22yo Male with Below Range T Levels

Pharma / TRT Testosterone Replacement
1

Hi guys this is my second thread but I will include all the results I could get. I’m really worried about this low T thing, I feel like I’m half alive.
-height
184cm or 6ft
-waist
Above average
-weight
90kg
-describe body and facial hair
lots of body hair all over, hairy chest, arms and legs. Facial hair grows at fast rate, but never really gets long. Body is stocky, I look built even tho I didn’t lift until recently. I have wide shoulders, muscular arms and a big barrel chested torso.

-describe where you carry fat and how changed
Hips, thighs, chest and belly. Was always like this but I managed to maintain a lower weight until now (I have trouble losing fat)

-health conditions, symptoms
Symptoms of depression and anxiety, anxiety I have managed to get over I think. I came off Lexapro/Celexa a month ago after using for 4. I feel fatigued, I have trouble falling asleep due to overactive mind. I don’t enjoy life as much. I feel weaker/less confident. I don’t enjoy sex as much, apart from some spurts I feel it’s a chore to do, and orgasms aren’t that great anymore. I used to be super horny. I get tired easily lifting.

-lab results with ranges
Prolactin: 151 mIU/L (45-375)
Free Thyroxine (Free T4): 14.3 pmol/L (10-19)
TSH: 1.63 mIU/L (0.50 - 4)
Free T3: 6.2 pmol/L (3.5-6.5)
Total Cholesterol: 3.8 mmol/L (0.0-5.5)
Triglyceride: 0.7mmol/L (0.5-2)
HDL : 1.5mmol/L (0.9-2.2)
LDL: 2.0mmol/L (<3.4)
Chol/HDL ratio: 2.5 (<5.0)
FSH: 2 IU/L (1-10)
LH: 4 IU/L (1-10)
Prog: 1.8 nmol/L (1.2-4.8)
Cortisol [4:45PM, 09/07]: 242 nmol/L (85-460)
Cortisol [10AM, 09/07]: 488 nmol/L (119-618)
Plasma Homocysteine: 7.4 umol/L (3.7-13.9)
Total Testosterone [09/07] 8.3nmol/L (8.3-30.2), after retest it was 8.6nmol/L, and last one was 9.9nmol/L
Dehydroepiandrosterone Sulphate: 8.6 umol/L (3-10.5)
Sex Hormone Binding Globulin: 16nmol.L (13-71)
Free Testosterone : 228pmol/L (225-725)
RBC Folate: 2593nmol/L (>800)
S fol 40.7 n/mol/L (6.0-45.0)
S total B12: pmol/L (200-700)
IGA (SE-Immunoglobulins) 4.07 g/L (0.7-4.0)
T Protein 80g/L (66-83)
SE-C-reactive protein: <3mg/L (<5)
Sensitive Oestradiol: 50 pmol/L (Prepubertal (M & F) <20 pmol.L, Postmenopausaul females 20-90, Adult Male 50-150)

T-Glutaminase <5 (-5) negative
Hameoglobin 155g/L (130-180)
Hct: 0.44 (0.39-0.51)
RBC: 5.0 x1012/L (4.3-5.8)
MCV: 88fL (80-100)
MCH: 31pg (27-34)
MCHC: 354 g/L (310-360)
RDW 13.4 (11-17)
Platelets 292x109/L (150-450)
White cells 7.1 x10*9/L (4-11)
Neutrophils 3.7 (2-7.5)
Lymphocytes: 2.8 (1-4)
Monocytes: 0.5 (0-1)
Eosineophiles: 0.1 (0-0.5)
Basophils: 0.1 (0-0.3)
NRBC 0/100WCC (<1)

Sodium 136mmol/L (135-145)
potassium 3.9 (3.5-5.5)
chloride 99 (95-110)
Bicarb 25 (20-32)
Urea 6 (3-7.5)
Creat. 80 umol/L (60-110)
T-BILI 10umol/L (4-20)
IRON 25 umol/L (26-41)
Ferritin 238 ng/ml (30-500)
eGFR >90ml
TRF 3g/L (2-3.2)

-describe diet
I eat a fairly healthy diet. Eggs, beef, chicken breast, olive/coconut/butter oil. Spinnach, avocado, lots of nuts. Very paleo with some treats here and there.
-describe training
I haven’t trained at all when I started feeling off, now I took up running and swimming again. And weight lifting. About 4 medium intensity sessions a week.

-how have morning wood and nocturnal erections changed
They haven’t really changed but not as strong and consistent as before.

Please tell me why I feel like sh*t, I’m 22 but I feel like I aged 10 years. I am trying to live healthier, I gave up pot a few months ago, cut down heavily on cigarettes. Used to drink daily, not once a week max and not too much. Doctor said he might prescribe me TRT but he said it may mess up my endocrine system.

2

You have secondary hypogonadism. Prolactin and estradiol are not causing this. At your age, need to consider disease of pituitary or damage from a blow to the head. This requires a MRI. [Note that not all pituitary adenomas are prolactin secreting.

You can do a trial with Nolvadex, [please not clomid]. If LT/FSH [and T] increase we then know that the top end of the HPTA is partly functional. At this point you can attempt an HPTA restart.

Your FSH=2.0 is more indicative of your LH status than LH itself.

TRT: If you need to go there, first try hCG mono-therapy. As hCG is a pain when you travel, you can also have a script for Nolvadex to use when travelling. You can periodically switch to Nolvadex for a while to improve fertility.

fT3 is elevated and TSH is also interesting. Please see the thyroid basics stick and check your body temperatures. Concern is that rT3 may be elevated, blocking ft3.

Using iodized salt continuously for years?

3

[quote]KSman wrote:
You have secondary hypogonadism. Prolactin and estradiol are not causing this. At your age, need to consider disease of pituitary or damage from a blow to the head. This requires a MRI. [Note that not all pituitary adenomas are prolactin secreting.

You can do a trial with Nolvadex, [please not clomid]. If LT/FSH [and T] increase we then know that the top end of the HPTA is partly functional. At this point you can attempt an HPTA restart.

Your FSH=2.0 is more indicative of your LH status than LH itself.

TRT: If you need to go there, first try hCG mono-therapy. As hCG is a pain when you travel, you can also have a script for Nolvadex to use when travelling. You can periodically switch to Nolvadex for a while to improve fertility.

fT3 is elevated and TSH is also interesting. Please see the thyroid basics stick and check your body temperatures. Concern is that rT3 may be elevated, blocking ft3.

Using iodized salt continuously for years?[/quote]

Hi thank you for that. Is it safe to do Novaldex or do hCG mono-therapy? I had a brain scan done a few months ago after some orbital damage and they said my brain seems fine, should I request anything specific? Also is there anyway to do a natural ‘HPTA restart’?

Oh and is it bad to use iodized salt? I even went out and bought some nescenet iodine supplement

4

Why exactly do you suggest against clomid? Everyone else seems to think otherwise. I am getting a sleep test done to see if I have sleep apnea, which I think I do as a mouth breather. Do you think that’s enough to cause the issue?

5

I’m also curious to hear why Novaldex is preferred over Clomid.

6

Many have a lot of nasty side effects on clomid. That is the main reason it’s preferred. Google “clomid side effects” and read a few posts from various forums.

7

But it’s not like a choice in different brands, clomid and nolvadex do two different things. What someone told me,

“nolvadex (tamoxifin) doesnt act on the pituitary in the brain. It binds to estrogen cells around the breast which in turn signals testosterone to increase through a negative feedback system. Clomid attaches to estrogen AT the brain not breast”

8

Axl

Nolva will get the job done with less risk of side effects.

However, I’d suggest you try HCG challenge first instead of Nolva restart.

MRI needs to be specific for the pituitary and is done with contrast

Anytime there is secondary hypogonadism, MRI is warranted IMO.

9

Get checked for secondary hypogonadism. I may have the same thing. Getting an MRI next week.