T Nation

22 Year Old with Questions

Hey everyone,

I am 22 years old and have been having all the symptoms of low t for about 2 years after I lost 100 pounds. I have an appointment with an endocrinologist in a few days and want to be prepared. I have gotten blood tests done and here are my results. I know I didn’t get all of them done but I was paying out of pocket and had to be picky. I have insurance now so I will get more done. Any help would be appreciated.

LH is super low and it’s no surprise that T is also low. You also need SHBG, E2 Sensitive and free T checked along with a host of others. Don’t let these Insurance doctors tell you you’re normal just because you’re within range, insurance companies typically don’t cover you 1 point above the low normal range.

There’s little chance your insurance doctors are going to be able to help you anyways, they simply don’t know how to do to your TRT because they learn nothing about trt in medical school. Most guys end up paying out-of-pocket for a doctor that knows what they’re doing.

I do have an appointment with a different doctor (an endocrinologist) so hopefull he is better than my last. My last was god awful so it can’t be worse

I met with the endocrinologist today. He basically told me that the reason I have low t is because of being depressed and anxious and that after we do a bunch of testing to rule out a tumor or anything like that, I should just see a therapist to see if that helps. Has anyone dealt with that before? Frustrating because I think the low t is the cause of the depression and anxiety. On another note, he seemed very knowledgeable about causes of low t and everything so that was a plus. Any help would be appreciated!

That’s what they all say ! Next step is antidepressants until you realise that this won’t work . And you’ll go back on trt when you get tired of hearing doctors telling you that it’s in your head.

I have not been on TRT. Any chance that a previous eating disorder is causing my low t? I was on a very low calorie (1200/day) and low fat (30g/day) diet for about a year and was exercising a ton.

So because the cause of low T is depression you are refused TRT, amazing stupidity! The use of SSRI’s will make a bad situation much worse! The likely cause of the depression is the low T, throwing medication at the problem is like putting a bandaid on an open bleeding wound.

It’s time for a new doctor.

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You lost 100lbs rapidly. Yes it was good to lose that fat, but your body saw that as starving to death. So yes your body slowed down your metabolism in order to keep you alive through the famine. Our bodies were never designed to deal with a constant over abundance of food and intentionally not eating. Yes eating disorders very well may have screwed you up.

What came first the depression or messed up hormones? Who knows, who care they are messed up and anti depressants do not fix that. If you think doctors are bad with a mans hormones you should see what they do with depression. The real kick here is that a major system of low T and or too much estrogen is depression. Guess what a lot of anti depressants do?

So what would be the best treatment protocol? Using a SERM to jumpstart my production or will my body just go back to low t after I taper off?

Not only that, but SSRIs can potentially cause low T all on their own.

@Ksman can you chime in?

Just got another test back

Total T: 241 ng/dL (240-850)
Free T: 6.51 (5.25-20.7)
Bioavailable T: 65 (83-257)

Done by the Mayo Clinic in Rochester (my endow wanted the best of the best to do my labs)

It worries me that SHBG wasn’t tested which is the gold standard for sex hormone evaluation, your T is obviously low across the board. Those ranges are go absurdly low.

the best of the best, that dont help if he does not order the right labs. Alot of drs, like mine, prescribe T replacement but have no clue how to monitor and adjust. Systemlord said earlier need e2 sensitive test, free t3 free t4, shbg

I tried to get e2 but he said since I don’t have sensitive nipples or gyno then it’s not an issue

Your doctor is a moron and missed the two most important male hormone tests, you need to say goodbye to this doctor as he sounds inexperience. Most doctors are uninformed when it comes to TRT.

I know by a few of the things he has done he sounds like he doesn’t know what he is talking about but during my visit he was really smart for the most part. When he was explaining everything to me and teaching me about all the different things he was spot on as far as information goes. He is just iffy on the tests but that’s probably the insurance companies interest more than anything

Your doctor has made some downright troublesome statements that are cause for concern, a therapist can’t do anything for your low hormone state, prescribing medications, SSRI’s will only worsen your condition.

If you’re alright with substandard care who am I to argue.

Good point

Just an update. I had an MRI done and it came back with a 5mm cist but the doc said that shouldn’t be the cause of my low t. Had cortisol checked and that was fine. Prolactin was fine as well. My free T4 was in the middle of the range. We have done every test necessary and everything came back fine. He said my options are either go on TRT or wait to see if my levels improve. I asked about Clomid but because I have a slight pituitary tumor I can’t go on that since it could increase the size.

So we can’t really find a cause.

I have an apt tomorrow to discuss treatment options.

My question is: is TRT the only viable option? I’m
thinking so. I am going to ask about hCG to preserve fertility as I am only 22 and want kids in the future.