T Nation

22 Y/O with Low T. Seeking Advice

Hi,
Seeking some advice regarding my current low T issues. Particularly keen on hearing peoples opinion on taking DAA & DIM given my current situation.

Information
Recently self inflicted significant harm to my endocrine system through sarms usage (what I thought was ostarine). At the time I was also placing myself under significant stress through over training, low calorie dieting and lots of work related stresses. To top it off I was also taking finasteride. End result was a complete crash in my testosterone. Currently have all sorts of low T symptoms.

Biographical Details
Age: 22
Height: 188 cm
Waist: 32-33"
Weight: 85kg
Body and facial hair: No issues growing hair
Where I carry fat and how it’s changed: Quite a fit individual, however, do find it difficult to lose that last little bit of fat and become lean.
Medical history: Nil
Rx and OTC drugs, any hair loss drugs or prostate drugs: Finasteride (only for 7 wks though)
Diet: Very clean
Training: 3 times per week
Testes ache, ever, with a fever?: No ache, but do get a tingling sensation
How have morning wood and nocturnal erections changed: Morning wood non existent

Lab results with ranges
FSH 6.9 (1.5-9.7)
LH 1.5 (1.8-9.2)
Prolactin 166 (90-400)
Oestradiol <70 (<160)
Test Total 7.9 (12.0-31.9)
SHBG 63 (17-56)
Free Test 94 (260-740)

Other Notes
Seeking other peoples input here, but thinking I’m secondary hypogonadism (given low LH) likely due to hormonal imbalances from the stresses I have placed on my body. Have seen an endo - his advice is to wait 3 months for hormones to normalise.

Currently doing everything I can to try improve my test levels - eating lots of healthy fats (lots of eggs), supplementing with ZMA and vitamin D, keeping weight training to 3 times per week max, minimising stress, alcohol and caffeine etc …

Feeling like shit at the moment and wanting to ask peoples opinion on taking DAA with DIM to help boost the LH? Really just want to do anything I can (preferably naturally) to speed up this process as this is really effecting my quality of life.

Also planning to start taking ashwaganda for cortisol control.

TRT is last option and would like to exhaust all possible recovery protocols prior.

Appreciate any advice you guys can give, particularly on taking DAA & DIM.
Cheers

Best way to increase LH is trying clomid or novaldex. This can also confirm if you are secondary.

My Dr at the beginning put me on 25 mg eod. No arimidex/anastrozole. After 8 weeks check total t free t ,estradiol , LH , fsh . If the clomid raises t and free t you can taper that off to see if you maintain levels.
At your age clomid def worth a try.

Also for your leisure reading…

Why?
Have you checked cortisol levels? Esp am cortisol?
Acth as well

It only takes one pill for those with certain genes to be ruined, these men are designed to break on the first pill and is irreversible. It’s called post finasteride syndrome, but you haven’t mention but one symptoms, tingling sensation in your testicles which could be from low LH stimulation and not PFS. I don’t believe based off your info that you have PFS.

TRT is your only option as you have two problems both of which TRT will fix and is your only solution. Your liver likely through scarring/damage from abuse in probably not fixable, once the liver is damaged, repaired and therefore scarred from the repair, the damage is done, you’re so young to have high SHBG, usually this is seen in much older men.

You also have secondary hypogonadism and there is no cure, clomid is a no go since it increases SHBG sending your Free T into oblivion. PFS can permanently crash the endocrine system after only one pill with no long term symptoms other than a crashed endocrine system requiring TRT.

It’s TRT or BUST!

Would like to have seen thyroid labs including TSH, Free T3, Reverse T3 and antibodies which you must fight UK doctors to get thorough testing. I hope you’re not in Australia!

Your endo has given you good advice here. Do NOT jump into TRT. You are young, you will most likely recover just fine with time and patience and at your age you will likely cause yourself harm with TRT. Don’t compound one mistake with another. Suffer through for a while and be patient.

2 Likes

Appreciate the advice & reading material.

@systemlord

Unfortunately, I do live in Australia.

Tingling sensation is often accompanied by the testies retracting and tightness of the ballsack. Is this a symptom of low LH?

Given the low LH was due to external stresses, and the HPTA is not shutdown, is it possible for LH to recover with time? The high SHBG, my endo seemed to believe this would decrease as testosterone normalises … reading what you’ve stated earlier I’m guessing this is not the case and I’m screwed?

Plan now is to suffer through life for 3 months and hope things improve. Point taken regarding liver damage - will do everything I can to minimise further toxicity of the liver.

Thanks all

Your testicles are under stimulated and atrophied, this is why you feel tingling. If LH gets any lower you’ll start to feel a dull ache in your testicles. Even if you managed to increase LH to stimulate T production, you have a second problem where your liver is over producing excess SHBG lowering Free T and the correct treatment for high SHBG is TRT.

TRT will kill two birds with one stone, raise testosterone and lower SHBG allowing Free T to increase. SHBG balances total testosterone, free testosterone, thyroid hormones and even insulin. Right now that balance is disrupted because SHBG is high normal and manipulating it is difficult unless you can throw enough excess testosterone at it which is actually what you need.

Australia is anti-TRT therefore doctors are closed minded and scared of TRT do to government oversight/socialized medicine. You testosterone will not normalize ever without intervention. A little naive on your doctors part to believe testosterone will normalize on it’s own.

Endo’s are typically very ignorant in sex hormones related to the HPTA and know almost nothing about how SHBG regulates free hormones, by nature endo’s specialize in thyroid and diabetes, not sex hormones.

You need to seek private care if possible.

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Thanks mate. Sounds like I’ve screwed myself big time here. Given endo has advised to wait 3 months, do you see any benefits/negatives to trying DAA with DIM to at least improve LH slightly while I wait. Thanks

I wouldn’t wait for him to get his head out of his you know what cause it’s not gonna happen, you need to find a specialist’s now as waiting will only prolong your suffering.

DAA and DIM is like trying to stop a freight train with a shopping cart, it won’t do anything. You need intervention now.

You could try stimulating your pituitary. L-arginine is supposed to help with that. Either way, running to hormones when you’ve already jacked yourself using drugs is worse than the initial mistake. Learn some patience. Getting on something now could be a permanent decision, waiting a couple of months is temporary. Don’t get talked into immediate action. Sometimes the best decision is to do nothing and see what happens.

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Alright guys, appreciate all the help. Endo wanted some labs done with a different provider. Here are the results.

FSH: 13 (1-10)
LH: 3 (1-10)
Test: 17.8 (10-35)
SHBG: 43 (13-71)
Free Test: 316 (225-725)

Looks like LH is improving slowly, SHBG has also come down. Will be waiting it out to see how things improve over the next few months.

Hoping to ask - should I be concerned about my high FSH? FSH/LH ratio is very high, my understand is these should track together? Not anxious about it, more curious from a knowledge & learning standpoint. Cheers

Are you taking clomid or novaldex?

If not i would suggest a testicular ultrasound. Rule out tumors.

Read about high fsh causes
Could indicate primary testicular failure

https://www.ncbi.nlm.nih.gov/m/pubmed/22177092/

what age do you recommend tho? i mean if the guy is suffering and exhausted everything then yeah why not at his age?

I wouldn’t necessarily say LH is improving, only that all hormones are always fluctuating, same thing with SHBG, levels are always changing staying within a certain range. My SHBG fluctuates between 16-22 nmol/L.

Gonadotroph adenomas, pituitary tumors secreting biologically active gonadotropins can be a cause for high FSH and normal LH.

Thanks for the replies all. Have booked an appointment to get testies checked out. I’m definitely feeling slightly better with an improved mood and energy. Have started notice some nighttime erections which I’m taking as a good sign! Ejaculate volume is very low, I assume the pituatary is recognising this and is why it’s pumping out so much FHS.

Great to have the support on this forum guys, would be even worse off otherwise as the Drs and endos here in Australia are clueless. Appreciate it

Cheers

Listen to everyone else about the androgens but I’ll add something about the supps. This may not apply to you, I’m just trying to be thorough.

Don’t overdo fish oil (1 gram/day max - better from fish) or vitamin D.

If you’re near sun and young, vitamin d should be dosed under 4,000 iu/day (better to test!). I had 2 mates both supplementing with 10,000 iu vitamin D / day and it seemed to crash both their testosterone. Even in doses like that it can lower serum retinol (vitamin A). It’s anecdotal, I know, but they ate liver a few times, and lowered the dose to 2,000 iu and testosterone came back from 200 to 600 ng/dl in a month. testing is best to keep vitamin d around 30-50 on the american scale (dunno others).

I’m not bashing supps. Intelligent supplementation can be a godsend.

If I were you I’d get more thorough testing, to double check or for a baseline: thyroid panel (ALL numbers - totals and frees, tsh) and glucose tolerance markers (fasting bg, a1c, fasting insulin).

Hope you get to the bottom of this!

Hi guys, 1 month down the track and I’m still feeling shutdown - testies have now atrophied substantially. During the day the testies tingle and hang “high n tight”. I can literally feel the cells dying (tingling sensation), and it is very uncomfortable. I assume they are starved of LH.

Have started taking DAA to try provide some temporary relief. Will be getting more bloods and a testicular ultrasound this weekend.

I appreciate the endos and everyone’s advice to wait it out, however willpower can only last so long and this is becoming unbearable. What is everyone’s thought on low dose clomid to try bring the testies back into action? although I am hesitant due to already high shbg. Will try L-Arginine as recommended if the DAA fails.

FYI - I did run a PCT of clomid and nolva after the initial shutdown, which worked and I was actually feeling great for a few months, however I appear to have crashed again.

Just been diagnosed with coeliac disease also which could be inhibiting recovery.

Thanks all, your help getting out of this hellhole is much appreciated. Cheers