as anti aging therapy. I have since moved to Phoenix and would like to restart the Clomid. I assume this is a prescription drug, can you recommend anyone in Phoenix who is aware of this therapy whom I could go to? Dr. Miller: Hi, Ralph, I don't know anyone in Arizona who prescribes Clomid. I do see patients from out of town if you are willing to make the trip.
Ryan S said:
Hi I am a 30 year old healthy male that as been taking testosterone injections (steroids) on and off over the last 8 years, Me and my partner have been trying for a baby for over 18 months when I got a fertility check I found out I have 0 swimmers. I have never took anything to kickstart my own test, will clomid help improve my motility??? please help Dr. Miller: Yes, it definitely could.
My husband who is 45 has had a red face for several months ago. Had low T and put on clomid. T levels increased but now face is extremely red. Does clomid cause facial redness? Dr. Miller: High testosterone levels can definitely increase red blood cells, thicken the blood, and increase circulation which could cause face to redden. The doctor who is prescribing your husband the Clomid should really be following his CBC, testosterone, other hormone levels, and symptoms. It is concerning to me that you needed to contact me to answer this simple question, so please make sure you are seeing the right doctor.
I had the same problem I've heard mentioned by several people above. Was using testosterone therapy for a few years and when my wife and I wanted to have children I had a zero sperm count. I was stopped the T treatments, prescribed clomid, and had my wife pregnant within 6 months with a "Normal" sperm count.
Hi Ryan of course you need a kick start try clomid it may help you to bring back testosterone to a normal range
Neil s said:
I've been on and off steroids for years and now suffer from depression and nervous anxiety, could clomid help me? Dr. Miller: Yes, if low T is the cause.
Jay V said:
If the clomid does work your test levels will rise but wouldn't your estrogen level also rise significantly as well? Could this lead to all the side effects associated with high estrogen in men? Are other drugs like nolvadex used together with clomid to conteract the estrogen? Dr. Miller: High estrogen doesn't always occur, really only when man is overweight or using too much. Optimal weight should always be obtained, or use aromatase inhibitor in the least.
dan c said:
I am a 65 yr old male in very good health. I work out about 5X/week. My T level is 275. I plan on taking 100mg of Clomid for 3 days and 50mg/day gor 60 days. What would you recommend I do after that? Dr. Miller: I can't give personal medical advice to you without you being my patient. And, I never recommend using clomiphene without physician supervision.
Paul K said:
Hi, 36 year old male. Abused prescription pain killers for 3 years and then was on suboxone for 3 years. Been off everything for 3 months but noticed no sex drive, lack of energy, and generally no motivation. Went to my doctor and found my test to be 184. I know I'm still healing but will my test stay low or will it eventually return to a more normal level. Would clomid be something I should consider in the meantime. Thank you for any advice. Dr. Miller: Yes, your testosterone may increase on its own as your health improves, but clomiphene may help accelerate the process.
I took propecia (finasteride) for hair loss, 5 months ago and since this time I have been unable to achieve an erection, my low T level was last checked at 6.9 nmol and LH was 1.4 iu/l and 2.7 iu/l Do you think clomid could help restart my hormone system again and get my T levels functioning normally? How long do you normally recommend going on clomid for and how much? Thank you in advance. Dr. Miller: Yes, propecia can do that. Clomid may work. I'm sorry but I can't give personal medicine advice here.
My boyfriend had very low testosterone for someone his age, 25, so his dr put him on androgel once his levels came up they put him on clomid for several months. Now he is no longer taking clomid his body hurts and he says his male parts hurt all the time now as well. He says he feels the way he did when they first realized his testosterone was low. My question is can a man take clomid for long term use? Dr. Miller: Yes, see studies on this website.
No gels. Injections work to raise t levels. After y6 months of treatment my levels are 267 were as low as 70's. Can Methadone cause low T? Orsstreet feuds that ate snorted? Did some years ago. I'm 42 n have had problems for over 13 yrs now. Will Clomid help me?
Chris S. said:
Great article/read, thanks for the info. 30 yr. old who got prescribed androgel for 3 months to see if it would help my low T. I have my doubts it did anything and also read somewhere it may actually harm my sperm production. May try for a third kid in the next few months so hopefully it didn't do much harm. Anyway, going to ask to get referred to a urologist as I believe they might be able to give me some better answers. I'll definitely ask about clomid, also about hcg. Really dislike the gel!!!!
mike B. said:
Shat about men who have had vasectomies? Will Clomid help them also? Dr. Miller: Vasectomies are not a contraindication to trying clomiphene for secondary hypogonadism in men. Yes, it should still work.
I have a low sperm count & would like to have children. My partner & I have been trying for 18 months. Will clomid help with with getting a stronger sperm count & where can I get it from. Dr. Miller: Yes, it can, and you can try going to your urologist or endocrinologist.
Hi. I had orchiopexy for one testicle around age 2, and now at age 36 I realise that my former doctor, since I was 6 months old has been negligent, since I have been complaining of tiredness and shortness of breath for the past 20 years or more. I accept my naivity also. I hve done severl annual medicals, and in 2011, one doc asked me if I knew I was anaemic for at least he past 7 years of medicals I had, but I did not. Now after after years of successfully falling asleep at work, home and almost fatally at the wheel, thanks to sites like this one, tested and found out about low T and the causes. It gets me angry and at times sad, since I think of the side effects which I see have manifested in my life. Unanswered questions now pieced together like a giant jigsaw puzzle. Poor memory, low energy, confusion, inability to keep weight off, weak erections.... I even went to a urologist for a prostate infection, and he said "These don't feel like healthy producing testicles", but I dismissed it since he did not suggest any tests or seem concerned enough to probe deeper than my first digital prostate exam. Plus, my wife got pregnant shortly after... so silly of me. I am currently taking DIM extract an have increased mt zinc using 10 pumpkin seeds per day, and plan to try maca root, as an natural alt. to testosterone injections. I have notes less tiredness and have a feeling of more activity (slight tingling sometimes) in the normal testicle. I am to recheck my T level shortly. If it is still low, can I try the CC, and is there any way to stimulate T production in the abnormal testicle. Also, are there any concerns you might have with this situation? Dr. Miller: Thank you for appreciating this website. There is no harm trying clomiphene. Orchiopexy shouldn't damage the testicle. And you also still have healthy testicle.
I just started taking this, and i feel way better. but i my face is crazy oily like i was 13 again. normal? and how does it affect metabolism? Dr. Miller: Yes, an increase in testosterone can increase oil production.
I started taking clomid 6 months ago - and I am beside myself with how well it has worked for me. I've put on at least 10 pounds of muscle, I feel great, I'm smarter, better mood and temper, and, well... I'm young again. It's certainly worth a try, given its safety and low cost.
My husband has been on clomid for 2 months. He recently had his levels rechecked. His testosterone increased from 200 to 706, & his estradiol increased from 20s to now 75. Has the Clomid caused this much of an elevation in estradiol? Thanks! Dr. Miller: Yes. If a person has extra body fat and doesn't lose weight, then any way you increase testosterone it will convert to estradiol.
I wish more endocrinologist knew this, I am 28 and was put on Androgel for Low T about the years ago. I am a type 1 Diabetic with serve chronic nerve pain (been to the best clinics around the states and tried everything in wholistic medicine most people have heard of. I understand that using pain medication contributes to the Low T along with diabetes. My wife and I were starting to plan on having a family when my family doc informed me three was a new endocrinologist in town so I could stop driving to Denver to have my diabetes managed. When I was put on the Androgel I was told I would become sterile if I didn't start the testosterone replacement therapy. Turns out it actually makes that problem so much worse?! I started on the clomiphene today thanks to my new, more knowledgeable doctor. I found this site researching side effects. Changes in appearance have been mentioned but not in any detail that I can find. Can you explain this in more detail? Chance of enlarged breast, voice pitch, muscle mass, etc? Dr. Miller: Chances of increasing testosterone too high with clomiphene is rare. However, testosterone does convert to estrogen, so if one has high body fat he would need to lose weight to avoid this. Or take an aromatase inhibitor.
Finan khan said:
I think it "Clomid" may be used after a dianabol consuption by body builders to restore the T levels to normal values.
I had tried it. It works to some degree . I can control my weight But occur rash at my left hand and right hand finger persist even after two month after I stop using it.Also my semen become transparent.
Hello. My partner has a low testosterone level however has always has barely any hair on his eyebrows and spots missing on his legs. I perceived an androgen issue? Anyhow after seeing a muscular geneticist as he seems to have some cognitive impairment and muscle wasting according to them the bloodwork found no common neuro muscular disease. He has high cholesterol, high blood pressure and sugar issues although not tested + for diabetes. Libido is a huge issue as well as speech/thought. He went on testosterone pills for a few months and he really boosted his energy levels however it did not help with the muscle issues. He has excessive thirst and a high metabolism and very pale. We are considering metformin for the hyperinsulin state he is in however the clomid may be better. We have seen doctors worldwide without much diagnosis. His creatine protease level was 300 which to them was an indicator something was up. Help! Will clomid and metformin be ok to increase his insulin sensitivity? He is 36 and looks very young. Dr. Miller: Please schedule a phone call to discuss.
Hi Dr Miller, im a 26 year old male who after taking finasteride i developed what seems to be permanently low T levels. My question is have you heard of clomid helping with people in my situation. Im fit and active and dont understand why after taking the drug my t levels never went back to normal. strength and frequency of erections have also slowly gotten better but it seems like my low t is stopping me returning to normal. Any help would be appreciated. Thank you. Dr. Miller: I'm sorry but not sure if clomiphene will help. Check out http://www.pfsfoundation.org/. Good luck.
Hello. Just got back from my primary care doc. Was previously on TRT 100 mg per week of test cypionate. While on the TRT I experimented with Semoralin to help improve my GH secretion for anti aging. I'm 34 years old and now having all symptoms of low T. I have been off TRT for 4 months and off semoralin also.
I have been on clomiphene (fertomid) for about a month. I am diabestes type 2. During the last 3 weeks my sugar levels have been raised, and I have a slight blurriness in the eyes. I am now on a diet to see whats cauisnf the problem. Can clomiphene cause such problems? Dr. Miller: Yes, clomiphene can cause visual disturbances. Have not heard of it causing diabetes.
The first time I took Clomid I felt the positive effects within days. Since then I've never been able to duplicate the success with Clomid. Is HCG a viable alternative for people who don't respond to Clomid? Dr. Miller: Yes.
Hi doctor... Only 1 injection of deposteron (testosteron) can cause testicular atrophy? Dr. Miller: I doubt it, but it may be possible.
I started clomid at 50mg / day and within 30 days my T level went from 158 - 1348. I feel great in the GYM and really feel like I am gaining muscle. The only notable impact was I initially had strange anxiety feelings. I found that if I worked out harder they would go away. (it could have been just the surge of the added T-Level). I don't know how long I can stay on at this level but I am not wasting a second and hitting the gym 5-6 days a week.
Juan M said:
I weight 200lbs and currently dieting. Will clomid be ok to take and not convert lots of estrogen? Dr. Miller: You have to discuss with your doctor. And yes, it can convert to estrogen if one is overweight.
Hi, What will the result be of taking Clomid either 25mg/50mg per day (whatever has been prescribed as best by a doctor) with the addition of Arimidex (Anastrozole) at a dose of 0.5mg twice a week? Would this cause more free testosterone to be available, and less of a conversion of the increased testosterone by the Clomid to Estrogens/Estradiol? Thanks. Dr. Miller: Yes, and an increase in total testosterone.
I am 52, in 1986, I underwent the process of lifting varicose testicles, sperm count per CCM 100,000 or less, medium or weak movement. Clomid pills dealt with for a year and then my wife gave birth to a girl in 1988 and gave birth, born in 1991. In 1998, underwent the process of lifting varicose testicles again and took Clomid pills for about six months, in 2000, my wife gave birth to a boy and in 2002 gave birth to a son. In 2012 I consulted a doctor about varicose condition of the testicles has told me that it does not exist, but the number of sperm become less than 70,000 per CCM. Dr. Miller Do you recommend eating pills Clomid now for procreation Is there a risk?. What do you recommend. Thank you. Dr. Miller: Yes, Clomid can increase sperm count.
How long does it take for clomid to take effect? Dr. Miller: It can take 4-6 weeks for full effect.
Alexandra V. said:
Dear Dr. Miller, me and my husband have been trying to conceive for 2 years now. We managed to get pregnant 5 years ago and he was diagnosed with low sperm count. A few few months ago he got tested tested again and now they are not even present. We have not yet seen a doctor for him, he's very skeptical about doctors. I also think he's a bit embarrassed and ashamed about discussing his condition. He's tried fertile aid and it didn't work at all. His mood is out of control and he barely sleeps and has a very difficult time putting on pounds. Can taking clomid help this/ our situation? If so how long will he have to be on it? Thanks in advanced for your help. Dr. Miller: It depends on the cause of his low sperm count. He needs a comprehensive evaluation. Clomiphene may help, depending on the cause. Good luck.
Daniel W said:
Can you take an AI and clomid together? Dr. Miller: Yes.
I have been taking this for three months and the only effect I have seen is a tremendous weight gain. I have put on about 35 pounds during this period. I must say also that I had prostate cancer and took radiation and kemo. should I continue to take this or is there and alternative? Dr. Miller: You need to discuss with your doctor, yes there are other alternatives.
I tried test. gel for 9 months and it did not work. However, I tried Clomid 50mg ED and it worked well for 4 months but is not working suddenly. I'm looking for options when Clomid stops working. I can't find any studies in journals that detail what to do when Clomid stops working. Thanks. Dr. Miller: If it isn't working then you may have primary hypogonadism and you would need to try testosterone again, maybe injectable T would work for you. Good luck.
SOME time ago I was on a steroid cycle - testosterone 400 and deca durabolin 300 every week. Now I started taking clomid to bring back my natural testosterone production- my question is: how much should I take it and what doses. Thank You a lot in advance. BTW I`m 33 now. Dr. Miller: Sorry I can't give personal medical advice here.
dr i am male 28 i had t level in 160 after taking clomid 50mg for 3 months it came to 890.how long it will stay on this level or when i need to go for next test??,thank you doc. Dr. Miller: It depends on a lot of factors. Studies show that after six months young men can try to wean off, in general. Everyone is different and you need to work with your doctor.
Dear Dr Miller, doctor prescribed clomid for me and my wife along with dose of vitamins C, E,B complex. we were trying to have baby for almost 5 years now. how frequent should the check up for sperm analysis? I already finished 2 clomid packs. Thank you. Dr. Miller: It can take two-three months.
I have secondary hypogonadism due to empty sella syndrome. I have slightly elevated prolactin, low lh and low fsh, and extremely low t. I also have graves disease and underwent RAI. I started clomid 50mg every other day about 3 weeks ago. Is it normal to feel more tired now and depressed? Is it possibly because it is making my testosterone convert to estrogen? Dr. Miller: I don't think clomiphene would work if one doesn't have pituitary. HCG would be a better choice.
I saw a urologist 2 months ago who recommended a varicocele removal surgery. A scan also stated that my left testicle was not as functional as the other. Can taking clomid reverse the condition and boost my sperm count as i have not had a baby yet with my wife? Dr. Miller: I don't think Clomid can overcome anatomical problems in the testes, but I am also not sure that a varicocele would interfere with sperm production.
Larry W said:
Doctor suggests clomid for me, but I am overweight, and she is concerned about aromatase - thus, she wants to put me on dose of natural progesterone, as well. She says this will help stop aromatization of testo. Correct? Thanks. Dr. Miller: One would need to lose weight soon, and take an aromatase inhibitor in the meantime. That's what I recommend, in general.
my uro prescribed me clomid. for my low T count. i'm hesitant to try it because i've read many complaints in online forums from men who said it caused low libido. what are your thoughts on this? should i try it? Dr. Miller: I haven't heard complaints of low libido.
saleem suliman said:
Dear Dr Miller i wanted to ask you that if supposedly we take test enth injections and usually they store more water in the body can clomid remove excess water from the body or is it possible to use test and clomid together? Dr. Miller: You need to speak with your personal doctor.
Doctor, the result of my test was 265 after 2 months of a steroid cycle. With this level, is it possible to make my wife pregnant? And should i take clomid? For how long? Any bad side effect of clomid use? Thank you. Dr. Miller: Read my article about side-effects. Possibility of pregnancy depends on sperm count, not testosterone level.
Dr Miller, I am a 24 year old male who has been suffering with depression, low energy, and overall feeling awful for close to three years now. I had a testosterone reading done and it came back at 270 ng/DL. The doctor wanted to confirm the test, ordered another, and the results came back at 474 ng/Dl. Both tests were done in the morning. For both reading, my free testosterone was 11 pg/ml. I have not had morning nor nighttime erections for over two years now, and am completely impotent. My doctor tells me I'm in the normal range, prescribed me viagra and an antidepressant. I still do not feel right nor do I have a sex drive. How should I go about getting the help I need? Dr. Miller: Find another doctor. You can contact me. Send me an email.
Is it possible for Clomid and hcg usage in men to affect women thru bodily fluids. I have POS and my husband takes Clomid and hcg for hypogonads secondary to bodybuilding. My POS has become worse and my prolactin levels have increased. Could this be secondary to intimate activity. My Gyn isn't sure 110% if Clomid and hcg can't be found in semen. Appreciate your help. Dr. Miller: Interesting question, I wouldn't think it would be significant, but sorry don't know the answer. Consider an endocrinologist, read about diet and PCOS.
My test levels are in range yet i always feel sad,depressed,lazy and testes have really shrunk to small size. My urologist has put me on 200mg of test shots every two weeks, but Ive read online that test shots actually cause them to shrink more. Should I talk to my Dr about clomid? Dr. Miller: Yes!
I just had my T tested, came back as 243. My doc says it isn't low enough for drugs yet. She suggests I workout more, however I currently workout 4 hours a week. I don't have the energy to workout more and have to really push myself to maintain this routine. I have difficulties maintaining an erection and am losing interest in having sex. Help! Dr. Miller: WOW, this is such sad advice! Come see me. Email me.
I understand that Clomid works in men with secondary hypogonadism by essentially lowering estrogen production. My estrogen is already in the low normal range. Dr. Miller: It doesn't lower estrogen, more like blocks the estrogen receptor.
Thanks you for sharing your insight on this incredible blog. very useful information. I have been diagnosed with secondary hypognadism and my Dr. has put me on 50mg Clomid every-day for 3 months. I started taking the medication only 10 days ago and have started feeling a little better in terms of mood, energy etc. however My sexual function has had a severe impact. I am no longer able to achieve or maintain erections. this is happening only after starting clomid. prior to that I did have low libido and very mild ED. Are these side effected of clomid? Dr. Miller: Thank you for your kind words. If testosterone converts to estrogen then that could cause low libido. I hope this helps. Please talk with your doctor.
I began taking Clomid to increase T and sperm count/quantity three months ago. My numbers are up, T at 800 and sperm count and quality now in the normal range. But I have developed some eye problems, the formation of several "floaters" including one very large one, I had a stye which came and went, have experienced involuntary twitching in one eye, sensitivity to sunlight, feel like my eyes are being forced into an intense stare etc. I contacted my fertility doctor and an eye doctor (the latter had never even heard of clomid, so I am not sure what use he was), and they both say there is no causal relation between my clomid usage and symptoms. I am encouraged by my numbers and want desperately to get my wife pregnant, but fear a correlation, as I have never had any eye problems in my 40 years and all of these new ones just in the few months since taking clomid. Should I see yet another doctor? Dr. Miller: Yes, you should see a different doctor. Visual changes are a known side-effect of clomiphene. HCG would be a good alternative.
Thank you for this article. My T gradually reduced from 3.99ng/ml in 2011 to 3.29 in 2012 and 2.93 in 2013. My LH is also in the low end while prolactin and FSH are normal. MRI in pituitary and ultrasound on testicles turned out normal. Did a SFA and I have 50 mil sperms per ML with 20% sluggish and 10% dead which is also good. I went to 3 specialists and they keep sugarcoating the issue as my T levels still fall under the normal range. I can get Clomefene Citrate without prescription in my country. Could you please tell me whether it will affect my fertility in a negative way? Dr. Miller: Clomiphene improves sperm count.
Thanks you for the very helpful blog. I'm 24 yr old and I'm suffering DE problem. My result test show me that I have low LH and FSH and my doctor recommended me using Clomid, so should I use Clomid to solve my problem? I still don't have wife or any plan to have children yet. Dr. Miller: If Testosterone is low, then you need to make decision with your doctor.
I have had both testicles removed due to cancer and can no longer afford androderm or other creams. My T level is close to nothing and looking for alternative. I am 49. Dr. Miller: Clomiphene would not work in this situation. Injectable testosterone may be cheaper than a cream. Or compounded testosterone cream through a compounding pharmacy is much cheaper than brand names.
Rob T said:
Dear Dr Miller, A google search on “low libido with clomid” will reveal a large magnitude of patients experiencing significant libido reduction and ED with clomid. In many forums clomid has been defined as “A libido killer” nevertheless it definitely increases T level. I understand from my research that this is a very common side effect but there is no clear justification. Most of the patients are seeking clomid to enhance their sex life but it looks like clomid is working against it. I am sure you have researched this subject. Would you please share your opinion. Thanks. Dr. Miller: This is not my experience, but that may be because I follow estradiol levels and treat high estrogen levels. If estrogen levels are too high that could reduce libido.
Dear DR. I am 19 year old male from pakistan and i have no facial hair. Because i have low testo. My total testo level is 237ngdl. Plzzz suggest me a treatment please otherwise i will be destroyed because my friends tease me due to no facial hair. Dr. Miller: Please go see Dr. Nanik Ram in Karachi. Testosterone level is not enough. You need more tests and physical exam for a decision. See this article:http://www.ayubmed.edu.pk/JAMC/24-2/Nanik.pdf .
dude low t is not called hypogonadism its called androgen deficiency, google images hypogonadism.
im 28 and have little facial hair all family men have very full beards. ihave foliculs too i used finasteride for 11 yeaas my testosterone is 4.1(3-9ref) dht 650 (250-990 ref) e2 55( men under 55 ref) tsh lh fsh t3 t4 d3 prolactin dhea and all hormones are fine but lh fsh are low normal range i have 17 vial hcg 5000iu and alot of clomid and letrozol with one is better? hcg+ letrozol or clomiphen? if hcg 250 iu 2-3x /week is enough?and can i use compounding hcg(powder with inject water) in refrigerator to use it for 1 month?and if clomid is better 12.5 mg 3x aweek is good and how long is it safe? Dr. Miller: I'm sorry but I cannot give personal medical advice here.
i have venous leak and low t. will increasing my t will fix the venous leak to some extent? Dr. Miller: Sorry I don't know the answer to this. However, high estrogen levels (which are common in men with low T) can cause venous insufficiency in general.
Say one has shut down their natural HPTA axis with testosterone enanthate....and after not touching it for a long time their natural test is low. My urologist said my gonads were a good size and he said more than likely secondary. I asked about clomid and he wasn't sure and said he would do research...haven't heard back in 4 weeks and decided to start...100mg clomid 7 days then down to 50mg...strength in the gym is up but lack of energy and sex drive still...would tamoxifen (nolvadex) be unsafe to add? In order to help LH and reduce estrogen? Dr. Michael Scally had recommended on his website...but nice to get other doctors opinions. Dr. Miller: I'm sorry but I cannot give personal medical advice here. You need to have blood testing and consultation, otherwise you are just guessing. In general, I only recommed aromatase inhibitors for short period until weight loss is achieved.
I want to thank you so much for the information here! I am 26 and have been suffering from extreme fatigue, foggy memory, no drive, mood swings... the list goes on. I went to my family Dr. here in WV and he had blood work done on me and found out that my T was 234ng/dL in March 2013 and has slowly gone down since then. He sent me to an endocrinologist that wanted to put me on antidepressants... then to another that said nothing was wrong with me. He was very frustrated and took it on himself to find out what was wrong with me so he issued a MRI on my pituitary gland, ultrasounds on my testicles, sleep tests, and more blood work. Everything came back normal except on the thorough blood work he noticed my LH and FSH being low at 1.8MiU/mL for LH and 1.6mIU/mL for FSH. He wanted to put me on AndroGel, but not only does my insurance not cover it, I eventually would like to have a kid so $200 every month for the rest of my life is out of the question. I tried bringing up Clomid to him and he was very adamant about it saying that it was not for me. So now... after all this time I continue to get worse and worry about losing my job and life to something I cannot control because I can barely function as a person. I have looked into a few doctors here in the state, but this state is not known for good healthcare and it makes it very difficult to find a doctor that will prescribe Clomid because they are so behind in the times. Do you have any suggestions on what I should do? Thank you for any feedback! It is extremely appreciated. Dr. Miller: I believe Dr. Warren Levin prescribes Clomiphene and his location is closer to you. Otherwise, I would be happy to see you.
I have above normal range SHBG (70 compared to range of 10 - 57). As a result, I have low Free T (7 compared to range of 9 - 55). From what I've read, it appears Clomid raises SHBG. Should I assume that Clomid would compound my problem of already high SHBG? Thank you. Dr. Miller: Not necessarily. I haven't seen that with clomiphene.
Dear Dr., clomid increase fsh also in men and high fsh can cause low sperm count. then clomid causes infertility in male? Dr. Miller: I haven't seen this. Actually the opposite. Clomiphene increases sperm count, and only causes high FSH if overdosed.
If low test is coming from a 4mm pituitary tumor, is surgery recommended? Patient has just started clomid. Dr. Miller: Decision to go to surgery depends on benign vs. malignant status and response to medical management.
I am a sixty-one year old male with an initial testosterone level of 530, which after two months of taking 25mg daily, jumped to 740. But my estrodial also jumped from 36 to 47. Is this a bad thing? Does this mean my estrogen went up? I am a hardcore athlete with a heart healthy diet, yet I still gained a few pound of belly fat during the last two months. Should I increase my Clomid dosage or take something to lower my estrogen? Or what? Dr. Miller: I cannot give personal medical advice here. However, generally, if one is overweight then any increase in T will also increase estrogen, which yes should be reduced. The best way to do latter is through weight loss, although an aromatase inhibitor may be used in the meantime.
Walt J said:
I have noticed blurred vision and could not attribute to anything till I read that it could be the Clomid, right? I have one other concern, however; there seems to be a lump about the size of a normal testical in the area where testicals can rest up in the body, the other 2 testicals are normal. Any idea? Dr. Miller: Yes, in general, clomiphene can cause blurry vision and one would need to see an eye doctor as soon as possible. Also, mass in testicles needs to be evaluated by a urologist. It could be anything from a tumor to a hernia.
I've been suffering from depression for 20 years and it the past 3 to 4 years it's gotten worse. Been on ever kind of anti depression drug out there. I went in for a physical about a month ago and found my lipid levels were out of whack. My current doctor of 15 years said he could do nothing more for my depression. So, I decided to see another doctor. I went over my medical history with him and was very candid about my struggles with depression. He immediately ordered a thyroid test, PSA, A1c and wanted to check my testosterone levels. Everything was in order except my testosterone. My reading came in at 191. I'm not sure what my free t was or shbg levels are. I was told that my levels were barely low and not to worry about it. I don't agree with him at all. Is this number low for a 52 year old male? If I can start feeling better by raising my t levels to me that would be priceless. Unless you have suffered from depression you can't imagine what it's like. It has such a negative affect on every aspect of your like. I'm not looking to be twenty again I'm looking for help with depression. All I know is I don't feel very good mentally and what I've been doing in the past is not working for me anymore. I'm 52, take pretty good care of myself and won't just accepted this is the way life is going to be for me. I'm thankful for people sharing there view points on low t. If I can nip this depression I think everything else will fall into place. Your feedback is appreciated. Take care! Dr. Miller: That is definitely low T and low T can cause severe depression, and increasing testosterone levels-using clomiphene, HCG, or testosterone (depending on cause) can definitely help. Sorry you have suffered so much!
Hello doctor Thank you for the invaluable information. I have 1 question: I'm a 27 years old man, married for over a year, wife is 4 months pregnant, I have long history of obesity since childhood, currently I weight about 110kg, but no other health/sex life issues. About 2 years ago, I discovered a herb extract used as aphrodiastic that is supposed to boost endogen testostorone level. After intermittent use, I felt the change: better self confidence, deeper voice, less social anxiety, more developed muscle, androgenic-like obesity, better mood and well being, less mood fluctuations Thinking of testosterone as a cause, it all made sense. The problem is clomid is much more accessible to me, and if it can get my testosterone level higher, is there any reason why i shouldnt use it on the long term ? Im very interested by this substance, but utterly afraid of its effect, mainly higher oestrogen levels. Thanks. Dr. Miller: I cannot give personal medical advice here. You need to find a doctor who can do blood testing and a consultation. Good luck!
Dr PJS said:
What are some of the typical aromatase inhibitors used to keep estrogen levels from becoming too high when taking Clomid? I realize that on your site you advise losing weight to help with estrogen levels but I wonder if Clomid + an AI might help with the weight loss. Dr. Miller: Yes, aromatase inhibitors may be used until weight loss is achieved but I haven't seen them help with weight loss. Anastrozole is a type of aromatase inhibitor.
Hi, my husband has low testosterone and is only 28 years old. He has had testosterone injections which did nothing and he has now been told to go on Axorin. I do not want him to go on that as we hope to have children soon. I feel your information gives us something new to work with. Could you please tell me whether it is required that HCG is required to go with Clomid or if Clomid can be used on its own. How long does it normally take to see any improvement in serum levels as well as in symptoms such as low mood, poor energy with this? Thank you! Dr. Miller: Clomiphene can generally be used alone. It all depends on cause though. Usually symptoms improve in a week or so, but they can take a few months to optimize. Also, if testosterone injections didn't help, there may be another problem.
john m said:
Hi doc I have been using clomid 25mg daily for 16 days I feel increase in strength but libido is gone , I still can have sex but it doesn't feel good as it used too even if I refrain from it 2 or 3 days .Before using clomid it wasn't like this so should I stop or give it more time. Dr. Miller: You need to see a knowledgeable doctor and get blood testing, and consultation. Your estrogen levels may be rising too much, or there may be another problem.
Hi Dr. I have low T & high FSH and my sperm count is zero where as my scrotal scan is normal. Me and my wife are trying to conceive for past 18 months without any result. I have normal sex life with normal erection and all. Will Clomid be helpful, please advice? Dr. Miller: That depends on the cause of your low T and high FSH, and what "high" FSH actually is in this situation. There may be a genetic reason for not having any sperm. You need to go to a fertility clinic, and they can always do a trial of clomiphene to see if it works.
Hello Dr. Miller, I was prescribed 50mg of clomid, 2 times a day for 15 days. (100mg per day)This was post therapy treatment after a 20 week course of testosterone injections. Shortly after beginning the clomid I developed a genital rash that became progressively worse. On day 14 of the clomid course, I quit taking it. The rash began to clear up immediately, though it has been a day to day progression for the better. Is it possible this was an allergic reaction? 62 yo male.
after clomid taken my sperm count and sperm motility normol .that result is forever or some time.pls tell me now i not taken clomid. Dr. Miller: It depends on cause of previously low sperm count and whether that problem was treated.
Hi Dr. Miller, my husband has been on trt for 5 years, he never had low T, just a need to bulk up, but is now dependent on it. Can he switch to clomid and if so, what side-effects should we anticipate from the switch. Dr. Miller: Yes, clomiphene (and sometimes HCG is necessary too) can bring testes back to life. Side-effects are in article above.
What are the side effects of clomid? Dr. Miller: Main side-effect is possible visual changes, but that is rare.
Hi.. ive been taking Clomid for 2.5 months now. I used to take Test/HCG but we found my sperm count to be zero. 25mg/day.. I hope this works. my main complaint is the loss of libido. Is that a side effect in men? Anything I can do to counteract? Dr. Miller: Loss of libido may be due to testosterone conversion to estrogen.
Matt UK said:
Hey Doctor, What a fantastic and enlightening site. I’m an active, sporty and healthy 32 year old man and live in the UK. I went to see my GP about 9 months ago suffering from a complete loss of interest in sex, a general constant feeling of lethargy/”mind fog” and on and off mild depression. He suggested a blood test and my test levels came back at 280 which he said were “within the NHS range” and therefore to be considered completely normal. I did some research myself only to find that test levels of 280 in a 32 year old man were anything but normal and everything that I was experiencing could be attributed to low test. I requested another appointment with my GP and forced the issue until he agreed that I should see an endocrinologist. I paid to go private as waiting to see an endo on the NHS can take months in the UK. The endo suggested that another, wider test should be taken – the results below… Follicle Stimulating Hormone – 1.8 IU/L (1.5-12.4) Luteinising Hormone – 3.5 IU/L ((1.7-8.6) Prolactin 282 mIU/L (86-324) Sex hormone binding globulin 24 nmol/l (16-55) Test 10 nmol/l (9.9-27.8) Thyroid stimulating hormone 0.95 mIU/L (0.27-4.2) Free Thyroxine 16.6 pmol/l (12-22) Total T3 1.9 nmol/L (1.3-3.1) As you can see – my “test” is very low again (just within “the range”) as is my FSH (just within the range). The endo took one look at the results and told me that I was “within the range” for everything – that I needed to see a sex therapist!?!?!?!? To be honest, this was an insult. I again did my research and I’m going to try to resolve the issue myself through very low dose clomid 25mg M-W-F for 6 months and then try and slowly come off. Throughout I’ll be taking blood tests to evaluate if it is working. I took a blood test this morning as I start the course of clomid tonight. Any advice or recommendations appreciated. Wish me luck. Kind regards. Dr. Miller: I am so sorry you are having trouble finding good medical care. Maybe try to find a urologist in the UK who knows about clomiphene. Or you can come see me. :-)
My husband is 23. Healthy. We went to a urologist, and his count was at 6 mil. He has been using testim gel every Monday Wednesday and Friday, and just this week has started taking clomid 50 MG, how soon do you think it will take to achieve pregnancy? Could this combination be bad? Or make pregnancy easier? Thanks! Dr. Miller: It can take a few months. Good luck!
Hi, im a wife who is very much worried of my husband's condition...we went to a urologist for low sperm count treatment...he prescribed clomid 50mg bid...he has been taking the meds for 10 days now and notices a big changed. he cannot achieve an erection. Dr. Miller: He may be converting the testosterone to estrogen. He should tell his doctor about this.
hello - I was diagnosed with low testosterone 240 first test / 310 second test and doctor put me on a course of clomid for 1 year. This increased testosterone to 730 and I felt benefit. I've now stopped clomid and test has dropped back down to 290 last test. Is TRT now only option? Have you heard of androxal doctor? What are your thoughts on this? Thank you. Dr. Miller: Clomiphene can be used long-term. Androxal is a single isomer of clomiphene but is likely much more expensive.
