T Nation

24 Year Old Guy, Low T

For the days before the blood test, insure you get next to no sleep and eat virtually no fats. Eat very little food.

This is controversial and people are going to scold me, but if you hit 400 TT and she won’t treat you, but you feel like shit, then it’s worth taking these methods so that you get below the stupid guidelines and get treated.

[quote]Shouk wrote:
For the days before the blood test, insure you get next to no sleep and eat virtually no fats. Eat very little food.

This is controversial and people are going to scold me, but if you hit 400 TT and she won’t treat you, but you feel like shit, then it’s worth taking these methods so that you get below the stupid guidelines and get treated.[/quote]

haha! I’m not going to say I wasn’t already thinking along the same lines for exactly the same reasons, BUT…

Alright everyone, the results are in.
This was un-fasted, ate and slept normally the day before.

Total T: 301
Free T: 86
SHBG: 15
FSH: 6.2
LH: 3.9
Prolactin: 8.0

PSA wasn’t covered under my insurance due to my age (though I wish I had known that before getting the results back).

Endo says that because my Free T is “well into the normal range” (I dispute this) she doesn’t feel like TRT is “worth the risk,” and that my low T is probably being caused by something else.

Her first thought was sleep apnea. “Do you have trouble staying asleep at night?”
“No.”
“Do you feel rested when you wake up?”
“usually.”
“Do you snore?”
"No."
She wants me to go get a sleep study which means two days out of work and again I’m pretty effing sure I don’t have sleep apnea.

Her next thought was depression. I flatly told her that I had struggled with depression for many years of my life, and I knew very well what depression felt like, and that I was not and am not depressed. She tried to step to me about the stigmas associated with depression and trying to look past them and said that you can be depressed without feeling depressed.
She then suggested I get on antidepressants, but she drew a blank when I asked her what kind of doctor in their right mind would prescribe antidepressants to a patient who doesn’t claim to be or feel depressed.

They’re gonna do an adrenal hormone (cortisol) test soon but otherwise she wants me to come back in two months for more bloodwork, and I guess I’m just supposed to keep losing my hair and my muscles and feel like trash for those two months.

Any thoughts on what to do next would be appreciated. I guess I’m gonna go for a third opinion from another endo, maybe someone’s actually going to tell me what to do with the eight vials of Test C chilling on my bathroom counter.

Or at least make me not feel terrible anymore.

…antidepressants? Really?

Sounds like a new doctor is in order however ensuring you don’t have even mild sleep apnea is worth a look if your insurance covers it. If so there is no need to go to a lab and spend big bucks. Have her or a sleep dr order a 3 day home study. Although it won’t test as much as a lab it will show if you have breathing issues at night.

I suggest that because I went misdiagnosed for 7 years. 2 lab based sleep studies were false negative. In fact I was even diagnosed with narcolepsy! I convinced my sleep doc to do the 3 day home sleep study, and bingo…it showed up…been on cpap since April and feeling great!

During this time I took every test known to man…was put on TRT 6 yrs ago…lab results were boarder line normal…and still felt like shit.

I’m just now getting my trt dialed in now with help from all the contributors from this website… Thank you for that guys. BTW I too had none of those issues she asked about. In addition I’m very fit, not much body fat . So I did not meet the Sleep Apnea profile…

So if it’s covered, based on my personal experience check that box off first, or you’ll be chasing these numbers and feeling like shit for years to come.

At least your Endo isn’t putting you on TRT at your age without looking for a solution. Once you go on TRT you become infertile and your nuts will shrink unless you’re injecting HCG. Your girlfriend probably won’t like that either. Most Endos just prescribe T without HCG.

Take your Endos advice on the sleep study and anything else she wants to look at to find a cause. Also, ask her about trying low dose Clomid to raise your T levels. Clomid works by stimulating your pituitary to produce more LH. They would probably start you at 25mg per day but a Clomid dose of 12.5 mg per day or every other day might be enough to keep your T levels in the 600 range. You will still be fertile and you will have a chance of restarting your own production or figuring out the cause and treating it so that you’re not dependent on injections for the rest of your life. TRT is the last option at your age. Try everything else before that.

