T Nation

25, Low T and Stuck


#1

-age
25
-height
170cm(5’7)
-waist
normal
-weight
73kg (160lbs) around ~18%bf
-describe body and facial hair
Some chest and normal leg hair, can grow a shitty patchy beard.
-describe where you carry fat and how changed
Belly and chest, very little on limbs. Puffy nipples that might be gyno.
Used to not gain a gram of fat despite eating tons.
-health conditions, symptoms [history]

I have struggled with ear infections throughout my childhood, have had many operations and antibiotics, and have had several bad reactions to antibiotics.

As far as (possible) T related issues;
Loss of motivation
(diagnosed)Depression
Bad Brainfog
Concentration problems
Memory problems
Poor sleep (I need way more sleep to even somewhat function than normal people)
Lack of sex drive
Tired often
Lack of self confidence
Social anxiety
Shit mood
Generally not feeling like myself anymore

Around the time all this started I also had a period of having to get out of bed 4 times a night to piss(in high volumes). Went to the doctor to get checked for diabetes but nothing came out of that.

-Rx and OTC drugs
None, besides the antibiotics years ago.
-lab results

TSH 0.9 mU/l (0.3 - 5.6)
(have FT3 from 2010 at 6.5(3.8-6.0) was already having issues then)
Cortisol morning 324 nmol/l (150 -600)
IGF1 25.5 nmol/l (12.5-41.3)
Prolactin 0.15U/l (<0.3)

LH 2.7 IU/l (1.0-9.0)
FSH 2.3 IU/l (1-19)

Testosterone 11.2 nmol/l (8.64 - 29) (Also have older labs that hovered around 9 nmol/l several times since 2010)
Free test 0.257 nmol/l (>0.125)
SHBG 18.6 nmol/l (18.3 - 54.1)
Estradiol 95.1 pmol/l (41.5 - 158.5)

-describe diet
I eat healthy enough, plenty of all macros. Supplement D3, general joint supplements and ZMA.
-describe training
Mostly strength training with some accessory work, I know what overtraining feels like and this is not it.
Reasonably strong and have a decent amount of muscle mass.
-testes ache, ever, with a fever?
I’ve had some rare testicle pain, but nothing super serious, never with fever. Always chalked it up to blueballs or something.
-how have morning wood and nocturnal erections changed
Rare now, used to have them pretty much every time. Even during the day.

My doctors won’t help, and gave me mostly retarded answers to questions and unsolicited advice straight from moms magazines. (Based in the Netherlands, so there are no real TRT clinics here.)

So I’m kind of stuck here, considering treating myself since good gear isn’t hard to get a hold of around here, but I’m just wondering if anything stands out here.

Any insights or advice would be greatly appreciated.


#2

Pissing a lot: Prostate infections can cause need to go frequently, but not increase volumes. Any discomfort there? Such things might refer to the testes, but your symptoms were minor and rare.

Low SHBG can simply be low for some guys, but does show up with diabetes. Your FT is decent. LowSHBG+T is lowering TT and TT thus understates your T status. The problem is that FT varies a lot and lab timing can catch higher or lower FT values, so there is uncertainty.

Have you had doctors examine your testes?
Testicular cancer is a young man’s disease.
There can be vascular abnormalities, often repaired with surgery.
Your TT, FT, LH, FSH do not suggest any problem in the testes.
Low FSH rules out most testicular cancers.

Thyroid:
TSH seems ideal, but often TSH results can be misleading.
fT3 should be mid-range or a bit higher. fT3=6.5 is too high.
See last paragraph in this post to evaluate overall thyroid function.
Please explain your use of iodized salt and sea food over the years.
How much of your food is prepared in your own home?
fT3 is the active hormone
rT3 blocks fT3 at T3 receptors
chronic illnesses, infections, inflammation and surgeries increase rT3
Do you get cold easily?
Are your outer eyebrows sparse?

fasting cholesterol?
fasting glucose?
RBC
hemoglobin
ferritin
hematocrit

What digestive issues do you have?
Any foods that you cannot eat?

Immune system: Vit-D is very important. Please take 5000iu per day. [how much Vit-D3 have you been taking?] Thyroid also affects immune system.

What drugs, Rx and OTC are you taking lately?
What supplements? only as listed above?

Please describe issues with joints. Do you take any medications for the pain or swelling [doses]?

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
  • 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.


#3

First of all thank you for your reply, KSman.

I have had my testicles examined once, I think back in 2010 (when I was already having issues). Nothing came out. I also never really had a hard time or pain pissing.

As for the 6.5 FT3 value, it came along with 0.2 TSH.
I have never paid attention to iodized salt, and most if not all of my food is prepared at home.
It has also been years since the infections, so that shouldn’t affect me now, or should it?
Cold has never bothered me, hot weather bothers me more, really.
Outer eyebrows do kind of thin out near the very edge, but very little.

Cholesterol total 3.6 mmol/l (6.5 - 5)
Cholesterol/HDL ratio 2.0
HDL 1.8 mmol/l (0.9 -1.7)
LDL 1.6 mmol/l (3.2 - 2.5)
Triglycerides 0.5 mmol/l (0.6 - 2.2) (are these even relevant here?)
Glucose 5.2 mmol/l (3.3 - 7.8)
Hemoglobin 8.8 mmol/l (8.5 - 11.0)
I only have ferritine bloods from 2010 and 2011 at 47 and 44.
I don’t think hematocrit was ever tested.

I eat plenty of eggs and other fats, the low cholesterol is surprising, honestly.

I do have watery feces quite often but I have experimented with diet and that doesn’t seem to be it. I think it might be related to anxiety or something. It comes and goes despite eating the same consistently too.

I take about 4000 IU D3, though I get outside often enough that vit D shouldn’t be a problem.

I don’t really use medication, maybe an ibuprofen or paracetamol once or twice a year when I have a bad headache and cant sleep.
I also supplement creatine monohydrate and whey.

As for joints and tendons, they sometimes feel a bit shitty because of training and work, I feel glucosamine and such helps.(Also contains vit c, copper, and manganese. Though I had symptoms before using this)
No pain meds for joints, ever.

And do the temperatures for the thyroid test have to be taken specifically orally? I think I only have an infrared ear thermometer.


#4

Really? That would be describing a degree of hyperthyroidism, nodules in the thyroid making hormones independent of the permission hormone TSH. Hyperthyroidism can be the end product of high TSH+time in the past caused by low iodine, state of thyroid can progress in mysterious ways.

Range: Cholesterol total 3.6 mmol/l (6.5 - 5) ?
HDL is very strong!

Odd to have joint problem at your age. Or the surrounding bits like rotator cuff?


#5

That was in 2010 though, and TSH seems to have stabilized so there is a high chance of FT3 being within range too, no?

I don’t get the logic behind the cholesterol total, but it seems low. Could this be the cause of problems? I eat a lot of fats, so this really did confuse me.

As for joints, my knees tend to feel like shit (unrelated to training as well) and elbows do sometimes get beat up from training. I fucked my elbow playing sports not too long ago.


#6

If you have ongoing joint pain and tenderness, you can try Rx 15mg Meloxicam once a day. It may break the cycle of inflammation and damage.

If your diet is normal and cholesterol is low, that is just the way some guys are. If diet was extreme, advice would be to change that.

TSH changed. You do need to get an oral thermometer to see whats going on.


#7

Tested my temp before I got out of bed, left it in my mouth for a while to make sure.

Morning temp came in at 97.7.