I originally had my testosterone tested a few years ago as my wife and I were unable to get pregnant. It was determined to be due to my extremely low sperm count. We have since had two great kids via IVF. The doctors tried me on a Clomid cycle, which improved testosterone from 300 to 500, but did not help my sperm count. My testosterone has hovered in the 250 - 325 range since, but I am finding it nearly impossible to put on muscle or gain strength (although my strength numbers are pretty good and I have competed in Powerlifting and Crossfit).
I am most interested in my health, but also performance, and curious what avenues I should look to before plunging into TRT. Appreciate any insight that can be provided.
-age: 35
-height: 5’10
-waist: 33
-weight: 180
-describe body and facial hair: Some facial hair above mouth and on chin, but nothing between sideburns and goatee
-describe where you carry fat and how changed: No changes and body fat been tested consistently at 12%, mostly carry in stomach, chest, lower back and triceps. Thin legs.
-health conditions, symptoms [history]: No health issues.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: No drugs ever.
-lab results with ranges
Testosterone: pre-clomid: 306, on clomid: 526; returned to normal afterwards
Free T: off-clomid: 5.6 ng/dl (low)
SHBG: off-clomid: 25 (high-normal)
LH: pre-clomid: 4.0 (normal), on-clomid 9.4 (high)
FSH: pre-clomid: 8.8 (normal), on clomid 14.4 (high)
TSH: off clomid: 2.1 (normal)
T4: off clomid:1.3 (normal)
Cortisol: off clomid: 16.6 (low-normal)
Estadiol: off clomid: 12 (low-normal)
-describe diet: high protein, high fat, moderate carbs; overall very clean
-describe training: 4 days of heavy strength training, 2 days of crossfit metcons, 1 day of LISS
-testes ache, ever, with a fever: No
-how have morning wood and nocturnal erections changed: No changes, but come and go in waves.
This biomarker basically hints at your chance of recovering naturally, if testosterone is low when this value is almost midrange, recovering natural is not possible. You’re never going to the same levels you had on clomid. The LH value also tells me your testicles are no very responsive to LH stimulation so any increase naturally will keep your levels suboptimal.
I wonder if you’ve ever had any blows to the testicles. These are disease state levels. Your testosterone levels do not increase as you age, they decrease 1% every year past 30, but do to poor lifestyle, diets and/or chemicals in the environment is speeding this process along.
I wonder did your doctor ever prescribe FSH injections, this hormone is responsible for sperm production. The reason I ask is clomid doesn’t increase FSH, it increases LH.
The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.
Here is a sample of the population and where healthy men measure up.
25-34 years of age 45 subjects 617 ng/dL You should be up here
35-44 years 22 subjects of age 669 ng/dL
45-54 years of age 23 subjects 606 ng/dL
55-64 years of age 43 subjects 562 ng/dL
65- 74 years of age 47 subjects 524 ng/dL
75-84 years of age 48 subjects 471 ng/dL
85-100 years of age 21 subjects 376 ng/dL You’re down here.
Clomid is good for short term treatment. For long term hop on TRT with injectable T enant or cyp if no further kids are in the planning. You will benefit from it.
Thanks to all for the replies. It sounds like most are recommending giving TRT a try. Are there any other biomarkers or things I should try before going to TRT?