[Deadcalm]

Interesting post here from another forum and a well-known doctor on there:

Another point which needs to be made is the failure of many (I have not read where Roberts has recomended this) to properly taper their SERM's at the end of pct.

As Dr. Shippen and I have each discovered independently, and discussed in a private conversation at an A4M conference in Las Vegas over two years ago, just 25mg of clomid is indeed a whalloping dose with respect to HPTA-stimulation. I therefore would want to see dosage decreases in 5 day increments, with the last step at 12.5mg QD.

And some people are taking quadruple that.

 

[hackskii]

Interesting post here from another forum and a well-known doctor on there:

And some people are taking quadruple that.

I recognize that writing, that is Dr. John Crisler, I read Shippens book, pretty good read.

One of the only doctors probably 20 years ago (Shippen) treated men with an AI when estrogen was negatively impacting the HPTA.

 

[Deadcalm]

I recognize that writing, that is Dr. John Crisler, I read Shippens book, pretty good read.

One of the only doctors probably 20 years ago (Shippen) treated men with an AI when estrogen was negatively impacting the HPTA.

Good spot!

So if Dr.Shippen and Dr.Crisler both agree that 25mg is a big dose for HPTA simulation, it just adds more weight to the theory that people are overdosing on this and 50mg of clomid or even 25mg may suffice in most cases, especially when used with another SERM.

There may be very extreme situations where guys need to try higher doses as a last resort, but the amount of people I see on this forum and elsewhere who suggest 100mg of clomid for 2-4 weeks for fairly simple 12-14 week cycles is quite alarming.

 

[Jalex]

Still makes sense to front load right? To build levels up asap as you want a big jumpstart.

Something like 100mg first 3 days then 50 for few weeks then 25.

 

[hackskii]

Good spot!

So if Dr.Shippen and Dr.Crisler both agree that 25mg is a big dose for HPTA simulation, it just adds more weight to the theory that people are overdosing on this and 50mg of clomid or even 25mg may suffice in most cases, especially when used with another SERM.

There may be very extreme situations where guys need to try higher doses as a last resort, but the amount of people I see on this forum and elsewhere who suggest 100mg of clomid for 2-4 weeks for fairly simple 12-14 week cycles is quite alarming.

Well, a couple of things going on here.

First some of those secondary guys that use clomid long term only use enough to get LH to move T within range, and this is long term use, not weeks.

Second post cycle with either the use of hCG during, or in PCT hCG hammers LH to lowest detectable levels and even at just .1 is common depending on how much hCG.

When LH is so low, 100mg for a week or two is not a bad idea, once GnRH becomes more sensitive at the pituitary, less can be used, and then tapering would be a good idea.

The issue would be that of ocular toxicity with the higher doses of clomid being used.

We know that endo docs use clomid at 100mg per day for 5 to 7 days to get the pituitary to respond to notice an influence to diagnose secondary hypogonadism.

So, I really don't see an issue with this, unless the person is prone to clomids sides, but many will not notice any sides from clomid like myself.

So, 2 weeks with 100mg clomid I don't really have a problem with as guys need those androgens up ASAP.

 

[Deadcalm]

Still makes sense to front load right? To build levels up asap as you want a big jumpstart.

Something like 100mg first 3 days then 50 for few weeks then 25.

I personally don't think so, but it wouldn't do any harm providing that it's a sensible front load. Something like 100mg for the first day and then 50mg thereafter with a gradual taper.

The studies mentioned in my original post achieved huge boosts in test on low doses without any front-loading. Hackskii also did a small clomid run with a starting dose of 50mg and achieved a large increase in T levels.

People say that clomid should be front-loaded to build up the half-lives, but they're perhaps erroneously applying the concept of AAS half-lives to clomifene. Steroids have an ester attached where the hormone only becomes active when it's gradually cleaved away by enzymes. Clomid doesn't have any of that. You take 50mg and 50mg is in your blood and working within a few hours. It then gradually takes time to leave the system.

It's more clear now that not a lot of clomid is required to inhibit the effect of oestrogen on the hypothalamus, and once it's working, it can't really work any more effectively, so I don't think there's any merit in the idea of trying to get half-life peaks to overlap like you would with AAS.

But as I said, I suppose a 100mg single day front load won't hurt. That's still quadruple what has been proven to work in HPTA stimulation.

 

[Deadcalm]

Well, a couple of things going on here.

First some of those secondary guys that use clomid long term only use enough to get LH to move T within range, and this is long term use, not weeks.

