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    Senior Member Benson's Avatar
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    I like clomid for lots of reasons, mainly because it lacks most of the toxicity issues of nolva and there is a decent amount of clinical data on its effectiveness in men, something largely lacking for tamoxifen.



    I do think that it is often overdosed which is what leads to the emotionality, the primary complaint of most male users.



    Here is an interesting study demonstrating that it is highly effective at raising T levels in hypogonadal men at just 25mg/day not the 150-300mg/day commonly advocated by steroid 'gurus'



    Clomiphene Citrate Effects on Testosterone/Estrogen Ratio in Male Hypogonadism

    J Sex Med 2005;2:716€“721.



    ABSTRACT



    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 testostosterone 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/estadiol ratio in men with hypogonadism. This therapy represents an alternative to testosterone therapy by stimulating the endogenous androgen production pathway.
    Remember, believe none of what you hear and half of what you see...





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    Senior Member zuper1's Avatar
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    Quote Originally Posted by Benson' post='396705' date='Apr 11 2007, 03:29 AM
    I like clomid for lots of reasons, mainly because it lacks most of the toxicity issues of nolva and there is a decent amount of clinical data on its effectiveness in men, something largely lacking for tamoxifen.



    I do think that it is often overdosed which is what leads to the emotionality, the primary complaint of most male users.



    Here is an interesting study demonstrating that it is highly effective at raising T levels in hypogonadal men at just 25mg/day not the 150-300mg/day commonly advocated by steroid 'gurus'



    Clomiphene Citrate Effects on Testosterone/Estrogen Ratio in Male Hypogonadism

    J Sex Med 2005;2:716€“721.



    ABSTRACT



    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 testostosterone 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/estadiol ratio in men with hypogonadism. This therapy represents an alternative to testosterone therapy by stimulating the endogenous androgen production pathway.
    I don't know about the toxicity issues of Nolva but i would prefer it over Climid,even endos in Greece who don't know shit do not prescribe clomid.

    Snip, Author Unknown but I suspect it is Anthony Roberts that might have posted it on his board.

    Why don’t we use Clomid, another SERM? Well, basically because it takes much more to do the same thing. In comparison, it would require 150mgs of Clomid to accomplish that type of elevation in testosterone, but Nolvadex also has the added benefit of significantly increasing the LH (Leutenizing Hormone) response to LHRH (LH-releasing hormone) (6). This most likely indicates some kind of upregulation of the LH-receptors due to the anti-estrogenic effect Nolvadex has at the pituitary. Although both Nolvadex and Clomid are both SERMs, they are actually quite different. As you already know, Nolvadex is highly anti-estrogenic at the hypothalamus and pituitary, while Clomid exhibits weak estrogenic activity at the pituitary (7), which as you can guess, is less than ideal. It should be avoided for the PCT I’m suggesting…and in fact, avoided in general…it’s simply not as good as Nolvadex.

    Need I even add that the 150mgs of Clomid you need to get the hormonal increase experienced with 20mgs of Nolvadex is much more expensive? So lets dump the Clomid…and no, using it along with Nolvadex will provide no “synergy” that I’ve ever seen in any relevant study.

    SO how much Nolvadex should you use during PCT? I favor using 20mgs.day, although to be totally honest, you can probably even get away with far less than that.



    Snipped from The A B C's of anti E's

    Now dig this: According to William LLewellyn, studies conducted in the late 1970's at the University of Ghent in Belgium used Nolvadex for 10 days at a dosage of 20mg daily, which increased serum testosterone levels to 142% of baseline, on par with the effect of 150mg of Clomid daily for the same duration! Depending on what you read into this, I'd say that Nolvadex is a superior buy for post-cycle recovery. That being said, Nolvadex is good, but not quite perfect, as it lowers IGF-1 levels. Post-cycle, though, when I'm worried about returning test-levels to normal, I'm not too worried about IGF-1 levels. Though, personally, I've found testicular atrophy during a cycle is attenuated to a greater degree by Clomid. So besides competing with estrogen at the receptor, these drugs both increase serum test levels, and both drugs may also alter blood lipid profiles. I couldn't find the studies W.L. mentioned, but still found that 20mgs of tamoxifen is equal to 150mgs of clomid for purposes of testosterone elevation, FSH and LH, but tamixifen did not decrease the LH response to LHRH (Fertil Steril. 1978 Mar;29(3):320-7.). Thus, I'd still reccomend Nolv over clomid. Actually, I think nolvadex is far superior to clomid for most purposes.

    As Nolvadex isn't actually an anti-aromatase, but rather a competitor for the receptor site, and seeing as it increases test levels so much, I'd say that it's actually a better post-cycle drug than Clomid (which wreaks havoc on my eyesight, due to it's Occular Toxicity.and Nolvadex has some of that property, but in my experience doesn't mess with my eyesight as much).



    Snipped from: Clomid, Nolvadex and Testosterone Stimulation

    by William Llewellyn

    Studies conducted in the late 1970's at the University of Ghent in Belgium make clear the advantages of using Nolvadex instead of Clomid for increasing testosterone levels (1). Here, researchers looked the effects of Nolvadex and Clomid on the endocrine profiles of normal men, as well as those suffering from low sperm counts (oligospermia). For our purposes, the results of these drugs on hormonally normal men are obviously the most relevant. What was found, just in the early parts of the study, was quite enlightening. Nolvadex, used for 10 days at a dosage of 20mg daily, increased serum testosterone levels to 142% of baseline, which was on par with the effect of 150mg of Clomid daily for the same duration (the testosterone increase was slightly, but not significantly, better for Clomid). We must remember though that this is the effect of three 50mg tablets of Clomid. With the price of both a 50mg Clomid and 20mg Nolvadex typically very similar, we are already seeing a cost vs. results discrepancy forming that strongly favors the Nolvadex side.



    Pituitary Sensitivity to GnRH



    But something more interesting is happening. Researchers were also conducting GnRH stimulation tests before and after various points of treatment with Nolvadex and Clomid, and the two drugs had markedly different results. These tests 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 tests 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 was significantly higher than pre-treated or 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 than 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, while prolonged use of Nolvadex serves only to increase pituitary sensitivity to this hormone. That is not to say Clomid won't increase testosterone if taken for the same 6 week time period. Quite the opposite is true. But we are, however, noticing an advantage in Nolvadex.



    As you see above that after 10 days nolva increases pituitary sensitivity to GnRH while Clomid DECREASE pituitary sensitivity to GnRH.

    Now I feel this is a real issue because most PCT should be run for a minimum of 30 days.

    If this is fact the case then Clomid is by far inferior and might inhibit recovery.



    Farther down in the article....snip.....



    To summarize the above research succinctly, Nolvadex is the more purely anti-estrogenic of the two drugs, at least where the HPTA (Hypothalamic-Pituitary-Testicular Axis) is concerned. This fact enables Nolvadex to offer the male bodybuilder certain advantages over Clomid. This is especially true at times when we are looking to restore a balanced HPTA, and would not want to desensitize the pituitary to GnRH. This could perhaps slow recovery to some extent, as the pituitary would require higher amounts of hypothalamic GnRH in the presence of Clomid in order to get the same level of LH stimulation.



    Nolvadex also seems preferred from long-term use, for those who find anti-estrogens effective enough at raising testosterone levels to warrant using as anabolics. Here Nolvadex would seem to provide a better and more stable increase in testosterone levels, and likely will offer a similar or greater effect than Clomid for considerably less money. The potential rise in SHBG levels with Clomid, supported by other research (3), is also cause for concern, as this might work to allow for comparably less free active testosterone compared to Nolvadex as well. Ultimately both drugs are effective anti-estrogens for the prevention of gyno and elevation of endogenous testosterone, however the above research provides enough evidence for me to choose Nolvadex every time.



    In the article above it was also suggesting Clomid raised SHBG which is what binds to testoserone and allows for LESS free test:

    "The difference in response might be attributable to the weak intrinsic estrogenic effect of Clomid, which in this study manifested itself by an increase in transcortin and testosterone/estradiol-binding globulin [SHBG] levels; this increase was not observed after tamoxifen treatment".



    Following so far, decrease pituitary sensitiviey (takes more to do less) to GnRH, which the hypothalamus tells the pituitary to release LH (which makes test) and FSH which makes sperm), increase in SHBG, which binds with test to allow less free test, which by the way is only 3% of the total test that actually is bioavailable.
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    Also, Clomid doesn't kill estrogen levels, which is actually a GOOD thing.



    PH use usually screws up one's lipid profile, partly due to lowering of estrogen levels.



    So, guess what happens when you use a strong anti-aromatase during a PCT.



    That is why I dislike compounds such as ATD.
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    Senior Member ozzman's Avatar
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    Here is another one, but with higher initial dosage, followed by a low dose for a while:



    *******

    Department of Endocrinology, Royal Victoria Infirmary and University of Newcastle-upon-Tyne, Newcastle-upon-Tyne, United Kingdom.



