T Nation

20 Yrs Old. Confused and Need Help

Hi,
I’m 19 (20 in a week), 160lb and have always been someone with what I have only recently realised are symptoms of low test, probably at least 2 years. Recently - the past 2 weeks it has got very bad and I am struggling to stay awake, depressed, anxious, low Sex drive etc
One of the main things is that I am struggling to stay focused and almost feel like I am not here a lot of the time, kind of like I’m in a dream/imagination (feel like I am going insane), also out of breath and legs ache a lot.
I have discovered that low t could be causing my problems.
I decided to take a blood test after explaining my symptoms and it came back that:

Serum total 25-OH vitamin D - 35.3nmol/L (Should be 50 min)
Serum testosterone - 9.8nmol/L (Range is 9-29)

I have been given some tablets to up my vitamin D, however I have been told that my testosterone is normal.
I feel that my testosterone is not considering I’m only 19 and I can barely function, and struggle to see a point in life. I understand that my vitamin D is low but feel like it’s not all that is causing the issue.

I was wondering if there are any other levels I should get checked, if my levels are fine and what I should do on this situation?

Thank you in advance

You need to get full blood labs to make sure nothing else is causing your low t and symptoms. High stress can cause your symptoms to and lead to a temporary drop in t esp if you are not sleeping well at night.

Any prior steroids? Medications? Injuries to head or testes? What made you suspect you were low for 2 years?

TSH
Free t3
Free t4
Testosterone
Free testosterone
Estradiol sensitive
Prolactin
Cortisol
SHBG
CBC
CMP
Lipid panel
Oops left out LH and FSH

Ok I will request that, thank you. I sleep 7-8 hours a night. Never taken steroids, smoked weed in the past but not often (never more than twice in one month), don’t drink alcohol very often only on nights out, which is decreasing due to my symptoms.
No past injuries
Thought I had mentioned that I was on terbinafine for 6 weeks, finished 2 weeks ago, liver function came back fine.
I’ve never had a sex drive and have been to the gym on and off throughout the period on and off. I’ve had the symptoms as described throughout, just without the consciousness bit. I have not been able to go consistently due to falling ill every time after a couple months - ( little progress seen - eat in calorie surplus - train well)
Thinking about it I have been going since the new year again hard, and am now taking time off again due to this.
Throughout my teenage years when out with friends or family I’m always tired and exhausted before everyone else and peaople cant understand why.
The only reason it’s taken me so long to do anything about it is because I always thought it was just going to pass / pubity

Puberty normal? Delayed or early puberty?

Erection issues?

Btw I forgot the estradiol sensitive lab to. You need that one too.

Not saying you arent experiencing low T issues as well but regarding

"Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

Blistering, peeling, scaly, or red skin rash

Changes in mood or behavior, depression

Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes

Fever, chills, cough, sore throat, and body aches

Unusual bleeding, bruising, or weakness"

Good point

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The hormones levels of a 100+ year old man, it’s going to take a doctor with an IQ over 50 to properly diagnose you. Most doctors are robots and don’t account for age related testosterone levels and that we start losing a percentage of testosterone after 30 year old, you have little testosterone to lose.

If something isn’t done to address your super low hormone levels the consequences are dire! The average levels for someone your age is 28 nmol/L.

I’m not entirely sure, I would say a bit later than most of my friends at the time. Currently I’ve only started getting little facial hair in past year, chest hair is minimal.
the only main symptom I have not experienced is erection issues. ( currently I don’t have trouble getting them/maintaining them, just don’t have any interest)
To get these test results do I just ask my doc for all of them indevidually or can I ask for something that will cover all these results?

I had a liver function and renal profile test before and after and both came back fine.
My serum albumin after was 53 ( range is 35 - 48g/L)
Before was 48
I will explain my symptoms again when I go back to discuss the blood tests suggested above to see if there could be other issues related.
I won’t be able to see the doc till next week as I am currently visiting family.

He is 20 years old. Do the labs I have stated above. DO NOT JUST JUMP ON TRT.
After labs results you may need to do further diagnostic test like ultra sounds or MRI.

Find a Dr who is concerned and understands that your situation requires further investigation.

You will get your sex drive back and enjoy your 20s.

Thanks all for the help, I am going to see a different one that is better that I have seen in the past, I will update when I have had a full test, do you think I should ask about anemia as this may be related or would it not be needed?

CBC - is complete blood count. It is a panel of test. If your are anemic it will show in the CBC - it includes counts of many cells.

CMP - is comprehensive metabolic panel. includes many other tests - you can look it up.

Sometimes libido is the first to be impacted when testosterone is low for you, years later erection trouble will follow and the eureka moment will hit you.

So, I only listed the results that I could remember at the time because I didn’t have the full blood test results on me. It turns out I have some of the ones that you listed, I will list all of the results below:

! Vit D - 35.3 nmol/L (> 0)

Serum testosterone - 9.8nmol/L (9-29)

HbA1c levl - IFCC standardised - 35mmol/mol

Serum free T4 - 19 pmol/L (10-22)
Serum TSH - 2.5mu/L (0.3-5.5)

RENAL
Serum sodium - 144mmol (132-146)
Serum potassium - 4.7mmol/L (3.5-5)
! Serum urea - 6.8mmol/L (2.5-6.7)
Serum creatinine - 100umol/L (59-104)
GFR calculated abbreviated MDRD - 83ml/min/1.73m*2
AKI warning stage - 0

LIVER
Serum ALT - 12IU/L
Serum total bilirubin - <15umol/L (0-17)

BONE PROFILE
Serum alkaline phosphatase - 85IU/L (30-300)
! Serum albumin - 53g/L (35-48)
Serum calcium - 2.46mmol/L (2.20-2.60)
Serum adjusted calcium conc - 2.35 mmol/L (2.20-2.60)

Plasma glucose - 4.3 (4-7.7)

FBC
Haemoglobin est - 154g/L (130-170)
Total white count - 4.7 109/L (4-11)
Platelet count - 257 10
9/L (150-400)
RBC - 4.81 1012/L (4.5-6.5)
Haematocrit - 0.443 (0.4-0.54)
MCV - 92.1fL (78-99)
MCH - 32pg (27-32)
MCHC - 347g/L (310-360)
Neutrophil - 2.6 10
9/L (2-7.5)
! Lymphocyte - 1.4 10*9/L (1.5-3.5)
Monocyte - 0.5 (0.2-1.4)
Eosinophil - 0.1 (0-0.4)
Basophil - 0.1 (0-0.1)
Nucleared RBC - 0

Yes that is what I am worried about

You’re missing fT3 and rT3, fT3 is the most important active free thyroid hormone, it’s where the rubber meets the road. These tests will tell you why TSH is slightly elevated.

Your fT3 -> fT4 conversion could be an issue and perhaps why fT4 is near the top of the range. A comparison my fT4 is below midrange and fT3 above midrange because I convert fT4 -> fT3 efficiently.

Ok thank you, I will ask for all of these to be checked on my next visit

Where are you located? Affects diagnostic and treatment options.

Age=20
height=
weight=
waist size=

How are you from an athletic point of view? Good eye-hand coordination and reflexes?

Do you take any supplements? - history please

Any blows to the head or whiplash? This can damage the pituitary.

Serum free T4 - 19 pmol/L (10-22)
Serum TSH - 2.5mu/L (0.3-5.5)

TSH=2.5 should be closer to 1.0
T3, T4, fT3, fT4 should be near or a bit above mid-range.
fT4 is well above mid-range
Thyroid lab ranges are rather useless and “normal” means very little.

TSH=2.5 is a serous issue. Normally when we see this we assume that most likely this is a case of iodine deficiency. But then we would expect to see fT4 below mid-range. So this is a complicated case. Thyroid is very complex, more complex than TRT. We can get a better idea of what is going on by looking at oral body temperatures. This is very important. You need to address thyroid and sex hormone issues.

Sodium was very high.
Were you fasting for the labs and dehydrated?
Try to be well hydrated for lab work.

Most of your blood levels are what we expect to see with low T.

Are your testes smaller or softer than ???
Do your testes ache at all?
You can get a doctor to examine. There are a couple of things that can go wrong.

LH/FSH will tell us if the problem is your pituitary, testes or mixed.
Prolactin can be elevated and that can reduce LH/FSH that causes low T.

You should look for higher amounts of Vit-D3. Better to find 5000iu, yes 5000, tiny oil based capsules and take with meals that have more fats/oils and avoiding taking with high fiber meals such as oatmeal.

Please discuss your history of using iodized salt.

Do you have?

  • feeling cold easy or easier since when
  • sparse outer eyebrows
  • thinning hair - not male pattern baldness
  • brittle nails or hair
  • dry skin

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

Thank you for your reply,
UK Bournemouth
Age=20
Height= 6.1ft
Weight=160lb
Waist size= 29in

Athletic POV = Have been to the gym for about 2 years on and off in stints of a few months at a time (made little progress, weight training)
As time has gone on I have become more knowledgeable about proper training and diet( counting macros etc)
Really want to be consistent and make proper improvements, however seem to fall ill before I can get in a solid routine( currently follow PPLPPL)
Reflexes/co-ordination= in geneneral I have good reflexes and coordination, however over the past few weeks as said I feel progressively worse, meaning this is suffering a bit.
Supplements= I take protein shakes when it fits my diet when I’m going to the gym. In the past (over a year ago) I have taken creatine.
Damage= I have never had any damage/ injuries to my head
Dehydration= I have been a bit dehydrated recently which I believe is due to the tablets that I was on, so I have upped the amount I have been drinking which has been helping. I have had issues in the past with dehydration from a young age which I have been to hospital with (was a lot younger) I seem to get dehydrated easily - feel like I have to worry about drinking enough fluids more than others. I had eaten before the test and believe I would have had something to drink but cannot remember
Testes= My testes do not ache and are a good size, I have no lumps and do not appear soft ( this is one of the only areas whete the symptoms are not very apparent, although I have little sexual drive/interest)
Vit D= I have been given pro D3 10,000 IU (1 a day - 6 weeks)
Iodized salt= I don’t eat iodized salt or put any salt with my food (not entirely sure what this is)

I do not have any of the symptoms that are questioned apart from a little dry skin in some areas, hair is thick not thin

Thank you for your advice will ask to get these levels checked on my next visit