Second post cycle with either the use of hCG during, or in PCT hCG hammers LH to lowest detectable levels and even at just .1 is common depending on how much hCG.

When LH is so low, 100mg for a week or two is not a bad idea, once GnRH becomes more sensitive at the pituitary, less can be used, and then tapering would be a good idea.

The issue would be that of ocular toxicity with the higher doses of clomid being used.

We know that endo docs use clomid at 100mg per day for 5 to 7 days to get the pituitary to respond to notice an influence to diagnose secondary hypogonadism.

So, I really don't see an issue with this, unless the person is prone to clomids sides, but many will not notice any sides from clomid like myself.

So, 2 weeks with 100mg clomid I don't really have a problem with as guys need those androgens up ASAP.

But the question is whether taking such a high dose like 100mg will really bring LH and FSH output up any faster. Once oestrogen is inhibited, it can't be inhibited any further, so whacking in a massive initial dose doesn't necessarily have any benefits. The MOA doesn't really relate well to the idea of "the more you take, the better/faster it works". Once oestrogen is inhibited, it all comes down to how quickly the hypothalamus and pituitary begin releasing their relevant hormones, and more clomid won't really do anything to speed that up if it's already doing its job.

My point here is mostly regarding the side effects such as ocular toxicity and depression/emotional issues, so if guys don't have any of that, then perhaps it isn't an issue. But either way, it's still not a healthy thing, so guys might be giving themselves much higher doses for no discernible benefit but some potentially negative effects.

I've also been having a look through the web and I'm sure that Crisler and Shippen have both done one week 50mg ED clomid tests. Given that they've said that 25mg ED of clomid is a "whopping" dose for HPTA stimulation, 50mg would still be double that amount and considered a high dose.

 

[Jalex]

I personally don't think so, but it wouldn't do any harm providing that it's a sensible front load. Something like 100mg for the first day and then 50mg thereafter with a gradual taper.

The studies mentioned in my original post achieved huge boosts in test on low doses without any front-loading. Hackskii also did a small clomid run with a starting dose of 50mg and achieved a large increase in T levels.

People say that clomid should be front-loaded to build up the half-lives, but they're perhaps erroneously applying the concept of AAS half-lives to clomifene. Steroids have an ester attached where the hormone only becomes active when it's gradually cleaved away by enzymes. Clomid doesn't have any of that. You take 50mg and 50mg is in your blood and working within a few hours. It then gradually takes time to leave the system.

It's more clear now that not a lot of clomid is required to inhibit the effect of oestrogen on the hypothalamus, and once it's working, it can't really work any more effectively, so I don't think there's any merit in the idea of trying to get half-life peaks to overlap like you would with AAS.

But as I said, I suppose a 100mg single day front load won't hurt. That's still quadruple what has been proven to work in HPTA stimulation.

Makes sense.

I guess the question is, we have no proof that a higher dose of 100mg ED does NOT have a more significant impact on levels. What we know is the increase in side effects (or risks thereof).

So theoretically, someone who appears to have no negative side effects at 100mg ED could continue with that protocol on the chance there is further benefits to a higher dose, with no detriment (to this individual).

 

[Deadcalm]

Makes sense.

I guess the question is, we have no proof that a higher dose of 100mg ED does NOT have a more significant impact on levels. What we know is the increase in side effects (or risks thereof).

So theoretically, someone who appears to have no negative side effects at 100mg ED could continue with that protocol on the chance there is further benefits to a higher dose, with no detriment (to this individual).

They could, yes. But I'd be cautious of doing so.

These side effects aren't just mild annoyances. Ocular toxicity is a serious thing, which is likely to be present even if no symptoms are apparent during these initial stages. We just don't know for sure what's really going on inside the body.

Given that doctors and numerous studies have suggested that 25mg to 50mg works very well, and they've advocated 50mg in clomid tests and PCT therapies, I would be weary of doubling the dose of clomid. That's one hell of a big jump which may well have hidden issues we don't know about.

Perhaps it's required if someone needs a seriously heavy PCT after exhausting all other options, but I don't think anywhere near that much is required for a normal 10-12 week cycle. Bear in mind that clomid is often partnered with another SERM with similar mechanisms, so you have to factor that in as well. 100mg of clomid and 20mg of nolva or 60mg or torem may be massive overkill which causes more harm than good for many normal AAS users.

Anyway, I'll be doing 50mg of clomid ED and 60mg of torem ED in my PCT (there's a log ready and waiting in the PCT section of this thread), so I suppose I'll find out. If I get hit hard by the clomid sides, I'll drop to 25mg clomid ed and keep the 60mg of torem.

