T Nation

22 Y/O, Primary Hypogonadism?


A lack of SHBG is the definition of incompetence, it shows a lack of knowledge. SHBG testing is the gold standard for sex hormone evaluation. SHBG is a critical component that’s intertwined with Total and free testosterone, it’s the balance between the bound testosterone and unbound testosterone. He’s not a doctor, he’s an registered nurse with no medical knowledge.

These low-T clinics aren’t in the business of treating the complex medical problems that often masquerade as low energy and decreased sex drive. Those can include sleep apnea, depression and other medical problems they just aren’t equipped to deal with because they aren’t doctors. They are wannabe doctors who didn’t earn the privilege of being called a doctor which takes many years in medical school to achieve.

At your age you should be in your prime somewhere in the 800 ranges.



thanks for the input


22 should definitely be in prime, however too many factors account for why he is not. 800 is high for anyone. 600 - 700 is normal.

First off, if you’re looking for the exogenous testosterone route, you need a new doctor as already stated.

Seeing how your T can fluctuate to almost 500, I don’t see why you can’t do it yourself. Most people think it happens overnight. It doesn’t. It takes dedication and time.

What’s your lifestyle like?
Complete diet?


Wow didn’t know it was that precise, :pray:t3:


Thanks. Given that I am extremely fatigued at all times, very irritable and cyclicly insomniac/nocturnal I cannot perform at a job so currently unemployed. Only exercise I can do right now, I go on 1-2 hr. walks approx. 3 days a week.

And I’m confused at the part where you said you don’t see why I can’t do it myself. Do what myself?


I think he means solving the low testosterone naturally with extreme dedication by changing diet, exercise and hard work. Sleep is a big one, getting less sleep one week will see testosterone low the next. If it continues so to does the decline in testosterone until you get to a point where you have symptoms.

You are secondary which is lower LH which can be manipulated to a certain extent, the pituitary is falling asleep on the job. Primary is a failure of the testicles where LH would be very high over the ranges, basically the pituitary is screaming (high LH) at the testicles to get to work. Your case isn’t the worst I’ve seen and you need to be looking at the thyroid, low thyroid can cause depression where it didn’t exist before.

Most doctors don’t order enough lab tests, one way you can check thyroid status is oral body temperatures using a glass thermometer upon waking (97.7) and at 2pm (98.6). It could be as simple as an iodine deficiency do to a lack of iodized salt in your food, thyroid requires iodine. If you failed to bring temperatures up to normal you would need to check Free T3, Free T4, Reverse T3 and antibodies.

Oral body temps will tell you if the active thyroid hormone Free T3 is low, sometimes Reverse T3 can be high which counteracts good Free T3 levels which has the same effects as low Free T3. Lots of people are scripted SSRIs for depression and anxiety instead of thyroid medicine.


Hello guys, quick update here. At the moment I am all scrambled up and I am pinching myself.

I ended up going through with TRT through a clinic based out of Georgia. I discussed my concerns with the CEO of that clinic regarding my thyroid health but they were not going to help me with another blood test to check my thyroid hormones as per my suspicions.

At that very moment I had to decide whether;

  1. I was going to forgo the TRT for quite a while and try to get a thyroid panel through my insurance (which would take up a lot of time) before deciding to go on TRT or not
  2. Start my TRT journey right then and end my suffering asap

I decided at that very moment to go ahead with the TRT program as I was sick and tired of waiting for months to treat this issue head on and end my suffering via many low t symptoms. I feel like I made the right decision given my circumstances.

So fast forward to 2 days ago (Tue. 6/7/18) and I have self administered my first ever T Cyp and HCG shots.

Heres where I am a bit shaken up

Yesterday I went over @KSman sticky on Thyroid health and took his advice to check my oral temp. So I went to local pharmacy and bought myself an oral thermometer.

This morning immediately after waking up I took my temp and I was at 97.4 F. KSMan says 97.3 and lower is a problem indicator. I figured nothing to alarming so I waited until mid afternoon like he recommended to check temp again.

At 4:15 P.M. today took temp and I was at 97.5 F. Now this is pretty low and def a problem indicator solidifying my theory of functional Hypothyroidism.

Now I am stressing out wondering if I should
a) Continue TRT but add Iodine supplementation
b) Drop TRT altogether and go get thyroid panel, optimize thyroid function to avoid poking myself for the rest of my life

My main concern is that if I drop TRT and try to go full natty I may never get to optimal T levels naturally and will simply waste a lot more time and suffering trying to fix a possible cause of low T in the first place in a natural way. As opposed to pinning myself for the rest of my life from such a young age.


Did you ever take the thyroid labs? Maybe check am cortisol as well to check for adrenal fatigue.
Check iron as well.

At 22 need to check for EVERYTHING. CHECK FOR UNDERLYING ISSUES. THE CAUSE. Yes you may end up on trt but critical to check all first.
Btw when my hormones are balanced my temperatures r good when not I have cold hands and temps r low. For me nothing to do with iodine.

Btw what mg did u take in you first shot?

You say you have insurance, can you give a list of things you want the Dr to check and he order labs?


I would never start HCG right off the bat, it’s difficult to know what’s causing what. Start TRT only and add HCG later so you will know if it’s the HCG making you feel bad, add one thing at a time.


I have not yet done the thyroid labs or Iron or Cortisol. I don’t feel cold or have cold hands or anything like that. I can set an appointment with my doc and see what he says. I have never met my new Primary Care doc as I just got health insurance a month ago.

My initial protocol is 100mg Cyp. Tue along with 40 units HCG and 1 AI pill. Then 40 U HCG on Wed.

Could low oral temp simply be from having low T for so long and not have to do with Thyroid?


Yes. And adrenal fatigue also. Many other things can cause hypothyroid. Make sure you are using iodide salt and that your multi vitamin contains at least 100 mcg selenium and 150 iodide.

Am thinking if you want to investigate further and stop after first injection should be fine. But I am not sure.


how do you test and treat adrenals? You test Cortisol and Adrenaline?

And you do you treat adrenal fatigue?


Hello fellows quick update I have been working 24/7 on my condition and I have made some very good progress so far.

A day following my last update I decided to drop the TRT program I had started after just 1 weeks worth of shots in pursuit of a natural approach to my condition.

Since then I immediately did a Thyroid and Adrenal panel which indicated I have “subclinical” primary hypothyroidism. The results are as follows.

rT3: 20.2 ng/dL (9 - 24.1)

Regarding rT3 : Should be < 15 by standard labs. Higher levels often indicate poor thyroid conversion and are associated with high stress levels.

fT3: 3.8 pg/mL (2.0 - 4.4)

ft4: 1.32 ng/dL (0.82 - 1.77)

Cortisol - AM: 12.9 ug/dL (6.2 - 19.4)

TSH: 5.380 uIU/mL (0.450 - 4.500) HIGH

Also Antibodies all came back negative.

I will say I am currently working on something big as my official strategy for taking on my problems naturally which I will be announcing in the near future. As for now I want to hear your guys input on my current summary.

My oral temp is performing perfectly well.

What is causing high TSH? Prolactinoma is out of question as LH and FSH are in normal range. Possibly Hashimotos disease? Yet Antibodies TPO and thyroglobulin came back within normal range. Possible Iodine deficiency? Or is it simply the elevated rt3?

According to the article from Dr. Westin Childs rt3 above 15 indicates poor thyroid conversion and are associated with high stress levels.

Perhaps the Hypothalamus response to poor thyroid conversion is elevated TRH and in turn elevated TSH by the pituitary. This is why you should never just go by the lab range and go by documented clinical trial via further self education. Sorry thinking out loud.

Why is my E2 so low? FT to TT ratio is in normal healthy range at 2-3% so that rules out elevated SHBG right? Im sure the cause of this is the same factor causing my low T, subclinical primary hypothyroidism, and associated diseases.

Low T
Low Free T
Low E2
High TSH
Elevated rT3

Please let me know what y’all think of this.



SHBG+T bound -->Free T–>E2, so sometimes when Free T is low, E2 can be low as well. This is your smoking gun and is confirmation of low T status. Reverse T3 is the only explanation for high TSH, some guys can have high Reverse T3 and it has little effect, others will have problems do to genetics. Same thing with high SHBG, some guys can have very high SHBG and still have enough Free T, others will have problems do to genetics.


Guys Im really going fucking mad right now.

I have created a genius custom panel (which already has all the codes on it for labcorp) to test all of adrenal function and more under the suspicion of (hypoadrenia -> low cortisol) or (low Iron) which is causing elevated rt3 via the liver causing my hypothyroid and low DHEA is causing my fluctuating/LOW testosterone.

I saw a Dr. today and first thing the arrogant pompous bitch did was shoot down my proposed test, and she said she would not order it and I need to see an endocrinologist instead. She said I don’t know what I’m doing and made some fucking snide remarks. I literally wanted to punch her square in the face I swear to god.

I would bet a lot of money that an endocrinologist would not even come up with a test as accurate, comprehensive and intelligent as the one I spent countless hours creating. If any of you want to see it, let me know and I will post it here.

And in case you guys are wondering, this silver spooned, trust fund baby old clam has been in practice for 30 years! And she could not even address any of my health problems. Not ONE SINGLE bit of input. Im telling you I’ve become real jaded and outright disgusted with Dr’s in general now. I’ve dealt with many of them, and I can easily say they are by far the most conceited and egotistic scumbags I’ve ever dealt with in any line of work. I mean they cannot use their brain cells (or lack thereof) for anything other than touting their authority by accreditation horns and masturbating in the mirror.

Now I have to hope that the next Dr. I see will order the test (which is highly unlikely), and then get a referral to an endo and hope they are competent enough to understand the test I created and order it. That could be more weeks and months. Im really at the end of my nerves here. Theres no possible way I could ever afford to do the test out of pocket, it will be thousands of dollars, so I have no choice but to keep going through the damn system until somebody takes me seriously.

I need your guys help if anything even for peer therapy because I really am fucking raging right now. I feel like everything is designed to be in my way. I am only doing this my way because it’s the best way and the only two things keeping me from doing it my way are Doctors and money. I am sick of dealing with god damn imbeciles at every turn.




As far as TRT is concerned, you need to leave sick care to get properly treated. Doctors who take insurance must keep costs down or else they could get in trouble from insurance companies, this is why doctors do minimal testing and the reality is stuff goes undiagnosed.

When you start paying for everything doctors aren’t going to fight you, their going to assist and support you. I have good insurance, but the doctors in sick care only care about ranges and have poor knowledge in hormonal areas of medicine.

I pay $2000 yearly for TRT and peptide injections through Defy Medical, it includes medicine, labs and consults.


Yeah but I am not on TRT. Everything I have been doing and am working on is to figure out why I have low T in the first place and I really feel like this test will finally give me the answers I have been looking for. TRT is my very last option


I understand you want to get to the bottom of what’s happening and why, your proper diagnosis depends on the skill of the doctor.

A lot of guys get tested to find out why testosterone is low and most test come back normal, there is some chemical in the environment that is causing these hormonal disruption. Scientists just found a chemical in household cleaner that is causing obesity in children and is changing gut bacteria, we are surrounded by chemicals.

Mosquitoes are eating plastic and spreading it to new food chains. Birth control in the water table, I give us 500 years before we are all gonners.


You’re right, there really is something epigenetic in nature going on in our world today. More young men of my generation are being diagnosed with androgen deficiency every year. It’s staggering how many young men are developing low T. It’s becoming pretty common now to see guys like me in their 20s with low T as opposed to the normal 30-40+ year olds.

Everything from RF energy in our devices to cleaning agents to glyphosate being sprayed onto our foods etc. is causing what I deem a modern epidemic of serious endocrine problems.

I will stay saddled, hold fast and do my best to find a good endo to work with me on this. I’ve come so far trying to figure this out, and if this last test doesn’t confirm my hypothesis, then I’ve done my due diligence and will start TRT, because I cannot possibly think of any other possible causes. Most likely Defy or Entourage.