T Nation

21 Y/O Male Considering TRT?


#1

Just had my blood work come back,

Test levels are 196.5 ng/dl
Free test - 4.2 ng/dl

This is incredibly low for my age (21) in fact is low for any age. Currently suffering from all the symptoms, lack of morning wood, depression, can’t gain muscle mass, what could be causing this?

Did a 4 week cycle of Anadrol last year like idiot did not do any PCT, i know this has more than likely messed up my natural test production, but will this be for life or will i recover on my own?

Feel terrible all the time, suffered from bouts of depression over the last year could any one give me some information about the long term effects of TRT ? and at my age am i too young


#2

Your cycle has shut you down! Have you had these symptoms from prior or after the cycle only?

You need to get more blood work in, there’s a good chance you can make a recovery with a proper HPTA restart/PCT. Please read the stickies in the about T replacement section of this forum. You need the blood work listed there.

If the HPTA restart is not successful, then TRT is the only option. But since you are shut down from a cycle, depending on the duration of the shutdown, a good PCT could restore normal hormone production. Age has little do with it, Thousands of young people, as you would see here have problems. TRT is a relatively new treatment and long term data is not available yet, but there is only positive effects to be had from it IF monitored by a professional who knows what he’s doing. Sometimes, TRT is the only option left when all other options are exhausted. I’m 25 myself.

Follow the links i mentioned earlier, you’ll see an HPTA restart thread in the advice for new guys sticky. You have much reading to do, start learning and hopefully you’ll recover.


#3

thank you for the reply, i always felt i went through puberty late, even now i have very thin arms and wrists, little to no facial hair, not much hair on my body either,
so i guess i have always had naturally low test but symptoms have gotten a lot worse since the cycle. I never even thought about test levels till recently so its hard to say if symptoms have always been there as i am noticing then alot more since doing more research

i have also read that hypothyroidism can cause low test, do my levels suggest a problem with the thyroid. also i have very high iron content in blood which could be a sing of hemochrombtosis, could this also have impact on test levels?

full details from blood work

                                                                                                    Range

THYROID STIMULATING HORMONE 1.74 mIU/L 0.270 -4.200
FREE THYROXINE 16.65 pmol/L 12.000 -22.000

17-BETA OESTRADIOL *<18.35 pmol/L 44.000 -156.000

FOLLICLE STIM. HORMONE 6.27 IU/L 1.500 -12.400

SEX HORMONE BINDING GLOB 21.37 nmol/L 16.000 -55.000

CORTISOL *692.82 nmol/l 171.000 -536.000

IRON *57.92 umol/L 10.600 -28.300

FERRITIN 94.06 ug/L 30.000 -400.000


#4

Your FSH suggests you’re not in fact shut down but still have low test.

Your symptoms suggest that you had some problems before but a cycle without PCT is hardly going to make things better in any way.

Facial hair is weird, from where I am, we are naturally hairy and I have decent facial hair despite low T.

Do you have LH, prolactin(imp), t3,t4 labs? Ft3,ft4 would be better


#5

i guess facial hair could just be hereditary but my older brother and dad both have beards, i feel like i have not fully developed and i am starting to believe this linked to low test. I am going for another Blood test on Monday and have an appointment with the doctor next week so i will discuss all of this with him, would PCT not be a viable option then if i am not actually shut down?

The last test was done at 9am when levels are supposed to be highest so id hate to think what they are like at 9pm. Its weird because i am very active and go to the gym 5x a week do not really suffer from fatigue, i have been on a strict diet eating clean yet struggling to bulk, i eat way above my calorie surplus but still struggle to gain weight and noticeable muscle mass.

i will post full details of the next blood test and make sure they test for the things listed above. Hopefully can get it sorted ASAP as the last year my anxiety has been getting a lot worse, Also i was wondering what could be causing such high Cortisol readings, and would this also impact on T levels.


#6

Your low iron and ferritin are a problem. Do you have digestive problems or food allergies/sensitivities? Strange diet?

Your cortisol was high. Were you a bit panicky about the blood work?

I am thinking that you problem was progressive and not caused by the Anodrol. One can always have some doubt about what one really took.

Many young men show up here with these issues, so you can find others and their stories.

You have to do a lot of reading where you may see some connections.

Follow these links found here: About the T Replacement Category

  • vice for new guys - need more info about you
  • things that damage your hormones

Your FSH suggests that your testes may be the problem and a HPTA restart would not then solve the problem. Have you had your testes examined? Any aching there?

?
Weight
fat patterns and how changed
height
athletic abilities
waist size

TSH should be nearer to 1.0. Ignore the lab ranges, they are not helpful.
Have you been using iodized salt? - history
Do you get cold easily?

How much is stress a factor in your life. That also includes accidents, illnesses and surgeries.

There are many symptoms of low-T and low thyroid function that are the same and you may have the combo of both.

Labs, you have some now.
TT
FT
E2
LH and FSH
prolactin !!!
CBC
hematocrit
fasting cholesterol
fasting glucose
AM cortisol [at 8AM]
Vit-D25 - or take 5000, 6000iu Vit-D3
DHEA-S [not DHEA]
Occult blood test to look for blood cells in your poop. !!!


#7

Listen to everything KSman says. You will learn more than you would from your doctor.


#8

I have been supplementing my diet with flax seed which has a lot of iron but apart from that I’m not sure what It could be, eat chicken, salmon for protein and then get my carbs from sweet potato, with veg. Very strict with my diet. Used to get IBS but since eating clean this has not been a problem. Had surgery for gyno in November didn’t come out as I hoped so this has caused much stress and aniexty

I have had my testes examined the doctor said they where a normal size and didn’t have any abnormalitys, I do remember times when I got a dull ache in them but it comes and goes

Do have a history of under active thyroids in my family which I will be bringing up with the doctor again so I can get further tests.

As for athletic ability I would say Im weaker than average bnot abnormally weak,

Flat bench 80kg
Deadlift - 130 kg
squat - 100 kg ( neglected training my legs for a long time )

As for weight I weigh 72kg Height 5ft 8/9 32 inch waist
As for fat i store around the hips and chest which is consistent with low T

Don’t have problems with cold and have never used iodised salt, not even sure what that is.

Edit - Stupid question, looked up I do use some salt in my meals but try to keep this to a minimum


#9

You are iodine deficient and that leads to underactive thyroid problems.

Study the ‘thyroid basics explained’ link and check oral body temperatures as suggested. Doctors never ask about iodine intake - retards.

Iodized salt was introduced around 100 years ago to combat thyroid problems from a lack of iodine.

Where are you located?


#10

KSman I have an update on my situation after attempting a HPTA restart and supplementing with iodine and selenium, I have had 4 sets of blood work to track my progress, it is progressing in the right direction however will need to do one more blood test 4 weeks after the restart to really find out if it has worked. Apologies in advance for the long post. Could you please give me some advice on my results.

First test - 12 May 2016

SHGB 21.37 nmol/L
TOTAL TEST - 6.82 nmol/L
beta 17 Ostradiol - 18.35 pmnol(Low)
ALBUMIN - 51.7 g/L
FREE TEST - 0.147 nmol/L
FSH - 6.27 IU/L
Cortisol 692.82 nmol/l
TSH - 1.74 mU/L
Free T4 - 16.65 pmol/L

I have added the increase or deacrese In values so you can see progress from the previous set of results.

Second test - June 17 2016

SHBG level - 33 nmol/L (+11.63nmol/L)
Total test - 17.2 nmol/L (+10.38 /L)
Albumin - 48 g/L
Free test - 0.341 nmol/L (+0.167 nmol/L)
FSH 6.4 U/L (+ 0.13 U/L)
LH - 4.4 U/L
Cortisol - (AM) 349 nmol/L (- 343 nmol/L)
TSH - 1.66 mu/L (- 0.8mu/L)
Free T4 13.89 pmol/L (- 2.76 pmol/L)
Prolactin - 206 mU/L

HPTA RESTART Protocol
(Week 1-2) 20mg Tamoxifen (ED) 0.5 Adex per week
(Week 3) 10mg Tamofixen (ED) 0.5 Adex per week
(Week 4) 5mg Tamofixen (ED) 0.75 Adex per week
(Week 5) - 6 Taper off Adex at 0.25 for 2 weeks to prevent rebound.

Supplements through out HPTA restart attempt. And carrying on from now on.

Ashwashgha - 1800 mg ED
Omega - 3 x 3 ED
phosphatidylserine
Selenium 200ug x 1 ED
Iodine - 0.45 mg ED (3 x 150 ug)
Vitamin D3 10 ug x 3 ED
Berroca multivitamin 1x ED
Milk thistle ED
ZMA

Test 3 - Week 3 of HPTA restart.

12 August 2016

Total test - 29.54 Nmol/L. (+ 12.34 Nmol/L )
17beta estradiol - 49.4 pmnol( + 31 pmnol )

Test 4 - 23 August 2016

SHGB level - 40.69 Nmol/L ( + 7.69 Nmol )
Total test - 28.72 Nmol/L. ( - 0.82 Nmol/L )
Beta 17 ostradil - 18.83 Pmnol (- 30.57 )
Albumin - 47.2 g/l. ( - 0.8 g/l )
Free test - 0.558 nmol/L. ( + 0.217 )
FSH - 10.01 IU/L. ( + 4.61 IU/L )
TSH - 3.02 mIU/L. ( + 1.36) !!!
Free T4 - 15.13 pmnol/L. ( + 1.24 ) pmnol/L

I have a few questions regarding my progress.

First of all does the increase in FSH induced by Tamoxifen suggest that my condition is not caused by primary hypogonadism and could be secondary, I’m thinking induced by stress and thyroid issues.

This brings me on to my next question, since supplementing with iodine and selenium my TSH has increased from 1.74 to 3.02 so has nearly doubled yet T4 output has stayed relatively the same, what does this suggest? Could it simply be the thyroid awakening after a long time of iodine deficiency, I think it’s important to add as a child I was lactose intolerant something I have grown out of but still do not drink milk regularly and drank very little as a child.

Libido wise I improved during the HPTA restart gaining morning wood for the first time in years, desire came back strong as well however this came and went through out. Since stopping however things have slowly returned to how they where before I believe this is due to my Estrogen crashing again possibly due to over dosing the Adex in my final week.

Any opinions or advice anyone could give me would be greatly aprecieated given my age I’m am looking to explore all avenues before committing to TRT. will update with final blood work in a few weeks.e


#11

When doing high dose iodine, it is expected and normal to have inflated TSH. So you cannot make any conclusions based on that.

I could not track restart protocol VS the labs very well.

If HPTA restart is a failure, you have still demonstrated that your testes are functional as this point. hCG might work for you.

I do not know the ranges for your labs.

Is that pmol/L

Please look at info that I have requested before that you have not provided. Give me something back please.


#12

apologies the information is a bit of a mess, Labs 3 and 4 are both after my restart attempt. Im located in the UK so units of measurement are different to USA. Yes the oestrogen is Pmol/L, translates roughly to around 5 pg/ml so way below the 24-30 sweet spot.

Here are my latest results with the ranges included. (Test 4)

ENDOCRINOLOGY Range

TSH 3.02 mIU/L 0.270 -4.200
FREE THYROXINE FT4 15.13 pmol/L 12.000 -22.000
FOLLICLE STIM. HORMONE 10.01 IU/L 1.500 -12.400
TESTOSTERONE 28.72 nmol/L 7.600 -31.400
FREE-TESTOSTERONE 0.558 nmol/L 0.300 -1.000
SEX HORMONE BINDING GLOB 40.69 nmol/L 16.000 -55.000
17-BETA OESTRADIOL *18.83 pmol/L 44.000 -156.000

Will be going for more detailed thyroid tests and will test Am temperatures.


#13

How long was Test 4 done after PCT?
Still on AI then?

High FSH seems too high for post PCT,

SHBG is way too high for E2=19 pmol/L
May be a hangover from some PCT issue.


#14

Test 4 was done 3 days after PCT ended, I did the test so I could see if FSH reacted to tamoxifen, am I right in thinking that high reading is due to tamoxifen still being in my system. SHGB is a concern for me as I can see it has risen dramatically along with test.

I was still taking AI when this was done so could that explain the low E. Since then I tapered off AI and am no longer taking anything other than the supplements listed. Will have a clearer picture once I do my next blood test which I plan to do 4 weeks post PCT, will this be enougg time to see if HPTA is able to hold by itself or would you recommend waiting a little bit longer


#15

@KSman

I have a recent blood test for more in depth thyroid analysis, GP has said everything is fine as its in range, however my experience with doctors recently has lead me to not believe in the whole range system. what do you make of these results?

TSH 2.09 mIU/L 0.270 - 4.200
Free Thyroxine 17.11 Pmol/L 12.00 - 22.00
Total Thyroxine (T4) 100.3 Nmol/L 59.00 - 154.00
Free T3 5.41 Pmol/L 3.100 - 6.800
Reverse T3 17 ng/dl 10.00 - 24.00
Reverse T3 Ratio 20.72 15.010 - 75.000

Thyroglobulin Antibody 16.140 IU/ml 0.000 - 115.000
Thyroid Peroxidase Antibodies 9.35 IU/ml 0.000 - 34.000

Vitamin B12 489.1 pg/ml 191.000 - 663.000
Folate ( Serum) 10.31 ug/L 4.600 - 18.700
25 OH Vitamin D 75.84 nmol/L 50.000 - 200.000

CRP - High sensitivity - 0.1 ug/L 0.000 - 5.000

Iron status (Ferritin) 85.38 ug/L 30.000 - 400.000


#16

Anyone help me out with this ?


#17

All of those labs are great, except for TSH=2.0 and supporting good body temperatures that you do not report.

Please summarize timeline with iodine and selenium what you do for iodine maintenance.