 

[Jalex]

They could, yes. But I'd be cautious of doing so.

These side effects aren't just mild annoyances. Ocular toxicity is a serious thing, which is likely to be present even if no symptoms are apparent during these initial stages. We just don't know for sure what's really going on inside the body.

Given that doctors and numerous studies have suggested that 25mg to 50mg works very well, and they've advocated 50mg in clomid tests and PCT therapies, I would be weary of doubling the dose of clomid. That's one hell of a big jump which may well have hidden issues we don't know about.

Perhaps it's required if someone needs a seriously heavy PCT after exhausting all other options, but I don't think anywhere near that much is required for a normal 10-12 week cycle. Bear in mind that clomid is often partnered with another SERM with similar mechanisms, so you have to factor that in as well. 100mg of clomid and 20mg of nolva or 60mg or torem may be massive overkill which causes more harm than good for many normal AAS users.

Anyway, I'll be doing 50mg of clomid ED and 60mg of torem ED in my PCT (there's a log ready and waiting in the PCT section of this thread), so I suppose I'll find out. If I get hit hard by the clomid sides, I'll drop to 25mg clomid ed and keep the 60mg of torem.

Indeed indeed.

Yes, following your pct thread closely as you are also incorporating aromasin correct?

Need to work out what protocol I'm going to use for my pct in a few weeks.

 

[hackskii]

Well if endo docs use 100mg per day, I doubt 50mg would have the same results.

Again I have no issue with 100mg for a couple of weeks, occular issues won't be an issue.

 

[Deadcalm]

Indeed indeed.

Yes, following your pct thread closely as you are also incorporating aromasin correct?

Need to work out what protocol I'm going to use for my pct in a few weeks.

Yep. I'll see how the aromasin goes and adjust my dose if necessary. 12.5mg EOD is my starting point followed by a taper.

 

[Deadcalm]

Well if endo docs use 100mg per day, I doubt 50mg would have the same results.

Again I have no issue with 100mg for a couple of weeks, occular issues won't be an issue.

Dr Shippen and Dr Crisler, who are more specialised in HPTA recovering from AAS use, both seem to be using 50mg of clomid for their clomid tests and on-going therapy:

The clomid was just a brief test-it was a low dose-- 1/2 a 50mg (??)) tablet for only 7 days, with blood work on the 8th. Per Dr. Shippen it was only intended to "rev the engine" (his words) to help determine where the problem lies. It was a limited test only and never intended as a solution. I was encouraged that I could see any results after only a week at a low dose.

This guy was even advised by Shippen to only use 25mg ED for 7 days.

I've never seen endos use 100mg per day personally, but even if they do, I'm not going to take their word as gospel, especially when there's mounting scientific evidence, anecdotal reports and comments from AAS-recovery specialist doctors that even 25mg is a whopping dose, and 50mg is double that.

And why do you think that 100mg of clomid every day won't make ocular toxicity an issue? Scally himself said this:

Regarding side effects, visual disturbances require immediate and prompt attention. In some cases, a migraine (headaches) equivalent may be diagnosed. In the more than 1000 patients I saw prescribed the SERMs tamoxifen and/or clomiphene, very few complained of visual disturbances or migraines/headaches. Tamoxifen was prescribed at 20-40 mg/day for no more than 45 days, while the clomiphene dose was 50-100 mg/day. In those that did, there was an immediate decrease in dose or discontinuation with almost daily follow up. None suffered any consequences.

So even at doses of 50mg-100mg per day, if any patients had eye problems (which he suggests some did), he immediately decreased or stopped the dose.

Given the nature of ocular toxicity, there doesn't need to necessarily be any symptoms for it to still be unhealthy for your eyes. It's a bit like saying that people are fine to drink as much alcohol as they want as long as they don't get cirrhosis of the liver. It's still detrimental to health below the point in which symptoms start to become noticeable.

But you're entitled to your opinion anyway. Personally, after everything I've read, I'll be advocating a lower dose to restore HPTA function for normal, sensible cycles. This board also seems to only be one of the few where 100mg of clomid is still commonplace. Most forums in the US and elsewhere are all suggesting 25mg/50mg clomid doses for their PCTs and recovering very well it seems.

 

[ollie321]

Dr Shippen and Dr Crisler, who are more specialised in HPTA recovering from AAS use, both seem to be using 50mg of clomid for their clomid tests and on-going therapy:

This guy was even advised by Shippen to only use 25mg ED for 7 days.

I've never seen endos use 100mg per day personally, but even if they do, I'm not going to take their word as gospel, especially when there's mounting scientific evidence, anecdotal reports and comments from AAS-recovery specialist doctors that even 25mg is a whopping dose, and 50mg is double that.

And why do you think that 100mg of clomid every day won't make ocular toxicity an issue? Scally himself said this:

So even at doses of 50mg-100mg per day, if any patients had eye problems (which he suggests some did), he immediately decreased or stopped the dose.

Given the nature of ocular toxicity, there doesn't need to necessarily be any symptoms for it to still be unhealthy for your eyes. It's a bit like saying that people are fine to drink as much alcohol as they want as long as they don't get cirrhosis of the liver. It's still detrimental to health below the point in which symptoms start to become noticeable.

But you're entitled to your opinion anyway. Personally, after everything I've read, I'll be advocating a lower dose to restore HPTA function for normal, sensible cycles. This board also seems to only be one of the few where 100mg of clomid is still commonplace. Most forums in the US and elsewhere are all suggesting 25mg/50mg clomid doses for their PCTs and recovering very well it seems.

I forone get really bad clomid sides, as ive mentioned on here before and that was 50mg ed for 10 days, thats all I could take, im going to try 25mg and see difference this pct and run for a longer period

 

[Deadcalm]

I forone get really bad clomid sides, as ive mentioned on here before and that was 50mg ed for 10 days, thats all I could take, im going to try 25mg and see difference this pct and run for a longer period

Crisler, a doctor and AAS HPTA restoration specialist, said this:

As Dr. Shippen and I have each discovered independently, and discussed in a private conversation at an A4M conference in Las Vegas over two years ago, just 25mg of clomid is indeed a whalloping dose with respect to HPTA-stimulation. I therefore would want to see dosage decreases in 5 day increments, with the last step at 12.5mg QD.

So I think you'll be fine with 25mg ED along with another SERM like 20mg of nolva or 60mg of torem if 50mg ED provides too many bad side effects.

I'll personally be dropping from 50mg to 25mg ED if the side effects are too bad for me in my PCT next week.

 

[hackskii]

Dr Shippen and Dr Crisler, who are more specialised in HPTA recovering from AAS use, both seem to be using 50mg of clomid for their clomid tests and on-going therapy:

This guy was even advised by Shippen to only use 25mg ED for 7 days.

I've never seen endos use 100mg per day personally, but even if they do, I'm not going to take their word as gospel, especially when there's mounting scientific evidence, anecdotal reports and comments from AAS-recovery specialist doctors that even 25mg is a whopping dose, and 50mg is double that.

And why do you think that 100mg of clomid every day won't make ocular toxicity an issue? Scally himself said this:

So even at doses of 50mg-100mg per day, if any patients had eye problems (which he suggests some did), he immediately decreased or stopped the dose.

Given the nature of ocular toxicity, there doesn't need to necessarily be any symptoms for it to still be unhealthy for your eyes. It's a bit like saying that people are fine to drink as much alcohol as they want as long as they don't get cirrhosis of the liver. It's still detrimental to health below the point in which symptoms start to become noticeable.

But you're entitled to your opinion anyway. Personally, after everything I've read, I'll be advocating a lower dose to restore HPTA function for normal, sensible cycles. This board also seems to only be one of the few where 100mg of clomid is still commonplace. Most forums in the US and elsewhere are all suggesting 25mg/50mg clomid doses for their PCTs and recovering very well it seems.

For the record Scally does use 100mg per day, and thus suggested that out of the thousands that have been treated very few complained of visual disturbances.

I myself at 100mg see some things going on after 21 days being on.

I really do not think that 50 or 25mg will give the same response as 100mg.

Here are some studies suggesting both side of things.

Here's a study showing low-dose Clomid therapy (25mg ED) boosts testosterone by 250% in 4-6 weeks:



Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism
,
Shabsigh A, Kang Y, Shabsign R, Gonzalez M, Liberson G, Fisch H, Goluboff E.
Department of Urology, NY Presbyterian Medical Center, New York, NY, USA. J Sex Med. 2005 Sep;2(5):716-21.

AIM: Symptomatic late-onset hypogonadism is associated not only with a decline in serum testosterone, but also with a rise in serum estradiol. These endocrine changes negatively affect libido, sexual function, mood, behavior, lean body mass, and bone density. Currently, the most common treatment is exogenous testosterone therapy. This treatment can be associated with skin irritation, gynecomastia, nipple tenderness, testicular atrophy, and decline in sperm counts. In this study we investigated the efficacy of clomiphene citrate in the treatment of hypogonadism with the objectives of raising endogenous serum testosterone (T) and improving the testosterone/estrogen (T/E) ratio. METHODS: Our cohort consisted of 36 Caucasian men with hypogonadism defined as serum testosterone level less than 300 ng/dL. Each patient was treated with a daily dose of 25 mg clomiphene citrate and followed prospectively. Analysis of baseline and follow-up serum levels of testosterone and estradiol levels were performed.

RESULTS: The mean age was 39 years, and the mean
pretreatment testosterone
and estrogen levels were
247.6 +/- 39.8 ng/dL
and 32.3 +/- 10.9, respectively.
By the first follow-up visit (4-6 weeks), the mean testosterone level rose to 610.0 +/- 178.6 ng/dL
(P < 0.00001). Moreover, the T/E ratio improved from 8.7 to 14.2 (P < 0.001). There were no side effects reported by the patients.

CONCLUSIONS: Low dose clomiphene citrate is effective in elevating serum testosterone levels and improving the testosterone/estradiol ratio in men with hypogonadism.This therapy represents an alternative to testosterone therapy by stimulating the endogenous androgen production pathway.

Study showing a hypogonadic 30-year old male, suffering permanent shutdown from steroid abuse, fully recovered natural hormone levels and HPTA function from 2 months of 100mg Clomid therapy:

Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse
,
Tan RS, Vasudevan D.

Department of Family and Community Medicine, University of Texas Health Sciences Center, Houston, Texas 77030, USA.

OBJECTIVE: To report a case of symptomatic hypogonadism induced by the abuse of multiple steroid preparations that was subsequently reversed by clomiphene. DESIGN: Case report. SETTING: University-affiliated andrology practice within family practice clinic. PATIENT(S): A 30-year-old male.

INTERVENTION(S): Clomiphene citrate, 100-mg challenge for 5 days, followed by treatment at same dose for 2 months.

MAIN OUTCOME MEASURE(S): Clinical symptoms, androgen decline in aging male questionnaire, total T, FSH, LH.

RESULT(S):
Reversal of symptoms, normalization of T levels with LH surge, restoration of pituitary-gonadal axis.


CONCLUSION(S): Clomiphene citrate is used typically in helping to restore fertility in females. This represents the
first case report of the successful use of clomiphene to restore T levels and the pituitary-gonadal axis in a male patient. The axis was previously shut off with multiple anabolic steroid abuse.


Here's another study showing only 7 days of Clomid therapy increased total testosterone by 100% and, more importantly, free testosterone by over 300% in young men:



The effects of aging in normal men on bioavailable testosterone and luteinizing hormone secretion: response to clomiphene citrate
, J Clin Endocrinol Metab. 1987 Dec;65(6):1118-26.

Geriatric Research, Education, and Clinical Center, Veterans Administration Medical Center, Seattle, Washington.

Serum testosterone (T) levels in men decline with age while serum LH levels, as measured by RIA, increase. To assess if the decline in serum T levels in healthy aging men is paralleled by an age-related decline in the bioavailable non-sex hormone-binding globulin (SHBG)-bound fraction of T and to determine whether there are age-related changes in LH secretion or LH control of T production, we studied 29 young (aged 22-35 yr) and 26 elderly (aged 65-84 yr) healthy men. All men had single random blood samples drawn, and 14 men in each age group underwent frequent blood sampling for 24 h, both before and after
7 days of clomiphene citrate (CC) administration.
Both mean 24-h serum total T levels and non-SHBG-bound T were reduced in elderly men compared to those in young men (P less than 0.05), while estradiol and SHBG levels were similar in the 2 age groups. Serum FSH determined by RIA and LH by RIA and bioassay were higher in the elderly men compared to those in young men (P less than 0.05), but the ratios of LH bioactivity to immunoreactivity and the LH pulse frequency and amplitude were similar.
After CC administration, mean serum total T and non-SHBG-bound levels in young men increased by 100% and 304%
, respectively, while in older men these values increased by only 32% and 8%, respectively. However, CC-stimulated LH pulse characteristics and serum levels of estradiol, SHBG, FSH, and bioactive and immunoreactive LH were similar in the 2 groups. Thus, both at baseline and after CC stimulation, elderly men had significantly lower serum total T and non-SHBG-bound (bioavailable) T levels than did young men, despite similar or increased levels of bioactive LH and similar bioactive to immunoreactive LH ratios and LH pulse characteristics. These results suggest that major age-related changes in the hypothalamic-pituitary-testicular axis occur at the level of the testes and are manifested by decreased responsiveness to bioactive LH. Administration of CC to young and elderly men resulted in similar changes in LH pulse characteristics and LH bioactivity and immunoreactivity, suggesting preserved hypothalamic-pituitary responsiveness in the elderly.

 

[hackskii]

So, as you can see, for some it may work, for others perhaps not, we all are different.

Notice the guy that was diagnosis permanent shutdown and the 100mg dosing.

Remember Scally still uses 100mg, Dr. John Crisler will not say how much he gives his guys, what he dose kind of for recovery he will not say, and if his guys talk openly he drops them as patients.

I have followed Scally from 2006, Shippen since 2002, and same with Crisler.

I am fully aware of their doses, what they say, and in contrast they all say similar things, not same.

Scally uses more hCG, and more SERM's.

Another thing, tamox and clomid are both SERM's but are used together for synergy, they do not act the same way, clomid is acts as an estrogen at the pituitary, nolva does not.

I feel they work best together.

Some suggest some estrogen priming with clomid, but all based on speculation and the debate on meso board never got rolling.

I do feel there are times that 100mg may be appropriate, and others not.

It would be like saying just take an aspirin for that broken arm, it kills the pain, yet was the wrong med being used.

 

[Deadcalm]

For the record Scally does use 100mg per day, and thus suggested that out of the thousands that have been treated very few complained of visual disturbances.

I myself at 100mg see some things going on after 21 days being on.

Scally may have used 100mg consistently in the past, but I've seen more recent comments directly from him suggesting that he uses 50mg-100mg depending on the situation. I've even quoted it up there.

I know he has his PoWeR protocol, but it seems that this wasn't just created by Scally. Scally was part of the team at the Program for Wellness Restoration, which created the PCT. Considering that this was mentioned in William Llewellyn's 9th edition book which was released in 2009, the protocol may now be anywhere from 6-10+ years old. Things can come a long way in that time period. Scally, Shippen and Crisler have both mentioned in more recent times the effectiveness and use of 25mg-50mg doses.

I really do not think that 50 or 25mg will give the same response as 100mg.

But why? As I've said before, many studies, anecdotal reports and comments from Shippen and Crisler suggest that 50mg is more than enough and even 25mg is a "whopping" dose for HPTA simulation. I'm basing this point on all of this evidence, and unless you have some evidence add weight to your theory, it just seems to be speculation.

Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism
,
Shabsigh A, Kang Y, Shabsign R, Gonzalez M, Liberson G, Fisch H, Goluboff E.
Department of Urology, NY Presbyterian Medical Center, New York, NY, USA. J Sex Med. 2005 Sep;2(5):716-21.

AIM: Symptomatic late-onset hypogonadism is associated not only with a decline in serum testosterone, but also with a rise in serum estradiol. These endocrine changes negatively affect libido, sexual function, mood, behavior, lean body mass, and bone density. Currently, the most common treatment is exogenous testosterone therapy. This treatment can be associated with skin irritation, gynecomastia, nipple tenderness, testicular atrophy, and decline in sperm counts. In this study we investigated the efficacy of clomiphene citrate in the treatment of hypogonadism with the objectives of raising endogenous serum testosterone (T) and improving the testosterone/estrogen (T/E) ratio. METHODS: Our cohort consisted of 36 Caucasian men with hypogonadism defined as serum testosterone level less than 300 ng/dL. Each patient was treated with a daily dose of 25 mg clomiphene citrate and followed prospectively. Analysis of baseline and follow-up serum levels of testosterone and estradiol levels were performed.

RESULTS: The mean age was 39 years, and the mean
pretreatment testosterone
and estrogen levels were
247.6 +/- 39.8 ng/dL
and 32.3 +/- 10.9, respectively.
By the first follow-up visit (4-6 weeks), the mean testosterone level rose to 610.0 +/- 178.6 ng/dL
(P < 0.00001). Moreover, the T/E ratio improved from 8.7 to 14.2 (P < 0.001). There were no side effects reported by the patients.

CONCLUSIONS: Low dose clomiphene citrate is effective in elevating serum testosterone levels and improving the testosterone/estradiol ratio in men with hypogonadism.This therapy represents an alternative to testosterone therapy by stimulating the endogenous androgen production pathway.

It's a useful study, but as you will already know, they used 25mg of clomid ED for powerful results in hypogonadal men. 50mg is still DOUBLE that dose, so it's still on the more excessive end of the scale.

