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)
Poor libido (Low sexual desire)
Fatigue (medical) always tired
Erectile Dysfunction - Weak Erections and No Morning Erections
Increasing abdominal fat
Memory Loss-difficulty in choosing words in language
Psychological and relationship problems
Ive had Grade 3 bilateral Gynecomastia (Had Surgery at age 17)
Frequent urination (polyuria) without infection; waking at night to urinate
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.
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)
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
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.