T Nation

21Yr Old, Suspect Low T


#1

I am a 21 year old male, I lift heavy and eat clean.

I suspect something is up with my test/e2 levels, I have always had a very thin bone structure, a very quite voice, have a difficult time getting erections even in the presence of a hot female, have wide hips/pelvis and womanly thighs (despite being at around 10% BF) and had pubertal gynecomastia since I was 13 (which I had to have removed at 18).

I had bloodwork done when I was 18 in which the endocrinologist said there was nothing wrong with me before I went ahead with the gyne surgery. And I recently had bloodwork done a few weeks ago to see if I am eligible for TRT. To which the same endocrinologist said nothing was wrong at all.

(Bloodwork done at around 8am for both tests)

Estradiol:
125 pmol/L (18) --- 140 pmol/L (21) range: <150

Free Testosterone:
426 pmol/L (18) --- 425 pmol/L (21) range: 90-700

Testosterone:
17.3 nmol/L (18) --- 14.6 nmol/L (21) range: 10-30

Sex Hormone Binding Globulin:
23 nmol/L (18) --- 23 nmol/L (21) range: 10-70

I am in vastly better shape now than I was at 18, I find it very strange that my test is decreasing already, and estradiol is going up (it was high to begin with). The endo said my results were within the range and that these fluctuations can happen during various times of the day, despite the fact that I explained to him they were both taken early in the morning.

I feel like I have no choice but to take matters into my own hands, based off the little research I have done online it seems that 100mg test E every 2 weeks is a safe way to go.

Any input would be highly appreciated, I have never used anabolics before. I am aware that TRT is for life if I start now.

So to summarize my main questions are:

  1. Does 100mg test E per 2 weeks seem reasonable in order to get me into the 600 pmol/L range given my bloodwork?

  2. From what I understand a PCT is not necessary when on such a small test cycle of 100mg/14 days, so will I not need to bother with HGC and/or an aromatase inhibitor?

  3. Given that my estradiol is pretty damn high (140 currently) when the range on my lab sheet is <150, again would an aromatase inhibitor be of any value?

Thanks


#2

Please go back and add reference ranges to your original bloodwork.

100 mg every two weeks is stupid...I have no idea where you got that from...

Treating yourself is stupid when you have little to no clue what youre doing

Injetting every two weeks is stupid...

What does PCT have to do with TRT? You do not understand the meaning of the word. HCG and AI are NOT PCT drugs...they are TRT ancillaries

You need to go to the stickeys here and read them, then find a competent doc to treat you.


#3

Added ranges.

So if injecting 100mg Test E Biweekly is stupid, what would be reasonable if I wanted to be in the 600-800 Free Test range, instead of barely above 400 like I am now?


#4

Okay after reading the stickies and looking at my original post, I can see why it may seem irrational.

I think comparing my blood work from 18 to 21 is just confusing and not necessarily conducive to improving my situation. Also because I live in Canada the units are different.

So let me start over:

Basically, my biggest concern is now my Estradiol level which is 140 (with a range of <150 in Canada) so it is on the very high end. For the purpose of better analysis if I convert it into pg/ml which is used in the US, it is 38 pg/ml.
38 pg/ml for a 21 year old male seems terrible considering the range posted in the Estradiol sticky is 13-54 pg/ml. This would also explain why I developed pubertal gynecomastia in the first place and also why I have a female looking pelvis/hips and a host of other feminine features.

My Total Testosterone (converted into US units ng/dl) is 420 ng/dl within a range of 288-864 ng/dl. Which again seems pretty low and would explain a lot of the low T symptoms I am experiencing.

So as a 5'11 170lb 10%BF (veins all over my forearms yet can never get rid of the fat on my lower abs) 21 year old male that supplements with just about everything (ZMA, Vitamin D, Vitamin B12, Fish Oil etc.) eats an almost perfect daily diet (150g protein/150g fat/<100g carb). Lifts 5-6 days/week, and have been maintaining this lifestyle since I was 17. I have:

Total Testosterone - 420
Estradiol - 38

What is the best way to improve this, or am I stuck living life with an extremely quiet voice, lots of fat on lower abs, thighs, chest and butt while simultaneously having visible veins all over my neck, arms, shoulders and calves. Tired and depressed all the time and only able to get hard once in a blue moon.


#5

You quite possibly have an issue that can be corrected. But you are already set upon getting TRT with hardly any tests to show that you need it.

This is why it is stupid. Nobody is saying you should continue to suffer and let it be.

You need to rule out any other issues that can be corrected and you may not need TRT in the end.

For example, if you have testicular cancer and have low T because of that, what good is it injecting Test without getting treated 1st.

You will fix your low T levels but your issue is still there.

You will want to rule out primary or secondary and what evet else you find and go in that direction. If after everything checks out okay then maybe trt might be needed. Until then you are really short changing yourself.

Your levels are on the low end but you need more investigation.


#6

Okay so disregarding any supplementation with Test E. Would taking an AI like Arimidex (1/4 of a 1mg pill every 3 days seems to be the general consensus) be a reasonable way to lower my E2 and make the T/E ratio more balanced?


#7

YOu should go to the sticky and post the info that is requested on there it will help a lot more.

Also you seemed to have misssed the point about finding out what is actually causing this. Wouldnt you like to know the root of the problem? That will change what the treatment is. Rather than just poke and hope. MOre tests are neccesary


#8

testlevel,

I have similar levels of E2 and T. Only I am twice your age.

The other posters are correct, you need to dig a little to see if a correctable root cause can be found. I am also in Canada, and so far it has been a frustrating experience. Doctors are symptom managers, nothing more. Further, they cannot think outside of the box. Be persistent.

Regarding your diet, I think you are not eating enough. I calculate around 2200 calories a day (assumed 60g carbs), which is nothing for a 170lb, 5'11", 21 year old active guy. Try 3000 calories a day and see how you feel. Also, do you do carb refeeds, and how often?

I'm not saying you don't have an underlying problem, but perhaps some lifestyle changes can help.

  • eat more
  • less cardio, if any
  • shorter workouts (ha, I am one to talk....)
  • check your fat ratios (SAT:PUFA:MUFA), keep SAT high and PUFA low.
  • occasional random day off
  • carb refeeds --- and really go to town on the food.
  • get enough zinc (e.g. 100mg/day + 2mg copper)

If you could get your TT up to 20 nmol/L, would you be happy? If so, give yourself a few months and try those suggestions while you continue to look for a root cause. You've got nothing to lose doing so.


#9

I would like to know the root of the problem, and from what I gather it seems to be the case that I just have messed up hormones, its been this way since I was 12 or 13 when I developed gynecomastia.

Here are some additional figures from bloodwork done last month:

DHEA Sulphate --- 6.9 umol/L (range 5.2-14.2)
C Reactive Protein (High Sensitivity) --- 4.6 mg/L (range <5.0)
Vitamin D, 25-Hydroxy --- 74 nmol/L (range 75-150)
AM Cortisol --- 483 nmol/L (range 140-690)
TSH --- 1.6 mU/L (range 0.38-5.5)
Prolactin --- 7.0 ug/L (range <15)

More than anything I am pissed off that I had to wait a month to see the endocrinologist only to have him say that everything is fine, he refused to even acknowledge that there was any problem at all with the high E2 and low TT.

I am definitely not eating less than I should be, roughly every 3 days I have huge refeeds. I would indeed be happy with TT upto 20 nmol/L. It is extremely discomforting knowing that I it was at 17 nmol/L when I was 18 and was in terrible shape and decreased to 14 nmol/L at 21 despite leading a far above average healthy lifestyle.

I agree that finding a root cause is extremely important, but I really don't know how to do that or if there even is one. I haven't messed around with any hormone altering medications and so on. I know my Vitamin D is below the range and have since upped the pill intake to 5000ui's per day. Surely Vitamin D alone can't account for such atrocious E2 and Test readings?


#10

Vitamin D deficiency may well be your (recent) problem. You're going to need more than 5000 IU/day for a while, then taper to 5000 IU/day and get your levels checked.

This is hot off the presses:


#11

UPDATE:

Found a doctor who agreed that my E2 was too high and TT could use an increase. Right away he wrote me script for arimidex (.5mg twice a week). What a relief, was almost ready to buy non human grade off craigslist after the endo told me to go away.

When I asked about adding T also, he first suggested bioidentical hormones to which I said I would rather have actual T injections. He was fine with this and put me on 100mg Test Cyp per week. I inquired about the HcG (I know this is not necessary right away) and he said we'll see if its needed next bloodtest in March, which sounds great.

Glad I was able to find a doc this reasonable, I guess he would be considered an "anti-aging" doc.

Took .5mg of the arimidex a few hours ago and already I am feeling much better, E2 of 38 at age 21 has made me feel like crap for the last few years, I haven't even injected the T and feel much better.

When I inquired about the T the doc said there was a back order of Test E until the end of the month so he gave me the script for Test C and said down the road I can switch over if I want. He also said to come back tomorrow if I wanted him to show me how to do the injection, so that is what I am going to do.

He said to use a 22 gauge needle, does that sound right for a once per week injection? (I am going to inquire about twice per week)

Also is there much of a difference between Test E and Test C?


#12

Test E and Test C are virtually identical--for our purposes

22 gauge is way too big...get 29/30 gauge insulin pins and inject into your deltoids, teardrops, and upper quads...there are tons of sites online that will show you how to do these...

Your doc may say that you can't inject T out of insulin pins--he will be wrong...

you have the T yourself, so dose it twice a week....no reason not to


#13

In this case I don't think I am going to go back to the doc for the injection, I thought 22 gauge might be too big, the doc seems to specialize in bio identical hormone gels moreso than injections so perhaps I will be better off just following KSman's injection instructions.

I am a little confused though, so I should pickup the 29/30 gauge insulin pins which should always be 0.5" in length? Does this include the syringe as well or are the needles and syringes separate things?

I will try to get the "#29 0.5ml 0.5" [50iu] insulin syringes" mentioned in KSman's post. My Test Cyp is 100mg/ml, so I should inject 50mg(.5ml) twice a week, which means filling the .5ml syringe all the way per injection?

Do the insulin syringes come with detachable needles or can I inject with the same needle I drew the T from the vial with?

Hopefully my questions make sense, just want to make sure I do this properly.

Thanks


#14

Needles are attached to insulin syringes--you can't separate them so they are one unit...you may have to have a script for them, depending on your state...some pharmacists will question you, others wont...just tell them its for insulin and you got your script filled at another store...

Yes you will fill your syringe up to the 50 iu mark each injection....twice a week...

Load times take about 2-3 minutes, so I usuaally just start it and hang it upside down in a toothbrush holder and hop in the shower and pin when I get out...its not a deal breaker eithre way...actual injection takes about 5 seconds


#15

Because I am filling the syringe to its max capacity (.5ml), will I have issues moving the plunger when I aspirate and try to manipulate it to remove air bubbles?


#16

You can't pull it back too far, but you have some wiggle room....for the most part, aspirating will be a breeze because you are highly unlikely to end up in a vein with half inch needle....

What do you mean "manipulate to remove air bubbles"? You don't pull the plunger back at all for that...when you are done filling your syringe, turn it needle side up and flick the air bubble to the top then push in on the plunger very slightly until a drop of oil comes out....easy


#17

VTBalla, thanks for your help. I got the exact insulin syringes mentioned by KSman and the injection went well.

I guess its a good thing that the T also absorbs fine in fat, incase the 0.5 inch needle doesn't quite make it deep enough into the muscle.

When I pushed the plunger down while the needle was in my thigh I did it kind of slowly (took about a minute to empty it fully) so it would get absorbed properly and not wasted.

Is this okay or should I drag it out for 2-3 mins just to ensure it all dissipates?


#18

jesus....my quad injections take me 15 seconds tops....just plug and push...the muscle will absorb it