Study showing a hypogonadic 30-year old male, suffering permanent shutdown from steroid abuse, fully recovered natural hormone levels and HPTA function from 2 months of 100mg Clomid therapy:

Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse
,
Tan RS, Vasudevan D.

Department of Family and Community Medicine, University of Texas Health Sciences Center, Houston, Texas 77030, USA.

OBJECTIVE: To report a case of symptomatic hypogonadism induced by the abuse of multiple steroid preparations that was subsequently reversed by clomiphene. DESIGN: Case report. SETTING: University-affiliated andrology practice within family practice clinic. PATIENT(S): A 30-year-old male.

INTERVENTION(S): Clomiphene citrate, 100-mg challenge for 5 days, followed by treatment at same dose for 2 months.

MAIN OUTCOME MEASURE(S): Clinical symptoms, androgen decline in aging male questionnaire, total T, FSH, LH.

RESULT(S):
Reversal of symptoms, normalization of T levels with LH surge, restoration of pituitary-gonadal axis.


CONCLUSION(S): Clomiphene citrate is used typically in helping to restore fertility in females. This represents the
first case report of the successful use of clomiphene to restore T levels and the pituitary-gonadal axis in a male patient. The axis was previously shut off with multiple anabolic steroid abuse.

I have no doubt it works, but this was the "first case report" from 2003, which was 12 years ago. Considering it's the first case report, there would not have been much, if any, past information to go on regarding clomid therapy for this sort of thing, so they can be forgiven for going straight in at 100mg. But things have came along way since then.

It would also be interesting to see the more specific details of that (i.e. pre and post blood work) as it's difficult to really tell if his results were any more successful or faster than the other lower doses which have been proven to work. He was on the 100mg clomid dose for 2 months, so it muddies the ability to tell how quickly it did actually work and whether a lower dose would have worked just as quickly.

Here's another study showing only 7 days of Clomid therapy increased total testosterone by 100% and, more importantly, free testosterone by over 300% in young men:



The effects of aging in normal men on bioavailable testosterone and luteinizing hormone secretion: response to clomiphene citrate
, J Clin Endocrinol Metab. 1987 Dec;65(6):1118-26.

Geriatric Research, Education, and Clinical Center, Veterans Administration Medical Center, Seattle, Washington.

Serum testosterone (T) levels in men decline with age while serum LH levels, as measured by RIA, increase. To assess if the decline in serum T levels in healthy aging men is paralleled by an age-related decline in the bioavailable non-sex hormone-binding globulin (SHBG)-bound fraction of T and to determine whether there are age-related changes in LH secretion or LH control of T production, we studied 29 young (aged 22-35 yr) and 26 elderly (aged 65-84 yr) healthy men. All men had single random blood samples drawn, and 14 men in each age group underwent frequent blood sampling for 24 h, both before and after
7 days of clomiphene citrate (CC) administration.
Both mean 24-h serum total T levels and non-SHBG-bound T were reduced in elderly men compared to those in young men (P less than 0.05), while estradiol and SHBG levels were similar in the 2 age groups. Serum FSH determined by RIA and LH by RIA and bioassay were higher in the elderly men compared to those in young men (P less than 0.05), but the ratios of LH bioactivity to immunoreactivity and the LH pulse frequency and amplitude were similar.
After CC administration, mean serum total T and non-SHBG-bound levels in young men increased by 100% and 304%
, respectively, while in older men these values increased by only 32% and 8%, respectively. However, CC-stimulated LH pulse characteristics and serum levels of estradiol, SHBG, FSH, and bioactive and immunoreactive LH were similar in the 2 groups. Thus, both at baseline and after CC stimulation, elderly men had significantly lower serum total T and non-SHBG-bound (bioavailable) T levels than did young men, despite similar or increased levels of bioactive LH and similar bioactive to immunoreactive LH ratios and LH pulse characteristics. These results suggest that major age-related changes in the hypothalamic-pituitary-testicular axis occur at the level of the testes and are manifested by decreased responsiveness to bioactive LH. Administration of CC to young and elderly men resulted in similar changes in LH pulse characteristics and LH bioactivity and immunoreactivity, suggesting preserved hypothalamic-pituitary responsiveness in the elderly.

Unless I'm missing something, that study doesn't even state what clomid dose was used.

But anyway, you have your opinions and I have mine. Based on everything I've seen and read, it seems more plausible now that a 50mg clomid dose ED will work very well on a normal 10-12 week cycle. Scally, Shippen and Crisler (who said 25mg is a big dose) have and still do use those doses (even when these men have seeked out these specialists because their own personal PCT has failed), studies support these doses, and anecdotal reports from other BB forums support this dose and its effectiveness as well.

