Discussions that mention nolvadex

Men's Health board


Hi all. I see that there are a number of posters on this board who are very schooled pertaining the issues I am posting, and I am hoping I can obtain some constructive feedback to ensure that I receive the best medical care.

I am in my mid 30's. I have suffered from persistent fatigue and other depressive symptoms for some time now, and my body is not recovering from some injuries. For the longest while, every doctor seemed to intimate that my symptoms were in my head, and that I must be suffering from some sort of treatment-resistant mental health issue. I believed something else was going on, and sure enough, a number of things have surfaced over recent months, as I began seeing seasoned specialists.

Eventually, I asked an integrative doctor to order tests to evaluate my testosterone. He agreed that this was appropriate given my symptoms. Because of issues regarding testosterone and beyond (as set forth below), he referred me to an endocrinologist, who is apparently very well credentialed.

The following are my lab results -- if tested twice, I list both values:

Testo, free and total: 355 & 373 (low end of range, not age specific)
% Free Testo: 1.22% & 1.29% (below normal)
Testo free: 45.9 & 45.3 (low end of range, not age specific)
LH: 4.1 & 5.2 (mid range)
FSH: 1.7 (bottom of range)
Prolactin: 6.1 (mid range)
Estradiol: 20 (low end of range)
DHEA-S: 146 (low end of range, not age specific)
IGF-1: 247 (high end of range)
ACTH: 47 (high end of range)

The endocrinologist unequivocally stated that I need to be on testosterone therapy, given my age, particularly in light of my symptoms. He said that this would be a life-long committment. He did not mention HCG or Clomid. While he mentioned that this would cause my testes to shut down, and stop producting testosterone and that my testes would shrink, he did not mention how this may affect fertility. He opined that my body's failure to upregulate LH and FSH to produce more testosterone demonstrated that there was a problem with my pituitary, perhaps the consequence of repeated concussive blows to the head. (I am getting a pituitary MRI on Monday.) He gave me Testim, 50 mgs., and told me to apply one tube every morning. He told me to wait 3 weeks before beginning T-therapy, as I just started taking Synthroid, and he first wants my body to adjust to that.

While I would like to think that the endo exercised sound medical judgment in dictating this course of treatment, I am concerned about my body shutting down its natural production, as well as any impact this may have on my fertility -- I don't have children, but would like to eventually. Based on the posts on this board, I am concerned by the fact that the endo did not mention HCG and Clomid (or Nolvadex). From what I've read on this board, it sounds like I may have a chance of kick starting my system so that I begin producing more LH (and FSH???) and, in turn, more testosterone. While I would like to proceed with the T-therapy, I also would like to do whatever I can to preserve testicular function and my fertility.

If you can give me some guidance, as well as some idea about the prospects of kick starting my pituitary/hypothalmus, I would really appreciate it. I've already printed out information regarding HCG and Clomid, which I plan to present to the endo before proceeding with T-therapy. But I want to prepare to ask pointed questions to ensure that I am receiving the best medical care. Additionally, if you can tell me whether proceeding as directed may compromise my fertility to a greater extent than some alternative approach, I'd appreciate that too. Finally, if you believe that the doctor failed to meet the standard of care, and that I therefore should seek out another doctor with a speciality in men's sexual health (perhaps a urologist), please let me know. I appreciate your candor.

Immeasurable thanks in advance. This is a terrific board! Happy holidays to all.

~j