T Nation

27 Y/O, Pretty Low T, Uncertain Diagnosis


Dear all,
First, let me apologize for my expression -I’m from Spain-, and thank you for all the useful information I’ve found in this forum.

I have suffered from symptons of low T since a couple of years ago: fatigue, depression, low libido and, specially in the last 10 months, erectyle dysfunction. However, I have always suspected that I did not complete puberty properly.

I have run some tests and I have not received a clear diagnosis yet, so I would like to take advantatge of your experience, because I feel lost and desperate.
These are the last labs, in the format “value, range”:
FSH: 3.47 mUI/ml, 1.5-12.4 mUI/ml
LH: 3.6 mUI/ml, 1.7-8.6 mUI/ml
Prolactin 14.01 ng/ml, 4.04-15.2 ng/ml
Estradiol 12.73 pg/ml, 7.63-42.6 pg/ml
Total Testosterone 2.9 mcg/L, 2.8-8 mcg/L
Free Testosterone 0.222 nmol/L, normal >0.250 nmol/l
SHBG 23.1 nmol/L, 14.5-48.4
Cortisol 19.26 mcg/dl, 6-19.4
Free Thyroxine 1.12 ng/dlL, 0.7-1.8
TSH 3.02 mUI/L, 0.27-4.2
GH 0.05 ng/mL, 0.02-1.23
IGF-1 241.1 ng/mL, 109-284
ACTH 30.7 pg/mL,
I also get a MRI from the pituitary gland, and it seems normal.

I also get a testicular ecography, and the results are:
-Left testicle, 9ml of volume (the minimum of an normal adult is 15ml), 6mm epididimal cyst, light varicocele
-Right testicle, 13ml of volumen, the rest seems normal
I also get an spermiogram, and the result is Azoospermy, I mean, complete absence of spermatozoons in the semen.

I weight 85 kilos, 173 cm tall. I have been lifting weights for almost 10 years. Not a significant muscular development, and some fat distribued across the body and, specially, in the love handles. I have gynecomastia in the left side from the puberty, and it has also appeared a little bit on the right side. No hair in the upper body, except by arms. Poor beard.

I have never used any sort of steroids -until that that I’m on TRT-, alcohol, opiates… anything.
Since September 2015-October 2015, I used testosterone gel, 5mg daily. I switched to testosterone cypionate, 250mg every two weeks or every 3 weeks from October 2015 to January 2015. From frebuary, I stayed 2 months clean to see if my body could produce some T. The labs were what I put above. In september, I was 2.6 total testosterone and 7.4 of free Testosterone in a range of 9.4-42.
According to my endo, it seems to be a non-congenital problem in the hypothalamus, probably caused by my depression and anxiety psychological problems. Is that possible? I’m not satisfied with the diagnosis.

What do you think?
I’m now one 250mg of cypionate every 2 weeks. I know that it is not a proper protocol, but here, in Spain, doctors are very reluctant to prescribe any T at all, AI or any low dose of HcG.
Thank you very much in advance.
Best wishes,


It’s very often that the low T is idiopathic which means no known cause, all we can do in such a case is treat is as the problem in itself. You will find most cases here where there’s no known cause that seems to halting T production. Try to optimise your health with a good TRT protocol and stop worrying about something which is of no use. If you are in all other ways healthy today that’s what matters.


All we can offer is in the links found here: About the T Replacement Category
advice for new guys
things that damage your hormones
protocol for injections
thyroid basics explained - please check your oral body temperatures

TSH=3.0 is a problem, should be closer to 1.0
Have you always been using iodized salt?
Do you feel cold easily?
Outer eyebrows sparse or thin?

Ask to self inject your T and inject 50mg twice a week.