T Nation

26 YO Male Low T, No Libido


#1

-age: 26
-height: 5' 8"
-waist: 32
-weight: 165
-describe body and facial hair: Do not lack for hair anywhere, all hair grows extremely fast, including beard
-describe where you carry fat: Carry fat all in the trunk( hips, stomach, chest area)

-No prostate/hair drugs ever
-- No steroids ever
-describe diet Intermittent fasting at the moment with adequate amounts of protein, fat, and carbs during feeding window
-describe training: CrossFit/powerlifing/olympic lifting
-testes never ache
-before starting ZMA morning wood was non existent

I've been dealing with the problem for the last two years. Prior to this I've always had an extremely active sex drive. I believe my problems are a result of stress, over training(CrossFit and Olympic lifting), not enough dietary fat throughout that period and rapidly cycling diets on the extreme ends of things(carb back loading to paleo). I have never taken any gear. After a intense CrossFit competition it felt as through I had broken myself, and have been in a fog since then. After seeing multiple doctors, a naturopathic doctor, and reading studies online I am improving in most areas( stress management, energy getting back to normal most days, lifting again) however my sex drive still sucks. I went from being able to go multiple times in a day, to being okay with sex once a month.

Currently I am doing 16/8 intermittent fasting, making sure I'm getting plenty of fats, carbs, protein, and quality vegetables in my feeding window. I chose IF because it seems to give me the most focus during the day as opposed to eating small meals throughout the day. I am also no longer training like an idiot in regards to intensity/volume, and am getting ample amounts of recovery time.

I am currently taking:

Vit d3: 5000mg a day
Fish oil: 1000mg a day
DAA: 3000mg a day(cycling off on weekends)
Pregnenolone: 50mg a day
ZMA: 2 capsules at night.

(all supplements and dosages controlled by my naturopathic doctor)

levels: feb 24 2014
Test serum: 473 (385-1193 ng/dl)
test free: 12.5 (9.3-26.5 pg/ml)
(these feb labs were taken at 3 in the afternoon, so accuracy is not ideal, although my test here is higher in the afternoon than in march when it was taken at 8am fasted, where its supposed to be at one of its highest peaks)

Levels: march 13, 2015

test total: 465 ng/dl
test bio: 53
test free: 97 (35-155pg/ml)
lh: 2.4
fsh: 1.7
estradiol: 13

Levels: 9/8/15
Test total: 498 (250-1100 ng/dl)
test free: 81.9 (35-155 pg/ml)
vit d: 43 (30-80ng/ml)
dhea:4900 (1000-5500ng/ml)
TSh:4.0 (.3-4.7 mcLU/ml)

Levels : 9/25/15
DHT: 23 (30-85 ng/dl)

pregnenolone: very low
Platelets: on the low side
Lipid panel: Cholesterol mg/dL 240
Cholesterol,LDL,Calc <100 mg/dL 170
Cholesterol, HDL >40 mg/dL 36
Triglycerides <150 mg/dL 168
Non-HDL,Chol,Calc <130 mg/dL 204

I feel like I lost that special little chemical that makes me feel like a fucking man, even though I'm stronger, faster, and in better shape than I ever have been. Any thoughts would be welcome.


#2

This looks easy, for me at least. Serious issues.

You are in the right place. Make sure that you are subscribed to this thread to get email notifications of posts here.

You have hypothyroidism, which by itself can affect your other hormones.

Please read these stickies: - this will take a few days
- advice for new guys - then post more info about you
- things that damage your hormones
- thyroid basics

I think that you have adrenal fatigue, caused by over training and starvation diets. You may also have compounded things by using seat salt instead of iodized salt, creating an iodine deficiency. We then expect that rT3 is elevated, blocking fT3, lowering mitochondrial metabolism, lowering ATP and pregnenolone leading to lower body temperatures and energy levels.

Thyroid labs are misleading.
TSH should be closer to 1.0
T3, T4, fT3, fT4 should be mid range or a bit higher

You need these labs: - you have some now
TSH
fT3
fT4 [please not T3, T4]
rT3 !!!!!!!!!!!!!!!!!!
Prolactin
AM cortisol, at 8AM please
CBC with hematocrit
AST/ALT
fasting glucose
fasting cholesterol [may be too low]

Need lab number and aways with ranges.

The stickies are the threads in the forum that always stuck to the top of the list. Look at the large numbers of posts/reads.

In the thyroid basics sticky, look for references [can use ^F] to:
iodine
iodized
Wilson [wilsons book on adrenal fatigue that you should read]
adrenal [fatigue]
TSH, fT3, ft4, rT3

Supplements:
EFAs, fish oil, nuts, flax seed oil/meal
double your vit-D3 intake, many need 5000iu/day
high potency B-complex multi-vits, with trace elements, including iodine+selenium

Do you feel cold easily?
Outer eyebrows sparse?
Dry skin?
General hair thinning?
What is your history/timeline of [not] using iodized salt and/or vitamins listing iodine?

There are many guys here in your age group, attracted to this site. Otherwise I am inclined to believe such problems in the general population are not so frequent. Your T levels are low, but that is a symptom/consequence, not a root problem.

Please try not to miss any points so I am back tracking.

Also, we can evaluate your overall thyroid function by checking oral body temperatures:
- when you first wake up, should be 97.7-97.8, higher is OK, 97.3 is a problem
- also check for 98.6 mid-afternoon

Read this post more than once, its a lot to swallow.


#3

First off, Thank you.

Original post should be edited now, I did find the stickys and added some things.

As far as your adrenal fatigue issues, I have researched that topic(among others) so thoroughly I am now starting school in january to become a doctor, one who deals in health management and actually listening, not ridiculous "normal" values.

