T Nation

22, Low Total T, Normal Free T, Number of Weird Symptoms


#1

Hi guys, I am writing here as someone might give me a good advice at how to approach testing for my condition.

Little bit about me:

6.2 inch
255 lb
Not muscular, just fat.
Pubic hair, little bit of chest hair, sparse beard (with a lot of space not covered).
Penis has always been under my peers size since I was a kid (now 11 cm erected).
Normal size testicles.

My lab results:

Somewhere in 2015 (21 years old) I have had testosterone (total and free), LH, FSH, E2 and something else tested. I don't remember or have those numbers anymore ,but I do remember that my total T was border low (something like ~300) and I was sent home with advice to loose weight and I am going to be good as my LH and FSH where normal (don't remember anything about free t).

Later in 2015 I had total T tested at 325 ng/dL and TSH: 1.71 uIU/mL. After that was sent home with "All good".

Than I was tested again:

05/12/2016 11:24 AM

Testosterone, TOTAL 385 ng/dL >=240 ng/dL
TSH 1.03 uIU/mL 0.40 - 4.20 uIU/mL
Prolactin 8 ng/mL 2 - 18 ng/mL
LH 4.0 mIU/mL 1.0 - 12.0 mIU/mL
ALT 48 U/L 0 - 36 U/L

Then retested with additional tests (with free t and cortisol requested by endo):

05/18/2016 8:34 AM

Glucose, fasting 94 mg/dL 60 - 99 mg/dL
Cholesterol 155 mg/dL <=239 mg/dL
Triglyceride 129 mg/dL <=499 mg/dL
HDL 34 mg/dL >=40 mg/dL
Low density lipoprotein calculated 95 mg/dL <=159 mg/dL
Iron 141 ug/dL 50 - 212 ug/dL
Iron binding capacity, unsaturated 221 ug/dL 110 - 370 ug/dL
Total iron binding capacity 362 ug/dL 228 - 428 ug/dL
Transferrin % saturation 39 % 14 - 57 %
PT 13.9 second(s) 11.7 - 14.3 second(s)
PT INR 1.1 Ratio
ALT 36 U/L 0 - 36 U/L
AST 19 U/L 10 - 40 U/L
Ceruloplasmin 18 mg/dL 16 - 50 mg/dL
TESTOSTERONE, FREE, CALCULATED 101.3 pg/mL 59.0 - 166.0 pg/mL
CORTISOL, 9H POST 1MG DEX 1.6 ug/dL 0.0 - 1.7 ug/dL

And that is about it with the tests, I couldn't get anyone looking into my tow total T and I have no idea what kind of calculations they have done for my free T.

As my symptoms goes:

1) No morning wood in my lifetime (well 3,4 times I can remember ,I really wanted to pee and I was about 14 years old).
2) Always had problems with maintaining an erection.
3) Always has been fat even playing sports like hockey, basketball all my childhood (my diet was under parents control).
4) I have been to urologist appointment 6 or 7 times in my life (starting from 14 years old). I periodically have shooting pain in my balls and sometimes in penis, burning sensations in penis after ejaculation and recently started having problems with urination. Tension in testicles (light massage is helping a lot).

Urologist could not find anything except underdeveloped prostate which showed up on scan. All STDs where checked and negative, cystoscopy showed nothing except weak urine flow.

5) Libido has always been off, never had an urgency of having sex or something ,cute girls are more of good art for me, but if there is a chance to get sex I am trying to do it as in my brain I understand that I want to be normal. During sex I am usually finishing in a minute and can't make it last longer, "recharge" time is very long (~5 hours).
6) Muscle gain... Forget it ,no matter what I do, it is the same as I had since 14-15.
7) As of my mood... I have always been a moody person, depressions and pessimism are the things to describe me (it doesn't mean that I never have good mood or I can't laugh) ,but usually depression is happening to people sometimes ,for me it is vise versa: good mood - is something that is happening sometimes.

There is much more to go detailed about, but I think that is enough to get an idea. I kind of thought it is the way I am and I am chosen to deal with that stuff or it is in my head, but number of shit happening with my body is getting other whelming, so I think there is something medical involved.

If you have any idea what I can look at as a reason of my low t and symptoms, it would be helpful.
My plan is to do full thyroid, pituitary, testicular testing to rule out everything and if still nothing found I am going to commit to TRT (I didn't do sperm count yet ,but I am kind of sure that I am already fertile as a banana).

If you wan't any additional info ,just ask for it.

Thanks.


#2

I have some new investigation tests done. Hope to get some info from you guys. Especially evaluation of my thyroid tests.

So the tests that have been done so far:

Albumin 4.8 g/dL 3.7 - 5.7 g/dL
Calcium 10.1 mg/dL 8.5 - 10.3 mg/dL
TSH 2.00 uIU/mL 0.40 - 4.20 uIU/mL
Free T4 1.2 ng/dL 0.8 - 1.7 ng/dL
T3, Total 113 ng/dL 50 - 170 ng/dL
LH 4.8 mIU/mL 1.0 - 12.0 mIU/mL
Cortisol morning 18.6 ug/dL 8.0 - 25.0 ug/dL
Creatinine 1.05 mg/dL <=1.34 mg/dL

My main question would be: Should I investigate in Thyroid more or it is fine?
My body temps are:

8am: 95.6
12pm: 97.8
6pm: 98.6 (I did drink coffee 3 minutes before taking this one).

I am waiting for TT/FT and E2 ,that should be back after holidays I guess.

No matter what my results are going to be I am switching my insurance from Kaiser to Cigna, so I don't have to fight for every test to be done. I have an appointment with a good urologist in August, hope he is going to be open for HCG 3 month high doses therapy for a restart attempt. If it doesn't work I hope I am young enough to recover my LH/FSH to the same levels I have right now and try clomid after the recovery. If even that doesn't work classic TRT is my only option.

I kind of don't understand why no one reply in my topic, if I have missed something, please let me know.


#3

Have you expressed your concerns to your urologist over your T levels? What did he say? It's weird he thinks your levels are normal judging by your symptoms.


#4

I have been to 6 urologists so far.

1st told me I have prostate infection (no test except prostate physical exam) and treated with antibiotics.

2nd told me I have infection again (no real tests again), treated the same way.

3rd time the same and I was additionally told that I have enlarged prostate. (I had prostate fluid examined for infections and stuff, all clean and no signs of infections). Also I had cystoscopy, all good except iron flow, it was weak. I was given beta blockers as an experiment to help with urine flow. I don't know did they help or it simply went away on its own ,but after half a year the problem disappeared, I dropped beta blockers after about 4-5 months as I stopped ejaculating on those pills and it scared me off.

4th time I insisted on ultrasound of my prostate and underdeveloped prostate has been discovered (small size of the gland). Interesting how I was told that it is enlarged, right... While doing the ultrasound the doctor saw that I have striae on my abdomen (I started getting them when I turned 20) and desided to check my hormones. That is how low T was discovered.

5th urologist told me my T is in range and he has a lot of patients like me and it is unknown what to relate my symptoms to as they don't fit to any known condition. (Translation: Go f**k yourself, I am not treating you and don't care).

6th urologist visit was the same as 5th one.

Having 7th opinion on new insurance and with a very reputable Doctor in August.


#5

What was your total testosterone like on 5/18/16?

Total testosterone of 385 ng/dL isn't in the low range, though some doctors will treat it.

Your free testosterone isn't low. 65 pg/mL is considered to be the cut-off for hypogonadism, although some will advocate replacement up to 80 pg/mL.

How about find a personal trainer, and get yourself into shape? Weight loss isn't easy, but shifting 30 or 40 pounds could improve your hormone levels.


#6

No number is Low or high when talking about a particular individual. Morgentaler said that in his practice, he doesn't offer replacement to a symptomatic men with TT over 400 and FT over 100 pg/ml. He said that ft less than 100 pg/ml in especially a younger male is indicative of TD.

All I have learned is there's no threshold like doctors like to treat all problems, but in hormones, everyone devolops symptoms at different levels.

However, I just saw OP is overweight, you need to work on that and see if that maybe causing low levels.


#7

New test results are available:

VITAMIN D, 25-HYDROXY 33 ng/mL 20 - 79 ng/mL
ESTRADIOL, ULTRASENSITIVE, LC MS/MS 38 pg/mL < OR = 29 pg/mL

Well, about being overweight... I am starting to treat it as a symptom not the cause as:

1) It is very very very difficult for me to lose weight, I spent most of my life playing sports with training sessions 5/7 days a week and unlike my peers I wasn't losing any fat or gaining any muscle.
2) I am on a very cal deficient diet (1500 per day) and losing about 3lb a month (I am also doing fitness 2-4 times a week). On month 4 (right now) I stopped on 247 pounds and the weight is not moving for like 3 weeks already. I can't cut more calories as it would be dangerous to eat even less. I also had 4 days when I went up to 2300 cal a day (not extreme deficient) and I gained 4 lb.
3) I never have been overeating in lifetime, always played sports and it feels like if I do give myself even smallest slack ,I am gaining fat as an insane maniac.

P.S. With high estrogen I guess HCG is out as an option? Should I try AI mono therapy? Get the estro to 20s and see if it will raise my TT?

Due to estrogen level I have to mention that I have always had puffy nipples and mild gyno. Fat has always been depositing in my butt and on sides of abdomen. I am always crying (can control it with my mind) when I get emotional. (This last one I even has been to a psych doctor ,as it is very annoying and I simply can't fight it anyhow. I wonder can it be caused by e2 levels or not.)

Thanks for reply guys. I am waiting for TT and FT tests, they should be out tomorrow.


#8

Weight loss is difficult. If you're shedding 3 lbs a month, that is good progress. Keep it up for a couple of years, and you'd be down to 190 lbs.

Calorie counting isn't an exact science either, but it's the best tool we've got. Are you sure your numbers are accurate?

If you want a comparison, I'm currently around 230 lbs, and a similar height to you. My free T is lower than yours (around 70 pg/mL) and any total T is a bit higher (400 to 450 ng/dL). I'm losing about a pound a week on 2600 calories, though I'm probably more active.