T Nation

21, Low Testosterone


#1

I am 21.
Grow a lot of body hair.
My hair has been falling out in clumps for years but I am not bald I still use minoxidil though.
My hair has premature graying (started when I was like 14).
Have always had some extra breast tissue.
It is hard to get rid of fat and gain muscle.
My libido is sometimes strong and sometimes nonexistent.
My growth stopped suddenly not gradually.
I do not take supplements except vitamins and whey protein.
I was vegan for 5yrs but have begun to eat fish and consume eggs and whey for about 1 yr before my test results.
I go to the gym 4 days a week.
I am extremely depressed, mood swings, etc. Have been on antidepressants Wellbutrin only worked for me but the generics of this drug did not and my insurance does not cover the brand anymore.

My first test results:
Vitamin D 31 (30-100ng/mL)-->I am supplementing Vitamin D3 now on my own
TSH 3rd Generation 5.14H (.4-4.5mIU/L)
Testosterone Total 204L (241-827ng/dL)

My second test results (free testosterone wasn't present as this isn't the complete test because the lab didn't send it over yet):
TSH 3rd Generation 3.07 (.4-4.5mIU/L)
T4 TOTAL: 8.2 (4.5-12 mcg/dL)
T3 TOTAL: 95 (76-181 ng/dL)

FSH: 2 (1.6-8.0mIU/mL)
LH: 4.3 (1.5-9.3 mIU/mL)
Testosterone TOTAL: 321 (241-827 ng/dL)

Both tests were taken at 8am. Any advice? The dr. wants me to see an endocrinologist and says they will probably do prolactin tests and an MRI or what not. I need the mental problems to subside because I have an internship this summer! I went back to generic wellbutrin hoping it will give me some relief before then. Thanks...


#2

How much time passed between your first and second tests. In the first one, you appear to suffer from subclinical hypothroidism. In the second test, your TSH is within range of the (old) values but still outside of the 3.0 upper range the AACE recommends.

Bring that number down and see what happens to the rest of your symptoms.

<--------------- Not a Dr.

Read page 2, number 1: http://dev.aace.com/sites/default/files/subclinical.pdf


#3

Thanks I was thinking about that but my primary doctor (who is a new doctor/resident seems to be reluctant to do too much out of line) said he wants to send me to an endocrinologist. This doctor is great but like I said reluctant. I told him I want the tests done within two weeks before I leave the state and so he is going to try and get me in to see this endo but if not he said he will just order the tests (prolactin, cortisol, testosterone again, thyroid again, etc.) and the mri... I am open to just taking something like armour thyroid first to see if that alleviates my symptoms.

By the way it was like a 3 week difference between tests...

If my testosterone at its highest is like in the low 300's then that explains why I have been having such a hard time gaining muscle even though I work out and spend a lot of money on food. i feel like it has been a waste and it is now harder than ever to motivate myself to go to the gym!

Do you think the wellbutrin will affect the results at all since it supposedly increases dopamine and norpinephrine in the synapse? I doubt it will do anything...


#4

What is your iodine intake? Post body temps, see the link.
http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/ksman_has_a_thryoid_problem

Hair falling out is a symptom of hypothyroidism. Is your neck thick where your thyroid is?

That is the only lab work that you have?
Example: http://www.lef.org/Vitamins-Supplements/ItemLC322582/Male-Panel-Blood-Test.html

Take fish oil.
How much vit-D3 are you taking.

Growth stopped: Any blows to the head or whiplash preceding that?


#5

I probably get around 100-300% iodine daily (100% in multi, i eat 4 eggs, and tuna)
My neck is pretty normal I think...
I don't remember any blows to my head...I did starve myself for 4 months though and lost like 100 pounds when I was 13...And when I mean starve I literally mean did not eat for days and started becoming anorexic because I began to fear gaining the weight back.
I take now 5000IUS of vit D3 and consume eggs, tuna and almond milk (d2)

Also my body temperature is usually a bit low (in the 97's). I rarely get sick(haven't had a debilitating cold in the past 5 yrs).


#6

A diet that is high in tuna may be high in mercury.

Low body temp: You do have functional hypothyroidism.

Starvation does cause damage and adaption of thyroid and adrenals creates lasting issues.

T4 and T3 are useless as most is bound to a binding protein. You need to have data for fT4, fT3. Suggest rT3 as well. Should also check AM cortisol, should be 8AM. Need CBC and lipids.

Where is the rest of your lab work?

150mcg iodine prevents goiter. Does not address optimal requirements. You can try increasing your iodine intake or go for life long thyroid meds. Are you using iodize salt? How long have you been using vitamins with RDA iodine?


#7

My tsh was always higher even when I was a vegan without eating tuna or animal products.

Yeah my body temp is usually always lower than 98.6. Even going to the doctors after being in the hot sun I was like 97.6. Last time I was surprisingly 98.

I feel like he ordered these labs but they didn't come with the online print out. I KNOW he ordered free testosterone and it wasn't on this lab so I will have to call and see if Quest sent it.

You want me to post my immune cell count urine analysis? None of that was out of range or nearly out of range except the MCH was slightly higher (I am not b12 or folate deficient though).

I am going to buy kelp supplements today and take like 1000% of iodine RDA for like a month. See if that lowers my tsh.


#8

Have you ruled out Hashimoto's? Iodine supplementation is contraindicated in cases of Hash.


#9

Can you just tell me what to test for my doctor said he would try and set me up with an endo and never did (he is a resident so sees numerous patients so I am understanding or maybe it is just because I have excess estrogen :)) I just feel absolutely horrible mentally and physically and I can't focus and I am 'supposed' to go to another state and do an internship but there may be issues with that and I don't even think I will be able to pull it off. I just need something to fucking jump start me or I'm going to kill myself because that is my only option psychiatric meds make me edgy and twitchy and nauseous and emotionally blunt me overall they make me feel uncomfortable.


#10

Hopefully others will jump in here, but I'll share what I can:

Your TSH levels indicate subclinical hypothyroidism. Hypothyroidism can be caused by Hashimoto's which is an autoimmune disorder in which antibodies slowly destroy the thyroid. It may present as hypothyroidism with bouts of hyperthyroidism. It's tested for by looking for the presence of antibodies against TG and TPO, as well as fine needle aspiration and radioactive scanning. In some circles, it's believed that iodine is contraindicated for Hashi's. I don't know if there is any scientific data on the matter as I've never looked.

You should be able to walk into your primary care physician's office, show him your TSH levels and receive a script for synthetic thyroid. I'm not going to get into the debate between Armour and Synthroid, but it's certainly out there if you care to look.

I believe, and I think there's a few on this board who feel strongly about this as well, that playing with testosterone replacement doesn't make sense until thyroid and cortisol levels have been optimized. I'll give you an example. I've dealt with severe fatigue for years. Because of that, I've used various otc stimulants including caffeine and ephedrine as well as Provigil to remain alert during the day. The constant stimulant use (and sometimes abuse) can stress the adrenals raising cortisol levels. Once I brought my TSH down to proper levels, my fatigue receded and I was able to go about my day with only a couple cups of coffee in the AM, not to mention how much better I felt in other ways. My mood definately improved, I was able to lose weigh, my brain fog lifted, memory improved a bit, etc. AM cortisol levels improved and I saw better results in the gym as a result of lower cortisol (I believe) as well as improved energy and motivation.

So, you may find that by treating your hypothyroidism, other hormone profiles fall into place.


#11

Thanks I am going to demand armour thyroid then. I feel like I may have excess prolactin and low dopamine. So I am going to get tested for thyroid levels, antibodies, prolactin, estrogen, testosterone, cortisol, sbhg.

The only drug that ever helped me with my depression was dxm and ketamine in high doses as they cleared my head and made me leveled so I think nmda receptor may influence depression for me...So I am going to drink cough syrup until I can get these labs straightened out I just don't know where I should go I guess I have to go to a new doctor in new hampshire...


#12

you really should read the info on this site before you talk with your doctor. stopthethyroidmadness.com/things-we-have-learned


#13

Okay my long post did not appear so I am typing the whole thing out again.

I went to the doctor and got my stuff tested again.

TSH-5.75 (.4-4.5) HIGH
TOTAL T4- 8.7 (4.5-12)
FREE T4 INDEX(T7)-3.1 (1.4-3.8)
T4,FREE-1.3 (.8-1.8)
T3,TOTAL-86 (76-181)
T3 UPTAKE-36 (22-35%) HIGH
PROLACTIN-16.4 (2-18) HIGH NORMAL
TESTOSTERONE, TOTAL-466 (250-1100)
TESTOSTERONE, FREE-112.8 (35-155)

My free testosterone looks great and my total testosterone improved over 100% from the first test. I have been working hard at bringing that up.

I have been taking 10mg of iodine for a few months (kelp and potassium iodide) which made me feel mentally better and my temperature rose but I gained a lot of weight (almost 15 lbs). And my body fat is still high (like 15%) even with exercising and eating well I also have had hair loss for years without bald spots that I would like to help stop... So the doctor prescribed me 30mg of the generic of Armour Thyroid (.5 grain). He wanted to prescribe me Synthroid but I said no.

I am reluctant to take it though because my thyroid seems fine...but I filled it and took one today cause I need help losing this fat. I feel a little light headed.

I also ordered l-dopa to help counteract the prolactin which I think contributes to my issues.

Any advice...I don't want to take thyroid hormones forever and screw things up.


#14

I don't feel that great after taking the armour I feel a little zoned out


#15

Nobody can give me advice here?


#16

You have extreme hypothyroid symptoms, but we can't tell why until we have more info.

Your FT4 is fine - your thyroid is producing enough of it, yet your pituitary is still screaming for more. You are probably (emphasize probably, not certainly) converting a lot of it to Reverse T3. You need to test FT3

Are you paying out of pocket or through health insurance? Basically, how many tests can you afford?

You NEED:
-Cortisol (8am blood draw)
-Free T3

You will PROBABLY also need:
-Thyroid Antibodies (TPO/ATA)
-Reverse T3

Tests I also strongly recommend and are needed to rule out some potential causes:
-Iron
-Ferritin
-Vit B12
-Vit D, 25-hydroxy

These tests are IMO all necessary, but ordered by importance in case funds are an issue. The more info we have, the more we can help. I personally wouldn't suggest medicating until the problem is further defined. It might help or it might not.

The bottom line is you have every hypothyroid symptom in the book despite the fact your thyroid is producing normally. Something is wrong.

Also, feel your throat carefully and check for lumps. A small lump could be an early stage goiter.


#17

I know I thought he tested for free t3 but he didn't. The total t3 is on the low side so I am sure the free t3 isn't that great.

Vitamin B12-is totally fine. Vitamin D-it was lowish but I have been taking 5,000-10,000IUs a day.

I don't have any goiter.

The doctor is only testing my next test for t4 and tsh but I am going to check more because when you take t3 (armour) it will push down tsh...I will get the other tests...

What do you think about the testosterone, free testosterone and prolactin?


#18

I am not nearly as knowledgeable about T as I am about thyroid and adrenals. I can throw out some ideas but I'd rather other people here address those issues.

Remove my vitamin test suggestions now: Still strongly suggest Reverse T3, Free T3, iron, ferritin (you can read about the hazards of low iron/ferritin at http://www.stopthethyroidmadness.com/ferritin/ , specifically section 3). Also thyroid antibodies, I suspect you don't have Hashi's but it is easy enough to know for sure.

I would expect both TSH and FT4 to go down if you are taking t3-only. I believe if high RT3 is the problem, taking t3-only meds will help. However, in that case you are merely treating symptoms as opposed to fixing the root cause.


#19

Thank you...Armour Thyroid is a mixture of t4 and t3. My doctor wanted to prescribe Synthroid so I had to fight for the Armour but he is a good doctor and listens...

The Armour is making me feel physically tired ironically. Like I want to go to sleep. Mentally I am not sluggish...I only had like 5hrs of sleep because yesterday the Armour made me VERY anxious and I couldn't sleep...a lot like caffeine and drugs dealing with norepinephrine do to me. Today I took it in the morning and didn't get anxiety but now I am slightly tired.

I'll have him test:

free t4, t3, tsh, ferritin, cortisol

He only ordered free t4 and tsh for my next labs!

Do you know if I can just check them myself or do I need to call him?


#20

You can ask him if they can send them straight to you... or else get a copy when you are there. I'm not sure what his policy is.

T3 has a short half-life... you may be better off with half the dose, twice per day (if you are dosing once per day).

I can't say this for sure without more labs, but my "educated guess" is that Synthroid is the wrong call. Your FT4 level looks pretty close to optimal to me. The problem seems to lie elsewhere - I'm guessing high RT3.