T Nation

20 with Very Low T (Among Other Things)

Hey everyone, I’m currently at a loss. Seems like my whole HPTA is screwed up, so I’m not sure where to start. I have chronic low energy, brain fog, muscle weakness, no motivation, ED, low body temp, the whole nine yards. I was cutting last year with Keto, which is when I felt the best, but have been maintaining for months with carbs and have felt terrible since.

I had a pituitary MRI come back as negative and currently have prescriptions for Test, Clomid, and HCG wondering which protocol to start. I really don’t want a life long commitment, but I would like to feel normal again. The highest I have ever seen my testosterone was 240 when I was 20 pounds heavier, so weight loss cannot be the cause.

Ocassionally after I eat, I get very intense brain fog and constantly stutter like I’m drunk, with accompanying dizziness. This seemed almost like prediabetes symptoms, no?
My endo wanted to do a “restart” with 100mg of clomid, but I read that clomid would just make my high SHBG worse.

Any thoughts are appreciated! I would very much like to be active and able to lift again.

Total T: 183 ng/dL** (241-827)
Free T: 20pg/mL** (47-293)
SHBG: 82nmol/L** (15-94)
T3:40ng/dL** (60-181)
Free T4: .86ng/dL** (.84-1.51)
TSH: 3.5mU/L (0.4-4.0)
Cortisol: 28ug/dL** (3-22)
ACTH:87pg/mL(7-69)
IGF1: 45ng/mL (91-442)
ALT: 48 U/L** (10-35)
FSH: 2.0 IU/L** (1.4-18.1)
LH:2.6 IU/L ** (1.5-9.3)
Prolactin: 13.6ng/mL (2.0-17.0)

Vitamin D is low-normal and Iron is good

Antithyroid antibodies present : 32U/mL (0-60)

Whoa!! What a mess. Sorry you are dealing with this. What does your doctor want you to do? Dosing wise?

Your adrenal function may be screwed up. Acth is high. Cortisol high. Dhea-s?

Thyroid high at 3.5.

Fix adrenal first.

Also you igf at 20 is way low. Your liver function is high too.

You need to investigate for underlying disease.
CBC? Glucose? A1c? Iron Panel? Ferritin?
Metabolic Panel? Post values if you have with ranges.
You need to go to a good Endocrinologist for now.

1 Like

It’s messy af:( the doc wanted me to do 100mg clomaphine citrate for a restart, but my primary just prescribed me injections. So i have either option, along with HCG mono-therapy if I want to go that route. I’m not sure what to do:/ I also heard that TRT wouldn’t be very beneficial with a screwed up thyroid, so I’m not sure where to go with that. I did try 50mg test cyp/wk for 6 weeks before stopping a little while ago. It made my total test go above range, but SHBG remained high so I felt the same. Hope that helps, maybe I just wasn’t on long enough ?

You weren’t taking enough test, for certain. You need to be at at least 100 mg as a starter, and almost certainly would need a higher does than that. I doubt the clomid would do much with a messed up thyroid, honestly. The test is said to lower SHBG over time, but there could be a lot of things going on to cause that. And before somebody starts ranting about needing extra test because of your SHBG, you should know that it actually binds to estradiol, test, calcium, and zinc. It has greater affinity for estradiol and test.
here is my link

Correct. Need free T3 and reverse T3 tested.

Of those options, I would try hCG.

No, waste of time. You could have started at 100mg, but you’ll need more, I would not waste my time with anything less than 150mg/week.

Ferritin is good at 283mg/mL (60-340) For the Metabolic panel:
Sodium 146mmol/L (136-145)
Potassium 3.9mmol/L (3.6-5.0)
Chloride 106mmol/L (98-107)
CO2 30mmol/L (22-28)
BUN 23mg/dL (6-20)
Creatinine 0.92mg/dL (0.7-1.3)
glucose 70mg/dL (74-100)
Calcium 9.9mg/dL (8.0-10.0)
Protein 72gm/dL (6.0-8.3)
Albumin 4.8gm/dL (3.5-5.0)
AST 28U/L (14-50)
Alkaline Phosphatase 44U/L (53-128)
Bilirubin 0.4mg/dL (0.3-1.2)

The CBC is:
WBC 3.33u/L ( 4.0-10)
RBC 4.0uL (4.3-6.0)
Hemoglobin 13.4gm/dL (13.9-20)
Hematocrit 39.4% (39.8-52)
MCV 97fL (80-97)
MCH 33pg (26-34)
MCHC 34gm/dL(32-36)
RDW 13.8% (11.5-15%)
Platelet Count 206uL (140-440)
MPV 10.6fL (6.5-12.4)
Auto % Neut 75.1% (37-80)
Auto % Lymph 12.9% (16-50)
Auto % Mono 10.8% (0-12)

Sorry, you’re not going to recover naturally scoring these levels, these are what we call disease state levels. SHBG is very high do to genetics or some chemical in the environment affecting the liver.

Other than throwing excess testosterone at the SHBG problem, you will not affect SHBG much without TRT. TSH is no good, while it may be in range, these ranges are not normal. No two doctors can agree what normal levels are and agree to disagree.

95% of the population has a TSH <2.5 as reported by studies, those above 3.0 are likely to have autoimmune thyroid disease. T3 is below ranges, you need Free T3 levels midrange or slightly higher. Thyroid medicine will see SHBG increase and so you will need testosterone levels in the high normal ranges or higher to increase Free T to the optimal range.

Start TRT with a Vitamin D deficiency and you are set to fail. Those with poor gut health are set to break as TRT can deplete minerals needed for normal function, Vitamin D is needed for your gut and TRT needs a gut that can keep up with the demands of faster, efficient metabolism.

Would you still recommend 150mg even if 50mg/wk put me above recommended range ?

So are you recommending that I take Vit D, start TRT, as well as thyroid meds to get my T3 up? Thank you for your input :slight_smile:

I agree with this. You need to investigate. You can start Chlomid for a kick but investigate. HCG isn’t going to do much but keep the boys working. However the petituataru gland will stop and that’s what matters. Unless I’m mistaken I haven’t taken HCG much and thus have not spent much time researching it either.

Hate to be a buzz kill, but it’s goinf to be hard finding any docs out there who find the root cause of issues. Or even those who care enough to dig into the topic and research outside the 5 mins you spend with him or her.

This is why your best bet is going to a natural holistic type doc who works outside the sick care establishment. I forgot what these docs are called. They look for natural solutions and cures and are doctors.

Do your homework.
Don’t depend upon the doctor.
Walk in with a plan and be ready to educate.

Otherwise you are going to go mad playing the sick care:insurance won’t cover it game.

2 Likes

Alright, going to start 100mg Test cyp today per week if there’s no other tips // BUMP. I’ll keep the thread updated if anyone is interested in about 6 weeks. Thanks for everyone’s input !