T Nation

24 Yrs Old. Low Test, Anxiety, Depression. TRT?


#1

Year 2013 - Used steroid on and off for 1 year on without having any knowledge regarding steroid.

3rd March 2014 - A year later i decided to stop steroid cold turkey and was feeling fine having no side effect of what so ever until 4th june 2015.

4th june 2015 - i took one pill of propranolol for my uni presentation which is a beta blocker to keep me calm. I got this idea through the internet. Directly after this pill went out of my system, i got a major anxiety disorder and major depression.

I was having a hard time to go on with my life day to day basis as my anxiety gone through the roof. My face got red everytime i talk to people. My words got stumble when i talk to people. Energy level decrease. Sex drive decrease. Motivation decrease. Basically my life has gone downhill since that day. I blamed the propranolol for this. Later on, i went to see a psychiatrist to deal with my general anxiety disorder (GAD). He gave a antidepressants which i forgot what kind of antidepressants. I only took it for 2 days because i cant stand the effect from it. Feel like zombie and major headache.

After that, i even set an appointment for cognitive behaviour theraphy (CBT) to deal with my major anxiety as well. It only lasted for 3 session because i felt more stress and i feel my anxiety increases more with my theraphist. But he did help me to succesfully remove my red face blushing with breathing technique that he taught.

16 January 2016 - i told my dad about my condition and he decided to bring me to his cardiologist (heart doctor). I explained my condition to the doctor. He decided to do blood test and find out i have low Test which can be one of the major factor for my condition.

Total Testosterone - 8.8 nmol/L (8.4 - 28.7)

He only check total testosterone. So he decided to give Nebido which a form of long acting testosterone (3 month half life every jab). His plan is to give 3 shots of Nebido which he believe is a plan to ‘restart my HPTA’ and then stop the testosterone and look at my Test level after that. At first i believe what he says because i didn’t make any research and have no knowledge on this. After many research, i realized that this doctor does not have a clue about hormones because HPTA can only restart by taking SERMS such as clomid, nolva and others. So he gave me 3 shots of Nebido every 3 month. Before each shoot he made a blood test but he only check Total testosterone. The other important aspect like LH, FSH, Estrogen, Prolactin etc he did not check. When i am on Nebido i wasn’t feeling fine. It could be due to Estrogen which i believe. I decided to just follow with his protocol. Along the way i suggest to the doctor to make a blood test every 6 weeks to monitor my hormone panel. He agreed. My testosterone has never been higher than 20 nmol which i suspect it can be the unsuitable protocol or the estrogen.

16 July 2016 - was my last shot of Nebido. 10 weeks after that i made another blood test with this cardiologist doctor. Turn out very bad.

Total testosterone - 6.2 nmol/L (8.4 - 28.7)
estrogen - 99.3 pmol/L

My testosterone was lower than before when i started taking nebido. It must be because my HPTA has been shutdown. Surprisingly, if i look back at my anxiety and depression condition, it is better than before i took nebido. In other words, theres is improvement. So i started to wonder does my anxiety and depression cause because of low test? or just a mental thing? However, if its just because of mental thing i still need to fix my low test am i right?

24th november 2016 - 18 weeks after my last jab of nebido (half life 3month/12weeks) i decided to meet with my family doctor who is just a normal GP. I explained to him about my condition and told him that i want to do a blood test including hormone panel. During this time i was more knowledgable regarding TRT and steroids. I pick up a TRT book by jay campbell which is a very informative book. This time out i told the doctor to do a full hormone check up which i got it from the book as well.

FSH - 1.2 IU/L (1.5-12.4)
LH - 2.3 IU/L (1.7-8.6)
Oestradiol - 91 pmol/L (28-156)
Progresterone - 2.0 nmol/L (0.7-4.3)
Prolactin - 34.2 ug/L (4.0-15.0)
Testosterone (total) - 11.7 nmol (8.6-29.0)
SHBG - 16.1 nmol (16.5-55.9)
Free Androgen Index - 72.7 % (35.0-92.6)
Testosterone (free) - 75.8 pmol/L (68.7-179.4)

DHEAS - 8.2 umol/L (5.7-13.4)
PSA (total) - 0.70 ug/L (<1.40)

25 OH Vitamin D (total) 48 nmol/L (>75)

Thyroid Funtion (all fine)
TSH - 3.850 mIU/L (0.270-4.200)
FT4 - 15.9 pmol/L (12.0-22.0)
FT3 - 4.6 pmol/L (3.1-6.8)

Turns out i still have low test and also low in vitamin D. From this blood test i was aware that i am secondary hypogonadism. My family doctor told me that he’s not that master in this hormone things but he has a friend who is a bodybuilder that understand hormones. Its not that im not seeing any endo. After the nebido shot, i went to see 3 endo and based on my view, none of them understand male hormone fully. All of them said that my range was in the ‘normal range’. Yes its in the normal range but its not normal for my age. Only this doctor (family doctor) agree with what me that its normal for my age to have this level. He even get a copy of jay campbell TRT book. The same book that i read.

Before jumping to TRT, his friend who understand hormones suggested me to go with clomid and nolva. So i did. I went with dr scally protocol but without HCG.

30days - clomid 100mg and nolva 40mg
45 days - nolva 40mg

During PCT, i notice my anxiety decrease which i suspect the rise in testosterone. But my sex drive is still low as well as energy level. As soon as i finish my PCT protocol i notice my anxiety started to crawl back again. But not so much. It can still be tolerate. After my PCT i decided to get a new theraphist for my anxiety. It has been 4 session with this theraphist and i can say that there is improvement towards my life. But there is still anxiety and depression. I plan to make a another blood test 6 weeks after my PCT which will be tomorrow on the 22nd february 2017 (6 weeks date after PCT end). We’ll see what the blood test tells.

Current feeling:

  • Energy level low (tired all the time although get 8 hours of sleep)
  • anxiety (but a lot better during 2015)
  • depression
  • low sex drive
  • motivation low

i do weight lifting 3-4 times a week. I keep track of what i eat. 2500 calories perday (maintenance) . My weight is 75kg with around 15-17% bodyfat. Mainly its the anxiety and depression as well as low energy is what bothering me. I cant get my life going if im always feeling like this. My eyes get watery when im anxious. My face got tense which end up for me to have an angry look.

What do u guys think? What if my blood test shows that i still have low test even after PCT? TRT for life?


#2

Your prolactin is high. Have you had someone follow up with that?

How much caffeine are you taking? I noticed a massive drop in anxiety when I quit, and I was only taking about 400mg/day.


#3

Hi I am 23 years old and have test levels around 50 free; normal is 300-1000 I am currently on androgel and it is going up slowly, but am afraid of needles. I can definitely tell low T is linked to anxiety and depression because some days I feel good and other I don’t. I have suffered from anorexia the past to years, but my weight is coming back up and the endo said I should start producing test on my own when my body knows its around its set point. I am currently 5’10" 130lb and I am afraid I will be stuck on TRT the rest of my life if I keep taking it… THOUGHTS?! I also workout about 6 days a week and do mostly cardio but have been incorporating in more compound heavy lifts to try to boost my test.


#4

yes i noticed that my prolactin is high. I do not know whats the cause of it. I dont take any caffeine or any other stimulants. u have any thought on the high prolactin?


#5

I don’t have much experience with it, but know it can be a sign of petuitary tumor. Its definitely worth checking with a doctor on it, because if that the cause of your low T it’s treatable without TRT. It’s fairly common and a simple procedure to remove from what I understand.


#6

i see. Does that mean i need to do an MRI to check whether i have petuitary tumor? Thanks for the info though


#7

That’s how it’s diagnosed. I’d see a doctor about it for sure though. There might be other diagnostics, the doctor would certainly known better than me.


#8

alritee. thanks.


#10

I do not know how or why this showed up on my list of topics…

I should have been on this from the beginning.

Thyroid is a mess.
TSH should be closer to 1.0
Problem often caused by iodine deficiency.
In UK, iodized salt not generally on the shelf.
If you do not consume a lot of dairy food and sea food, you are deficient.
Thyroid lab ranges are rather useless, unfit for purpose.
fT3 is the active hormone and below midrange
fT4 is below midrange and a reservoir for T4–>T3 conversion.
Check oral body temperatures to eval overall thyroid function.
Note that selenium is critically needed by you now.
This can drive a lot of anxiety and some have resolved that by addressing thyroid/iodine/selenium issues.

You were misled re PCT,
See the HPTA restart sticky.


Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • HPTA restart
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.