T Nation

25 Y/O, Low T and High Estra?


#1

Hello,I am the newbie around here and I really don’t know where to put this message, but it would be nice if someone can offer an opinion.
Age
25
Height
174 cm
Waist

Weight
189 lbs
describe body and facial hair
everything is normal
describe where you carry fat and how changed
primary in my abdominal area (Inbody 12,6 % fat)
health conditions, symptoms
Throughout the years I was sensing decrease in libido and I started getting nervous. At the age of 25 I managed to get to 6% bodyfat (checking with inbody, I think it is nor really accurate) through very hard diet, naturally. Then I keep on eating only carbs and protein, almost zero fats (I had one week of eating what I wanted), just to be shredded and my libido was really on the low end. Also I had couple of parties where I drank really hard. Then I had my first panic attack during an exam period, since then I am quite anxious about going to shop and basically everywhere I can do it but with bad inner feeling. I got SSRI Tritico, but it only helped with sleeping, but tiredness, lack of motivation and anxiety is still there.
Rx and OTC drugs, any hair loss drugs or prostate drugs ever
No drugs
lab results with ranges
TST 11.1nmol/l (range 6.073- 27.1 nmol/l)
Estradiol 107,6 pmol/l (range 0-172)
Prolactin 6.5 ug/l (range 2.64- 13.13)
Cortisol 157 nmol/l ( 101- 536)
Sadly, no other substances were not tested
describe diet [some create substantial damage with starvation diets]
I have started my diet at 22 years old , and constantly I have been eating rice and chicken breasts, tin of tuna and one corny bar (6 meals a day- only source of healthy fats was 5 eggs not even every day. and a once in two or three weeks I had regular dishes with my family (but not healthy). I will completely restructure my diet (adding healthy fats, vitamins and so on), can you guess when can I get my tst lvl naturally little bit higher?
describe training [some ruin there hormones by over training]
Mixture of many (Corte, cutting- every part trained two time a week, now normal every day one or two parts (Mo- legs, Tu- chest, biceps, Thur- back, Friday- tric., shoulders) but want to switch it back to corte to maximilize tst
testes ache, ever, with a fever?
Nothing
how have morning wood and nocturnal erections changed:
Nocturnal none, morning- really rare, rather non-existent, I have quite a difficulty to maintain errection, no libido, only a little bit to porn, but I have to force myself……

Is it possible to lower Tst lvls with this shitty diet over the years to that point or is it something else what is going on? Can you please tell me what should I do ?
Iam from the Czech Republic, sorry about the language


#4

Your English is very good.

Starvation diets are very harmful, causes hormone problems and some of that may be from driving cholesterol very low. Starvation diets can also increase SHBG. Very low body fat is also unhealthy. You need to adjust your priorities to seek quality of life, not body image.

I am concerned that eating a lot of tuna may be creating harmful levels of mercury in your body. https://worldmercuryproject.org/mercury-facts/mercury-in-fish/
https://www.google.com/search?q=mercury+in+canned+tuna

You might have been getting useful amounts of iodine in the tuna. Please make sure that you have iodized salt for cooking and on the table. See last paragraph in this post to evaluate your overall thyroid function.

Cortisol can have a big effect on energy and well-being. It peaks in the morning then declines. Should be an “AM Cortisol” test, done at 8AM or 1 hour after waking up. Results at random times are not very useful.

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.


#5

Hello,
Thank you very much for your answer!
So I would do a lowcarb diet with cyclical refeed.The base would be healthy fats and carb would be only in limited amount and I would eat them for dinner to sleep better. I think insulin would balance and other hormones start too (anabolism). I would eat three times a day.
The versions of my diet:

  1. Version- training day
  2. Version- free day, adjusted calories income
    After the last training I would do a cheatday, I would eat anything.
  3. Version- Carb day- Only one day a week. The goal is to make somekind of supercompensation with exact rate and quality in order to have efficient refeed.

I’ll have my thermometer tommorow so I’ll start measure my temp tommorow.

I want to do additional blood test, which include:

TSH
T4f
T3f
AntiGT
antiTPO
Cortisol
ALT
AST
Glucose
Hemoglobin
Hematocrit
SHGB
Cholesterol ((HDL, LDL), Triacyglycerol, Apo B, Lp(a))
Mercury
Zinc

I have read stickers and Vitamin D is really expensive to test, is it fundamental to have it tested? Should I something add or is something useless?
Thank you for your answers!


#6

You are better off skipping Vit-D25 labwork and taking 5,000iu Vit-D3. Look for tiny oil based gel caps.

Do “AM Cortisol” and try to do at 8AM or 1 hour after waking up.