Labs:
free t4:0.8 - 1.6 ng/dL 1.6
free t3: 222 - 383 pg/dL 331
reverse t3: do not have
Prolactin: Do not have access to labs, was on upper end of normal range
am cortisol: 28 8-25 mcg/dL ( although a 24 salivary cortisol panel indicated that it was extremely low)
cbc with hemocrit: White Blood Cell Count 4.16 - 9.95 x10E3/uL 4.24
Verified by slide estimation
Red Blood Cell Count 4.41 - 5.95 x10E6/uL 5.55
Hemoglobin 13.5 - 17.1 g/dL 17.5
Hematocrit 38.5 - 52.0 % 49.8
Mean Corpuscular Volume 79.3 - 98.6 fL 89.7
Mean Corpuscular Hemoglobin 26.4 - 33.4 pg 31.5
MCH Concentration 31.5 - 35.5 g/dL 35.1
Red Cell Distribution Width-SD 36.9 - 48.3 fL 39.6
Red Cell Distribution Width-CV 11.1 - 15.5 % 12.1
Platelet Count, Auto 143 - 398 x10E3/uL 106
Mean Platelet Volume 9.3 - 13.0 fL 12.6
Nucleated RBC%, automated 0.0
Percent reference range not reported per accrediting agency
Absolute Nucleated RBC Count 0.0 - 0.0 X10e3/Ul 0.0

lipid panel: holesterol None mg/dL 240
Cholesterol, HDL >40 mg/dL 36
Triglycerides <150 mg/dL 168
Non-HDL,Chol,Calc <130 mg/dL 204

Glucose: 65 - 99 mg/dL 88
ASt: 16 iu/l(0-40)
ALT: 19iu/l (0-44)

Vit d: meant to say IU, not mg, already take 5000

-I do seem to be a bitch in the cold now, except for when I sleep. I often get night sweats which have gotten better, but are definitely still there.

-eyebrows cant really give definitive answer, i'm super hairy

-hair has always been thin

-skin can get quite dry, especially around nose/mustache area

-only iodine i get is from roasted seaweed snacks and sushi, though Im not sure how much they actually contain. timeline..a long time, only time i would get iodized salt is if a restaurant cooks with it, I never add table salt to my food

-I will buy a thermometer to test results, I know when I get it taken at the doctor (usually afternoon) it is always 98.6

I believe that is everything you asked for that I currently have knowledge/possession of.


#4

While I'm no expert like Ksman, your testosterone levels look fine. I know the range is typically 250-850 ng/dl but the vast majority of people, I've seen at least, tend to be in the 459-550 range. My TSH Went from 3.5 to around 1.5 and my mood and energy greatly improved. My base T-levels are roughly in the 420s range


#5

Yea man I'm not looking to do TRT, just want to feel better. How did you lower your TSH? I've been researching iodine supplementation, and it seems everybody has a different opinion on whether it is harmful or helpful.


#6

TSH should be closer to 1.0
T3, T4, fT3, fT4 should be mid range or a bit higher

free t4:0.8 - 1.6 ng/dL 1.6
free t3: 222 - 383 pg/dL 331
TSH=4.0

These are quite high, something is going on.
Looks hyper but TSH suggests hypo.
Pituitary may be making more TSH that called for. Can be a [rare] pituitary defect.
Hypothalamus might be blinded to thyroid levels by rT3
Need body temperature details to help narrow down possibilities.
Do you feel shaky/nervous? [hyper]

Prolactin can:
lower FSH/LH, lowering T
cause depression by lowering dopamine
lead to gyno
One looks for a prolactin secreting pituitary adinoma via MRI. Can be easily managed with 0.5mg/week Dostinex/cabergoline.
Can get large and press on optic nerves if ignored.

Typically, restaurants do not use iodized and and ditto for prepared foods. So do not count on an iodine from those salt sources.

Is your thyroid enlarged, lumpy or asymmetrical?

Cortisol is very import for energy levels. Look into this more carefully. High ? Low or varying?

Did you run across the fT3 - mitochondria - ATP - basal metabolic rate and body temperature connection? Mitochondria also need CoQ10 that is made in the liver.


#7

Glossing over hyper doesn't look like any of those symptoms fit really well besides the anxiety/shakiness. I've had benign essential tremors in my hands since I was like 16 though. I remember my prolactin levels were on the upper end, but after reading I do not believe it was anywhere near the levels that indicate a pituitary adenoma(still searching for those labs). I also know there is no way my doctor will prescribe and MRI. Thyroid does not appear to be enlarged or lumpy. According to the salivary test my cortisol levels were basically flatlined all day, and I have been taking steps to improve that with supplements and stress reduction.

Side note: I was in a hopeless spiral unto I decided to try keto with bulletproof coffee. In one day it completely took away most of my brain fog and greatly improved energy, it was like a year long foggy haze had been suddenly lifted. I imagine it was from the introduction of much needed fats back into my diet, so I make sure to continue to get those(seemed to be the grass fed butter that did the trick) Now of course I use intermittent fasting with improved my concentration levels even more, but the last thing left is sex drive. Its such a drastic change from how I used to be that I can't just chalk it up to being tired or in a bad mood.

If restaurants don't use it then I almost never get it, and my parents used mortons salt all my life, but I'm not sure if it was the iodized one. In regards to IR, I don't want to go overboard because some studies seem to point to iodine potentially making hypo worse, what would you recommend?

Still reading up on the rt3-mito-atp connection, and going to buy the thermometer today, so I will take a reading tonight, and tomorrow morning.


#8

If cortisol was high then dropped, that can happen with adrenal fatigue.