    OBJECTIVE: Inhibition of pituitary gonadotropin secretion in men by T is principally mediated by aromatization to estrogen (E), which inhibits hypothalamic secretion of GnRH. We hypothesized that adult-onset isolated hypogonadotropic hypogonadism (IHH) might result from an altered central set-point for E-mediated negative feedback. DESIGN AND SETTING: Longitudinal clinical investigation unit-based evaluation of the clinical and biochemical response to E-receptor blockade. PATIENT(S): A 31-year-old man presenting with an 18-month history of sexual dysfunction resulting from severe adult-onset IHH (LH 1.7 U/L, FSH 2.0 U/L, T 3.5 nmol/L). INTERVENTION(S): Initial therapy with 50 mg of clomiphene citrate (CC) three times a day for 7 days, with overnight LH pulse profiling and 9 am T levels evaluated at baseline and on completion. A 2-month washout period, followed by low-dose maintenance therapy (25-50 mg/d) for 4 months. MAIN OUTCOME MEASURE(S): Baseline and stimulated T levels and LH pulsatility; effect on sexual function. RESULT(S): Clomiphene therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. CONCLUSION(S): Isolated hypogonadotropic hypogonadism may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. On theoretical grounds, reversal of gonadotropin deficiency with CC might be expected to have a similar biological effect.



    **************

    And another one used specifically after steroid use:









    ************



    Department of Family and Community Medicine, University of Texas Health Sciences Center, Houston, Texas 77030, USA. robert.s.tan@uth.tmc.edu



    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.
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    Senior Member zuper1's Avatar
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    Yeah,but Nolva beats Clomid
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    Senior Member Benson's Avatar
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    Quote Originally Posted by zuper1' post='396852' date='Apr 11 2007, 04:31 PM
    Yeah,but Nolva beats Clomid


    At what? Preventing gyno perhaps due to its affinity for breast tissue.



    For restoring T production, there is really no clinical evidence that supports the contention that it is more effective than clomid.
    Remember, believe none of what you hear and half of what you see...





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    Senior Member zuper1's Avatar
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    Quote Originally Posted by Benson' post='396861' date='Apr 11 2007, 10:15 PM
    At what? Preventing gyno perhaps due to its affinity for breast tissue.



    For restoring T production, there is really no clinical evidence that supports the contention that it is more effective than clomid.
    I can guess you didn't read my post.

    Clomid cause desensetization of pituitary to GNRH.

    Clomid cause vision problems,sometimes irreversible.

    Clomid cause emotionality.
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    Senior Member Benson's Avatar
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    Quote Originally Posted by zuper1' post='396886' date='Apr 11 2007, 06:32 PM
    I can guess you didn't read my post.

    Clomid cause desensetization of pituitary to GNRH.

    Clomid cause vision problems,sometimes irreversible.

    Clomid cause emotionality.


    I think you have your drugs mixed up. Tamoxifen is much more likely to cause permanent eye damage (PMID: 1591689) than clomid which (very rarely) causes transient visual disturbances that almost always go away once the drug is withdrawn. The visual disturbances are also dose-dependent.



    And it only causes emotional disturbances when its overdosed...as I pointed out in my first post, the dose needed to restore testicular function in hypogonadal men is 1/10 the dose often suggested by steroid 'gurus' It should surprise nobody that it makes men weepy at 350mg/day, especially because it has a half-life measured in days...



    Clomid has been studied over long periods in men and has demonstrated efficacy and safety....something that has never been done with nolva.
    Remember, believe none of what you hear and half of what you see...





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    Senior Member Benson's Avatar
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    Toxicity of Antiestrogens

    The Breast Journal

    Volume 8 Issue 2 Page 92 - March/April 2002



    The object of this article is to review briefly the preclinical and clinical safety of some antiestrogens. Tamoxifen, toremifene, droloxifene, and idoxifene are polyphenylethylene antiestrogens, whereas the pure antiestrogen, ICI 182,780 or faslodex, as well as raloxifene, is of a different structure. Tamoxifen has been shown to be genotoxic in several studies. It induces unscheduled DNA synthesis in rat hepatocytes and micronuclei in MCL-5 a cells in vitro. Tamoxifen also induces aneuploidy in rat liver in vivo and chromosome aberrations and micronuclei in mouse bone marrow. Toremifene has also shown to be genotoxic, but to a far lower extent, by inducing micronuclei in MCL-5 a cells in vitro and by inducing aneuploidy in rat liver in vivo. Tamoxifen has been shown to be hepatocarcinogenic in the rat in at least four independent long-term studies. The initiation of tumors in the rat is the result of metabolic activation by cytochrome P450 isoenzymes to an electrophile(s) that binds irreversibly to DNA. The other antiestrogens have not been shown to be carcinogenic in rodents. In several independent clinical studies, the risk of endometrial cancer has increased among tamoxifen-treated women. After reviewing the available data, the International Agency for Research on Cancer concluded that there was sufficient evidence to show that tamoxifen is a class I human carcinogen. The increased risk for endometrial cancer occurs predominantly among women who are 50 years old or older and who have been treated with tamoxifen. It is not yet clear whether the uterine tumor formation is a result of genetic mechanisms, analogous to those seen in the rat liver or due to the estrogen agonist action of tamoxifen. However, the other antiestrogens with a more or less similar intrinsic estrogenic potential have not been shown to be carcinogenic in humans.
    Remember, believe none of what you hear and half of what you see...





