T Nation

23 Y/O HPTA Restart? Help?

Hello,
I am having some issues, and I have been a closeted reader for awhile trying to soak in as much information as I can. I even waited till I was older to see if I would still grow out of the way I have been feeling. My life feels very baseline, nothing excites me much and have low confidence. I am fatigued/yawning throughout the day even though I get 6+ hours a night. I don’t drink coffee or do drugs.
-age 23
-height 6’4-6’5
-waist 34
-weight 200lbs
-describe body and facial hair: My girlfriend has more arm hair. Legs are little above the knee little to none, same with chest. Facial hair is slow growing and patchy, cannot grow a mustache or beard.
-describe where you carry fat and how changed: Used to be obese/overweight when I was 16, I lost 100lbs in total. Body fat seems to be carried from naval to thighs down.
-health conditions, symptoms [history] : Overweight/obese at a young age, during this time I dealt with a lot of anxiety and was put on Zoloft. “Hereditary” blood in urine (not visible), however seemed to go away when I lost weight.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Only zoloft for a small amount of time.
-lab results with ranges: Posted below
-describe diet: My hunger (urge to eat) is sometimes non existent. When I lost my weight I tracked macros and lost weight at a slowish rate. Sometimes I wouldn’t “starve” myself but I wouldn’t eat because I woke up late.
-describe training: Moderate intensity, I rarely have an urge to push myself.
-testes ache, ever, with a fever? Yes frequently they do, especially the last two years. Doctors told me it’s because of a small hydrocele(had an ultrasound). The hydrocele pain feels dull, but my I do have aches that feel different. Also noticed my balls are up higher and tighter to my body.
-how have morning wood and nocturnal erections changed: Yes sometimes no wood, especially if I ejaculated the night before. Sex and masturbation feel good, but nothing amazing and I don’t lust to have sex all the time. During the day I rarely get erections. I could care less about a naked girl, no lust. Went to a strip club and could not get aroused…

My doctor told me he won’t order blood tests because insurance won’t pay for them. So I ordered these through walkinlab. Let me know if I should get more. I just visited Europe and was able to get pharma grade test, arimidex, and nolva. If needed to do trt or try a HPTA reset.

Thanks,

You seem to be indicating based on your Total T and Free T numbers that you have very low SHBG (under 15), low SHBG men typically have anxiety and problems with diabetes and obesity. Estrogen test is the wrong testing methodology, men require the LC/MS/MS method as the standard test can overstate a man estrogen. Few doctors even realise this fact.

All you need to do is lower your dosage, Free T is too high. You need to describe your protocol. Insurance and TRT don’t go together well and doctors typically fail miserably at hormone treatment and understand very little how to read your blood biomarkers to determine the correct dosages and injections frequency.

The medical community has largely ignore hormone therapy for several decades, so they know surprisingly little, the doctors that are knowledgeable in this field don’t take insurance, if they did they couldn’t do their job because insurance companies tend to refuse labs associated with male hormones as you already found out the hard way.

If in the US you need to inject your doses either EOD or every day do to low SHBG, my SHBG is 16-18 and I don’t feel my best unless I’m injecting EOD. Low SHBG men tend to have a ton of free hormones and that means free estrogen which is definitely a negative. Hypothyroidism can cause low SHBG, or more directly low thyroid hormones.

Checking oral body temperatures will directly reflect Free T3 status, measure waking and afternoon temperatures, you need to be 97.8 waking and 98.6 by 2pm. Free T3 is the only active thyroid hormones and is where the rubber meets the road. Doctors typically refuse thyroid panels checking Free T3, Free T4, Reverse T3 and antibodies to do costs. You can run these yourself, but seeking treatment under your insurance may be pointless.

Most go private do to having to fight with doctors and insurance companies.

Appreciate the quick reply @systemlord
I read here quite frequently and every time I do, I learn something new. After I got my e2 test I realized it was the wrong one, and I know which one is the correct one now.

I am not injecting or taking anything at the moment. I think you misunderstood what I meant by being in europe. All I did was buy the necessary drugs just in case the need arrises for my own protocol. I want to feel better and on a mission to do it.

I know my body temperatures, my girlfriend thinks I am crazy for checking. I wake high 96 to low 97. During the afternoon I will peek to high 97 low 98.

I do not want to be on trt for the rest of my life, but I want to be optimal, in your opinion should I go to TRT? Or HPTA reset? maybe more blood tests?

Definitely a process for me two year ago I wouldn’t even think about getting a blood test due to anxiety…haha! Now it’s no problem.

Those Total T and Free T numbers are perfectly fine, which is why I thought you were on TRT. The free t is what matters since it’s the hormone that does all the magic, your problems may lie in thyroid hormones. Check cortisol and ferritin levels, thyroid requires both. Low body temps are indicating a problem.

Ok, haven’t heard of ferritin. I know cortisol test is best done via saliva, is ferritin best to do blood or saliva? Would getting a thyroid panel be pointless when I know my body temp is low? Over this year i’ve been trying to incorporate more iodine.

You definitely need to get your thyroid checked. Given your history, I would bet heavily that is most of, if not all of your problem. Regarding E2, the test you have is often fine (compare below). It does not sound as though you have E2 (low of high) symptoms anyway.

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Hi Yaculloan, Tell me this is a typo and you are not 23.
What a fantastic post my friend. Your thoroughness is refreshing.
Looking at your blood tests the issue is not T or E related.
Thyroid and Cortisol are the two biggies when T is not the issue.
Best of luck and thanks for a great thread to read.

Thanks @hrdlvn any suggestions for thyroid and cortisol testing? I know the thermometer quite well and read saliva testing cortisol is the best. I tried taking iodine, and didn’t see much results but I was lazy without and wasn’t consistent.

Check am cortisol, also checking saliva cortisol through out the day and a night one. Check ACTH, free t3 free t4 , reverse t3 and tsh, prolactin . Talk to your dr that u want to investigate your adrenals and see what he can order.

If you are going to try the over the counter (OTC) thyroid you need 3 supplements and you need to take them everyday. In 7 to 10 day you will know if they are working. You will just feel better. I know that is not scientific but there you go. I really like the PURE brand. Iodine 225mcg/day, Selenium 200mcg/day, Zinc 30mg/day. If you don’t feel better in 10 day you need a comprehensive thyroid panel.

And the dam cortisol test ain’t cheap either.

You can look around for better prices or make a list of the tests and give them to your PCP maybe insurance will pay. Med Ins hates TRT but usually does not have issues with thyroid and cortisol testing.
Hope that helps.

Got my supps! Will give them a try and report back. Lately I have been feeling hungrier usually I don’t have an appetite.

Are people in there low 20s usually in the 800+ range for TT? My FT seems so high and but TT seems low for my age. I am considering doing an HPTA restart with nolva/arimidex, and or doing the post protocol for trt to get in the 800 range. I just don’t want to be on it for the rest of my life…

I am a quite active fellow and lift frequently.

Free T is what helps with recovery after a workout. TT is just not as important and 560 is a very good number. The average 20 year old male having an 800 TT is pretty much bro-science and wishful thinking. Maybe in the top 10% and they usually won’t have your Free T. Free T is what you feel and you should be feeling on top of the world with yours. Which tells us you’ve got something else going wrong. T is not your problem.

Got it, so if it did start trt my FT would also rise? Woke up this morning my temp was 97.7 about an hour after i woke. I’m going to see how it goes while take the supplements. You said that if i chose otc medicine. Is there anything else I can take?

My biggest concern is low libido, and if my thyroid appears to be fine. I might just try the protocol for trt and see if this makes me feel better.

Thanks,

Just the three supplements is all that is required. If you don’t feel any different in 7-10 days they are more than likely not helping. After that just make sure you use salt with iodine in it or supplement that a couple times a week.

The problem with TRT is its a replacement not an addition. When your body detects the endogenous testosterone it shuts down production of LH and FSH these are the hormones that tell your testes to make T and sperm. So in a month or two you are sterile.
Even with the best PCT you may never recover your full production. The longer you are shutdown the harder it is to get it all back.

That’s not your “waking” temperature, morning temperatures should be taken before you get out of bed, waiting an hour is the transition phase between waking and afternoon temperatures.

Endogenous testosterone is your natural production, exogenous testosterone is suppressing intratesticular testosterone production or the bioidentical hormone that is TRT.

I stand corrected.

Checked my temps and I wake up almost on the money at 97.7. I am going to continue checking just to be sure. During the afternoon I wasn’t getting up to 98.6, again I will keep checking.

I just wonder what TRT would feel like with a higher TT. My sexual desires are low, energy is down, and I just feel flat all over the board. I understand the whole process of how your body shuts down. Usually when people start TRT do they come off and on? I know you check your bloods every so often.

*going to add that my outer eyebrows are sparse.

The only reason people come off TRT is because of the doctors, finding a knowledge one is challenging.

You using a glass thermometer?

@systemlord using a digital fever thermometer.

It seems my temps are fine when I wake up, however don’t get to 98.6 by mid day.

I bought a digital and it’s inaccurate when compared with readings on my glass thermometer. I’ll trust analog everyday versus tech.