T Nation

22 Year Old Seeking Advice

Hey guys seeking advice here. Been to mens health clinics, endos, uros, etc. and I’m left with my last resort being to tank my levels so I can be treated.

I’ve been trying to pinpoint the reason for my low T and I feel like it’s due to me using an SSRI called lexapro for 2 months, but before that I used effexor for 2 months as well. I started using these after being prescribed them because I had a concussion and I was severely depressed during recovery. I sleep walk and fell a good height onto the back of my head.

After using lexapro and stopping cold turkey I’ve been plagued with brain fog, low motivation, low energy, concentration issues, and the reason why I even figured out something was wrong with my hormones, low libido. I had ED trying to get it on with my girl and ran to the doctor the next day. Over 2 years now I’ve had many different blood tests and opinions and all the doctors seem convinced I’m fine.

Bloods 1 year apart:
Estradiol: 98 pmol/L (ref < 159)
SHBG: 19 (12 - 60 nmol/L)
Test: 13.5 nmol/L (8.4 - 28.8)
Free Test: 399 pmol/L (196-636)
Prolactin: 5.1 ug/L (4.0-19.0)

1 year later:
TSH: 1.72 0.32-4.00 mIU/L
Free T4: 11 9-19 pmol/L
Free T3: 4.5 2.6-5.8 pmol/L
Prolactin: HI 20.8 4.0-19.0 ug/L
Estradiol 66 <162 pmol/L
DHEA: 10.9 <15.0 umol/L
Test: 14.5 8.4 - 28.8 nmol/L
Free T: 455 196-636 pmol/L
SHBG: 12.3 10.0 - 70.0 nmol/L

Throughout these years (2) my test has been as low as 12.8 nmol/L, highest 14.5 nmol/L.
I’m 6ft, 180 lbs. Was given HCG monotherapy with a mens clinic, worked for everything except libido, was very expensive as well and I couldn’t afford it so I decided to stop and seek TRT through the doctor. Before HCG I was 162 lbs, after I was 180lbs. 500 IU 2x weekly. Stayed on for 4 months. I also worked out before, during, and after treatment about 3-5 times a week.

I didn’t include the HCG bloodwork, the first bloodwork is much before treatment and the last one is much after.

Labs as of last week

TSH: 2.47 0.32-4.00 mIU/L
Free T4: 13 9-19 pmol/L

Thyroglobulin Antibody
12 < 40 kIU/L
Thyroperoxidase Antibody
<9 < 35 kIU/L

FSH:5.0 1.0-8.0 IU/L
LH: 3.0 1.0-7.0 IU/L
Test: 12.8 8.4 - 28.8 nmol/L

Every doctor I see says my endocrine system is fine (except the mens clinic which under no circumstances would give me actual TRT) and the problem is something else, most likely my concussion. I’m seeking some advice on what to do at this point.

Thanks in advance.

Have you sought a private TRT doctor? We have a “men’s clinic” here and they are only after money, idk if that’s the same as yours.

I use Justin groce at the restore clinic. Very big on finding a way to alleviate symptoms while staying in healthy/safe ranges. Super smart dude.

I was put on trt at a young age as well and it was a task trying to get it.

T levels aren’t great, but not awful. Libido and ED likely due to high prolactin. I would investigate and exhaust that thread before TRT. Finding cause of high prolactin and lowering it is your lowest hanging fruit. Probably associated to head injury.

1 Like

I’m now seeing a private TRT doctor after I get blood work again, too many doctors have completely wasted my time and money it feels like.

I’ve been taking vitamin E, my endo said my prolactin is at the high range but he’s not worried about it so I don’t know. In Canada, it took me 1 whole year to get this endo and will take similar to get another one. Talked to my GP, again they’re not concerned about my prolactin. I’m stuck.

Your prolactin is barely above range.

You can try p5p form of vit 6 to bring it down a bit. See if that makes you feel better.

I think 100mg a day can help.

Vitamin B6 is an essential vitamin that’s converted into it’s active form, known as Pyridoxal 5-Phosphate or P5P in short, by the liver

1 Like

Typical. The symptoms you describe sound more like low DA/high PRL than low T (although there can be a correlation). Since you’re young, I’d take the others advice here and use P5P 200-300mg daily to bring that down and retest

You seem to be focusing on only the Total T, when you should be looking at the Free T which is closer to the top end of the ranges.

Your Free T remained pretty consistent on both labs even though they are a year apart. The SHBG can fluctuate and can increase or decrease the Total T while affecting the Free T which is exactly what I see in your second test.

You can see the Total T decreased and the Free T increase.

The SSRI’s can increase the prolactin.

1 Like

I see, so my total T is not much of an indicator here solely. So my Free T being good, may my issue not be testosterone related like the doctors suggest?

Sounds like solid advice, I’ll pick some up and retest then. Hopefully my issues clear up, thanks.

The Total T is inactive, the Free T is what your body needs and is better than midrange.

So the idea being, guys hop on TRT to increase their Free T, but you have to raise total T in order to do that?

The impression I’m getting is my testosterone is not a problem in this case, regardless of the symptoms.