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    Senior Member Grassroots082's Avatar
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    I noticed no eye disturbance/tracers with Clomid even at 100mg/day but with Nolva they are apparent at 40 and I swear my vision has not been the same since the use of Nolva (glad I sold that shit). The last SERM I tried was Toremifene and I was pretty happy with that, but from my experiences Clomid or Toremifene would be my SERM of choice.
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    Senior Member Jay Black's Avatar
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    What's the concensus on using both for PCT? I've seen it advocated several places.
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    Senior Member Benson's Avatar
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    Quote Originally Posted by Jeff' post='396922' date='Apr 11 2007, 10:39 PM
    What's the concensus on using both for PCT? I've seen it advocated several places.


    Unless you are especially concerned with gyno, I see no reason to use nolva with or ahead of either clomid or one of the newer SERMs that do not share its toxicity.
    Remember, believe none of what you hear and half of what you see...





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    I'm using both during my extensive PCT in high doses (Clomid 100mg/d, Nolva 40mg/d). I've not noticed any vision issues and minimal emotional issues. YMMV.

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    Although I gotta admit I get weepy much easier within an hour after my dose. Fortunately, it's irrational and identifiable, so I laugh at it, like Clomid is a dog or something:

    "Oh you silly clomid!"

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    Senior Member Grassroots082's Avatar
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    It has a half life of 5-7 days (source) so I would imagine that to be largely psychological, but perhaps there is some type of initial response. Are you taking liquid clomid or tabs?
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    Quote Originally Posted by Grassroots082' post='397712' date='Apr 17 2007, 05:47 AM
    It has a half life of 5-7 days (source) so I would imagine that to be largely psychological, but perhaps there is some type of initial response. Are you taking liquid clomid or tabs?
    Liquid, and I just notice it *more* in the bit of time after I take it. I have noticed being a bit more emotionally flighty over the past 3 weeks, but I imagined much of that was more of my test levels getting back to a normal level.

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    I am trying to figure out what Benson was gettting at in this thread.



    Is he meaning to say that clomid might be a good thing to use at 25mg/day for sustained higher test levels rather than usage as a pct drug? In other words, you could use low dose clomid to be in the upper bound of testosterone to promote gains rather than running a true cycle where test levels are super human?



    And, I am guessing that the down regulated gnrh system would be less pronounced at 25mg/day than at 150mg/day and shouldn't be a concern with prolonged use?
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    Senior Member Benson's Avatar
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    My main point was that the normal pct recomendations for clomid are way higher than they need to be to restore testicular output. And that when the dosage is kept at a reasonable level (50mg/day or so) clomid is almost entirely devoid of side effects.



    As a corollary, low dose clomid would appear to be a decent way to make sure your production was optimized without incuring the risks of basement-level estrogen as you might get using an AI for the same purposes. The purpose of the study I posted was to evaluate the use of clomid as an alternative to HRT in hypogonadal men, something it appears to work decently for.



    I have not studied the GNRH-sensitivity issue much but given that there are lots of studies of men using clomid at various doses for long periods and it doesn't seem to be a problem, my suspicion is that the effect is small.



    Lastly, I wanted to point out once again that nolva is a moderately toxic drug and its use should be limited given the availability of other, SERMS.
    Remember, believe none of what you hear and half of what you see...





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    Senior Member lepiricus's Avatar
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    ahhh, thanks for posting Benson.



    Last year I was self medicating w/ 20mg/day of nolva for low-normal test and after 3 weeks I was high-normal in test and fsh/lh. I did this for about 3 months then tapered off. I did notice an improvement in my symptoms as well, no side effects to speak of. I did not have a blood test to look at after 3 months though.



    I was thinking of a mimic of that using clomid at 25 mg/day, I was just worried a bit b/c of the reported gnrh sensitivity altering ability.
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    Senior Member zuper1's Avatar
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    Quote Originally Posted by lepiricus' post='398478' date='Apr 22 2007, 06:13 AM
    ahhh, thanks for posting Benson.



    Last year I was self medicating w/ 20mg/day of nolva for low-normal test and after 3 weeks I was high-normal in test and fsh/lh. I did this for about 3 months then tapered off. I did notice an improvement in my symptoms as well, no side effects to speak of. I did not have a blood test to look at after 3 months though.



    I was thinking of a mimic of that using clomid at 25 mg/day, I was just worried a bit b/c of the reported gnrh sensitivity altering ability.
    When you have cleared from Nolva haven't had any bloodwork?If not how were you feeling,better than on low to normal test?
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