Maybe a toxic metals panel would be good if you feel you have been exposed.

Testing mercury is a good idea. I do not know how this is best done. What is in your blood does not address what might be in your tissues.

Long article here: http://www.lifeextension.com/Protocols/Health-Concerns/Heavy-Metal-Detoxification/Page-01

CBC typically covers hemoglobin, hematocrit, RBC and more. [complete blood work].

For fasting blood work, drink water to not be dehydrated.

Thyroid autoimmune disease testing is typically done as a followup to other thyroid lab results.

If body temperatures are good, there might not be an real need to do any thyroid testing.

If you have problems from extreme low body fat and are intending to change that to support better health, you could make those changes first as the historic value of lab results now may be poor. Example: Years ago my wife switched to a ‘natural salt’ and I was greatly affected, checked body temperatures, checked the salt package and started taking high dose iodine. I had no interest in seeing thyroid lab results when I knew that I was iodine deficient and was fixing that.


#7

Hello again with couple of updates.
I’ve just got the results from the lab. Firstly, I state the previous ones
28/04/2017 13:06

E2- 107.6 pmol/l (range 0- 172)
Testosterone- 11.1 nmol/l (6.073- 27.1)
Prolaktin- 6.5 ug/l (2.64- 13.13)

New labs:
18.05.2017 7:00
Retikulocyt Blood 0.008 (0.005- 0.025)
Leukocyt 6.19 10^9/l (4-10)
Trombocyt 212 10^9/l (150-400)
Erytrocyt 5.08 10^12/l (4- 5.8)
Hemoglobin 162 g/l (135- 175)
Hematocrit 0.475 (0.4- 0.5)
Volume of eryt 93.6 fl (82- 98)
stain in ery. 31.9 pg (28- 34)
Konc. Hb v ery 0.341 kg/l (0.32- 0.36)
Volume tromb. 9.3 fl (7.8- 11)
Span. distrib. ery 11.8 % (10-15.2)

Neutrof. tyče 0.000 (0-0.04)
Neutrof. segm. 0.510 (0.45- 0.7)
Eozinofly 0.014 (0-0.05)
Bazofily 0.005 (0-0.02)
Lymfocyty 0.377 (0.2-0.45)
Monocyty 0.094 (0.02- 0.12)

Metabolites:

Glucose serum 5.0 mmol/l (3.8- 5.6)

Liver tests:

ALT serum 0.55 ukat/l (0.05-0.79)
AST 0.46 ukat/l (0.05-0.68)

Lipid

Cholesterol serum 4.8 mmol/l (2.2-5.2)
Triglycerids 1.14 mmol/l (0-1.46)
HDL- Cholesterol 1.21 mmol/l (0.91-3)
LDL cholesterol 3.1 mmol/l (1.5- 3.36)
Index aterogen. 4.0 (0-4)

Endo. hormones

TSH serum 4.390 mU/l 0.4-4 HIGH
fT4 Tyroxin vol 14.3 pmol/l 11.5- 22.7

Lipid/ apolipoproteins

S_Apolipoprotein AI 1.48 g/l (1.00- 1.90)
S_Apoli B 1.04 g/l (0.50-1.70)
S_Lipoprotein Lp(a) 22.9 nmol/l (<75,0)

Hormones

S_T3 (fT3) 4.4 pmol/l (2.6- 5.7)
S-Anti TPO < 0.3 kU/l (0.0- 5.6)
S-Anti TG 1.3 kU/l (0.0- 4.1)
S-SHBG 25.8 nmol/l (16.2- 68.5)
S_Cortisol 369 nmol/l (101- 536)

Estradiol 170.4 pmol/l (0-172)
Testosteron 18.1 nmol/l (6.073- 27.1)
Prolactine 24.00 ug/l (2.64- 13.13) High
Folitropin 5.7 U/l (1.27- 19.26)
Lutropin 2.5 U/l (1.24- 8.62)

Firstly, I cannot understand how these results could be so different from the first ones after 20 days. Based on the thyroid sticky, TSH is really elevated, so does it mean that I have hypothyroidism? But I think fT 3 and 4 is in normal range so could there be a problem with rT3 ( Could I destroyed it by 4 months long zero fat diet and then partying and drinking and having really big amount of stress?) My temperatures in the morning are 36.0- 36.1 C= 96.8 fahrnreit, so it might means that iam IOD.
I use iodised salt called Alpine salt, but I have started adding 150 uQ iodine pill, 100 uQ selen and Vitamin D 5000 UI. Before bedtime I just used SSRI (Trittico 150mg- it is used for both sleeping and antidepressant, but I’ve read that it can easily elevate prolactine, so I stopped using it after nearly 5 months and replaced it with Melatonin 2mg and Magnesium 470 ml. Could SSRI be the reason why is prolactine elevated so much? Or should I get a brainscan? It is my fourth day without Trittico and Iam struggling with sleep, can you please recommend me how could I improve my sleeping ( I really don’t want to go back to SSRI). Somehow when I got to bed I struggle a bit with breathing, then I start to be constricted inside then I start to be nervous and I can’nt fall asleep. During the morning iam like a deadman and in the afternoon it is slightly better, but really not enough energy for a gym.
For high estradiol I take anastrazole 1mg, is it good choice or bad one? The symptoms are as I listed above: really extreme fatique I can’t even have an energy to go to gym, I have trouble with breathing. Since my TST has elevated I am no more totally shy, or without any selfconfidence, I can go to school, mall, even with girl for a walk , anxiety is lower but I feel like pressure in my neck, and my neck is somehow burning a bit (not like sorethroat) I cannot recognize if it is a nervousness or if it is just because the difficulty with breathing and sometimes burning.) I was so restless that I had to move with my legs or arms, but it is much more better now, but as I wrote, something is still wrong.
I do not know what about cortisol, it was taken 1 hour after I woke up, and I do not know if it is low or high, can you give me a hint? The libido improved the second day when I was without Trittico and also with the supplementation of Selen, Iodine, Vit D, but next two day without libido, but I think I can maintain errection a little bit longer.
Should I go to endocrinologist and let him check my thyroid and do additional tests? Or can you give me any other advice please? Iam really tired with this extreme fatique and very poor inability to sleep. Before the diet I was I think more nervous than average people, but my energy levels were great and I was a bit nervous when I was with the girl, but now Iam tired all day, motivation is slightly better, but no libido and Iam really afraid to go to sleep now. I do not know what to do anymore. Oh and my feet are cold very often. Your insight would be much appreciated. I described all my symptoms to my sexologist/psychiatrist and he just gave me another SSRI and it supposed to boost me up, but I do not want to go near that thing……


#8

Neck burning or ache from your thyroid?

Your TT levels make sense relative to FSH=5.7 and LH-2.5
fT not tested
SHBG is low relative to E2 which makes diabetes a possible concern, but glucose suggests no risk of diabetes.

Low SHBG increases fT - free testosterone

AST/ALT do not suggest a liver issue that might explain lower E2 clearance and increased E2.

TSH way too high, should be near 1.0
fT4 should be near mid-range and is low.
fT3 is well below the typical mid-range 5.0 pmol/L, I think this is low and fT3 range is abnormal.

We need your body temperature when you wake up [low] and mid-afternoon [high].

No sign of thyroid autoimmune disease.

Alpine salt stated iodized or mineral analysis shows some natural amount of iodine. There is not enough iodine in any natural salts.

Prolactin increases during sleep and drops during the day. There are not recommended times of day and associated lab ranges. You tested 13:06 then 7:00, so hard to compare the two directly. Note that while prolactin increased, T did not fall. With time off of trazodone, if other prolactin labs show high prolactin, then maybe a MRI brain scan, otherwise not.

Did you do labs for mercury and other heavy metals?
Jittery might be in part from higher cortisol levels.


#9

Thank you very much for response KSman.
Well it is definitely not neck burning, but now like a constant pain on the right side along larynx and beneath it. When I touch it I feel pressure and little pain, but I do not know if it is thyroid or anything else. I will make an appointment to endo and let her check my thyroid and I will present my results. Unfortunately, I did not do any labs for mercury and other heavy metals, but I will insist on endo to make adittional tests.

My morning temperatures are 35.9 C to 36.1C- 96.62F to 96.98F, afternoon temperatures 36.4C- 36.5C- 97.52F- 97.7F.

Do you think my adrenals are not in a bad shape?

In terms of sleeping Iam able to fall asleep after 2 mg of melatonin but Iam awake at 4am and then I cannot fall sleep again. Any advice for improvement of my sleep?

It seems that I need to recover TSH, fT3 and fT4, is it even possible to lower TSH if it is that much elevated, without thyroid meds? And if somehow can I get it done should I try HPTA restart or it is just pointless in my case?


#10

You’ve lowered your testosterone levels into the ground from dieting. Stop dieting and start eating at maintenance. Dieting did this to me as well. Dieting to low bf without testosterone usage is stupid and dangerous. Do not do it again as you will feel just as awful. Your body does not want to be in a deficit.

In regards to macros you should be eating atleast 20% fats.