T Nation

21 Years Old and Lab Tests

[21 years old]
Hello,
At first I want to say sorry for following mistakes- english is not my native language, so please be forgiving :). Two years ago I’ve started experiencing, practically every symptom of low t(humour changes,constant fatigue, my brain efficiency became no existent(i felt very inteligent eariel), lost interest in everything, my libido became non existant (I don’t wanna sex at all, although i have a partner for like 3 years), i have erectile dysfunction (it works, but not as it should work), I have almost no hair on chest, back and my beard is only 40% in hair. (I know it now- It didn’t see like it for me then), I had gynecomastia since i can remember, didn’t have any significant voice mutation (if any at all), my penis size at rest hasn’t changed at all during my puberty - theese are things that I’m noticing now- I wasn’t concerned about it at all then.
I’ts also worth mentioning that 1,5 half year before my problems I was at strict healthy diet and 6days x week training (4x gym and 2x Handball). I lost 30 kg/70~lbs 115kg to 85kg (186cm/6,1feet). When my problems started i slowly gained my weight back, since I started to give up on everything that brought me joy before + i lost all the vitallity - 2 hour training on gym started to look like miracle to me :/.
I made lab tests In half way of those two years of problems and testosterone came back at 240~ ng/dl levels 8:00 am test,
I went to two specialists with that and they told me its in norm range and i shouldn’t be concerned and instead I should diagnose myself towards depression, so sadly I did - 2 years of psychiatric help, and 3 months of psychoteraphy later. My psychoterapist told me that this low testosterone should be diagnosed more since I’m 21 years old, my symptoms are more and more intense.
I made tests and educated a bit myself on topic of testosterone but the results that came back today concerned me a bit- since im visiting specialist on hypogonadism on friday, and dunno what to think about it.
Those test i made week ago and they were taken at 8:00 a.m.
FT3 2,30-4,20 norm 3,93 pg/ml
FT4 0,89-1,76 1,81 ng/dl
TTE(testosteron) 241-827 norm 225,16 ng/dl (same lab as the one that result 240 were year ago) CLIA method, ADVIA Centaur XP- Siemens(analyser)
PRL 2,10-17,70 9,81 ng/ml
TSH- completly in norm
Vit d3 36 ng/ml - norms say its optimal

Today i made second tests before my visit - those were taken at 10:30 a.m - since the line was so long i had to wait 2 hours…

|FSH|1,97 mIU/ml|1,37 — 13,50|
|LH|4,37 mIU/ml|2,0 — 12,0|
|Estradiol|↓ 16,0 pg/ml|20,0 — 77,0|
|Testosteron|16,52 nmol/l|1,63 — 34,00| (another lab)
|Cortisol|18,6 µg/dl |before 10 a.m.: 3,70 - 19,40 after 17p.m. 2,90 - 17,30|
Any adviced on if should i follow my diagnostics in direction of hypogonadism, or weirdly it’s all symptoms of depression? That I don’t rly think I’m in. I just lost interest on everything and my life became dull, I dont feel even close of concidering killing myself… Every advice is appriciated :).

Your testosterone shouldn’t be dipping down into the 200 ranges ever, if your levels aren’t consistently higher than 500, you have low testosterone. These ranges are bullshit, younger men in their 20 have levels at their highest in the high normal ranges and then slowly decline 1% every year after age 30.

It’s not alright for a 21 year old man to have the same testosterone levels as present Trump who is 72 years old. Doctors are trained to ignore the patient and treat the reference ranges, you need to go private specialist who know what the F*** they are doing.

The majority of doctors know nothing about sex hormones or what constitutes normal testosterone levels in a particular age group, the only thing they know is in range no treatment is necessary, below range and treatment is necessary.

I can provide a ton of studies proving where diseases strike and at what ranges they tend to occur.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction. Further study is required to evaluate the validity of these testosterone thresholds for CVD risk.

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Thank you very much, you have no idea how much it means to me and how much hope it gives to get knowledge about my health condition plus replies like yours are motivating, after two years of living half dead. The lab i wad cocerned the most was "|Testosteron|16,52 nmol/l|1,63 — 34,00| " - it was same week as 220 level but another lab - thought that maybe first one was false- after visiting endo and getting response that even 250 is ok - was scared that 16,52 is too high for treatment, but forgot that im visiting expert this time :). How about that E2 level - red somewhere that this could also be cause of depression/anxiety like symptomps? Thanks for the response again, ill do my best to gain some knowledge before friday, to be conscious talking to doc.

Your estrogen is consistently low, healthy young men see estrogen higher between 20-30 pg/mL or higher. Low estrogen would cause depression, anxiety and osteoporosis. The majority of doctors are incompetent with anything related to sex hormones worldwide.

Your doctor should be concerned with where your levels are the majority of the time, where they are over the next month, one lab test is hardly a complete picture and is only a snapshot in time of a target that is always moving and fluctuating.

If you failed to go through puberty, low growth hormone could be a reason.

Have you ever had IGF-1 tested?

@systemlord No I have not. Should i do it before the visit? Also should i test T tomorrow or the day after. Maybe any other tests to give him as big picture as possible.
I’m living pretty far away and don’t really know when I’ll be able to visit him second time- so getting there with as much information as possible would be optimal.

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Your 21 need to look at underlying disease.
Your FSH was low could indicate secondary hypogonadism. I would suggest a testicular ultrasound and MRI pituitary.

Could it be?
klinefelter syndrome
Kallmann syndrome
Head injury

I’ve done MRI week ago, forget to mention- it looks all right. :slight_smile: Didn’t have any injury. Will do testicular ultrasound, thank you @charlie12

Ur welcome :+1:t2::grinning: