T Nation

21 Year Old, Low T & Hypothyroid

Hello,

I just turned 21 and have been having lethargy issues and a very low libido for about the past year. I recently got bloodwork done and found out some of my labs values are concerning. My doctor took a look at it but wasn’t worried about the test levels or elevated prolactin. I just went on 75 mcg of Levothyroxine this morning in hopes of fixing everything. My lab values are below. Anyone have any advice on how to move forward as far as testing or treatment plans? Thank you

Lab Values 4/12/19:
Cholesterol - 151 mg/dL ; 100-199
Triglycerides - 61 mg/dL ; 30-150
LDL - 78 mg/dL ; 10-130
HDL - 61 mg/dL ; <100

TSH - 24.5 mcIU/mL ; .27-4.2
T3f - 2.6 pg/mL ; 2-4.4
T4f - 0.9 ng/dL ; .7-1.7
Prolactin -27.8 ng/mL ; 1.6-18.8

TT - 265 ng/dL ; 280-1000
FT - 8.2 pg/mL ; 8.7-55.0
LH - 1.9 mIU/mL ; 2.0-12
FSH - 8.3 mIU/ml ; 1.0-12

Metabolic panel and CBC both looked great. After reading some threads on here I am very confused/concerned about my values. Any thoughts!?

Nothing to be confused about. You definitely have a thyroid problem. And your test is stupid low, especially for your age. You should be getting checked for a pituitary tumour or something along those lines. You LH is out of range low. Maybe the thyroid is using up all of your resources, but I’d be nervous.

What would you recommend as the next step in treatment? I have a follow up in about a month with my GP to recheck values and adjust the Levothyroxine. Should I schedule with an Endo or even consider TRT yet?

Thyroid thyroid thyroid find a good doc who follows dr. Rouzier methods and get after it. Thyroid for me was 5 in tsh. Trt didn’t work for me until I fixed the thyroid. Fatigue and depression evaporated within hours of my first magic pill.

What meds are you on?

Never been on anything until starting 75 mcg of Synthroid this morning

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Following. My tsh is only at a 4.7 so a little elevated. But same symptoms. My total test was at 267 a year and half ago, started trt and has not been much help.

So, thyroid is no joke. OP needs to be tested for all kinds of crap. I’m not saying that this is likely, but they should check for Graves, Plummers, and any kind of tumour (benign or otherwise). You need a good ultrasound of the thing and some blood work. Maybe you will need TRT too, but for right now you need to figure out the thyroid. Thyroid disease is slow progression, except for anaplastic cancer. It should form a visible growth quite quickly. Everything else is slow and you don’t have to rush, other than to alleviate symptoms.

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Ask the doc for armor thyroid or compounded t4/t3. More often than not Synrhoid doesn’t do a good job.

At the risk of sounding like someone else, you need a different doctor. You should have been referred to an endo at least.

Your testosterone levels are lower than elderly men with one foot in the grave, most doctors are afraid of prescribing testosterone and will just shrug their shoulders at very low levels.

Standard of care for TRT is non-existent and most doctors have no clue what they are doing and prefer to do nothing, you should seek private care for your TRT. Don’t expect endo’s to know how to do TRT, most aren’t capable of managing your TRT protocol.

Your testosterone levels should be at the top of the reference ranges, not the bottom, pituitary gland is looking to be the offender and high prolactin could be the cause.

So as far as I’ve gathered… My best bet would be to seek out an endo as well as Imaging of my pituitary gland? How often should I get my labs redone and anything else I should include in my labs?

I would try and fix thyroid first. Same time i would do the following:

See an endocrinologist
Further labs. Like dhea s, acth, cortisol (to help check adrenals), thyroid antibodies, igf-1, fasting insulin,dht
Ultrasound of thyroid
Maybe even adrenals ultrasound
Pituitary MRI
Self Exam your balls

Also if you can’t get your middle leg to perform, use Viagra/Cialis for now.

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If the MRI doesn’t show any tumor secreting prolactin, then prolactin is elevated do to other reasons and you would need to consider starting clomid or TRT, high prolactin is usually treated with cabergoline.

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Thanks for the feedback! If the MRI is negative for a Prolactinoma, should I wait for my Thyroid levels to balance out before trying to get on TRT? Or should I talk to the doc about it soon after?

No reason to wait in my opinion, testosterone will likely still be low when thyroid levels are optimal.

You want Free T3 midrange or preferably high normal.

I would deal with one thing at a time, personally. To each their own, but it’s hard to know what’s going on if you change a lot of things all at once. TRT can be enough of a task to dial in on it’s own without other complications. You’re 21, no need to rush the TRT f you can avoid it.

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Yes thyroid and trt together. You have very low levels like me. I was at 3.5 and 285.

I would go to discountedlabs.com and buy their labs if they are cheaper than what doc charges. If they bill insurance never mind.

Thyroid is easy to dial in. You dose until you are in the top 25% of free t3 range.

Trt is hard. Ranges are 21 max on free t, but 3 years ago they were 25 and years before that even higher. So we don’t know what levels folks really need. Some feel great low and others are fine higher.

You will need a legit trt / her specialist
To guide you when the time comes. Do not use the sick care system of endos and etc.
They are mostly uneducated on the subject and will not do your sickness any justice.

When thyroid worked for me it removed brain fog and fatigue. Without thyroid trt usually won’t work. TRT made me feel good; heal, repair, sleep, libido and more increase

Did you ever have elevated prolactin levels before you dialed in your thyroid?

No I did not.