Doctor, It seems to me that long-term exposure to suboxone drove my T level way down (almost below 100). I obviously had other issues given the initial need for suboxone in the first place but i was put on an unnecessarily high dose before i knew better. i am down to 8mg a day now. Anyway, several years later, after being “depressed” for well over a year, with no treatment taking, I self-diagnosed as low-T after watching some commercials on the tele. I was given the tests and put on Axiron. My T levels skyrocketed and believe me, the change was noticed; not only could I actually get out of bed and take a shower, I could focus, had motivation, etc, not to mention a significantly increased libido and the accompanying physical responses, etc. SO MY FIRST QUESTION WOULD BE, ASSUMING ONLY THE INFORMATION I HAVE GIVEN YOU, IS SUBOXONE THE MOST LIKELY CASE OF MY LOW T. Moving on, after half a year or so, a lot of my hair began to fall out and I have basically been trying to strike the perfect balance between one and two pumps ever since. I “discovered” Clomid several years ago and brought, to my first urology appointment, two reputable studies i found on Google Scholar testifying to its efficacy. The doctor looked at me like i was crazy and told me it was for fertility (women’s presumably). Anyway, I got an MRI that eliminated any physical cause for secondary hypogonadism, and everyone seems to think its that suboxone. What do you think AND, more importantly, can Clomid work if I am still taking Suboxone even though I am reducing my dose. I want to take as few meds as possible but I would prefer Clomid to Axiron for all the reasons explained in your essay, and which I have read about before. SO AGAIN, MY SECOND AND MAIN QUESTION IS WHETHER CLOMID WOULD WORK ON SOMEONE WHO IS TAKING SUBOXONE? Any helpful advice you can give me is greatly appreciated. Dr. Miller: Yes, any opiate can cause low T. Yes, clomiphene can help, but not necessarily.
49 year old male with test at 226. Had a prostate infection which caused psa spike. Negative biopsy as well as halo test. Urn wants me to start on axiron. Is clomid an option? My gp had mentioned it before. Dr. Miller: Yes, but depends on if low T is due to primary or secondary hypogonadism.
I have been on clomid 50mg every other day for about 100 days now and have had great success despite empty cella and slightly elevated prolactin. My T levels have improved greatly and the only down side is slightly elevated estradiol. It took me years and many other treatment methods that made the situation worse to talk a doctor into giving me clomid. Now my challenge is trying to talk this doctor into giving me Armidex in order to combat the elevated estrogen. Do you think Armidex would help? Dr. Miller: I'm sorry you have had such trouble finding good care. Yes, Arimidex is an aromatase inhibitor which can prevent the conversion of testosterone to estrogen. However, many times just losing weight can help since the aromatase enzyme is mostly found in fat cells.
Dr. Miller First, thank you for all you do. I was actually assigned to CA operations with my company when it was discovered that I had prostate cancer. My current urologist just put me on Clomiphene Citrate. I am a 58 year old male. About three years ago, I was feeling extraordinarily sluggish in all habits of my daily routine. I sought the advice of an endrocrinologist who, after a complete blood test, discovered that I was extremely low on testosterone. He started me on Androjel & I began to feel like my old self again. When I was relocated to CA, my insurance refused Androgel & I ended up with Testim. Ironically, this drove up my PSA. My doctor recommended a urologist to remove all doubt about cancer. I did have cancer. Fortunately, it was very early on. I had 10 weeks of radiation which did kill the cancer. Subsequently, my PSA dropped after a year to a level below 1.0. Dr. started me back on testim. But, my PSA shot up to 3.5, 4.0 & 3.0 successively. Anyway, she decided to start me on Clomiphene Citrate for the very reasons you describe. So far, I am feeling more of the drain of testosterone than a revitalization of my testis producing it. I know I need to give it some time. My wife consider ourselves holistic & desire a healthy continued life when mother nature drags her feet. Your input would be very much appreciated. Thank you for your website. Finally, at the heart of the matter, while my current urologist has my best interest at heart, I feel that she lives within the confines of Urology. Your description of purpose appears to be more in line with that of my wife's & mine. What would you recommend at this point? Dr. Miller: Sorry for your situation and thank you for all the compliments. Unfortunately, a rising PSA after prostate cancer may mean a recurrence or metastasis and this absolutely needs to be ruled out first. The increase may be cause by clomiphene or testosterone, it doesn't matter. Please see another urologist about this matter and get a second opinion. According to the American Urological Association, Serum PSA should decrease and remain at undetectable levels after radical prostatectomy. The AUA defines biochemical recurrence as an initial PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory PSA value 0.2 ng/mL or greater. Values obtained with different assay methods or kits cannot be used interchangeably. Results cannot be interpreted as absolute evidence of the presence or absence of malignant disease.
I read your blog and wanted to ask you a question that has been bothering me... I took a steroid cycle and used Clomid (generic from Cipla) to restart my HPTA. I have noticed a sudden onset of eye "floaters". Lots of white and some black dots in my vision, big, small, etc. would you be concerned if I was your patient? I know floaters in general are not normally a sign of anything serious, but because of my situation I want to make sure it isn't a sign of a tumor or something serious. I plan on continuing Clomid at 50mg for another month or until my blood results show upper normal T. Thanks, I appreciate your response. Dr. Miller: Yes, I would go see your eye doctor and doctor who prescribed Clomid about this matter.
I don't know where to begin but I will give it my best shot. I'm a 52 year old male that has suffered from depression for 20 years. Been on a variety of antidepressates and talk therapy with sub par results.It seems like my mental state has been going down hill for some time. I just don't have the sense of well being and really could care less if I'm here or not. I recently went to the doctor for an annual physical and found my lipid levels to be out of line. Glucose fasting 123mg/dl, cholesterol 228mg/dl, trig 536mg/dl, hdl32mg/dl, ldl 113mg/dl a1c 5.5, TSH 2.04, PSA 0.3 and testosterone 191. cbc normal. My height is 5'8" weight 177, non smoker, occassional drinker. I explaned to the doctor that I've had night sweats, choronic elbow problems for the paost 12 years. I've stopped taking advil, 4 months ago I did take hydrocone for pain. I take a multi vitamin, fish oil, gluso/chondrotin and 2000iu of vitamin d. The main concern I have is with the way I've been feeling. Lack of interest in life,I really have to force myself to go out, sex drive is so so and very moody. I'm just wondering if low t could be prohibiting me from leading a more fulfilling life. A few years back I became very ill. For weeks I woke up sweating so bad I had to change my clothes, sometime twice a night, fever chills, headache. Went to the doctor and was checked for lymes, came back negitive but they put me on antibotics for 21 days. I haven't had night sweats that much since than but am very intolerate to the cold. It never seems like I can warm up. I guess in a nut shell the biggest thing I need help with is depression. I do cardio and burpees for exercises and eat pretty decent. My doctor just doesn't seem to concerned about a 191 testosterone reading. Should I be concerned? I'm thinking of seeing an endo for advice. Your feedback is appreciated. Best regards. Dr. Miller: I am so sad reading your note. Yes, definitely low T will cause depression and a lot of your other symptoms. Yes, definitely see an endocrinologist. Proper treatment can reverse high triglycerides and diabetes too. If you are able, I can take care of you too.
Dr. Miller initally I had migraines during my teens and early adulthood. For that last 18 years I had been migraine free. Started Enanthate at 100mg/week. After starting TRT my migraines returned and my Hemocrit levels increased up to 56%. Reduced dosages to 20mg/week and my migraines have become less frequent and hemocrit levels are back to a better number. But I am now starting to show more signs of fatique and lack of energy. Would Clomid have the same effect on my migraines and hemacrit levels or do think that is something I should consider. thanks. Dr. Miller: I haven't seen elevation in hematocrit or migraines with clomiphene. The migraines during puberty and with testosterone injectables is likely due to rapid fluctuations in levels which occurs in those situations. Good luck.
I am a 22 year old male who has low T from steroid use. I want to restore my testosterone to naturally high levels, and I am seeing by research that HCG with armidex and test cypionate or androgel is popular and getting good results. Will I be able to restore my test production back to normal after 8-12 weeks of treatment of this? Any advice would be greatly appreciated. Thank you. Dr. Miller: Yes, testes can come back to life, and in general I recommend clomiphene or HCG.
When is the best time of day to sample blood for Testosterone levels? Dr. Miller: If you want to check peak level, then 8am.
I read your blog about clomid and i was hoping you could answer a couple of questions. Specifically, i have been diagnosed with metabolic syndrome, i take metformin, my T levels were around 250, and my Endo inidcated that it shouldnt be low as my testicels are actually quite large. Does this sound like a situation in which Clomid might be effective? More to the point, how does clomid interact with diabetes? Dr. Miller: Yes, clomiphene may help. Diabetes can cause secondary hypogonadism, through hypothalamus probably.
Yes I took propecia and had a quit 3 months ago.. I went to see a urologist about a month ago.. My total test scores were 383 and lh was 2.5 and fsh was 2.5.. Uro put me on test cream for 6 weeks I have noticed small improvements.. I go back in 2 weeks and he mentioned he might put me on Clomid.. I experienced ed while on the drug... Do u think the Clomid will help me??? I have been off propecia for 3 months.. I get really good responses from ed meds like Viagra and Cialis at the moment.. Uro mentioned Clomid in our last visit?? Dr. Miller: Yes, clomiphene may help.
Mrs. D said:
My husband is 57 yrs old completed 44 radiation treatments for aggressive prostate cancer exactly one year ago, no surgery. It has also been one year since his last injection of zoladex. His PSA is .01 and his testosterone level is still less than 20, but he says he can't live like this. Most days he cannot get out of bed. He can't lift a 20 lb bag of dog food or open a jar. Would Clomid give him any relief? It's about quality of life now. Dr. Miller: Clomiphene may help, or testosterone of course. Read Dr. Abraham Morgentaler's work.
I am so glad I came across this article! My last two pregnancies ended in miscarriages. I checked out fine, but my husband has low testosterone. For a while he was using a cream that didn't work, so he tried injections for months before the oncologist told him they actually lower sperm count. Here we are trying and trying to conceive again with no luck. I do have a few questions for you, if you don't mind: Since Clomid blocks estrogen, does that affect a man's ability to produce a daughter? I was also wondering if you could share any side effects and how long it can take before sperm count improves. Thank you for this great information!! Dr. Miller: Clomiphene doesn't prevent men from creating daughters. Side-effects are in above article. It can take 3 months for sperm count to improve. Good luck!
FSH IS 1.8 AND LH IS 2.7 AND TT IS 384 WITH SHBG OF 12. IS CLOMID GOING TO HELP WITH THAT. Dr. Miller: That is consistent with secondary hypogonadism, so clomiphene could help. But, you need to figure out what is cause of secondary hypogonadism, additional testing should be performed.
I am very impressed by your blog. The information on this page is very helpful. My T levels were 184 (low), while my LH (6.8 - normal) and FSH (10.8 normal). After taking Clomid 25mg for 25 days and 5 days off, my T Levels increased to 627 (normal), but it also increased my LH to 10.1, FSH to 20.7 and Estradiol to 64.3, which are considered high. What should I do? Should I discontinue Clomid? What are the side effects of high LH, FSH, and Estradiol? Should I combine Clomid with any other medicine, which may help to lower LH, FSH, Estradiol? If so, which medicine? Thanks for your help. Dr. Miller: I can't give personal medical advice here. Please find a doctor skilled in prescribing clomiphene. That estrogen is way too high.
Edgar L. said:
What is a normal range of testosterone for a 30 year old male?, i had my right testicle removed due to cancer when i was 25, i've never had my T. Level tested before surgery, so I cannot tell which was my level before with two testicles. but i can tell I felt differently after, i gained a little weight even tough i had an active life gym 3-4 times a week and have a decent diet, I noticed that my erections are a little more difficult to achieve, not impossible but i do feel i require more stimulation than before. and I do feel sometimes I am not as hard as I used to be, I also feel that I depress easily, before the surgery I was a very optimistic and positive person. My normal T. Level tests have come from 250-320 without any treatment. Some doctors had told me that this level might be OK and normal for my body and stopped pursuing a Testosterone solution, however i decided to investigate more because I read a normal range to my age would be over 600 T level. I went to an endocrinologist and he ordered some more tests, My LH came in range at 5.19 mUI/mL and my FSH is higher than range 12.78 mUI/mL. I would like to suggest a combinated treatment to my endo. Could I combine testosterone gel and clomiphene? I would like to prevent my left testicle from producing the few testosterone that it produces now and avoid low sperm count. In the past one of the doctors recommended just clomiphene, it rose my T. up to 415 only, i'm not sure if i took it long enough to give up on it, after that I tried just gel one dose a day recommended by my urologist, but it rose me over the range after three months and my urologist blamed me of abusing it, he said I should stop taking any treatment and I did. before this I also tried alternating one day of gel and one day of 50mg clomiphene and I went up to 538 after a month, and then I checked it again after 2 months and was up to 800, which according to my urologist it was high as well so I stopped treatment, but I would like to restart it and now with a different doctor. Let me know any comment. Thanks. Dr. Miller: Sorry about your cancer, that must have been rough. Yes, you want to be on higher side of testosterone range, 800 is not too high. 300s is definitely too low. Different clomiphene dosing may help, or HCG, or likely testosterone with clomiphene may be necessary in cases like yours where there is some primary hypogonadism. You need to find another doctor who is comfortable with higher testosterone levels.
Dr.Miller, Thank you for the informative article on low testostrtone .I have secondary hypogonadism for past two years, low fsh,lh and testosterone. I went to hospital because of growth in breast size.Other than this I had no other complaints, have good energy levels, no headaches, no problem in achieving erection. In addition to test the Dr checked function of liver, kidneys, pituitary by checking hormones produced by it. All test came out normal. My Dr put me on 50mg Clomiphene twice daily for two weeks in a month and anastrozole 3 times a week for four months. I was to continue with this treatment plan for four months. I have been taking Clomiphene for three months and decided to check my testosterone levels. It saddens me to tell you that there has been no improvement in my testosterone. Generally,is clomiphene really for me and what may cause it not to work to improve my testosterone levels. We don't have good medical care from where I come from and I would appreciate if you may suggest what other additional test I should do to get over this challenge. Dr. Miller: I'm sorry you haven't been helped. I can't give personal medical advice here. You need thorough evaluation for cause. Are you on any medications, for example? Clomiphene is also usually dosed daily or every other day, not only two weeks of month.
fsh 6 miu\ml 1.6\ 11 lh 5.71 0.8 \ 9.1 prl 5.98 ng\ml 2.7 \16.9 testosterone 3.36 ng\ml 2.6 \10.1; sperm 3 million after 2 month with 25mg clomid daily and hcg 1500 3x weekly last day of 2 month i make hormone test i find testosterone go up 7 and fsh go down 0.8 i wait 1 month and make sperm test i find 1.5 million go down what i will make now. Dr. Miller: Thank you for sharing.
Is there any possible connection between taking clomiphene and developing insomnia? I started taking clomiphene last July, and the first 2/3 weeks I was on it, I felt amazing: more libido, more energy, gaining muscle, stronger, etc. After a couple weeks I started developing severe insomnia that hasn't gone away since then. I've continued taking 25mg every night, but I'm starting to wonder if taking it in the morning would be better for my sleep. Do you have your patients take it at a certain time of day or does it not really matter? Dr. Miller: I haven't had insomnia side-effect in my patients taking clomiphene, however it may have to do with your dose, and your testosterone or estradiol level. Or, the cause of your secondary hypogonadism in the first place. Please consult with your physician.
I am a 55 yr old male. Started taking clomid last August to raise T levels. Just had my blood test and T levels have increased to a normal level but my PSA was .6 and it is now 9.4 No prostate cancer in family history, Dr told me to stop the clomid and have PSA level retested in 3 months. Does clomid or the increased T levels cause PSA levels to jump. Dr. Miller: When increasing testosterone level (whether by using clomiphene or testosterone)causes PSA to rise then prostate cancer needs to be ruled out.
clomid affected my left leg and arm and caused seizures. I can walk but still feel the pain, what should I do? Dr. Miller: Go see your doctor.
Hello dr. I was wondering im a diabetic in my 30s and take thyroid ,metformin, glipizide, and a cholesterol medicine. i just got told i have low t levels and was prescribed this clomid but was really concerned about side affects from my others meds. is there a safety risk??? Thanks. Dr. Miller: There are potential risks with any medications. Find a doctor who can help you reverse your diabetes and thyroid as that may resolve your low T.
brian c. said:
prescribing clomid or other steroids is nothing more than treating the symptoms and not the cause. low test. and high blood fats are commonly caused from low thyroid. depression and anxiety are many times caused by a low fat diet, your brain is almost all fat so take cod liver oil twice a day and keep it cold. fix your thyroid and your test. level will double and your blood fats will drop like a rock, not to mention your hdl will go up. treat the cause not the symptoms!! Dr. Miller: Thank you for your comment. It's true, increasing fat in diet and treating low thyroid can help increase testosterone. Clomiphene citrate should only be prescribed after comprehensive evaluation and treatment of reversible causes.
Ron C. said:
I've been on some kind of Test replacement therapy for 10 years now. That was before all the hype and commercials ladies. The thing is your body adapts to the dosage and you have to increase it over time. That's why the gels and patches quit working for me. Dr. Miller: Thanks for your comment. Clomiphene or HCG still may work even though you have been on T for some many years, depends on cause of low T in the first place.
i have been diagnosed with low T when i was 27. now i am 32.still the levels are same. i don't know what is the real cause. there is no problem with pituitary gland. could it be primary hypogonadism then? then will taking clomiphene help? Dr. Miller: You need to find a doctor who can help you. Clomiphene doesn't help primary hypogonadism.
Do you know of a doctor in or around Atlanta that you could recommend? I was diagnosed with low T several years ago and hated using the topical gels so I just stopped. Getting worse now so I am hoping Clomid can help. Dr. Miller: Try Dr. Nicole Peoples.
Dear Dr. Thanks for the great information. I want to seek you advice as well. I am 30 years old male, all my life had normal sex drive..until few years back had low desire without noticing, thought at first due to focusing on work life. After getting married a year ago i faced ED and low desire, after checking with Drs. I found by prolactin level high 60 ng/ml (range2.5-17) and found FSL/LH/ ( low normal while T total and free below normal (T-total was 1.1 range 2.4-8.3 ng/ml ...free was 4.2 range 8.7-40 pg/ml).... MRI showed microadenoma 8mm, I was advised to take dostinex which immediately showed great results in less than 2 month... ED was fixed, FSH increase to 4 miu/ml LH 3.5 mIU/ml, T-total 3 ng/ml T-free 16pg/ml and prolactin was suppressed below normal range...sperm count was 96 million/ml(total 228 million) in May 2013 and in Oct I also checked semen again sperm concent. was 80million/total 400 million. Month ago (JAN-14) I rechecked the adenoma and it was suppressed to 4mm.All is great till now but the weird thing that when I have redone my semen, the count of semen declined hugely to 16mill/ml (total 80 mill) with 50% motility...a huge decline from 80million/ml only in 4 month (normal range above 15mil/ml)...also the FSH and LH although within normal range they declined to FSH-2 mIU/ml (range 1.5-14), LH 1.8 mIU/ml (range 1.5-8), Total Test 2.7 (range 2.4-8.3), Free T 10 (range 8.7-40)...while desire and ED still looks normal....I am really confused Dr. and afraid that I am in declining trend and not sure what is happening? do you believe I need to take clomid or other HCG..I am keen to have good fertility as I do not have children yet...really appreciate your feedback. Thanks in advance. Dr. Miller: I'm sorry I can't give personal medical advice here. However, in general, treating a prolactinoma doesn't always reverse the secondary hypogonadism and HCG or clomiphene may be required, at least temporarily. Or suppressing prolactin longer and more may likely be tried first.
Should women taking clomid also combine it with AI or weight loss? Dr. Miller: I am not an expert in the use of clomiphene in women, however I do know that prescribing an aromatase inhibitor to women can cause serious harm.
Hi Dr. Miller, I started having low libido and lack of sexual energy two years ago due to hypogonadotropic hypogonadism. After seeing an endocrinologist last year, I was started on Clomid 50mg daily for 3 months. While things didn't get back to normal, they got at least 50%-60% better (performance was back to normal, but libido was not). However, my symptoms reverted back after discontinuation of Clomid. My doctor then put me on 50mg Clomid once a week as an indefinite measure. However, after 3 months, I reverted back to pretty much original symptoms. Since then, my libido has been fairly erratic--sometimes helped by Clomid, sometimes not. Do you know of any reasons / solutions? Thank you! Dr. Miller: Usual maintenance dosing of clomiphene is daily or every other day. Also, if estrogen levels are too high it can decrease libido or cause other problems.
Hello Doctor, I am 28 and have fibromyalgia. I was taking androgel for about 1 year, along with hydrocodone, morphine hcl, lyrica, limbrel, chlorozoxone, and levothyroid (for hypothyroidism). I had never received any warnings from my urologist about the possible negatives of taking a testosterone replacement and find it recently online. I weaned myself off of it as I started taking vitamins with L-arginine in it. I will be asking my doctor about Clomid and HCG when I see him next month thanks to reading this. I had noticed that since I started taking the androgel I eventually felt like my sex drive actually decreased, and my testes had shrank some. My urologist has been rather judgmental of me for taking Rx pain killers. Which unfortunately I really cannot go without due to my fibro pain being as painfully strong as is. I had went through all types of medications for fibro and lyrica was the only one I could take that worked or had the least side effects from. Unfortunately though, I cannot take the dose my Dr recommends or I risk impotence side effects. I am hoping though, that if I do begin taking Clomid and or HCG that I can increase my lyrica dosage and with any luck not have the side effects and get myself off the pain killers. I am wondering if you have any knowledge of any patients similar to myself around my age with fibromyalgia and hypothyroidism? It has been extremely difficult for me since my fibro suddenly started approximately Oct 2011. Thank you. Dr. Miller: Opiates can cause secondary hypogonadism. You need to find an integrative doctor that can help determine the cause of your fibromyalgia and reverse it.
Dr. Miller, i am 26, when i was 24 i took pro hormones and after taking them i gained muscle but later developed Gynecomastia, they are not too big but are there. My sexual desire decreased, sperm count, and erections became weaker. My dr. Prescribled clomid and they help but a few weeks after stopping i start having bad erections again. Is there a better way to treat this? Dr. Miller: Treatment with clomiphene for a longer period may be necessary. You have to discuss with your doctor.
Hi Dr. Miller, My husband had been on testosterone injections every 2 weeks for a T count around 70 for the last 5 years. His Endo and Uro have no idea what's wrong with him, as he does not have a tumor, and does not have erectile dysfunction. He is 28. We are trying to get pregnant, discovered he had zero sperm, and is now on Clomid. It has been 3 weeks since his last injection, one week on the Clomid, and he feels terrible, similar to what he felt like prior to injections: exhaustion, general malaise, dehydration, inability to concentrate--he's like a giant space cadet. Any idea how long it may take for the Clomid to stimulate his testosterone production? I know there's a risk it may not do it at all, but if we're lucky and it does, I just want any kind of time frame to help him through it, so he can think "I only have to be in a funk for 2-3 weeks instead of the entire time" on the Clomid, which is when I get pregnant. After one week on it he wants me to be pregnant yesterday so as to get back on his injections. Thanks for your help. Dr. Miller: The effects of clomiphene can take several weeks to feel. For sperm production, waiting at least 3 months is usually necessary. HCG may help too. Stopping testosterone overnight is not recommended. Seek a second opinion for the cause of his low T. Good luck!
I've had low testosterone for over 10 years, and have been on Androderm, Androgel, and now Fortesta. My level without testosterone was about 190, and with the testosterone moves up to about 350-450. My testicles appear to have shrunk and my new urologist commented that they were small and this might be due to taking testosterone supplements. Could a Clomid approach instead of artificial testosterone restore the size of my testicles and increase my testosterone to normal? To restart my testicles to working, would I need any other drug beside Clomid? Dr. Miller: If one has secondary hypogonadism, then yes it's a good alternative to testosterone, and usually only clomiphene would be needed.
My husband has high levels of estrogen and low testosterone. He has one testicle (one was undescended as a baby and they were unsuccessful in saving it) and about 2 years ago had a spermatocele in the remaining testicle that eventually resolved itself. We have been trying for about 15 months to get pregnant unsuccessfully. My husband's internist put him on spironolactone for about 3 months last year, which now that I read about it, lowers testosterone instead of increasing it as he told us?!? I'd like to get my husband in to an endocrinologist who will not prescribe something that will decrease our fertility. My husband is also very overweight, and has put on about 50 pounds in the past year while we've been dealing with the low testosterone - he has no energy and low libido. Do you know of an endocrinologist in Utah that you think could be helpful? After reading this, I'm thinking clomid with an aromatase inhibitor would help. Just don't want to waste time and money trying to find someone who only will do androgel or something like that. Dr. Miller: Your husband's sperm needs to be evaluated. He may need a fertility clinic to help with sperm retrieval. Or HCG/clomiphene may help, depends on results of his evaluation. Good luck!
Dr. B from Canada said:
I have been using Clomid for a few of my low Testosterone men for the last few years. I am finding that I only need to use a small dose for most, 12.5 twice or even once a week. I can stop and some will have normal T levels for 6 months or longer. Has this been your experience? Also what is your feeling on Androxal (not available in Canada yet)? Dr. Miller: Yes, I generally recommend using lowest effective dose. If primary cause of secondary hypogonadism is reversed, then yes sometimes only short-term treatment is necessary. I prefer using drugs with longer safety history.
Dr. Miller, I'm a 48 yr old male. Muscular but also carrying at least 40 extra pounds. I lost 30 recently (started at 70 lbs overweight) while on clomid for six months, exercising and eating very healthy. Diagnosed with secondary hypogonadism prior to starting clomid 25 mg EOD. Total test went from 250 to 550. Feel much better. However very worried about dangers of taking clomid for more than six months. I seem to have significant increase in eye floaters so worried this is caused by clomid and staying on it will make this side effect worse. What is your experience with clomid and eye floaters? How long is safe to take clomid? Is switching from clomid to HCG at this stage something that could be effective? I don't want to lose the benefits of clomid but also don't want to permanently damage my eyes. Thank you in advance for any info you can share. Dr. Miller: Yes, any eye disturbances can be caused by clomiphene. HCG is good alternative when clomiphene causes side-effects.
Great information here thanks for doing this blog! I'm 45 year old male with T levels that hover around +/- 150 (without treatment). For about a year I was on various doses of Androgel. It did not raise my T levels at all. Next was Testopel injections that got my levels to 450 at a high point. Now I'm on Axiron which seems to be working not sure what my T levels are yet. One thing I have noticed with all of these is sleeping issues (insomnia, waking up, etc…). I have sleep apnea and use CPAP. Do Clomid and/or HCG have similar side effects? Dr. Miller: Sleep apnea is a known testosterone treatment side-effect. I haven't seen clomiphene or HCG causing sleep apnea, but suppose it is possible. Real question is whether you have primary or secondary hypogonadism, and whether primary problem is being treated.
Hi, I want to use clomiphene to increase T levels. Not having some very low T, but would it harm to use it for bodybuilding purposes, with no particular issue? THanks. Dr. Miller: I don't recommend using clomiphene or any other drug for doping purposes.
May I ask you how fast is Clomid in alleviating the symptoms of hypogonadism? I am a 30-year old male. For the last 12 years I have been struggling every day with insomnia, heart palpitations, muscle tensions, anxiety and exhaustion. Even though it has been very difficult to function with these symptoms, I have never had low mood and my libido has always been high. Since no somatic problem was found, I was put on many different anti-depressive and anxiolytic drugs, with no results. One year ago I tested for the first time testosterone. My T results from the last months are around 300-350 ng/dl, free T between 38-48 pmol/l, LH 4.1, 1.8, now 1.4 U/l. Additionally recently an osteopenia / starting osteoporosis has been found. No one knows whether my symptoms are related to T or not. I have been on Clomid for the last 3 weeks (25mg every other day). I still haven`t tested my blood, but I can see no improvement, my heart palpitation are even stronger than before. I do not ask for medical advice, I wanted simply to know how fast Clomid is and whether 3 weeks are enough to see improvements. It could also mean that the symptoms are not related to T. Dr. Miller: It can take several weeks to feel the effect of clomiphene, and higher dosing may be necessary in the beginning. Repeat levels need to be checked. HCG is an alternative if clomiphene is not effective. Try to find a doctor who can help you determine the cause of secondary hypogonadism. Osteoporosis and all your symptoms are consistent with low T syndrome, but there may also be additional problem.
My urologist must have been ahead of the curve on this. I went to him in July 2005 after i found out i had a low sperm count (20,000). He tested my testosterone levels and they were low as well. HE started me on clomid and after 3 years my wife and i had a son. We went back 2 years later and I started up on the clomid again and 7 months later my wife was pregnant with our daughter. I took it daily. I do not want any more children but i want to go back on because i believe this is the safest way to increase my T levels. I'm just curious about side effects after going off. I have noticed a lack of sex drive since going off...Dr. Miller: If cause of secondary hypogonadism is not discovered and/or reversed, then coming off of clomiphene will cause cause low T symptoms and low sperm count to recur.
Have been stressed out by life but test levels came back at 188. I had an undescendent testicle as a kid and had it operated on. It has always been much smaller than the other one. My sex drive through my 20's-30's was always good and am wondering if only having one fully functioning testicle means I only have some of the test I should. My test readings from 2009 were 355 and urologist said all was normal even though for my age at the time should have been 800 or more. Am 43 now and have soft weak erections that happen and then go limp. My muscles ache too and energy sucks. Can Clomid help? Any Dr. In the Washington DC or Northern Virginia area that can help? Dr. Miller: LH and FSH need to be checked to give best indication of whether or not clomiphene will help. Contact Dr. Warren Levin in your area.
raj s. said:
I had a problem with erectile disfunction and low sexual drive,so can clomid cure my this problem??? Dr. Miller: Depends on the cause.
Dr. Miller, I was diagnosed with low t about 8 months ago and have been prescribed (urologist) cypionate 2ml every 2 weeks (400mg). I feel decent for about a week and then I decline after that until about 3 days after next shot. I'm retaining a good amount of water...enough that my knees hurt quite a bit. I went to another doctor to check on other options. He seems to want to actually see if we can fix the problem which would be great. He started me on Clomid 25mg but since I started (shortly after my shot) my blood pressure has skyrocketed. From 120-140/75-85 to 180/100-116. Could this be related to the clomid? I have stopped test shots. My libido has me feeling like I'm 26 again (I'm 37). It is strong. I've felt pretty good except for the blood pressure. I don't have a lot of confidence in this doctor aside from his progressive approach with clomid. Dr. Miller: One would need to have blood work to determine if any other problem could be causing high blood pressure. Any side-effect with any medication is possible though.
Can Clomid trigger a heart attack? I started clomid and then I felt chest discomfort so I had to stop it. Dr. Miller: I haven't heard of that reaction but any side-effect is possible with any medication. Depends also on your underlying health.
Hi Doctor miller, I was recently prescribed clomid by my doctor. I am currently experiencing adrenal issues and low FREE test. My Free test is 9. My total is about 500. I have been experiencing poor mood, no motivation, terrible fatigue, anxiety. Would clomid be helpful? My eye sight has declined in the past few months. Would clomid worsen my eyesight PERMANENTLY? I took Propecia for several months but stopped due to low libido. Now i am terrified of taking anymore hormonal meds. How do i know if you respond back? Thank you for your help. Dr. Miller: You need to have LH and FSH checked to determine if cause of low T is primary or secondary. Clomiphene can help in secondary hypogonadism.
dear doctor, I was very interested by your article here as I think I may be experiencing low T. I am an 18 year old male with Testosterone levels at 4.8 ng/ml (normal range 2.6-8.7) and very low FSH (1.8 mIu/ml) and LH (2.9 Iu/L) I don't understand much about all this but I do understand my symptoms which are erectile dysfunction, low libido, pain in the penis shaft and testicles and also what seems to be the beginning of gynécomastia. I believe the problem has been brought on by the popular hair-loss drug, Finasteride which I took for only three days then stopped about a month ago. my situation has been getting worse every day for the last two weeks and I'm just very worried. I have mood swings and sometimes it's hard for me to sleep. I have however put myself under a lot of stress because of all this, I am very worried and have that "butterfly in the stomach" feeling almost all the time. Unfortunately I did a bit of research and found something called post-Finasteride syndrome or PFS which seems to include all my symptoms. knowing about this and reading that it will never go away has certainly not helped. I was also tested for PRL which seems to be just in the upper 30% at 19 ng/ml (normal range: 3-25) so my questions are A.Do you think I actually have PFS (which is a form of secondary hypogonadism) and do you think it's actually possible I got it after three days? or do you think my mind is playing tricks on me? B. do you believe that clomid could help my situation? if so how long do you expect I should take it? C. Do you think it's possible that all my symptoms are stress-related as my parents keep telling me? D. I've started taking fish oil and adjusting my diet in a way that helps increase T levels but do you think the low FSH and LH can be helped as well? E. I've already seen a urologist and I have another appointment very soon. should I ask him for more tests? what should I be tested for? should I ask him for Clomid? should I ask for referral to an endocrinologist? F. do you think intervening with drugs like clomid at this stage will help in the long term? I greatly appreciate your reply. I am very very worried and really don't know what to do. as you can imagine, being only 18, the thought of becoming impotent is destroying me. your advice will be greatly valued. Dr. Miller: Sorry about your situation. Yes, unfortunately, post-propecia syndrome is a possibility. Clomiphene may help.
maggie m. said:
My husband has recently diagnosed with. Oat syndrome and underwent a procedure to tie up a vein that was expanding and. Heating up his sperm, also a biopsy. Was taken from his testis, he is about to go On the T injection, and I'm soooooo glad I've found this site, clomid seems to be a better option and I think his doc did mention something about it, my question is will clomid help with oats syndrome?? Dr. Miller: It's possible. Good luck!
low T37 said:
Dr. Miller I have been on 3 pumps of androgel 1.62 for two years and my T level went to 197 and has stayed there and my doc says that is good enough. After reading this I feel he is wrong, do you know of someone I could see in utah? Dr. Miller: I'm sorry I don't know any doctors in Utah. Try a urologist with expertise in endocrinology.
How would you assess the risk of lowered SHBG in a male patient with age-normal testosterone (free + utilized) started on clomiphene 25mg EOD? Also, how long after treatment initiation would labs for E2 be necessary to obtain? Patient is 30 y/o with no relevant history. How does DM2 change this picture? Thank you in advance for answering my question. I am trying to get a better understanding of the feedback mechanisms involved here based on your clinical knowledge and experience. Dr. Miller: SHBG will likely rise with increasing testosterone level. I prefer to check at least estrogen and testosterone levels about 4-6 weeks after starting clomiphene. Type 2 diabetes can cause secondary hypogonadism.
Dr. Miller - I was treated four years ago for prostate cancer with proton beam therapy. I had taken testosterone prior to that. Could Clomid possibly be recommended in my case? Can it raise PSA levels? Also, my Rx provider indicated Clomid for me would be an "off-label" use subject to their approval. Your comments much appreciated. Dr. Miller: Sorry about your prostate cancer. Clomiphene can help if cause of low T is secondary hypogonadism. Yes, it can raise PSA too. Yes, clomiphene use in men is off-label.
Tadele B. said:
Dear Dr. Miller: As my doctor told me I have cause secondary hypogonadism problem and he put me on Clomid 50mg. As soon as I start i feel stomach, vision & pelvic pain but I continued for 45 days mean while I do not feel penis weak (not erect) Libido. what do you advice me my doctor I am sorry to say he can not correct the problems. Dr. Miller: You need to find a doctor who can help you. Sometimes HCG is necessary instead of clomiphene, depends on the cause of your hypogonadism and your individual response.