Each to their own!

 

[hackskii]

You know, on Meso board, both Scally, and Cristler did not agree with the dosing of each others protocol, in fact they were mortal enemies.

So, do you see any issue with 100mg ED for a week, or two, then tapering the dose down?

If so state your concerns, end explain why?

 

[Deadcalm]

You know, on Meso board, both Scally, and Cristler did not agree with the dosing of each others protocol, in fact they were mortal enemies.

So, do you see any issue with 100mg ED for a week, or two, then tapering the dose down?

If so state your concerns, end explain why?

For the record I'm not suggesting that I know any of this for a fact. I'm simply applying some thinking to various sources of information which may perhaps help people with their future PCTs. Especially those who have serious emotional/depression problems or eye issues.

My reasoning is the following:

1). The majority of studies, anecdotal reports and comments from HPTA restoration specialist doctors like Crisler and Shippen all point to doses of around 50mg (and sometimes less) being extremely effective at restoring HPTA, and this isn't even factoring in the uses of other serms like torem or nolva which will add to that effect, so 100mg (which is double to quadruple the dose used effectively in many men) may increase the risk of side effects and emotional problems (thus hampering diet and training during the critical PCT phase) along with potentially dangerous occular toxicity for no discernible benefit.

2). Scally's post suggests that he has given guys 50-100mg per day clomid therapy to treat hypogonadism and has had some patients start experiencing eye problems, with which he's immediately reduced or dropped the dose, so there's evidence that occular toxicity can occur at those doses, and can also occur even if symptoms are not readily apparent.

3). There's plenty of evidence that 50mg of clomid works very well, and sometimes even 25mg, but there's zero evidence that 100mg of clomid works any faster or more effectively, so there's solid ground for suggesting 50mg ED, but it's just speculation to suggest anything higher when many guys have used 50mg PCTs and recovered well.

4). Higher doses of clomid like 100mg ED may be useful in extreme circumstances when someone has exhausted all other options, but this dose is being suggested for guys running normal 10-12 week cycles, which I think is completely unnecessary.

5). I don't see how the MOA would make double or quadruple what's an effective dose more effective or faster. Once oestrogen is inhibited at the hypothalamus, it can't be any more inhibited. The speed of LH and FSH production is related directly to the speed of the hypothalmus and pituitary production, and clomid dosages have no bearing on that. They just simulate the environment which the hypothalamus uses as an indicator to start producing LH and FSH.

Crisler and Shippen have both agreed that 25mg is a "whopping" dose, so even if we were to be very over generous with the dosage, 50mg is still double that and has been shown to work. Perhaps someone can frontload clomid for a few days if they wish (even though it increases the risk of occular toxicity and emotional problems), but I think 50mg every day with a taper in the last week or two is more than enough for normal guys on sensible cycles which avoids the bad side effects.

I've also been doing some reading on GnRH sensitivity at the pituitary, and it seems that high clomid doses may even DECREASE the GnRH sensitivity at the pituitary and therefore cause a reduction in LH and FSH output. This is by William Lewellyn:

Researchers were also conducting GnRH stimulation test before and after various points of treatment with Nolvadex and Clomid, and the two drugs had markedly different results. These test involved infusing patients with 100mcg of GnRH and measuring the output of pituitary LH in response. The focus of this test is to see how sensitive the pituitary is to Gonadotropin Releasing Hormone. The more sensitive the pituitary, the more LH will be released. The test showed that after ten days of treatment with Nolvadex, pituitary sensitivity to GnRH increased slightly compared to pre-treated values. This is contrast to 10 days of treatment with 150mg Clomid, which was shown to consistently DECREASE pituitary sensitivity to GnRH (more LH was released before treatment). As the study with Nolvadex progresses to 6 weeks, pituitary sensitivity to GnRH significantly higher than pre-treated 10 day levels. At this point the same 20mg dosage was also raising testosterone and LH levels to an average of 183% and 172% of base values, respectively, which again is measurably higher that what was noted 10 days into therapy. Within 10 days of treatment Clomid is already exerting an effect that is causing the pituitary to become slightly desensitized to GnRH

Given this, I would suggest that the "more is better" mantra may actually be harming recovery, and that it's important to just settle on the right sort of mid-lower range dose which has been proven to be highly effective without the unnecessary risk of going higher and causing bad side effects, occular toxicity and potential hypothalamus desensitising issues.