Try googling clomid for low testostosterone and read up on it. There are no long term studies on the safety of it so most Endos will not use it for more than 6 months or a year. The lower the dose you use, the safer it is. Most side effects occur at higher doses of 100 mg per day. Enclomiphene (Androxal) is a better form of Clomid with less side effects and it’s awaiting FDA approval for long term use. It might be available next year.

If you’re interested in trying Clomid, ask your Endo. If she won’t use it, you could try Dr. Eugene Fuchs at OHSU. He uses it long term and has had men on it for 8 years with no side effects.

Yeah, I realize after reading through some of these posts that I’m making it sound like I super want to be on TRT and injecting shit into myself for the rest of my life, but I don’t - it’s honestly all just borne out of frustration with the fact that I’m feeling terrible and nobody is able to help me.

I’ve been screened for sleep apnea before, both when I was heavier and when I was having trouble sleeping earlier this year, and nothing’s shown up on those tests - I may do the three day home study though. Can’t hurt. Same with the cortisol tests I mentioned above.

I’ll also get in contact with Dr. Fuchs - not necessarily for Clomid but his website says he specializes in Low T treatment, and I have to believe that a specialist in that specific field won’t tell me to use antidepressants for low T. Thanks for the recommendation, Freddy.

Thank all of you for the support and information thus far, it’s been a huge help to know I’m not alone in my situation or the sheer amount of aggravation I’ve been dealing with

are there any medications you have just started to take recently??

This is just a little history on myself to give you some insight on HRT/TRT.

Im 27 and have been on HRT for almost a year now. I was fortunate no meet a doctor who was willing to give me what I needed in order to make learning process easier. It did take some time though and a lot of reading. I basically came to the conclusion that more Test wasn’t necessarily better. We lowered the dose into two weekly shots and included HCG to the mix. By lowering the amount of T and dividing the dose I was able to come off of my arimidex dose. My levels are currently at 1,900 and there is no need for an AI at this time. Everyone is different but my point is that there is almost always a solution. Oh and I actually just got my gf pregnant a few months ago which shows that HCG does make a difference. Do take the advice of checking out all other avenues before deciding to go on HRT. It doesn’t hurt to try this first.

Alright everyone - sleep apnea screening came back with totally normal sleep. At Freddy’s recommendation I got in touch with Dr. Fuchs. We went over everything a few days ago and I’ve started Clomid 25mg/day.

I FEEL AMAZING.

OH MY GOD.

IS THIS WHAT NORMAL PEOPLE FEEL LIKE ALL THE TIME?

OH MY GOD, YOU GUYS.

I have TONS of energy, I could chisel my own face into Mount Rushmore using nothing but my dick, my brain is running on full throttle, and I’m sleeping like a rock.

Oh my GOD, you guys.

Thank you all SO MUCH for everything.

It sounds like you’re having a great response to the Clomid.

Here’s a thread from today of a 23 year old guy’s response to the same 25 mg dose of Clomid. You might lose the great Libido if your TT and E2 raise too much. It might be a good idea to test your TT, FT and E2 ASAP while you’re feeling so good. It will give you a good baseline to try to get back to if you lose the libido later. You can get a test package for those 3 items for $65 at Healthonelabs. The best location to get the bloodwork done in Portland is the Labcorp on Steele St. I had to wait an hour at the Barnes location. If you get your own labs done, don’t mention it to Dr Fuchs.

Hey everyone, just wanted to pop back in.

My Total T, late in the afternoon, was 523ng/dL a week ago. This is nearly double my initial reading of 217ng/dL.

As stated, I feel amazing and haven’t had any negative side effects - actually, some of my family members have said I seem a little more moody and irritable, but I’ve also been very stressed out at work, so who knows. Other than that, though, no side effects.

Doc has told me to just stay on this regimen. 523 still seems a tiiiiiiiny bit low for my age, but, again, it was late in the afternoon, and I know it’s highest when you first wake up.

