Clomid (and Enclomiphene): Known Side Effects

Since writing about enclomiphene last week, I’ve seen queries about its safety. Clomid, which enclomiphene is an isomer of, has a spotty reputation for safety. So how safe is enclomiphene?

Over a 3 month trial, enclomiphene had no serious adverse effects and a couple of minor adverse effects (diarrhea, nausea). 3 months is hardly representative for a compound that is intended to be used indefinitely, however, and on that front we're gonna have to wait until further trials are complete. In the meantime, let's look at the side effects of clomid and make some inferences.

In its clomid form, there is evidence for liver toxicity due to the zuclomiphene isomer. Clomid is a mix of two isomers, zuclomiphene and enclomiphene. Zuclomiphene sticks around and accumulates over time, whereas 97.5% of enclomiphene was cleared at 24 hours, so chronic toxicity is not expected to be an issue when enclomiphene is taken on its own.

As to the vision side-effects, meta data indicates that clomid predisposes toward central retinal vein occlusion (CRVO). That’s where the retina swells due to the vein that drains blood closes off. It’s not necessarily chronic and may return to normal, and risks increase as you age. It’s important to note that if you start to experience these vision side-effects, and you continue the clomid, the symptoms can persist for several years.

I could not find any evidence that CRVO is to be found with enclomiphene but that’s not to say it is not possible, nor are you more likely. It’s a potential risk that cannot be ruled out due to lack of data. I don’t think it’s an especially large risk given the low dosages being advocated for the compound (12.5mg ed versus 50mg ed for Clomid), but chronic use might induce those predisposed.

That’s not enough to change my original thoughts on this compound as being worth the risk as a TRT alternative as it's the second isomer that comprises clomid, zuclomiphene, that is thought to cause some the side effects that have been associated with clomid. Therefore, my conclusion (at least for right now) is still that this is a better alternative to clomid for fertility or increasing natty testosterone production.

And one final note: enclomiphene is not a PED in so far that it’s not performance enhancing in the way we usually mean. It does have its place, but if I’ve done anything to help ‘hype’ this compound in any way I apologize - not my intent.