T Nation

21 Y/O with Progressively Worsening Test Levels

Hey there everyone I’m a long time lurker of these forums and have just now decided to join and share my story and see if I can get any more insight. It amazes me the amount of people that will post a question without first researching the internet. There is a 99% chance someone else has asked the same question that you have.

Anyways I have been having these hormonal issues for almost 2 years now. They all began with me feeling very cold all the time with progressively worsening fatigue and sexual issues. Before all of this began I had an outstanding sex drive and happiness in life. I always had a healthy diet with a steady workout routine. I’m around 6ft 187lbs with a nice amount of muscle and strength. I ordered my own comprehensive blood work off of privatemdlabs on 8/15/2016, and have done so many times throughout the past two years. The first round of blood work showed a TSH level of 5.8 with a Prolactin level of 21 which was outside the scale. Total Test levels were normal around 600 and free testosterone was mid range on the scale. SHBG was always around 20-30 on every round of blood work I have had.

I began supplementing with iodine and waited a couple more months to get another round of bloodowork. TSH remained elevated and Total Testosterone levels were now coming in at 360 which baffled me that it could drop so rapidly within two months. After the shock of seeing my levels so low I began to seek out help from an endocrinologist because my primary doctor would not help. The endocrinologist was even worse than my primary doctor and said my test levels and tsh were normal and that he couldn’t understand what was wrong with me. He ordered blood work that tested for inflammatory markers and celiac disease as well as ferritin and iron levels. All of those came back completely normal and I made sure to get copies of my values so I could research myself. I took matters into my own hands and ordered research grade clomid to see if I could restart myself.

After 4 weeks of 50mg a day of clomid my Test came back at 890 and I felt great besides the side effects from clomid. The clomid made me feel highly emotional and I haven’t had emotional breakdowns so it was terrible and I promptly tapered off and quit it. I began seeing a wellness clinic here in Birmingham, Alabama that is very well known for its intergrative approach towards health. I told this doctor everything that I have done and he decided the best thing to do was try to treat my Thyroid first and wait on testosterone due to my age. The months after clomid all of my test levels stayed steady at 600 but eventually had a slow decline back into the 400s.

The nature Throid helped my tsh levels get back down to 1 but test levels never improved. My doctor decided to try HCG MONOTHERAPY at 100iu a day and it worked great for 3-4 months but I eventually got fed up with trying to control the estrogen levels that it caused. My doctor prescribed Arimidex at 0.25 twice a week but I could never dial it in. Erections were either fantastic or sorry. I eventually decided to quit my thyroid medication and the hcg in hopes of treating myself naturally. The thyroid medication was making me feel hyperthyroid anyways. I stopped everything almost 3 months ago and have been feeling just fine. I have actually felt better while off of my thyroid medication. Body temperature is always a consistent 98.6 and recent blood work has shown a natural Tsh of 1.8 which I’m happy with for the time being.

What is concerning is that my test levels of never improved back to my natural levels of 600 even after 3 months of being natural. My LH and FSH are always around 6 or 7 yet my total testosterone has fallen back into the 300-400 levels again. They held steady in the 500s for a short period but have fallen again. Erections have been perfectly normal and the only side effects from my test levels is my terrible energy levels and headaches I get every day, and not to mention worsening performance in the gym.

My doctor wanted me to start on 60mg of Test Cyp twice a week with 500iu of hcg and 0.25 of Arimidex on the days of test injections, but I never started due to being weary of starting this long road at the young age of 22. I know this was ridiculously long but I would love to hear some insight from this amazing community

TLDR: 22 Years old with test levels in 300-400s and considering trt even though very unsure if I want to begin this long journey.

22 is quite young to start TRT. You have done everything right as far as not going that route. But if your FSH and LH are in upper range limits and your test is low that is an obvious sign of primary hypogonadism. You may want an ultrasound to see if you have an issue with varicocele. If you are primary, HCG will provide limited benefit. However, the benefits you scene from clomid and HCG prior imply you are not primary, so I would look to get an ultrasound done.

I will definitely look into scheduling an appointment with an urologist to get an ultrasound. Neither the Endo nor my promised physician thought about a varicocele. Can you have a varicocele and it not be obvious? I don’t have any obvious sign of abnormality with my testicles. If varicocele comes back clear what is my next step? Back when my doctor recommended trt he went ahead and injected 200mg right then and there in his office and the days following were some of the best I have felt in 1.5 years. I decided not to continue with shots tho and didn’t do any pct without any side effects. Previous labs just a week ago came back with LH and FSH around 5 with total test of 340. The mental and physical problems have really been tough to try and put up with. Brain fog is bad especially in the evenings when I can imagine my levels are extremely low due to diurnal fluctuations. Surpassingly my sexual function has been fine despite low sex drive.


For reference it was 6 months ago when he recommended me trt and I have a follow up appointment this month. Test levels have not naturally corrected in that time period. It concerns me that my body is fine with my low test level as it seems my LH and FSH having remained completely normal this whole time and not been elevated.

I have question lets just say for example he does have a varicocele. What would this mean. Because I have had varicocele on the right and the left side starting from the age 25 and never had any problem by the age of 28 my testosterone dropped all the way down to 317. Do you think a varicocele could cause this?

There difference between me and @dosssy is that when I started to have my symptoms and I got my blood work done my FSH and LH were closer to the low side.

But here the thing if you go threw surgery to repair the varicocele how much will it boost your testosterone back up and isn’t there always a chance of them coming back?

Bump. I would love to hear some other advice


115 ng/dl is the increase documented via studies. I have unilateral varicocele. I was sitting at 290 ng/dl. If I went through the invasive surgery and successfully increased by 115 I would still be low normal. You have to take into account the risk that by cutting off that particular route of blood flow you do have a risk of that testicle dying. It has happened. My urologist said it wasn’t worth it. At 36 with low test I wouldn’t see any real benefit going under the knife. Just a thought.

I’m looking into scheduling an appointment with a urologist to see if a varicocele could be the root of my problem. My other wellness doctor told me 6 months ago to start a trial of trt and see if it will help, but at 22 Years old I am worried about long term. It’s been a year and nothing has helped me naturally, and my diet and workout regime has always been flawless.

Your still a young man. Talk to the doctor. If it can help then go for it.

Would a trial of trt for say 6 weeks be something to think about? That’s what my doctor recommended for me.

That was barely enough time for me to know if TRT was working, you should at least notice mood improvements by then. You could get lucky and respond fast, everyone is different. I’m a slow responder to TRT.


I just got some updated blood work in. Total testosterone came back at 463, and LH and FSH came back at 5. Erectile function has been just fine but libido and fatigue have been the major symptoms. I feel great in the morning but tend to crash right after lunch. Would Trt still be something to try or is a test level of 463 just fine for a 21 year old?

Test levels that I obtained almost 1.5 years ago were consistently over 600. My symptoms aren’t severe but I can greatly see the difference in my energy levels and lack of motivation. Body aches have also been a major symptom too. I’m still trying to figure out what has caused this drop in test levels despite normal LH and FSH.

Have you read the stickies? Have you had your thyroid checked?

Yeah I’ve read the stickies long before I became a member here at tnation. Thyroid was what was the problem to begin with due to a tsh of 5.8. I was on thyroid meds for over a year, but I recently quit and began supplementing with iodine and my thyroid levels and body temps have been just fine. Tsh stays around 1.5 and free t4 and t3 are always above midrange. I believe my thyroid is what began all of this, but even though my thyroid is fine now my testosterone levels never recovered.

The doctor wants me to try a trial of trt to see if it could help but I’m still wary of it due to my age, but If it could improve me feeling like an old man then I would be all for it. I already have two 10ml vials of test cup and 20,000 ius of pregnyl. I just am timid about starting.

Total test range was 264-916.