T Nation

19 YR Old, Low Test, Very High Estrogen...


#1

First of all im an 19 year old male, about 210lbs.

Basically, i got my appointment with an endo (NHS) and he was quick to knock me for suggesting my testosterone levels are low for my age and my estrogen is high - even after i explained all my symptoms and brought charts and information of normal testosterone levels in men, he didnt want to know, hes sent me for another blood test to check over cortisol levels, SSHBG and to re-do the test and estrogen. He said he wont treat me for low t high e because he dosent see a problem.

Serum Testosterone Level: 16.4/482 nmol/L (8.0 - 30.0)

SSHBG: 13 nmol/L (13.0-71.0)

Prolaction 257 (0-550)

Serum Oestradiol Level: 149 pmol/L (<= 150.0)

Serum Prolactin level: 111 mu/L (<= 550.0)

TSH: 2.2 miu/L (0.2 - 6.0)
Free T4 14.4 pmol/L (10.0-25.0)

Symptoms:

Poor libido (Low sexual desire)
Fatigue (medical) always tired
Muscle loss/atrophy
Erectile Dysfunction - Weak Erections and No Morning Erections
Increasing abdominal fat
Poor sleep
Difficulty concentrating
Memory Loss-difficulty in choosing words in language
Shyness
Anxiety
Psychological and relationship problems
Ive had Grade 3 bilateral Gynecomastia (Had Surgery at age 17)
Irritability
Frequent urination (polyuria) without infection; waking at night to urinate
Achy muscles
Night sweats

Where do i go from here?
Whats the deal with SHBG levels?

Any help and direction is appreciated so much, ive had to leave college because im so stressed and fatigued about all this.

update

The Endo basically agreed the symptoms match with a hormone problem but said my levels are normal and he wont treat me.
He said many times my Estrogen is normal and he would be happy if he had that level and my testosterone is fine. He even said if i was to take an AI i could have bone problems?
He basically said he didnt know what to do or why i was having these problems - i kept pointing out my testosterone level is not healthy for someone of my age and its clear why im feeling these symptoms and he said my bioavalable testosterone is within the top 99% of the population so he dosent see my testosterone levels as low.

I also got the results from the blood test i last had for cortisol, test, estrogen etc..

These tests were at 9 am but i hadnt slept and had woke up at 5pm the day before... so it was basically my night time.

TSH 6.9 Miu/L (.020-6.00)

Free T4 15.9 Pmol/L (10.0-25.0)

SHBG: 16 (13-71)

Oestradiol (extractn) 132 pmol/L (<150)

Testosterone 8.9 nmol/L (8.0-30)

[b]
Cortisol 246 nmol/L (Random cortisol is dependent on time of sample: 0900h cortisol 150 - 600 nmol/L 2400h (midnight) cortisol <50 nmol/L)

Cortisol after short synacthen test: 495 nmol/L
[/b]

Now i asked the endo if it mattered how id slept or if i did at all before i got my cortisol checked and he said no, but in the brackets next to my reading it states "Random cortisol is dependent on time of sample" does that mean my Cortisol level of 246 should really be compared within the midnight range? so under 50 - witch it isnt.


#2

Did you tell him about the frequent urination? You're very young for that and it suggests a possible prostate issue or diabetes (fatigue, irritability and higher bodyfat can point to diabetes as well). Or maybe you just drink a lot of water. Not trying to scare you, just things you need to rule out. I'd have those evaluated before you do anything else.


#3

Check your thyroid: tsh, free t3, free t4. I will almost GUARANTEE you have low thyroid hormones. Even if TSH is 'normal' check your thyroid hormones. Are you cold easily? Temperature usually low? I would also recommend supplementing with vitamin d3 and iodine+selenium.


#4

Yes i gave him a list of every symptom i have but he just checked my balls and sent me for a blood test.. i have an appointment with him next month And no i dont really drink a lot, ive had this frequent urination problem since puberty.


#5

No problems with Temperature, my GP said they checked my thyroid and its ok.
I also had a full blood count and blood sugar levels checked and they were fine.


#6

When they say they checked your thyroid, that means they looked at TSH and if it isn't outrageously high they don't care. I had a 7 (.5-4.5) TSH once going to the doctor for psychiatric meds and he said it has to be like 30 for there to be a problem. Well when I retested (with t4, t3) my T3 was almost too low. So you need a full thyroid panel which I am sure you didn't get. With your SHBG pretty low I would think your T3 may be low.


#7

Get copies of all your labs and post them here, don't take the doc's word for it. "OK" does not mean optimal, it just means you don't fit someone's arbitrary clinical definition of disease. You gotta be assertive with this and manage your own healthcare. Nobody has a stake in this like you do.

I know you're working within the confines of the NHS and I have heard how difficult it can be, but it may be time to find a new doc.


#8

You have a nice case of depression and all the joys of cortisol and low energy/poor sleep that come along. I'd take tons of fish oil and eat a diverse diet, maybe a multivit supp, and chill the fuck out. Believe in yourself and you'll make it, your outside situation ain't that bad. TRT won't fix you up as it's not your main problem. Just my view.


#9

How the fuck do you know that without the necessary labs? "Depression" is what docs say condescendingly when a patient's lab ranges come back in range. I don't think OP will need TRT (though it's too early to say), but clearly something is wrong, his E2 is sky high.

Many times depression is a SYMPTOM and has an underlying cause in the hormones. Telling him to chill out is not only horrible advice but downright offensive to someone who has a real hormone issue causing it.

edit - OP read all the stickies and get more labs and symptoms posted in here. E2 is very high. Are you overweight? Did you diet down to a really low bodyfat level?


#10

E2 is sky high, yeah he needs TRT, yeah....c'mon. That's only my wiew on things as I don't see what else he could focus on fixing, maybe you do? Depression is a loose term where hormones can be a cause(rarely, especially for a 19y/o!) or effect if there is a health issue, in which case that is what needs to be adressed by his doc, not trt (or however you would fix "hormone issues"). MY opinion based on the info is to get the mood issues fixed, not saying I know that nothing else is wrong...duh.

Chill out is offensive? Boo hoo. It sums up the point.


#11

Ugh.


#12

Im going to get my thryoid levels fully checked and get the results on paper, cheers.


#13

Went to go see my GP today and requested a FULL thyroid test aswell as LH and FSH, she basically said she would only treat LH and FSH in women and that i should ask my endo who i see in 6 weeks to check my thyroid again and see what he thinks..

heres what i have from a previous thyroid test though

TSH: 2.2 miu/L (0.2 - 6.0)
Free T4 14.4 pmol/L (10.0-25.0)


#14

First of all 99% of the brits I have dealt with when consulting have been vitamin D deficient, This would be the first place I would check.
Low shbg - insulin resistance needs to be ruled out, but because since uk is in the stone age when it comes to health issues it will be impossible getting the proper test done to determine what is wrong.

Your thyroid is one the low end of normal, but its really the ft3 levels which are the major indicators of thyroid imbalance. Ft3 could be all over the place in relationship to ft4.

More so I feel that insulin resistance may be the culprit probably from crappy life styles, poor diet, and lack of exercise., bad sleep hygiene
I would suggest getting a lipid panel done as well as more indept thyroid testing ft3, rt3 to answer thyroid question.

Most likely, you issue could be resolved with proper lifestyle and stress management unless there is some medical history we are unaware of
such as diabetes, heart disease, and other issues in your family.


#15

Endo basically agreed the symptoms match with a hormone problem but said my levels are normal and he wont treat me.
He said many times my Estrogen is normal and he would be happy if he had that level and my testosterone is fine. He even said if i was to take an AI i could have bone problems?

He basically said he didnt know what to do or why i was having these problems - i kept pointing out my testosterone level is not healthy for someone of my age and its clear why im feeling these symptoms and he said my bioavalable testosterone is within the top 99% of the population so he dosent see my testosterone levels as low.

I also got the results from the blood test i last had for cortisol, test, estrogen etc..

These tests were at 9 am but i hadnt slept and had woke up at 5pm the day before... so it was basically my night time.

TSH 6.9 Miu/L (.020-6.00)

Free T4 15.9 Pmol/L (10.0-25.0)

SHBG: 16 (13-71)

Prolaction 257 (0-550)

Oestradiol (extractn) 132 pmol/L (<150)

Testosterone 8.9 nmol/L (8.0-30)

[b]
Cortisol 246 nmol/L (Random cortisol is dependent on time of sample: 0900h cortisol 150 - 600 nmol/L 2400h (midnight) cortisol <50 nmol/L)

Cortisol after short synacthen test: 495 nmol/L
[/b]

Now i asked the endo if it mattered how id slept or if i did at all before i got my cortisol checked and he said no, but in the brackets next to my reading it states "Random cortisol is dependent on time of sample" does that mean my Cortisol level of 246 should really be compared within the midnight range? so under 50 - witch it isnt.


#16

bump