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18 Yrs Old, High Cortisol/Prolactin, Low E2

Hello, i’m 18 near 19 years old. For a long i’ve suspected i could have low testosterone. I had gynecomastia for a long time. I’ve difficulty in losing weight and i can’t gain muscle too easily also. I’ve practised sports, gym included, for some years with lack of results. Besides, even though i’m young i feel like i have low libido and lack of sexual interest, comparing to people of my age. I also have experienced low energy and lack of motivation. I rarely have morning erections and i have none spontaneous erections throughout the day. I decided to take some blood tests.

Total testosterone: 4,23 ng/mL ( Men: 2,8-8,0)
Free testosterone: 10,5 pg/ml (Men : 20 - 39 years: 5.1 - 22.7 ;40 - 59 years: 4.6 - 19.4; > 60 years: 1.9 - 17.5)
Cortisol: 19,8 ug/dl (Morning: 6,2-19,4)
SHBG: 18 nmol/mL (Men: 15 - 18 years: 9.7 - 49.6; 19 - 49 years: 18.3 - 54.1; >49 years: 20.6 - 76.7)
E2, 17-Beta Estradiol: 7,8 pg/ml (Men: 11,3 – 43,2)
Prolactin: 20,1 ng/mL (Men: 4,04 – 15,2)
TSH: 2,02 uUI/ml (0,27 - 4,20)
Total T3: 1,21 ng/mL (0,80 - 2,00)
Total T4: 9,13 ug/dL (5,10 - 14,10)

I’ve noticed that cortisol and prolactin specially are high. Estradiol is low. Testosterone seems to be within the normal values but i think that considering my age, i should be higher. Give me your thoughts please. Is it all healthy or is there something you think I should worry and might be causing my symptoms. Thanks for your help

We’re going to need some lifestyle information, like if you lift, how often, what do you eat, how much drinking, pot smoking…?

Used to lift 2-3 time a week. Stopped this year. Eat healthy, no fast food. No drinking nor smoking

Please elaborate. And do you do any form of exercise?

Have you tested yourself for iron and ferritin?

Unless you are taking some kind of medication or drugs that can cause high levels of prolactin, I would make sure to go to the doctor to rule out that you don’t have hyperprolactinaemia.

In men, the most common symptoms of hyperprolactinaemia are decreased libido , sexual dysfunction, erectile dysfunction, infertility, and gynecomastia.

Your E2 is too low to be causing your gyno (unless you have been taking an AI for that) so definitely worth checking this out with your doctor.

I haven’t tested iron and ferritin. I don’t take any medication or drugs.

Used to practise professional kayaking, 6 days a week. Now i just run, once a week, not the ideal. But the symptoms remain the same

Your E2 is low, which causes problems, your test is middle of the road. I didn’t see LH or FSH. So, E2 is low because of your test levels, probably. Your SHBG is a little low too, but that means that your free T should be better but it can also indicate that you have something else going on. Higher end of the range for SHBG usually means healthier and better chances of longevity. Your Prolactin is way high, and likely related to gyno issues. The question is, what is causing that Prolactin number?

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Given your history, you need to run that down.

The low estrogen is very concerning, low estrogen can cause osteoporosis. You need healthy estrogen levels which is north of 20.

I’ve seen men diagnosed with osteoporosis with an estrogen in the mid teens on this forum.

Especially at your age you need to rule out disease. You may need to go to multiple doctors like an endocrinologist and urologist.

Def get a pituitary MRI and testicles ultrasound.

I would see a Endocrinologist to investigate your cortisol number as well.

What is your weight?

Check a1c and am insulin. Do entire metabolic panel.
What time was your cortisol lab taken?

You may have adrenal issues as well.

Was your puberty normal? Did your junk grow? Body hair?

You may need trt but must investigate first.

I’m 1,82 m, 72 Kg.
The cortisol was taken at 9 am
junk grew fine; body hair seems fine but i dont have much facial hair

Have you spoken to a doctor regarding your blood work, especially prolactin?