T Nation

18 Y/O Family Member with Very Low T

Hey guys my friends son has been going through some major symptoms of low t lately depression, anxiety, libido issues so they had him tested and his total t was at 168 he has never done anabolics or any other drugs he works out is skinny and has a clean diet. 3 years ago he had drug induced lupus from minocycline for acne. He just turned 18 but has been suffering for a while. I mentioned I was on trt and it has worked wonders for me but being so young I wasn’t sure if this was a good option as your on it for life and if he eventually wanted kids it might interfere with that but I hate to see him suffer like this I didnt see his labs but from what they said everything is normal besides his t score and he has anemia rbc is at 4.24, hemoglobin at 13.3, and hematocrit at 40.1 is there anything else he should look at?

Thyroid, sleep, diet are the main ones. Also a pituitary check would be good. I would be pretty hesitant to recommend TRT to an 18 year old without exploring all other options first.

Sleep is good he said they checked thyroid and that was good not sure on pituitary though I will have them mention it to there doctor. I agree on 18 being to young but I think that would be a last resort thanks for the response

The question is what’s causing the anemia, Thalassemia is a possibility, then again it could just be low-T. TRT will increase the RBC, HCT and hematocrit without a doubt. The docs will probably try clomid first which increases testosterone without shutting down the HPTA before considering TRT.

The LH and FSH will tell you if it’s a pituitary problem, usually secondary hypogonadism would see LH low, primary would see a high LH value indicating a testicular failure. If prolactin is high enough it can suppress testosterone.

  • LH-Luteinizing Hormone
  • FSH-Follicle stimulating hormone
  • Prolactin
  • Cortisol
  • Comprehensive Metabolic Panel
  • Lipid profile/panel

Awsome thanks I will forward that to his parents.

I would do more labs in addition to what is above. Rule out disease and get baselines.
Cbc with diff
Iron panel
Ferritin
DHEA-s
A1c
Insulin (try fasting )
Estradiol
Shbg
Total and free t
Thyroid panel
Complete Urine analysis and culture

And read about lupus such as. Once you read about lupus you may want to do other diagnosis tests. Like cardiac heart echo, check blood for inflammation markers like CRP, ESR there’s more. In a 18 year old I would def do a testicular ultrasound as well. And probably a pituitary MRI.

https://www.mayoclinic.org/tests-procedures/ana-test/about/pac-20385204

Ok cool thanks there going to be working with an endocrinologist so I’ll make sure there looking at all this thanks for they input