By Travis DeGraff

Clomid Non-Responder

As you may or may not know clomiphene (or Clomid) is perhaps the most commonly used Selective Estrogen Receptor Modulator (SERM) of all time. Specifically for prohormone and anabolic steroid users for the purpose of recovering their natural testosterone levels after stopping their anabolic cycle. I’ve also written on it’s use for PCT, bridging between cycles, and it’s potential as a TRT alternative.

New Clomid Study on Hypogonadal Men

The dark side of Clomid is that it doesn’t seem to work for everyone. It’s not uncommon to see a failed post cycle therapy (PCT) even with the proper dosing and length of Clomid administration. It would be great if we could predict the effectiveness of Clomid before using it, right? Or at least have a general idea of how often it works. That’s exactly what a Sexual Medicine Clinic in New York City wanted to find out, which is the basis for today’s topic of anabolic discussion [Ref 1].

The authors were particularly interested in clomid for the use on younger men who still had an interest in maintaining fertility. To test the overall response to Clomid they informed new patients over the course of 4 years on the benefits of Clomid over Testosterone replacement (fertility, no testicle shrinkage). If the patient agreed to try Clomid they were given 25 mg’s of Clomid every other day to start. Keep in mind all of the 76 patients in this study had testosterone levels below 300ng/mL before getting any form of treatment.

In order for a patient to be considered a “responder” to Clomid therapy they had to have testosterone levels greater than 400 ng/dL and an increase in total testosterone levels of 200 ng/dL or more.

Any man who did not respond in the first 6 months was not discarded.  Rather their Clomid dose was increased to 50 mg’s every other day for another 6 months.  And again 6 months after that the dose was increased to 50 mg’s every day (assuming they didn’t reach “responder level” already).

Did everyone respond to clomid?

Of the 76 men, 49 responded to clomid therapy based on their initial definition of responders, and non-responders.  Meaning about 1/3 rd of the men did not experience an increase in total testosterone of 200 ng/dL, and never reached over 400 ng/dL testosterone levels.

  • 32 men were given 25 mg’s every other day
  • 17 men were titrated up to 50 mg’s every other day
  • 27 men were titrated up to 50 mg’s every day

Based on the content of this paper it’s unclear if they considered those at the 50 mg/day dose as “non-responders” or if they simply didn’t continue to follow-up with them and their total testosterone values.  Nonetheless the following table describes their hormone values before and after/on treatment:

clomid non responders

You might be alarmed by the increase in estradiol (E2) but keep in mind this happens whenever you use a “Selective estrogen receptor modulator”.  Also note that the testosterone to estrogen ration went from 6.2 to 11.2, and none of the participants experienced gyno, or tender titties.  It’s also important to keep estrogen at the higher end for a good libido (Read – How high is to high for Estrogen?).

The Luteinizing Hormone (LH) Connection

As I previously mentioned the scientists also tried to determine why some individuals had a positive response to clomid, and why others did not.  They found that testicular volume (greater than 14 mL) and LH (less than 6 IU/mL) were the strongest predictors of a positive response to clomid.  Having a greater testicular volume implies a greater number of leydig cells, and thus response.  Also in general you may be able to gauge your response to clomid by how much your nuts shrink on cycle.  Those with little shrinkage may recover better.  However you might be surprised to find that a lower initial LH level has a better response to clomid than having a high LH level.  Why?  The authors explain it as follows:

“This is most probably due to the fact that patients with low T and elevated LH levels most probably already have maximum stimulation of their Leydig cells by LH and thus struggle to generate the greatest T production.”

This means that if you have bloodwork done at the end of your cycle, and your LH is still very high, but testosterone is rock bottom, you may have trouble recovering with just clomid (this also assuming you were using no ON cycle HCG).

All of this simply suggests that when it comes to your testosterone levels there are no guarantees.  Clomid works for most men, but not all.  So whether you are using it for PCT, or for bridging it’s important to get lab work done as frequently as is affordable.  If you are interested in trying out clomid (for research) please check out Blue Sky Peptide for your research needs.

 Final Worthy Note – Enclomiphene is Mentioned as Promising

I could not pass up the opportunity that these authors once again mentioned the potential benefit of the “super clomid” or enclomiphene.  Again enclomiphene is the single isomer of clomid with less estrogenic activity.  The authors believed that it may induce a greater response for all men, and thus reduce the number of non-responders.


 

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