19 Yrs OId, Low T (Newbie) and Desperate for Help

-age
19 yr old male
-height
6’1’’
-waist
~33 in
-weight
~185 lbs
-describe body and facial hair
Little to no arm hair, a little chest hair, some leg hair, a very small amount of facial hair under chin
-describe where you carry fat and how changed
Carry fat primarily in mid section, no noticeable change recently
-health conditions, symptoms [history]
Mono 2 years ago, other than that, no other health conditions
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
No
-lab results with ranges
Will attach below
-describe diet [some create substantial damage with starvation diets]
~2200-2400 cals, 45% carb, 30% fat, 25% protein (all as of about 1-2 months ago, before that more protein, slightly less carb), alcohol about 1-2 times a week
-describe training [some ruin there hormones by over training]
Over the past two years I did a combination of crossfit training, usually 5 days a week, sometimes 6, sometimes even twice a day. Definitley overtrained/underrecovered, which is why I took a month off from all training this past October.
-testes ache, ever, with a fever?
Testes sometimes ache a little, but two md’s have checked them and said they are perfectly fine
-how have morning wood and nocturnal erections changed
Rarely get morning wood anymore, sometimes I get nocturnal erections. General libido has definitley decreased over the past two years.

Are your outer eyebrows sparse? Not that I’ve noticed
Have you used iodized salt for years? Sea salt some times, otherwise not knowingly
Do you get cold easily? Not particularly

When did problems start? Any blows to your head before that? Problems started about a year ago, and no significant blows to the head around that time.
Were things better earlier? Things were definitley better a year and a half ago
More hair before? Not really. I feel like I never completed puberty and got all my hair (my brothers and father have much more)

Hello all,
I apologize if I seem nieve, but I am extremely lost and concerned, and am looking for any help or information. Anyways, I believe that over the past two years I was overtraining/under-recovering, which eventually resulted in me having low testosterone. I have had multiple blood tests to confirm this (will attach some relevant blood work below). As a result, I took a month off of training entirely, in October, and since have been doing significantly less volume/intensity training, in order to recover. In that month off, my symptoms of low t and overtraining noticeably improved (mood, libido, energy), but they still are not optimal. I am looking to figure out if my low t I have is still being caused by overtraining, or if there is another reason that myself and my md’s are missing. I am desperate to increase my testosterone levels, but do not want to do any sort of HRT because a) I am 19 years old, and b) I have ambitions to join the military, which does not allow any sort of HRT. Any help or information regarding my situation/bloodwork is greatly appreciated. Thank you in advance
.


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@KSman I’ve read around and you seem like an expert; any thoughts? Please.

Or anyone? Please, I am desperate for information related to my case.

If its worth anything, just know im in the same boat. 19 with low testosterone and no clue why.

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Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Low-T is the symptom, need to find the cause.

Secondary hypogonadism and T levels have always been lowish.

Might be in part be caused by low thyroid function.
Thyroid lab ranges are insane.
TSH should be nearer to 1.0, TSH=2.35 is a problem
fT4 is mid-range which is good.
fT3 is the active hormone that regulates mitochondria in your cells as part of the body’s temperature control loop. fT3 was not tested.
Please check oral body temperatures as per the thyroid basics sticky.

Testing PSA at your age was nuts, do not repeat

Labs:
TT=255
FT
T4=6.2 is well below midrange
fT4=1.1
fT3
rT3 - you may need to fight for this
E2
LH/FSH 2.1/4.4
fasting glucose
fasting cholesterol
TSH=235

Liver function appears OK.
prolactin is not a cause

TSH and T4 suggest iodine deficiency. What is your history of using iodized salt? Iodine is needed to make thyroid hormones.
Are your outer eyebrows sparse?
Do you feel cold easily?

Stress, in your case, over training can affect your adrenals and rT3 can become elevated. rT3 interferes with fT3. This condition is characterized by increased T4–>rT3 and if T4 levels are increases, you get even more T4–>rT3. So we need to look at this possibility.

When young guys over-train, blasting with adrenalin with low T and/or low thyroid function, that is an added level of stress. Many simply would not have the energy or endurance with those background conditions.

Action items:
report history of iodized salt
report oral body temperatures
start reading the stickies

Most doctors fail at these things. You need to know more than they do, not hard, and cannot be passive.

Understand that TRT creates risks to fertility. Also discussed in the stickies.

PS: We do see a lot of guys your age show up with similar conditions and over-training sometimes as well. You are not alone, small comfort.

First, I would like to express my deep gratitude for your response; I feel extremely lost and confused regarding this issue.

I have not noticed significant sparsity in my outer eyebrows.
I do not feel particularly cold easily.

To address your “Action items:”

No consistent history of iodized salt, only sea salt occasionally.
No access to oral body temperatures currently, but will get an oral thermometer tomorrow.
Also, my Free T is posted above, higher in my original post, for reference.
I have read through much of the stickies, looking for similar cases, but have not found much.

So just to sum up the other part of your response: You suggest that I get fT3 and rT3 tested?
Also, do you have any knowledge of success stories from guys with similar conditions as mine? I ask purely out of desire for comfort.

Thank you again.

If body temps are good, you could skip rT3, fT3, but I suspect that your body temps will be low.
Looks like you are probably iodine deficient and TSH indicates the same.
rT3 is the hallmark of stress, later you can look for references to rT3, stress, adrenal fatigue and “Wilsons book” in the thyroid basics sticky.

TRT will of course work.
I assume that by success that you are looking to fix your system. That is in no way predictable. Some have brittle HPTAs and we see things go wrong in this age range.