Anyone have any thoughts/comments/etc? Again, I feel TERRIFIC, no side effects have been noticed.

Here’s a study that says that the variation of T levels between morning and late afternoon is 35% in young men.

If you were at 800 in the morning, a 35% drop by late afternoon would put you at 520. Try getting an early test between 8 and 9 AM next time. It will probably be a lot better.

"In males, serum testosterone levels show a circadian variation, with the highest levels in the morning and lowest levels in the late afternoon. In young men, the variation in testosterone levels is approximately 35%. "

Hey dudes, I’m back!

I’m at the end of my final refill on Clomid, and have felt great for months - my total T levels have consistently been in the 800-900 range and I’ve put on nearly 15 pounds of lbm - but for the past week, I’ve felt like absolute garbage, exactly how I felt before I started - actually, maybe a little worse, but the same symptoms. No changes in diet or training for the past month and a half.

Now, this could all be completely unrelated to the Clomid (low motivation, insomnia, loss of muscle mass could just as easily be from stress or fatigue as I understand it), but has anyone ever heard of such a thing? I’m trying to make an appointment for more bloodwork to see if I can get to the root of this, of course, but information is always good. The only info I can find about people crashing on Clomid is when using it as PCT, which isn’t quite the same situation.

Thanks in advance.

Test LH/FSH as well as FT, TT, E2 and post ranges this time.

Your testes are good.

Never stop SERM suddenly, need to taper out and might need to have some anastrozole to avoid estrogen rebound. Search for “HPTA restart”

Hey KSMan, thanks for the prompt response. Just to clarify, I have not yet stopped taking Clomid, I have been in the process of tapering off for a couple weeks, down from 25mg/day to 12.5mg/day, will then be moving to 12.5mg EOD before being off of it. If necessary I can get another pack just to make the transition a little easier.

Symptoms kicked in after about a week of starting the taper off, though my taper-off was a little inconsistent due to a business trip, i.e., “oh shit, I haven’t taken my clomid in two days” “oh shit, did I already take it tonight?”

I will report back with all lab results. Spoke to doctor and he wants me to get the tests after I’ve been off for a month but agrees that the whole panel you listed up above is the best bet. Should I not worry about Anastrazole/HTPA restart at this time?

Your are feeling a drop in T and possible E2 effects as well as possible E2 reducing T.

Your labs will tell the story.

Cool. Will keep everyone posted.

Alright, last question - is there any merit to the idea that I need to wait until I’ve been off for a month before I get my labs? Because I feel like crap NOW, man.

If worse comes to worst I can probably try to find some Clomid somewhere and re-taper off, but I’ve been pretty consistent in my tapering and began to feel like garbage as soon as I dropped below 25mg/day for a few days consecutively (finished taper off with 12.5mg EOD)

@KSMan, just wanted to update.

Two years on, my levels seem to have tanked again, which my doc says is not unheard of, especially after taking Wellbutrin, which I started doing. I’m back on Clomid 25mg/day but I do not IMMEDIATELY feel GREAT like I did last time. Is this to be expected?

I also say they “seem to have tanked again” because bloods will be back on Monday morning. Symptoms are all identical to last time, except worse. I just wanted to check in the interim to make sure my shit isn’t permanently ruined. Ha!

I had been getting regular blood work every 3-6 months and there was little to no variation from normal ranges mentioned earlier in this thread (T levels at approx 800 in the morning, fasted) until about three months ago when I started feeling horrible, and also my insurance ran out and I lost my job so I don’t have a blood test from that point. Like I said, just want to know if my delayed response to Clomid is normal, especially while pushing Wellbutrin out of my system. Starting Wellbutrin seems to be the catalyst here, as that made everything MUCH worse about a month and a half ago, and my doc said that could absolutely have an effect.

Anyway, yeah, just checking in.

Thanks again.

Addendum: looks like Wellbutrin takes about 2-3 weeks to clear out of your system so I’ll hold out until then to panic :wink: