T Nation

24 Y/O Low T and Free T, High FSH


Been having libido, depression and body comp problems for a while, I suspected low test so I got some tests done and confirmed it. Questions from the sticky answered:

-age - 24
-height - 170cm/5'7"
-waist - 32"
-weight - 72kg/159lb
-describe body and facial hair - Very hairy legs, little body hair elsewhere. Not much facial hair.
-body fat - All in the stomach region, hard to say how it's changed over time because I was super light up until a few years ago when I started putting on weight.
-health conditions - Asthma and hayfever since childhood
-Rx and OTC drugs - Asthma and hayfever meds, nothing too extreme
-lab results with ranges - below
-describe diet - Medium-high protein and fat, lowish carb. Only eat whole foods, only drink water and milk, also started green tea a couple of weeks ago.
-describe training - 5/3/1 three times a week, still not very strong and never overtrained. Current training maxes for squat/bench/DL are 120/70/135kg to give you an idea.
-testes ache, ever, with a fever - No
-how have morning wood and nocturnal erections changed - Used to have morning wood every day as a teenager, now it's quite rare, maybe a couple of times a week if I'm lucky. Wake up multiple times a night (I've had moderate insomnia for years) and sometimes have an erection, maybe once every two nights.

Here are my lab results with ranges. Some figures were tested twice a week apart, so I've listed both figures:

1st Total Test: 18 nmol/L (10.0 - 33.0)
2nd Total Test: 14 nmol/L (10.0 - 33.0)
1st Free Test: 48 pmol/L (60.0 - 130.0)
2nd Free Test: 35 pmol/L (60.0 - 130.0) - This test was done unfasted, which can apparently cause a lower reading?
1st SHBG: 28 nmol/L (13 - 71)
2nd SHBG: 24 nmol/L (13 - 71)
TSH: 2.9 mU/L (0.40 - 4.00)
Prolactin: 8 ug/L (<15)
E2: 97 pmol/L (<150)
LH: 9 U/L (3 - 20)
FSH: 21 U/L (3-20)

American values for T and E2, will probably make more sense to you guys:

1st Total Test: 518 ng/dL (288 - 951)
2nd Total Test: 403 ng/dL (288 - 951)
E2: 26.42 pg/mL (<40.86)

As far as I can tell most of those results are normal, the only things standing out are low T, very low FT, and high FSH. I could easily be missing something though. I did ask for more detailed thyroid testing but the doctor flat out refused, "I've been a doctor for 30 years, your TSH is normal no further testing is required" etc.

I had testicular and prostate ultrasounds done, everything was confirmed to be of normal size and blood flow looked good.

I've been referred to an endocrinologist, but before I make an appointment it would be great to have some input from people here as to what my issues could be, and what treatment I may need. Thanks!