T Nation

21, Do I Have Hormone Issues?


#1

Thanks in advance for any insight you can provide.

Age: 21
Height: 5' 9"
Weight: ~185-190
Hair: Very little body hair. Patchy sideburns if I let it grow. To look neat I can shave once a week. I could not shave my stache for a year and I'd be okay.
Fat: hips and stomach hold most of my bodyfat. no change that I've noticed.
Conditions/Symptoms: No morning wood. Ever. Seriously. Can't get an erection usable for sex and haven't been able to since I became active at 18. Have to take Cialis or something similar. Never very firm, even when alone. Serious mood/depression issues for years. Various anti depressants did nothing and the side affects made me worse. Extreme fatigue where no matter how much I sleep I'm still exhausted. Overwhelmed with the urge to cry often.
RX: No prescriptions. I currently take a multivitamin, vitamin D, and fish oil. Protein shakes after workouts.
Labs: this lab was taken at 19 when I tried to go to a urologist to fix the erection issues.
TESTOSTERONE, FREE SERUM: 15.7 ng/dL Ref: 9 - 30
TESTOSTERONE, TOTAL SERUM: 475 ng/dL Ref: 240 - 950
Diet: I avoid carbs as matter of taste preference and it makes it easy for me to keep weight off. Very little fast food.
Training: was definitely better about this in my past. Currently I make it to the gym 2x a week for heavy compound lifts
Even when my diet and training were on point all the symptoms were the same.
Testes ache ever: Nope.
Morning Wood: None. ever. At least for the past 2 years.

Just looking for general advice I guess. Been wrestling with these problems for years and just want to get other opinions since my old doctor wasn't concerned. My T numbers aren't abysmal but this was taken when I was 19. I feel like I should be at the higher end if I'm only going downhill from here.

Any advice on what to discuss with a doctor? The only thing I can think to do is have another test done and have E2 checked. Thanks for any advice you can give me.

New Test Results as of 9/2

FSH 2.0 1.6 - 8.0 mIU/mL
LH 3.4 1.5 - 9.3 mIU/mL
Prolactin 6.9 2.0 - 18.0 ng/mL
Testosterone, Total 801 241 -827 ng/dL
TSH, 3rd Generation w/ Reflex to FT4 1.38 .40 - 4.50


#2

It sounds like you have hormonal issues...

I would test:

testosterone
free testosterone
E2
prolactin
lh
fsh
tsh
free t4
free t3
cortisol
CBC w/ cholesterol (complete blood count)

How are your muscle gains?...My doctor tested me for low testosterone because I was severely depressed and foggy and had puffy nipples, stubborn fat and it is VERY difficult for me to gain muscle.


#3

x2 on Retinoid. If you have budget issues I would consider E2, TSH, and 8am cortisol as the MANDATORY bare minimum tests.... Free T3, Free T4, cholesterol, DHT (dihydrotestosterone), and DHEA-S to be the next most important. I might even slide up DHT to the mandatory level (libido, sexual function).

How strict are you with carb avoidance? Excessively low carbs for long periods of time can mess with the thyroid production line. This is potentially part of the fatigue problem.

Estrogen would explain the moodiness and bodyfat storage - how lean are you? I'd be shocked if you had optimal E2 levels with these symptoms.

DHT could explain the lack of sexual function. How is your libido? Do you desire sex, or is the desire intact and you just can't perform?

Adrenal fatigue is common with hormone problems. If you have this, it must be addressed before you try to fix anything else first. That's why you need a cortisol test, make sure blood is drawn at 8am.


#4

Yeah that's what I thought, I had the same problem. You are probably swimming in cortisol, among other negative things goin on in you. I would advise you to get your mood under control, perhaps with the help of some supplements, working out, and whatever makes you feel good. To make it short if you don't fix that you're screwed no matter what else you try, sorry to have tell you that. How many years have you been having those issues to the point where you noticed them...?


#5

Fairly good, actually. When my diet and training were at their best I gained a pretty good amount of lean mass. My strength gains always felt oddly lacking in comparison, though.

While I definitely ingest less carbs than the average American, I'm not too low. I have rice multiple times a week.

I'm at ~15% bodyfat. I've been as low as 10 recently.

I desire it and just can't perform.

When I was training as much as I wanted my mood was definitely at its best. The only downside to that was if I didn't make it to the gym for 3 days I could feel my mood and general state of mind going to shit overnight. Noticed the sexual problems ~3 years ago. Mood problems for probably 5 years but they didn't seriously worry me until 2 or 3 years ago.

Thanks for all your input guys.


#6

Your ability to put on lean mass and getting down to a relatively low body fat % and stay there seems like you probably don't have a real issue with testosterone. Just my GUESS. It could be something else though (hypothyroidism also seems unlikely, but still possible).


#7

You'd be surprised...I put on 25 lean pounds in a few months before I ever got into TRT. I've always been skinny and I don't put on a lot of fat even when all-out dirty bulking. My T was 302. Granted, I was a novice lifter and did things right, I don't ever expect to repeat those gains in that time period. Diet and training can accomplish a lot even with shit hormones, up to a point.


#8

Well maybe low testosterone really doesn't make it THAT hard to lose fat...For me, I was blowing up like a balloon and gained like 30 pounds in about 2 months with going to the gym 4 days a week while my testosterone levels INCREASED and my thyroid levels decreased a little. Now I am on thyroid hormone and I lost 15lbs with changing nothing. So maybe it is just certain hormones that makes it a son of a bitch to lose fat!


#9

Thanks for the input. Decided to stop seeing Urologists and called around to the compounding pharmacies near me until I found a recommended doctor that is in network for my insurance. Appointment is in about a week so I'll post the results when I hear back.

Cost isn't too much of an issue with tests so I'll be getting all of what has been suggested; seems to line up with my understanding of the recommendations in the stickies.


#10

Well, whatever my problem is, it looks like it isn't test. The good feelings I had about this doctor didn't pan out. I gave them a list of the additional tests I wanted done and was told they would be. Nope! Doctor basically said she had no idea what was up with me and referred me to a Urologist.

New Test Results

FSH 2.0 1.6 - 8.0 mIU/mL
LH 3.4 1.5 - 9.3 mIU/mL
Prolactin 6.9 2.0 - 18.0 ng/mL
Testosterone, Total 801 241 -827 ng/dL
TSH, 3rd Generation w/ Reflex to FT4 1.38 .40 - 4.50

Also have Comprehensive Metabolic/CBC results if those are of use. The only out of range value I have is Carbon Dioxide. Starting to think that all the shit going on is just my personality or something. Thanks for any input.

Edit: The doctor also said my testicles were DEFINITELY smaller and softer than most. Out of the other 3 doctors that have had the privilege of examining my junk, only one of them said something was odd about my testicles.


#11

Your 5-ar might be screwed up... also, you may have high E2. Did you have E2/DHT checked?


#12

Your lh and fsh levels are on the lowish end. Maybe taking some clomid would help reset them...Testosterone looks good, prolactin is fine. May have some issues with environmental factors/chemicals. That is why I like clomid but I doubt you will be able to find a doctor to prescribe it to you with those T levels. So you will have to find a web site for that which someone may know...I am trying to find clomid myself and can only find tamoxifen, which does the same thing but in my opinion isn't as good and can actually cause libido problems...Also I would take some iodine. That helped my morning erections and helps deal with the estrogens in our environment as well as eating cruciferous vegetables and avoiding offending substances as much as possible.


#13

Doctor said she would, and then didn't. Scheduling a followup with a different doctor so I can get them tested.

Wont lie, I have a pretty murky understanding of LH and FSH. Thanks for the lead, I'll start researching that and the iodine.


#14

Why would he take a SERM to increase LH/FSH with testosterone already in the higher levels? This doesn't make any sense....LH/FSH are there to induce testosterone and sperm production in the testes, not just for number chasers to find an "optimal" number...they are getting the job done, testosterone wise, so don't need to be at some "magic number"...LH/FSH is not the cause of his issues...


/
OP: Any idea why your testosterone rose so much from your OP to your recent blood tests? That's a pretty substantial increase...

You also may want to have a sperm count done, to determine if your nuts are functioning properly in that regard...


#15

If he is still having symptoms of hypogonadism, such as inability to get erections with lower lh/fsh levels then raising them may help.


#16

How?


#17

I have no idea other than the large gap in time. The blood test in the OP was done when I was 19. I think around 2 or 3 PM. My training and diet were vastly superior back then so I'm pretty puzzled.


#18

People with normal T levels that take HCG (acts as LH) and men who take clomid for fertility report that it helps libido. I am not sure how it does but we know that just raising testosterone doesn't necessarily translate into higher libido and that a lot of drugs that raise LH/FSH do not necessarily increase libido either (like tamoxifen and letrozole) and in fact kills people's libido usually even when E2 is kept normal/high. It was just a thought as everything else seems normal and clomid is relatively side effect free when taken for a month.


#19

Usually those people have low T. OP doesn't. There is probably something else going on here.

And why on earth would you want to keep E2 "normal/high" when trying to increase libido?


#20

Too low of E2 will cause libido problems. You want E2 to be normal. What I was saying is letrozole, for example, can decrease libido even if E2 is normal. Drugs have varied effects and usually the drug companies don't even know all the effects of their drugs as they are just 'random' compounds that were found to do this or that. As I mentioned, HCG and Clomid sometimes increase people's libidos even when they have normal T as T isn't the only thing that influences libido so Clomid and HCG may affect libido in another way without having to raise T. Just like some people using Dostinex report increased libido even without having high prolactin. There is some evidence that Dostinex down regulates progesterone among other things which may also account for increases in libido. If you read above I said that he didn't have a T problem most likely before he came back with new labs so I am well aware that he doesn't have a testosterone problem. Now do you have any more questions? :slightly_smiling: