22 Years Old - Hypogonadism


22 Years old
6’4’’
don’t know waist measurements
~200 lb
body and facial hair is ok, can grow a beard, hair everywhere.
BUT i carry my fat on my thighs and hips

Been feeling tired and not much libido for a long time now. I sweat pretty fast and hefty. I have dry skin. I recover very slowly. I got my test checked the first time when i was 20 - something around 12 nmol/l. Doc said everything was alright. Later i found out i should be in the 20-30 nmol/l range. One time, i tried DAA combined with a weak aromatase inhibitor. What happened: I felt a little bit better and i started to lose hair instantly (-.-).

Half a year ago i went to see an Urologist. Checked for hypogonadism, found out that my T was at the lower end, wanted to give me a shot of T-enanthate to see if that’s my problem. I said i wanted to rule out possible causes first, tried to fix my sleeping pattern, why was (and is still) pretty bad. It takes a long time for me to fall asleep and most of the time i wake up feeling drained. I will try to go to bed at the same time every day and be active in the morning in the future - hope that helps.

I got my hormone levels tested a few more times - results are below (image). As you can see, things actually got better. But it’s still far too low. During/after puberty i did a lot of weight training and cardio, often overtraining. Do u think that could have cause my low T?

After seeing the latest poor results, i decided to give the replacement a try. Got my first shot five days ago. He gave me 250mg Test Enanthate. Interval should be three (!!) weeks. I understand now that this is a pretty horrible shedule. However, i felt pretty good the last few days, is that placebo or will the enanthate be that fast acting? Now i’m pretty worried about Estradiol. Given my elevated E2 without any T replacement, this now has to be through the roof…and it feels like i have some gyno growing underneath the skin. Again, this could be placebo as i always had a little bit of something there.

Never taken any hair loss drugs.
My Testes did never ache.
Nocturnal erections were very weak, sometimes gone for extended periods of time. This changed dramatically while on Testosterone.
Maybe i should continue to improve my sleep and start to restart my HPTA with a SERM?

I have hypogonadism too. I started on 300 every 3 weeks. It is a TERRIBLE plan. You will feel great for about a week, and then your estradiol is going to skyrocket putting you right back where you started. I started getting gyno symptoms as well (itchy chest, sensitive nipples) due to the high dosage of test.

You need to try to get your doctor to let you self inject twice a week. Weekly injections at the very least.

Hard to understand your SI units for labs and really need to see the lab ranges.

Please CAREFULLY read the ‘for new guys’ sticky and posts your waking and mid afternoon body temps, also show degrees F, and your history of iodine intake from vitamins and iodized salt.

Look at the size of your blue genes for waist size.

Can you self inject T?

“What happened: I felt a little bit better and i started to lose hair instantly (-.-)”
Possible increase in T, DHT increases and male pattern hair loss triggered. Watch for same with the T shots.

What are the standard imperial units? Gonna convert the data, then work out a new chart with lab ranges.
Will take temperature measurements tomorrow. Iodine intake shouldn’t be a problem, always used iodized salt. But i’m pretty sure i can get my doc to measure my Thyroid hormones.
My jeans are size 34.
I didnt ask my doc if i could self-inject yet. But i’m definitely up to that.

About that hairloss - that’s what i thought, too. I guess the aromatase inhibitor left the T open for the 5-reductase(?).

I already asked my doc what he thinks about HCG to maintain fertility. He said that this wouldn’t really maintain fertility and that it originated from bodybuilding. I didn’t bother to argue with him yet, but i’m pretty sure he doesn’t know too well what he’s doing.

Doc is a typical idiot, running on opinion and ego, empowered to make up facts.

The effects of T on the HPTA with “body building” are exactly the same as with TRT. Either will shrink the testes, in time creating irreversible damage.

http://jcem.endojournals.org/content/90/5/2595.full

I hope the units are understandable now. I think the free androgen index is just the ratio of total test and SHBG, multiplied by 100.

Temperature readings:
morning: 96,62 F
mid-afternoon: 97,8 F
evening: 98,15 F

Maybe i should try to get my doc to prescribe some Tamoxifen to restart my HPTA?
Injecting every other day really isn’t something I’m looking forward to. Though i will do it if necessary.

I greatly appreciate the advice!

Your body temps: If the readings are accurate, you have a good case of functional hypothyroidism. Keep sampling the temperatures.

Temps: Taken oral deep under your tongue when not eating, drinking, talking etc for 1/2 hour or more? It is helpful if the same thermometer can show 98.6 with someone else.

Read this for context: KSMan? - Testosterone Replacement - Forums - T Nation

From the labs it appears LH and FSH aren’t low or repressed.
Prolactin is high normal though.
Your a little E2 dominant with the low T.

You need more labs which are listed in the sticky.

In your case an HCG challenge would be a good diagnostic to see if the problem is primary or secondary. It seems primary because the FSH and LH levels are good, but T is not responding. The HCG challenge would confirm. You probably need a low dose AI.

[quote]Tunapancake wrote:
From the labs it appears LH and FSH aren’t low or repressed.
Prolactin is high normal though.
Your a little E2 dominant with the low T.

You need more labs which are listed in the sticky.

In your case an HCG challenge would be a good diagnostic to see if the problem is primary or secondary. It seems primary because the FSH and LH levels are good, but T is not responding. The HCG challenge would confirm. You probably need a low dose AI.[/quote]

Maybe i just got a very high aromatase activity, thus converting all my free T to estradiol?
The first three to four days after the 250mg test e shot i felt pretty pretty good. Strong libido, i was calm, strong and i really wanted to do sports. But this feeling disappeared after the fourth day. Now i have absolutely no libido, way less than before the shot. I guess i’m full of estradiol right now.

About the thyroid function - no, i didnt wait that long not speaking or drinking prior to measuring. Will do more readings tomorrow. But can hypothyroidism impair the test production by that much?

Hypothyroidism can lower T, if full blown. Sub-clinical can make one feel like crap even if other hormones are optimal. Hypothyroidism and hypogonadism share many symptoms.

Morning temp usually is at 97,5 F
Evening (about 10 pm) at 97,9 F

It’s hard for me not to speak/eat/drink for half an hour in the afternoon, because my job requires me to talk, but i’m sure i will find a few occasions to fit.

Thanks for your help.

mid-afternoon temp is 98,4 F

looks okay, doesn’t it?

I doubt i can get my doc to do a HCG challenge, but i have an appointment with an endocrinologist in a month. Seems to be way more competent.

Thanks for the help, so far.

Hey guys, got news.

Short summary:
low test, switched doc cause first one immeadiatly set me on 250mg / 3weeks and was an idiot. Went to see an endo who checked everything my blood contains.
Two interesting things came out:

  • high morning cortisol (265.3; lab range 62 - 194 ng/ml)
  • elevated TSH (3.94; lab range 0.27 - 2.50 µIU/ml)
    BUT my ft3 was normal (3.2; lab range 2.00 - 4.40 pg/ml)
    and so was ft4 (12.7; lab range 9.30 - 17.00 ng/l)

He gave me T4 to counter the high TSH.
After a month of 75 micrograms of T4 per day:

  • TSH 0.29
  • ft4 14.4
  • ft3 3.4
    I then asked him if there really was any use to the meds cause ft3 didnt really increase PLUS it was ok from the beginning with. He didn’t respond. It’s been a week now since i asked him -.-

I always thought that ft3 is the most important factor, since it’s the biologically active hormone. high TSH just means my body has trouble making enough t4, right?
However, i do worry a bit about that high cortisol. But i do remember that i was pretty nervous when i went to see the doc. So maybe that’s the reason for the elevated cortisol?

He said my Test was ok, but that lab range is incredibly low:

  • total test 3.54 (1,93 - 8,36 ng/ml)
  • DHEAS 3.0 (0,80 - 5,60 µg/ml)
  • SHBG 22.9 (10,0 - 57,0 nmol/l)
  • free Androgen Index (calculated from SHBG and total test) 53.45 (15 - 95) ← this is why he thinks we shouldn’t inject test, still in the mid of the range
  • E2 22.8 (<45)
  • FSH 2.8 (< 6,0 mIE/ml)
  • Prolactine 10.3 (4,04 - 15,2 ng/ml)
  • LH 3.6 (1,70 - 8,60 mIE/ml)
  • DHT 999.5 (250 - 990 pg/ml) ← pretty high, given my low T

Thanks in advance

What is your protocol now?

When were labs taken in reflection of your last injection?

Thyroid: they all matter and all play a part.
Endo checking only total T is an idiot.

Are you natural at the time of these labs? Why is lh and fsh still in play?

[quote]iw84aces wrote:
What is your protocol now?

When were labs taken in reflection of your last injection?

Thyroid: they all matter and all play a part.
Endo checking only total T is an idiot.

Are you natural at the time of these labs? Why is lh and fsh still in play?

[/quote]

I’m all natural! :smiley:

Nice!! Good for you!

:slight_smile:

[quote]iw84aces wrote:
Nice!! Good for you!

:)[/quote]

ya well not really.
What can i do about my cortisol?

You could recheck it and do a 4 point cortisol test as this is the only way to really test cortisol.

We see people who have a fear of needles or you said you were nervous about seeing the doc having cortisol tests come bak high.

Why don’t you test the adrenals.

Cortisol
Insulin
C-peptide
ACTH
Rt3

As mentioned in the stickies we need a lot more labs.

The hormone labs tell us about your hormones but not what’s going on with the rest of your body. The body is a functioning unit when I e system becomes unstable others will sometimes follow suit

Cortisol can spike if you have anxiety at time if lab draw. But may not be a factor.

High TSH can enlarge the thyroid.

With the thyroid med, do you feel different?

TSH=0.29 suggests that dose may be too high. Watch your body temperatures to see if you are getting too warm. Yes, fT3 did not change so we might expect that nothing else should change.

Your T levels are too low for your age. Maybe this will change with thyroid meds.

What is your fasting total cholesterol lab data? Glucose?

DHEA-S seems good enough to feed DHEA–>T in your testes.

Anything may or not be a factor and I was saying it does happen that people are stressed at the time of labs and get high results.

Also said 4 point cortisol test is the best way to test it…