@rogue22 I don’t have any advice to help at this point, but I just wanted to let you know that I am going through a similar situation to yours. 19 y/o, low t, high TSH. I’m trying iodine replenishment right now because my normal temps when waking up are low (96.6-97). I wish you the best and hope you can find a way to feel better. Also, I may have to take a look at the possibility of overtraining. I have never considered it, but after you mentioned it I certainly believe it could be playing a role in my situation.

As you suspected, temps were low:
Morning temp- 96.9
Mid afternoon temp- 98.2

So based on the stickies, this data indicates that I should be taking iodine.

However, I am curious, will this process help increase my testosterone levels?
I know endo’s aren’t exactly praised on this forum, but I had an endo examine my thyroid physically, and examine my labs, and he said it was functioning fine. Do you think the thyroid/ HPA axis is the root of my low T issue? Thanks

Just one piece of the puzzle. Now read the thyroid basics sticky.
Get a multi-vit that lists iodine+selenium and other trace elements that does not list iron.

Check that someone else hits 98.6F on that thermo to gain confidence.
No drinking, talking, exercise or eating for some time prior.

Will this increase T? Rarely it seems. But we do see a lot of thyroid+testosterone issues and the suspecting a link is easy. Had one guy go on thyroid meds and recovered decent T.

Guys can feel down, even with high T and optimal E2 if thyroid function is low. Their labs are perfectly normal so docs do nothing and I have never seen that a doctor has asked about iodine intake.

My doctor asked me if I wanted to start a Clomid protocol to address the low T issue. Do you think this would help me at all, given my scenario? I’ve read mixed reviews on Clomid on this forum and other web pages.

Please read the HPTA restart sticky and note comments on use of SERMs, lower doses and need to taper off onto a controlled lower E2 level. Try to get Nolvadex or a commitment from doc to switch from Clomid to Nolvadex if Clomid makes you feel bad.

@KSman
Still waiting on starting any sort of SERM. However, most recent labs are (sorry, don’t know all the reference ranges bc dr.'s assistant told me over phone and was in a rush):
T4 = 1.3
Total T3 = 63 (86-192)
Total T = 474 (250-1100)
Free T = 87.1 (35-155)

What do you make of this? I have recently been supplementing with Kelp daily, if it makes a difference.

Like to see TSH near 1.0
T3, T4, fT3, fT4 should be near or above mid-range.
T3=63 is way to low
But concerned about what gets written down over the phone.

??
Check that someone else hits 98.6F on that thermo to gain confidence.

More labs came in:
TSH= 2.93 (.5-4.3)
Iron, total= 52 (27-164)
Ferritin= 23 (11-172)
SHBG= 24 (10-50)
Estradiol= 27 (< or = 39)
Morning DHEA (Saliva) =15.2 (2-23)

Anything? I don’t understand what you’re saying about Thyroid hormones…sorry for naivety

TSH=2.93 is too high.
Lower body temps make sense.

T4=1.3 is mid-range, what we like to see
T3=63 is very low, and well below mid-range

Your body converts fT4–>fT3 and fT3 is the actual active hormone.
Your ferritin=23 is low that is a known cause of impaired T4–>T3.

Are you eating eggs and red meat?
Do you have digestive problems or food allergies?
Diarrhea?

We need to know if your iron is low from a low level GI bleed, blood loss in your gut. Doctor can have you do an occult blood tests. Occult means hidden, blood would not appear visible to the naked eye.

Otherwise your CBC does not indicate anemia. But there may be hints there.

Normally I steer guys away from iron, but in your case, you need an iron supplement and/or a diet change. Do not donate blood.

Need to test fT3 and fT4 to understand better. Do not test T3, T4.

Were you taking kelp for that lab work? How long?

I eat eggs almost every day, and red meat occasionally.

No food allergies, but some digestive issues and diarrhea.

Would occasional blood in stool be what you are considering here? (that happens)

I also eat spinach frequently which is supposed to be high in iron.

I was taking the kelp for about a week before that lab work.

I might add, when I first got blood work done back in September '16 to address this issue, my Hemoglobin was 13.8 (technically anemic) but then went back up to slightly above 14 and has hung out there since then.

Finally, are you suggesting that I take an iron supplement?

Thanks, as always.

@KSman

Dear @KSman sir. Ive been using finasteride for about 4 years. Initially inhad no problem with Erectile functions. Last 2 years i felt ice got no Erections. Met a urologist. Took tests which shows all my levels to be normal. So he told me to stop fin n prescribed me viagra for ED when I needed. I tried tribulus, Mucuna purines supplements and got back the same Erections and wellness feel as i was beofre 4 years. But when I stop with in 3 days i go back to my state where I dont get Erections or even morning woods. I tried clomid + nolva (12.5 clomid +10mg nolva ) EOD but it killed my Erections more ! BUT the first day after clomid + nova i had great section n good feel, it did not last but vanished off as days passed with clomid n nova. I ve read most of your posts regarding restart n trts. Now please tell me how can I make my self normal. ED is killing me. N what I’m confused is if tribulus + Mucuna can make me feel normal n give good ED then it means my test or hpta is all fine ?! Or I’m messed. Can you please help me come out of this .

@KSman anything? I am really eager to make some sort of progress here

Try it and see if ferritin improves. Your CBC did not show any obvious other issues. When iron is low, one suspects a GI blood loss. Are you a blood doner?

Your hematocrit is low. When T is lower, HTC gets lower, your 42.7 seems lower than expected for your low T.