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18y/o, 263 Pounds, 176ng/dl Testosterone. Need Help

First, I’d like to start with some background information. I have NEVER touched steroids or any hormone changing compound and I am not planning to. The only supplements I have ever taken were Protein, Pre-workout, and Creatine. I have been lifting consistently for 3 years. My goal was to compete in a powerlifting meet at some point.

My lifts are:

Bench 275 * 5

Deadlift 535 * 1

Squat 485 * 1

I weigh 263 pounds at 28.9% percent body fat (Dexa scan). I have been losing fat slowly but surely.

Here’s where the problems come in. About three months ago, I realized that I wasn’t recovering as fast and I had sort of hit a plateau with my lifts. I also had some nipple pain and tenderness. At the time, I didn’t think much of it and thought I just needed to work out harder. Then three weeks ago, i went to the doctor for a routine check-up and I took a full doctor’s panel blood test with testosterone included and my results came back as the following:

TSH : 1.97

Estradiol: 20.1

FSH : 2.6

LH : 7.3

Progestrone : 0.2

Prolactin : 7.5

Free Testosterone: 52.8 pg/ml

Sex Hormone BIN: 9.3 nmol/L

Testosterone 176 ng/dL (Doctor “normal for my age is 650 - 900”)

My doctor immediately saw that something was wrong and referred me to an endocrinologist. My endo then told me that he will repeat the blood tests to make sure but that most likely my previous results were accurate and that I might have to go on TRT. He discussed all the risks with me such as shutting down my natural testosterone production, shutting down HPTA, shutting down my LH, infertility and increased risk for heart attack and increased risk for prostate cancer. My doctor’s theory as to why my testosterone is low, is that it was always low and that my lifting was compensating for it until my body simply could not catch up anymore.

Any advice is welcome. I have so many questions because I was so surprised when I saw my results and frankly I am scared.

If anyone can answer some of these questions it would be greatly appreciated:

  1. How could I have been progressing in the gym so well with such low testosterone for my age?
  2. What could have caused my low test if I have never taken any hormone changing compound?
  3. What other long-term or short term side effect will I get from doing TRT at only 18?

If I forgot to cover anything or if there is any other information that you would like to know feel free to ask.

You need to find a new doctor fast, this statement indicates he is old school in his thinking, these flawed studies about prostate cancer and heart attacks were based off old men placed on TRT who were already compromised and had heart trouble do to being low testosterone for decades.

Prostate cancer is an old man’s disease and if you have the gene, you will get prostate cancer as it’s genetic. Prostate cancer is more associated with older men and not younger men, older men have lower levels of testosterone. When was the last time you heard of a young man with high testosterone with prostate cancer?

The likelihood of you finding a knowledgeable TRT doctor inside insurance is low to non-existent. You are missing important testing, no thyroid hormones were even checked.

Testosterone Therapy in Men With Prostate Cancer

The use of testosterone therapy in men with prostate cancer was previously contraindicated, although recent data challenge this axiom. Over the past 2 decades, there has been a dramatic paradigm shift in beliefs, attitude, and treatment of testosterone deficiency in men with prostate cancer.

Testosterone Replacement Therapy and Prostate Cancer Incidence

While early studies demonstrated a positive association between testosterone and prostate cancer, evidence on the nature of the relationship has evolved with time and newer data. Studies examining links between baseline testosterone levels as well as testosterone therapy and incident prostate cancer, reveal a more complex relationship. Moreover, investigators have reported their initial experiences with supplementing testosterone in men with a history of both treated and untreated prostate cancer.

Testosterone and the Heart

Testosterone (T) has a number of important effects on the cardiovascular system. In men, T levels begin to decrease after age 40, and this decrease has been associated with an increase in all-cause mortality and cardiovascular (CV) risk. Low T levels in men may increase their risk of developing coronary artery disease (CAD), metabolic syndrome, and type 2 diabetes. Reduced T levels in men with congestive heart failure (CHF) portends a poor prognosis and is associated with increased mortality. Studies have reported a reduced CV risk with higher endogenous T concentration, improvement of known CV risk factors with T therapy, and reduced mortality in T-deficient men who underwent T replacement therapy versus untreated men. Testosterone replacement therapy (TRT) has been shown to improve myocardial ischemia in men with CAD, improve exercise capacity in patients with CHF, and improve serum glucose levels, HbA1c, and insulin resistance in men with diabetes and prediabetes. There are no large long-term, placebo-controlled, randomized clinical trials to provide definitive conclusions about TRT and CV risk. However, there currently is no credible evidence that T therapy increases CV risk and substantial evidence that it does not. In fact, existing data suggests that T therapy may offer CV benefits to men.

I can throw studies at you all day showing the opposite of what your doctor is stating, I assure you he will be unable to provide any studies showing TRT causes prostate cancer or heart attacks. These have been debunked.

Excellent question, testosterone has been on the decline for the last several decades across the globe, our father fathers had higher testosterone and each new generation of men are seeing testosterone and sperm production on the decline.

We live in a toxic environment, cars expel poisonous noxious gases, we eat processed foods and foods with little nutrients. We are killing ourselves slowly.

Your SHBG is very low and concerning, low SHBG men can struggle on TRT. Testosterone and estrogen bind to SHBG and since you don’t have that much of it, most of your hormones will be free and bioavailable. That means Free T and Free E2 will be high and difficult to control if you shoot for high normal levels.

You body fat percentage and low SHBG will ensure estrogen side effects, T is very low and estrogen is already in a good range which will change once you begin TRT.

TRT will lower SHBG so I suggest you inject EOD or daily to avoid unnecessary estrogen sides in the form of Free E2, daily has a better chance of you succeeding. Sometimes low SHBG is genetic and other times can be explained by low thyroid hormones, fT3 and or high rT3.

Everything you want to know about low SHBG is in this thread/video.

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Endo should be investigating root cause esp at your age. Was your puberty normal? If not, read about Kallmann syndrome and less likely
klinefelter syndrome.

You probably did ok at the gym cause you are young.

Medications now and before?

Testicular ultrasound a must. Your testis could be failing. Tumor? Need ultrasound.

Endo should check adrenals too

Am cortisol
Acth

Check metabolic panel
A1c
Ferritin

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That is not true.

That is plausible.

Your low SHBG saved you for a while. Your fee test is 3% of total, pretty good. While it is in the lower end of normal, if your SHBG was in mid range your free test would be in the 20s.

Good question, difficult to say without more lab tests. You may not find an answer.

He covered them, but the long term risks of low testosterone are not good. I’d consider getting a semen analysis.

My test results and the doctor explaining the risks were my general family doctor. My endo ordered new blood tests and the results are coming tmrw. he ordered a full thyroid panel along with a full lipid panel and a full metabolic panel. he also ordered a semen analysis.

My puberty was very normal. Doctor asked about it too. Only medication i have been on is aderall for my ADHD. my endo ordered a full metabolic panel and my results come in tmrw. he did an exam on my testis and said that they were fine. I am also getting a sperm analysis done.

The endo ordered a semen analysis, and my new bloods come in tmrw. thank you for the help. i feel better knowing that Heart and Prostate risk are not a worry

See if they can order an ultrasound. I mean she is not even a urologist. Just tell her you want to play it safe. Cover your bases man. The ADHD meds can affect but I don’t know to what degree.

You probably should get a pituitary MRI too. Again cover your bases. You need to rule out disease. Like this you can make an informed decision about trt.

If endo did not check AM cortisol and acth not to sure about her knowledge. Also a1c. You are overweight. Diabetes?
Your shbg is super low. There are causes for that too.
Need CBC and the ferritin.

Also future consideration is trying novaldex or clomid instead of trt. This medication pushes out more LH so that testes make more t. And this is a good way to see if it’s the balls fault.

Not true with the trt false narratives how fucking frustrating.

Think about it like this. We naturally produce T. Replacing T into our body is not different than having natural t right? So why is it that all men are not prone to these issues prostate and heart when we’re 22 and having high levels? Yah because it’s bullshit.

First they thought it was because of too much T. Now they realize it is possible too much t and not enoug oversight. More importantly and majority of the cause is due to genetics. If you are genetically prone to heart disease, ps issues - then you will exp this issue regardless if on trt or not.

Not every man experiences issues with there heart or prostate when levels increase. This is how you realize that it’s mostly genetics and life style:

Like diabetes. Regardless if you eat healthy or not, this problem will surface.

They are actually using TRT to heal men with heart issues… for prostate cancer they have given abnormally high dosages to kill that problem.

The reason we have this false narrative is because of law suits and med mal. There was many law suits baseed on docs prescribing and client dying while on trt . The media reported on this without basing it on facts. This spread like fire and now this is all I’ll informed folks know about TRT. It’s kind of the same with groups of people. The news calls an ethnicity violent and now we think millions are violent. Ignorance right?

Anyways it’s debunked and I would be the last person to start trt if it was true. I was very hesitant to start trt … after investing some proper time into research I found the truth.

Don’t lose the opportunity to live a healthy normal life because one docs uneducated POV.

Perfect. I wish they’d fix the forum son that the stickies were actually at the top and not hidden.

That’s not a stickie. I wanted a stickie but admin felt no need to. I made it a bookmark to make it easy for me to copy link.

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I am not diabetic but i will check with my doctor just in case. the doctor also mentioned clomid as an option after they see my new bloods. I will read those articles asap.

You need to run the test and diagnostic tests mentioned. Don’t let them tell you otherwise. You must advocate for yourself. You may have to be a little pushy. It’s ok to do this. Trust us. We all challenge our Drs we get better care that way.

Plus good to get baselines on everything.

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is am cortisol really that good for testing? (blood test)

AM cortisol Along with acth and dhea s. Can help determine adrenal fatigue. Some dhea and cortisol is produced by adrenals.

And if a problem with adrenals is suspected can do saliva cortisol several times in a day.

If am cortisol serum is low you got a problem. That’s where is should be highest.
Then acth stimulation test , all serum, can confirm adrenal fatigue or deficiency.

Not saying a 4 point cortisol test is not good. Cause problems can be later in the day.
Just saying AM cortisol serum is ok to test for an obvious adrenal problem pretty quickly.

sorry to ask but i recently had my cortisol tested 18 from range 9-22 am and acth at 44 (high) would that mean anything? i know you mentioned acth testing i will check that out

18 in am is very good. You need to read up on acth. I think acth signals adrenal to make cortisol

Corticotrophin-releasing hormone from the hypothalamus acts on the pituitary , which secretes ACTH. ACTH travels to the adrenal glands via the bloodstream. Cortisol from the adrenal then feeds back to the hypothalamus to shut down the cycle.

ACTH Stimulation Test (Cosyntropin)

Purpose: Evaluation of possible primary or secondary adrenal insufficiency, as well as disorders of adrenal steroid biosynthesis, such as congenital adrenal hyperplasia (CAH).1,2

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sounds like a mess ha! but you explained it better than my doc (have to consider i didnt asked her about it. she saw the high acth and in a flash she said o noooo you might have cushing).

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I would repeat the ACTH and am cortisol before doing any further testing or confirming anything. These hormones fluctuate greatly.