T Nation

19 and Possibly Low T

I’ll just get straight to the info. I’ve read most of the stickies, so hopefully I did everything right…sorry if I didn’t.

Age: 19
Height: 5’9’’
Waist: size 32 pants, but if you mean my naval 37’’
weight: 174lbs
Body hair is okay. Legs have been hairy my whole life. Chest hair is just small hairs in the middle. Some stomach hair, mostly in the middle. (weird because I’m of Iranian decent and both my dad and brother are extremely hairy, and all of my cousins). Facial hair sucks. I shave like once a week to once every two weeks (generally the latter). I have patches and they are bad to me (again weird because both my brother and dad shave daily, and same with all my male relatives).

  • I carry most of my fat in my abdomen. I also have some large deposits in my thighs and hips.
  • Only health condition (except this) is mild asthma. I have it under control, and barely use my inhaler.

Labs: test1: 1/8/2013
LH 6.5 range: <8.6MIU/mL
Prolactin 8.2 ng/mL (no units or range)
FSH 7.7 mIU (no range)
Test total 429 ref range: 300-1080 ng/dL
SHBG 22 range: 11-80 nmol/L
Free Test 97 range 47-244 pg/mL
%free test 2.3 range: 1.6-2.9
E2 26 range: <43 pg/mL
DHEA Sulfate 417 range: 88-483 ug/dL

Lab 2: 1/30/2013
DHEA Sulfate 345 range: 88-483 ug/dL
Total test 345 range 300-1080 ng/dL
SHBG 24 range: 11-80 nmol/L
Free Test 73 range: 47-244 pg/mL
Free % 2.1 1.6-2.9
Prolactin 8 (no range again)
E2 28 range: <43 pg/mL
LH 7.7 range: <8.6 mIU/mL
FSH 6.9 (once again…)

I had a third lab that just tested for TSH:
TSH 2.27 range: .27-4.20 ulU/mL

I had a lipid panel done about a year and a half ago, they’re likely around the same as my diet and exercise hasn’t changed at all:

CHOLESTEROL, TOTAL 128 125-170 mg/dL 11/5/2011 2:11 PM QUEST
HDL CHOLESTEROL 59 31-65 mg/dL 11/5/2011 2:11 PM QUEST
TRIGLYCERIDES 56 38-152 mg/dL 11/5/2011 2:11 PM QUEST
LDL-CHOLESTEROL 58 <110 mg/dL (calc) 11/5/2011 2:11 PM QUEST

Sorry I don’t have more, I’ve been seeing a Urologist currently, and those are the labs he ordered for me. He’s prescribed me Nolvadex 10mg 2x a day, and I’ll write in symptoms what it has helped me with. Recently changed the Nolva to just 10mg once a day though, eventually having me ween off it in 3 months time.

Here are my symptoms:

  • Brain fog for sure. It’s not 24/7 but it’s pretty often.
  • Urologist actually felt me chest, I have gynocomastia
  • Can’t get it up a lot of the time. When I can, it’s hard to keep it up. Putting on a condom has to be done insanely quick, plus I have to start bareback when having sex, then transition, otherwise I get soft while inside. Erections are fine now with Nolva. Only had one problem where I lost an erection.
  • I get testicle pain in my right testicles once in a while. sharp for a few seconds, then dull. Never had a fever with the pain that I know of. Doctor checks for any masses, none there.
  • I have nocturnal erections, and morning wood virtually everyday now with the nolvadex. Before, it was a few times a week.
  • Daily fatigue. I need to nap almost every day even with 8 hours of sleep. I feel tired throughout most of the day, have to sleep relatively early.

Diet:
Generally have 3-4 whole eggs for breakfast, sometimes with bread. Lunch will be turkey or chicken, or beef, whatever I have on hand or my dining hall is serving. Dinner is the same. Generally eat plenty of protein and fats, I never avoid cholesterol. Carbs are usually 100g-150g a day.

training:
Generally lift 3x a week. Max 5-6 exercises per session. I don’t test maxes often, I get plenty of sleep most nights. I haven’t been to serious about it because it’s hard to be motivated right now.

I realize my numbers aren’t necessarily extremely low, but the symptoms really bother me. Like I said earlier, the doc prescribed nolva 10mg 2x a day, and it’s helped my erections substantially, my problems come with the continued tiredness, fogginess, trouble concentrating, and lack of motivation. Doc has pretty much completely dismissed TRT, or doing a restart protocol with Clomid, Nolva and hcg even after asking him about that. I also started seeing a therapist and she says that she doesn’t think it’s depression, and neither do I. Trying to hit this from all angles (both physiological and mental) and see what end up happening. Help is very much appreciated, I can’t say that enough. I’m sure many of you guys know the frustration of the symptoms.

If I need to add anything let me know. hopefully We can figure this out…

Edit: Waking body temperature today was 96.6, measured about 15 min after waking up. Temperature of 98.3 at about 14:46. Also added some reference ranges that I found on my tests.

read the thyroid basics sticky ur waking temps are low…

Several of my male patients have shared with me that they?re having problems in the romance department more frequently. They experience erectile dysfunction often and are also feeling depressed and fatigued. They wonder if maybe they have a hormone deficiency, or are coming down with a bug or some other condition. I explain that perhaps a testosterone hormone deficiency is to blame, but I?d like to also check another hormone, their thyroid, as a potential cause for their symptoms. Let me explain.

A Man?s Thyroid and Sexual Performance

As a man gets older, usually past the age of 50, erectile dysfunction can become an issue for them. In fact, recent SHIM (a 5 point sexual health inventory for males) studies show a high prevalence of erectile dysfunction in men over age 50. Although ED can have several causes, including blood flow/heart conditions, the most common is low testosterone levels which are regulated by the thyroid. In turn, high TSH levels (low thyroid) can reveal ED in a man.

In the SHIM studies mentioned above, 71 male subjects were divided into 2 groups, 27 men with hyperthyroidism and 44 with hypothyroidism. The euthyroid (normal) control group also numbered 71 men. The men were asked to answer 5 questions aimed at determining erectile dysfunction. The study revealed that 52% of the hypothyroid men had erectile dysfunction, with 38% of those men having severe erectile dysfunction. In contrast, 27% of men in the hyperthyroid group had ED with 29.6% having severe cases. The good news result of the study is that after euthyroid (normal) levels were returned with either supplementing of thyroid hormone in hypothyroidism or suppression of hormone in hyperthyroidism, only 30% of the total group remained with ED. The bottom line recommendation of the study was that men with thyroid dysfunction commonly have ED which is reversible. Men with erectile dysfunction should have their thyroid hormones balanced 6 months in advance of considering any other ED treatment

keep taking temperatures :slight_smile: tell the doc you want a full thyroid panel.
read about iodine (in the sticky)
don’t take iodine if you want to get further bloodwork as it may affect ur results

my temps are low also :frowning:

[quote]iw84aces wrote:
read the thyroid basics sticky ur waking temps are low…
[/quote]

Alright I read the through the whole thing, and I’ll send an email to the doc to see if he can put a thyroid panel request in for me. I’ll keep taking my temperature morning and noon, and see what happens. I’m a bit confused. I realize I don’t have T3, T4, rT3, rT4 level on the lab, but my TSH is mid range, wouldn’t that indicate that thyroid is not the problem? I can see how the temperature would dictate otherwise, so would that possibly indicate elevated rT3/rT4?

EDIT: Forgot to add, after I started dropping the tamoxifen to just 10mg/day, I’ve been having erection problems again. Took forever for me to get hard, then I had a hard time keeping it. It’s also finals week so I’m not sure if it’s stress related at the moment though…

You have come to the right place. There is a steep learning curve. You are been forced to learn what you doctor does not understand.

List your CBC and fasting glucose. Also need ALT/AST.

Any tingling/numbness of toes at night. Lots of thirst and urination?

TSH is worrying, keep checking temperatures.

read the thyroid basics sticky, report your history of iodine intake: iodized salt and vitamins that list iodine

You need total cholesterol to be near 180. Low cholesterol limits your ability to make steroid hormones and is also associated with increased all-cause mortality for levels below 160. Your ranges are bogus and misguided!

Most cholesterol is made in the liver. So I would like to see liver function oriented labs. Your cholesterol intake is high, so something is abnormal in the liver.

Can you explain why your cholesterol levels are low?

However, your DHEA-S levels are good enough to support T production.

TSH is high, but doc does not think so. You need to follow up with:
-TSH
-fT3
-fT4

You have possible:

  • thyroid disease
  • and/or iodine deficiency
  • and/or adrenal fatigue with elevated rT3

If you have trouble with stress and some stress events leave you feeling drained, you may have cortisol problems. And then you need labs:

  • AM cortisol
  • rT3 [low cortisol aka adrenal fatigue] leads to uncreased rT3 which blocks fT3, see that sticky

You need to identify why you have these problems.

You are estrogen dominant with your T and E2 numbers. That contributes to fat gain and inability to loose fat. You really need to loose weight BTW. And thyroid problems will also have the same outcome. You need to also eat less and if you get your hormone situation fixed/balances, then your metabolism should allow for fat loss.

^^ listen to him… goodluck sir

Alright thanks for helping me get started with all of this. I emailed my urologist’s office and they told me to talk to GP about getting thyroid labs, so I’ll have to call him soon. I managed to get some old labs though that I had done in late 2011, I know they’re old but this was the first time I wanted to address my issues. Of course the doctor told me to just relax when I’m having sex, then referred me to counseling which I did for 2 months and didn’t really help anything except my confidence a bit, so I just sort of shrugged it off and tried to continue with my life.

attached is the labs I took. Here’s the answers to all your questions:

Any tingling/numbness of toes at night. Lots of thirst and urination?

  • I get tingling in my left hand sometimes, and feels sort of numb. Heightened especially if I’m using a stimulant or something at the time. I drink a lot of water for sure, and am generally thirsty a lot of the time. Not sure about increased urination though, seems to just be a few times a day.
  • I’ll keep checking my temperatures and put them on an excel spread sheet and upload them in a week’s time. Missed today’s because I pulled an all nighter for my OChem final…

Can you explain why your cholesterol levels are low?

  • I really have no idea. I never avoid it, I eat red meat often, and if not then whole eggs. I’m not aware of a history of high cholesterol in family either.

You really need to loose weight BTW

  • Yeah I plan to start soon, finals have been stressful so with the new quarter coming up I’ll be able to keep my diet in check and get lifting more consistently too

report your history of iodine intake: iodized salt and vitamins that list iodine

  • I don’t avoid salt, but I’m actually not sure if it’s iodized. I just took a salt shaker from my university’s dining hall and use that haha. Otherwise I do not supplement at all with Iodine, could be a deficiency.

Some more info that may be important:

  • I sweat a lot when sleeping. I only notice it when I nap though (probably because it dries off by the time I wake up in the mornings)
  • I burp a lot. It comes in waves. I’ll feel a small sharp pain in my rips, then start burping and it goes away. This is probably unrelated and more gastrointestinal but thought I’d share.
  • I get pain (very light) in my side(s) sometimes. Seems to occur only when I don’t drink enough water.
  • I get especially sleepy after eating carbs. That’s why I limit myself to 150g a day or so.
  • Just a side note, I feel like I’ve noticed an increase in muscle mass since I’ve taken the tamoxifen, makes sense just wanted to note it. Additionally, I’ve been working out less so I do think it correlates.

Thanks for all the help so far. Gonna keep taking my temperature, and I’ll talk to my Doctor about getting a full Thyroid panel and ALT/AST along with a new CBC and fasting glucose.

EDIT: Wanted to add, is there anyway to increase my cholesterol? I’ve been reading articles online and it seems I want to hover around 200 total, and not even go below 180…and I’m at ~130 so seeing how it’s a precursor to all the steroids in my body, could that be the cause?

In addition, I have a CBC and a comprehensive metabolic panel from 12/8, I was sick at the time though so I wasn’t sure if it would be helpful. If you think it is, let me know and I’ll post it.

My temperatures have been really weird. Yesterday morning it was 95.8, then this morning it was 97.2. Mostly it was in between before, but those two are peculiar. Evening temps generally are around 98.3ish. The cholesterol is bothering me more and more. I read more online and I realize that doctors are morons and don’t keep up with modern literature and it’s rather frustrating.

additionally, I talked to my dad about this, and he seems to be on the side of “it’s in your head.” ever since I dropped the Nolvadex down to 10mg/day, I’ve had problems with erections again. Morning wood is sucky if it’s there, when I was trying to have sex it took all of my concentration to keep my hard on (hardly makes sex enjoyable) and even when I was masturbating, my dick was not really that hard, and I had a hard time keeping my erection. Sex drive has significantly gone done. Haven’t been wanting to have sex with my gf really. We’re separated for a week because of spring break, but before I wasn’t pushing sex just because I wasn’t really horny. This all tells me that it’s not in my head, so I don’t know what the hell to say to my GP, and my dad.

I need to talk to my dad or mom about ordering new thyroid tests and all that. Gotta call my GP today or this week as well to get the tests.

I was thinking what if I just buy iodine supplements? If I supplement for a week or so (including a loading phase to flush out the bromine/to add a normal amount in my body), and things get better, then it could save me money on blood tests. What do you guys think of that?

Wish I was confident enough to say just go for it, I personally have been supplementing with Iodine myself though. I found myself to fall under the “why not” and just started taking 3.75mg a day, and now up to 13mg or so. My temperatures are still all over the place though (not nearly as low as when I started in the AM).

All other symptoms haven’t changed though, so I shall go forward with blood tests.

So to sum up, I say go for it, and if I’m wrong (which I doubt I am for this particular question) hopefully someone will speak up :stuck_out_tongue:

Maybe I’m thinking about this wrong, but let me lay down my logic and see if it makes sense.

So I take Iodine supplements now for a week or two (obviously it’ll take a while to get to normal levels) and try to replenish my iodine to something more ideal. After some time, if my symptoms go away then yahoo I figured out the problem, don’t have to worry about this shit, I can just supplement with iodine.

If my symptoms don’t go away, I can get a thyroid panel, CBC, possibly hormones again so I can see what’s going on there, and if the iodine supplement even helped my thyroid hormones at all.

Does that make sense to anyone else?

Maybe I’m thinking about this wrong, but let me lay down my logic and see if it makes sense.

So I take Iodine supplements now for a week or two (obviously it’ll take a while to get to normal levels) and try to replenish my iodine to something more ideal. After some time, if my symptoms go away then yahoo I figured out the problem, don’t have to worry about this shit, I can just supplement with iodine.

If my symptoms don’t go away, I can get a thyroid panel, CBC, possibly hormones again so I can see what’s going on there, and if the iodine supplement even helped my thyroid hormones at all.

Does that make sense to anyone else?

Yes, its about that simple. If your temperatures increase, you are diagnosed for having an iodine deficiency that was creating a functional state of subclinical hypothyroidism. If you also feel better too, that is OK.

Ask if food services uses iodized salt? Is there iodized salt at home?

[quote]KSman wrote:
Ask if food services uses iodized salt? Is there iodized salt at home?
[/quote]

Figured out they don’t, and when I lived at home with parents, they would barely salt anything (brother has kidney disease, has to watch his blood pressure) and it wasn’t always iodized from what I’ve seen at home.

Alright, gonna order iodine supplements to take for now then. I’ll keep a log of my temps for now, and post them at the end of this week, then continue the log when I get the supps marking what day i start supplementing. I’ll consult the thyroid guide for dosing instructions because I can’t remember it off the top of my head.

Thanks a lot for the help. Really hope it works out.

Just curious, could the drop in sex drive and erection caused by lowering my dose of nolva point to a different problem? I’m obviously not too versed on the interaction of the thyroid and the rest of the endocrine system, but I would suppose the previous lack of estrogens being able to bind may have helped my erections and or sex drive. Or could it be a sort of placebo effect?

I just wanted to share my thoughts real quick on something that I keep reading and it’s sort of depressing me. I keep reading other users on here, aged 33, 44, 45 etc. with similar test levels, sometimes even higher, and they seem to get prescribed TRT, and they get back to their youthful selves, all is well and they can go back to enjoying their lives (obviously not always as quick as I’m typing out, and sometimes probably not at all unfortunately). It just bother me that a 19 year old has to deal with all this bullshit.

No offense to all the 30+ year olds, trust me I know the symptoms too and they suck and I do think that everyone should be treated, but the fact that my doctor is satisfied with just treating my ED (not even fully mind you, and it’s probably coming back from what it seems) not treating any of the other symptoms I’ve brought up with him, and that my GP simply dismisses all of my problems as being psychological just really depresses me. I talked to my dad about it too, and I don’t even know what I expected from it. I thought of all people he’d get that I didn’t think that it was a psychological thing.

It sincerely depresses me that I can’t live this youthful life that so many adults tell me about. How they were full of energy all the time, could do almost anything they wanted, having sex (while I’m sure this is inflated by most guys it’s still frustrating that I have ED problems pretty often) like rabbits with their girlfriends, and just overall enjoying their youth. I hear these stories of “oh I wish I was young again, to have that energy, and that drive would be amazing” Well I wish I was young period.

I feel like I’ve never had that energy, I feel like I’ve never had that drive, never had the capacity to really enjoy sex completely because I have to keep my erection going (better with the 10mg/2x/day nolvadex but before and now it sucks). I envy those people, and that’s really the only reason why I’ve decided to finally tough this out and seek treatment until the end.

If it’s as simple as an iodine deficiency, then even better I’ll be good to go in a couple weeks time. If it’s hypothyroidism, I want to get myself full treatment so I can enjoy my life already. If it comes to TRT from hypogonadism, or whatever then so be it. As this point, I welcome the 2x weekly injections, I welcome treatment, if not for increasing my drive and want, then for increasing happiness and my overall quality of life.

I realize this forum isn’t meant as a journal or whatever but I wanted to share these thoughts if not for others to see, then for me to have written down some where I can read them when I feel like giving up and stopping seeking treatment and just overall stopping to care. I don’t expect many people to read this, so cheers if you do.

There are a few paths here for guys in your age group. In no particular order.

1- HPTA never worked right and never will. TRT is required, then things can work out pretty good.

2- As above, but there are other problems which can complicate things:
–a There is a background thyroid problem, either a medical condition or iodine deficiency
–b There is adrenal fatigue, which can increase rT3, compromising thyroid system function
–c Other health issues

3- One has deep hypothyroidism that is compromising many bodily functions, including hormone production.

With 2a, one can resolve the problem with meds or iodine. If this is not done, TRT will increase/restore your metabolic rate/demand. In that case, TRT can make one feel worse. With 2b, similar issues and 2a+2b is also seen here. So one needs to be looking for other problems and not have low-T tunnel vision.

We do see a lot of guys here at your age with such problems. These are rare [I expect]. However, the content of this site lands guys here when they do internet research. As for doctors been stupid and dismissive, we do see that as a problems for all age groups. But the insensitivity for the issues with young guys is terrible.

And ‘stopping to care’: Many with these hormone problems are depressed. Hold on, keep struggling to get the care that you need and keep learning about these issues.

Thanks for the words of encouragement. Like I said in my post I just need something to read over when I lose sight of why I care, and I really think this thread and what you and I have both posted here will help me.

My guess is that I have an iodine deficiency coupled with a shitty HPTA. Even when my parents used Iodized salt when I was much younger, I was always rather slow to develop (for my ethnicity especially) never got armpit hair until later, much later than any family. Always had shitty beard development, and while I know for some people that’s just genetics, Iranian are known to be hairy, so it never made sense to me. I’m waiting for my iodine to come in the mail, and plan to take about 50mg a day if I can handle it for two weeks, then drop it down to 12.5-25mg a day and see how I feel. I’m still taking nolvadex 10mg/day, but by the middle of next month it’s going to be 10mg EOD as per doctor’s order. I’m due to take another hormone test before this July when I’m supposed to see my Urologist again, but I’m thinking of just getting a new one from the how to find a TRT doc guide so I can find someone who will actually care fully about my problems. But hey, who knows, maybe supplementing Iodine will fix everything.

I’ll continue taking temps for now, and I’ll post a pre-iodine chart when I can, then in another couple weeks I’ll post the post iodine chart. Personally, I suspect it’s a deficiency, but supplementing is probably the best way to find out.


Alright got my body temps in. Morning temps were generally my waking temp. Literally as soon as I wake up. If I wrote late it was like 15-20 min after, not too significant.

For afternoon temp, it was generally around 3-4, sometimes later. If I wrote late it was night time already.

Looks like it could be some sort of thyroid problem, or adrenal fatigue (is that right?) so I bought some Iodine supplements, and I started taking them (marked the day on the spreadsheet). I’m taking 50mg/day, and I’ll continue for 2 weeks, continuing to measure my temperature twice daily and see if there’s any improvement.

I’d like to add it seems my morning erections are more frequent suddenly out of no where. Sex drive is still pretty limited at the moment. Not dying to have sex or masturbate really and it’s been a while. Kind of afraid I wont be able to get it up when I see my gf tomorrow night, but we’ll see what happens, hoping for the best.

Going to delay any thyroid blood tests for now to see if the iodine will increase my temp, and possibly cure everything or something along those lines (not really expecting that). I’ll keep at it, possibly have a CBC and lipid panel done again, with hormones to see where I’m at. Stuff can be expensive though, so I don’t know how much I want to do it again while I’m with the same doctor who seems to be ignoring my other problems. So in the mean time, I’ll hopefully be able to find a doc who understands low test with younger people, and doesn’t just cop out by saying “nolvadex solved your ED, have a great day.” Also continuing therapy for now, not so much for these problems at this point, but because it’s actually rather enjoyable talking to someone about issues of whatever nature they may be.

I like your attitude towards identifying and solving the problem, GOF. That will go a long way. Good luck and keep us posted.

I was reading a couple of the thyroid websites that KSman posted, and it seems like it may be thyroid related. I have that hunger for oxygen a lot of the time that the website seemed to talk about and it’s really annoying. So I was wondering what the course of action may be after I confirm it or figure it’s not true. Taking the iodine now, but would that really solve a low T3/high rT3 (or T4/rT4) problem? I don’t know enough about these hormones to know but if someone can explain what I would do that would be awesome, especially considering it’s probably sub-clinical and I won’t have anything prescribed.

Tag me on my thread when you see changes from the iodine. I still think that your low cholesterol is part of the problem.

Iodine will fix low iodine problems, then you can see whats left after that.

alright here are the temps. I know i’m kind of late with them, but I’ve been super busy to be honest.

Urologist also told me to take nolvadex EOD now, seems to not be helping at all anymore though…

So let’s see how I’ve felt.

-got ED problems once again, even when masturbating. Probably because nolvadex is EOD now…fucking stupid.
-Sex drive is meh, don’t really feel like having a lot of sex all the time or anything, even after abstaining for a while
-still pretty tired most of the time
-mental fogginess is still there
-hunger for oxygen is actually gone I think, haven’t noticed it recently
-fat and hair is the same
-morning wood seems to be a little less often now with the nolvadex being EOD

still feel kind of shitty as far as the mental fog and such goes. Feeling a bit happier though, could be iodine, who the hell knows. Seems like temps have gotten higher and stabilized though. Thinking about finding another specialist through a compound pharmacy in my area once I find some time.

Advice on what to do next is appreciated as always.