T Nation

18 Y/O. Low T, Anxiety, Brain Fog, Low SHBG

18 Y/O male from Czech republic
6 ft 1
35 inches
200lbs, 15-20% bodyfat
-describe body and facial hair
Lot of leg hair, a little chest hair, a little facial hair.
-describe where you carry fat and how changed
I carry fat around my mid section and chest area.
-health conditions, symptoms [history]
-5 Y/O - diagnosed with pollen allergy
-13 Y/O- I became very depressed at that time. I also grew up a lot at this age.

  • 15 Y/O - I started having really strong pain under my knee caps–> Doctor told me I have Chondromalacia patella—> cleared off after 6 months
    -16Y/O - Anxiety, memory problems,Diagnosed with varicocele, April 2016- first testosterone blood test (came back low at 296 ng/dl), July 2016- varicocele surgery( didn’t raise my TST levels).
    -17Y/O- Diagnosed with pineal cyst, Immunologist also told me that I have weak immune system and latex allergy.
    -Rx and OTC drugs, any hair loss drugs or prostate drugs ever
    No hair loss drugs or prostate drugs. Lexaurin 3mg (only when I am having an anxiety attack).
    -I take 5mg of Xyzal (allergy meds) every day, 5000 IU Vitamin D3 every day, 1000-2000mg Vit C, 30 mg zinc, 3 omega3 capsules, vit B complex, Multivitamin containing 55μg Selenium
    -lab results with ranges
    See bellow
    -describe diet [some create substantial damage with starvation diets]
    -When I was 14 yrs old I ate a very low calorie diet because I wanted to lose weight. Then I started working out and eating typical bodybuilding diet(3000-4000 cals/day). October 2016- stopped training in the gym and following my diet due to health problems (read bellow).
    -describe training [some ruin there hormones by over training]
    July 2014 —> October 2016 - bodybuilding routine 5 times a week
    April 2017 - Started training in the gym again. (3 times a week)
    -testes ache, ever, with a fever?
    I had testes aches when i was in elementary school. I think I was 10 years old. It dissapeared after few months.
    -how have morning wood and nocturnal erections changed
    No nocturnal erections. Weak or any morning erections.
    Do you use iodized salt?
    Yes, I’m 100% sure that I’ve been using iodized salt at least last 7 years.

Family members medical history: My mom is hypothyroid and my dad is type 2 diabetic.

Body temperatures: Moring tempertatures are around 96 F
Afternoon temperatures around 96.8 F
Evening body temperatures are ussualy the same as afternoon (96.8F)

Symptoms: Depression, Memory loss, Anxiety attacks, gynecomastia (developed when I was 14), hot and cold flashes, low energy, frequent urination, muscle weakness,cold legs, common inflammation
I am 18 year old guy living in Czech republic. I would like to know what is wrong with me because I can’t live like this anymore. My problems started when I was 13 years old I became really depressed because of my new school. Three years later (16 Y/O) I started experiencing a lot of Low T symptoms ( I didn’t know what testosterone was at that time). I went to urologist and he decided to do a bloodwork. He also checked my testicles and found varicocele --> So he put me on the waiting list for surgery. I saw my blood results few days after first visit. Testosterone came back low, So he sent me to endocrinologist. She ordered another blood test–> Testosterone came back bellow the range, Estradiol was skyhigh and my thyroid antibodies were also high ( See blood results bellow).She did ultrasound of my testicles and everything was normal. She also did ultrasound of my thyroid and found out that I have few little cysts ( 5 mm) on my thyroid. She said that my testosterone levels are fine and my thyroid is also fine. She was 100% sure all of my problems are just psychological, So she gave me antidepressants. Few months later my doctor ordered brain MRI. After that they told me that I have a pineal cyst (15x9x8mm). She said it isn’t nothing to worry about. But I read It can shut down some of my hormone levels, especially melatonin. So I’m going to try melatonin suplement because I have very poor sleep quality last few years. And now the most important part of my story.: Endo refused to put me on TRT or any kind of drug that can raise my T levels, because she thinks my lab results are normal. Doctors here in Czech republic won’t put me on TRT because they have absolutely zero knowledge about it. So I bought UGL testosterone cypionate and research chem. arimidex. I want to start taking 100mg testosterone twice a week intramuscular along with arimidex 0.25mg 2/week. But I’m not sure if that can help me because i have very low SHBG. I am wondering if I can raise my SHBG with some kind of thyroid medication because my thyroid is definitely not working properly.

Prolactin 177 mIU/l (56-278)
Testosterone 296 ng/dl (288-1200)
TSH 2.54 mIU/l (0.3-4.0)

Testosterone - 261 ng/dl (288-1200) Low
Estradiol 226 pmol/l (0-210) High
DHEA-S 8.37 (1-12)
TSH 1,62 mIU/l (0.3-4.0)
fT4 10.7 pmol/l (7.6-16)
antiTg 14,6 (0-4) High
antiTPO 0.84 (0-9)
cortisol 556.4 (104-535)
LH- 3.7 (0.8-7.6)
FSH - 8.3 (1.3-19)
Prolactin - 7.5 ng/ml (0-15)
Androstenedione 1,53 (2.1-12.9) Low
HGH 17.05 (0.01-3.00) High
IGF-1 - 406 (397-657)

Hemoglobin 145 (135-175)
Hematocrit 0.42 (0.4-0.5)
LH 3.3 (0.8- 7.6)
FSH 7.2 (1.3-19)
Prolactin 7.2 (0-15)
Estradiol 170 (0-200)
Testosterone 286 (288-1200) Low
TSH 2.23 (0.3-4.0)
fT4 4.1 (7.6-16)
HGH 7.47 (0.01-3.0) High
Fasting glucose-5.93 (3.3-5.6) High

TSH 4.13 (0.3-4.0) High
fT4 14,75 (7.6-16)
fT3 5.12 (3.8-6.0)
PSA 0.20 (0-4.5)
Testosterone 344 (288-1200)
FSH 7 (1.3-19)
LH 3.4 (0.8-7.6)
Fasting glucose 5.9 (3.3-5.6) High
Prolactin 174 (56-278)

Total cholesterol 3.53 (3.50-5.00)
Triglycerides 0.43 (0.00-2.00)
HDL 1.40 (1.00-2.80)
LDL 2.18 (0.00-3.00)
ALT 0.38 (0.06-0.67)
AST 0.48 (0.05-0.67)
Bilirubin total 7.8 (5.0-21.0)
creatinine 72.0 (40.0-79.0)
Urea 5.8 (2.6-8.3)
Calcium 2.52 (2.15-2.60)
Magnesium 0.86 (0.70-1.10)
Fasting Glucose 5.51 (3.30- 5.60)
Testosterone 383 (288-1200)
Estradiol 184 (0-210)
Prolactin 210 (56-278)
Progesterone 1.6 nmol/l (0.0-9.5)
Cortisol 398 (104-535)
TSH 2.61 (0.30-4.00)
T4 80.66 (78-157)
T3 1.87 (1.3-2.7)
fT4 7.4 (7.6-16) Low
fT3 6.5 (4.3-7.4)
Thyreoglobuline 3.8 (1.6-50)
anti-TG 0.9 (0.0-4.0)
anti-TPO 1.10 (0-10)
HGH 0.94 (0.01-3)
IGF-1 383 (397-657) Low
SHBG 9.4 (10-57) Low

My Hemoglobin and Hematocrit levels are always on the lower side of the reference range.

P.S. Sorry for my English…

Hi Mike. Your English is fine, no apologies needed. I’m not a doctor, but I do have multiple food and chemical sensitivities of which anxiety+depression+brain fog are classic symptoms. Physical weakness may be as well, these things vary with individual. Not being a doctor, I can’t comment on your blood work. But I would say the most important part of your story is you have not mentioned seeing a nutritionist. Seriously: IF you have undiagnosed allergies, environmental chemical and/or food sensitivities, you are highly unlikely to address your other issues until the immune problems are recognized and resolved.

Common food sensitivities are grains – not just gluten, but corn and rice may also be problems
Dairy and soy – do you take whey and/or soy based protein supplements? Eggs? Beans?

The list of potential culprits goes on and on. Doesn’t mean you have more than a few, or any for that matter. See James Braly, MD: Dangerous Grains and Dr. Braly’s Food Allergy and Nutrition Revolution. The latter is an excellent all-round nutrition reference. But do look into seeing a professional nutritionist/dietitian.

Environmental airborne allergens may also be involved, particularly those most folks don’t consider or recognize: carpets, dust mites, just about any non-natural volatile organic compound e.g. air fresheners, cleaning solutions, scented detergents, etc. Natural gas can be far from pure methane; some people have trouble just with that. Car motor exhaust – do you live over an attached garage? Diesel, both the fuel and exhaust. And so on. Doesn’t mean you’re sensitive to any of these, but with brain fog, anxiety, and depression, they’re all possibilities to consider.

Thank you for your answer. I will definitely visit a nutritionist. I eat whey protein and eggs almost every day( NO digesting problems). I know that I can’t eat some foods ( bananas, avocados, tomatoes, dairy …) it gives me really bad digesting problems. I also have latex allergy. Sorry, I forgot to mention it above.

Hello Mike 99cz

Your case is complicated because some of your labs appear like they are from different people.

Your thyroid is a mess and numbers change a lot. Please get a vitamin that lists 150 mcg iodine, or more and 200mcf selenium. This may resolve your thyroid auto-immune issues. The thyroid nodules may be from iodine deficiency in the past. High TSH from that can cause the nodules. Maybe we can prevent this from progressing to hyper-thyroidism. Please self-eval overall thyroid function via last paragraph in this post.

Ignore HG and hGH results. GH is released in pulses with a short half-life. Please use IGF-1 to evaluate GH status.

Hematocrit is low because T is low. But there could be another cause contributing to this such as a blood loss in your gut. Any food allergies etc.
TRT typically fixes low hematocrit.

Low SHBG means less SHBG+T which then reduces your TT number.

Low SHBG is often seen with and a symptom of diabetes. There is a A1C test that is more definitive than serum glucose. However, there are some guys who have low SHBG with no identifiable cause.

(96.8F) or 98.6F-37C body temperature?

fT3 5.12 (3.8-6.0)
When fT3 is mid-range, normal body temperatures are expected. When body temps are low, we suspect that rT3 is elevated and interfering with fT3 at T3 receptors. rT3 is increased in “adrenal fatigue” caused by daily stress or stress events. When young guys have low energy from low T and/or thyroid issues and gt energy to train from sheer will power and adrenalin, this can fatigue the adrenal glands.

E2 generation should be low as low FT means less FT–>E2. Problem may be poor liver clearance of E2. That can be from a liver problem. Please get AST/ALT tested.

Useful? http://uroklinikum.cz/

  • 50mg T cyp twice a week, use #29 12mm 0.5ml insulin syringes, SQ over upper leg
  • 0.5 mg anastrozole at time of injections
  • 20mg nolvadex [preferred] EOD or 25mg clomid EOD

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc
  • thyroid basics

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

You are welcome Mike. The specialist buzzword you may be looking for is “Environmental Medicine”. I wouldn’t be on this thread if I weren’t considering TRT myself. But an Environmental Medicine MD might suggest you hold off for a bit while he or she investigates possible underlying cause. (My own non-medical opinion of course.) I’m very interested in KSman’s comment – I’ve had body temps similar to yours in the past, but haven’t monitored it carefully recently. I’ll probably open my own thread after I collect that and recent blood data.

Yes, my labs are from different doctors. I had the A1C test done and it came back at 38 ( range is 20-42). Body temperatures above are correct… 96.8F, NOT 98.6. Should I also take T4? It could decrease my TSH levels and maybe increase SHBG.
ALT 0.38 (0.06-0.67)
AST 0.48 (0.05-0.67)
Bilirubin total 7.8 (5.0-21.0)

I see no reason why that would change SHBG by a large amount, but will be interesting to see as you resolve your low thyroid function.

I pointed out that your fT3 was adequate to support good body temps and that if temps were low, rT3 is suspected and adrenal fatigue. In that situation you have too much T4–>rT3 and taking T4 leads to more T4–>rT3. You would want time-release T3, probably 25mcg and that is a compounding pharmacy only item in USA, probably unobtainium in other countries. You need to read the thyroid basics sticky from beginning to end. Testing rT3 is needed. Another complication can be from using statin drugs causing low CoQ10, but that is not on the table at your age.

Taking T3 will lower TSH and that will lower T4 production and T4 will decrease. Then there is less T4–>rT3.

If you read the thyroid basics sticky and think that stress is a major issue for you, you can get and read Wilson’s book on ‘adrenal fatigue’ and see if that seems like it applies to you. The book might create some ‘language’ issues for you.

Thank you for your answer. I am going to start your TRT protocol next week. I will definitely try T3 in the future. rT3 blood test will be really hard to get… I don’t know any lab which can run it. I have a question about your TRT protocol - Why did you recommend Nolvadex? Is it necessary for me to take it? And what about gym training if I already have adrenal fatigue?

A post was split to a new topic: Low T, Low Estradiol. Advice?

You need to preserve fertility at your age. So you need to inject 250iu hCG SC EOD or use a SERM. I recommend Nolvadex because some guys simply feel bad on Clomid. It acts differently for some guys, other are great on it. hCG can be hard to get and expensive. SERMs are typically much more available and affordable.

If you inject T and do not use a SERM or hCG, your testes probably will get small and soft and scrotum will pull up tight. This can easily affect your own sexual self-image and also how you are perceived by women.

And there is a high risk of infertility and you should protect your ability to have children. At some point a woman will not be interested in a guy that cannot father her children.

Young guys have the ability to train when they have low-T, low thyroid function or both. That means adrenalin that causes adrenal fatigue or makes it worse.

I just realized that I used corticoids (eye drops) when I was 13 years old. Do you think that It can be somehow related to my problems?

No, not enough to have systemic effects.

Hello again,
I’ve got new labs. What do you think about it? I have been on TRT for a month. My protocol: 50mg test C 2x/week, anastrozole 0.25mg 2x/week. Neither nolvadex nor HCG have I obtained yet. Which product is better? I felt great during the first two weeks on TRT, then I experienced a small crash. Do you think it is connected to the shutdown of hormone stream (pregnenolone etc.)?

8:00 AM
Prolactin 150.7 mIU/l (56.0-278.0)
Estradiol 55.3 pg/ml (0-57)
Testosterone Total 564 ng/dl (288-1100)
Cortisol 289 nmol/l (104-535)