T Nation

27 Year Old VERY Low Testosterone

T-Nation: 27 years old, VERY low testosterone

Hi everyone,

-27 years old
-5â??10â??
-30â?? Waist
-Moderately hairy chest and back. Full beard. Hair thinning on top of my head.
-My fat is carried in the lower stomach area. I am pretty shredded everywhere else with pretty incredible bicep/forearm vascularity.

-Symptoms: No sex drive at all, ED, constant fatigue, weakness in legs, intolerance to cold, depression, anxiety, social isolation, frequent urination

-Medication: Clomiphene 50mg daily

-Lab Results: Iâ??m only including things that I believe to be relevant, please let me know if you need more:
Testosterone TOT: 37 (250-1100 ng/dL) L
Prolactin: 8.9 (2.0-18.0 ng/mL)
Sodium: 129 (135-146 mmol/L)L
Estrogens, Total: 138 (130 or LESS pg/mL)H
FSH: 2.7 (1.6-8.0 mIU/mL)
LH: 0.4 (1.5-9.3 mIU/mL)L
Cortisol, Total: 15.1 (mcg/DL)
FRT4: 0.66 (0.65-2.30 ng/dL)
TSH: 1.23 (0.40-4.00 uIU/mL)
TotT3: 0.58 (0.75-1.78 ng/mL)L

-Diet: In January, I wanted to lose some body fat and started a cut. I took things too far, my calories were entirely too low and I was overtraining as well. I was not eating sufficient amounts of fats or carbohydrates. Once realizing I took it too far (147 lbs in March), I began to slowly increase caloric intake in an effort to put on lean muscle mass. I am currently eating sufficient calories. My protein comes in the form of eggs, tuna, chicken breast, ground turkey, tilapia, salmon, cottage cheese, whey protein. My fats come from eggs, cheese, nuts, nut butter, salmon, ground turkey. Carbohydrates are primarily slow digesting. I was drinking a TON of diet soda but have since cut out artificial sweeteners entirely (3 weeks ago- Iâ??ve lost about 8 pounds in this time frame as well which is confusing. Evidence that artificial sweeteners really do slow down one’s metabolism, maybe?.) Supplements are whey protein (no artificial sweetners) and Quest Protein Bars (100% All Natural Line).

-Training: I was overtraining severely. High volume/intensity power and hypertophy lifting in addition to 2 20 minute HIIT workouts and 4 30 minute LISS cardio sessions. Upon realizing this may have caused some of my problems, I took last week off entirely from working out. (This was difficult to do!). I resumed training this week on a MUCH lighter basis- nowhere near the load/volume/intensity that I had been.

-Initial Doctor Visit: I finally got blood work done in August at an Urgent Care clinic because I had been ignoring my symptoms for too long (I donâ??t have a PCP). They almost laughed at me but were not laughing when they saw my results indicating low testosterone, elevated liver levels, and low sodium.

-Endocrinologist: I visited an endocrinologist who did an examination and ordered a pituitary MRI, liver ultrasound, and thyroid ultrasound. He was fairly certain I had a substantially large pituitary adenoma. The MRI and ultrasounds were all negative. He then referred me to a neurologist because he said there was a lesion on my right parietal lobe which could be causing my symptoms. I have yet to follow up with a neurologist because I donâ??t feel this is the root cause and feel the endo was just trying to pass me off.

-Urologist: A physician family member guided me to visit a urologist. He did a full examination (prostate as well, this is not fun). He asked if I ever wanted to have children and I said that I might. Because of this, he suggested Clomiphene as a more physiological approach to increasing my testosterone. I have been taking 50mg daily for the past 2 weeks. Prostate was enlarged. I am due to return for follow up blood work in October.

-Lifestyle changes I have since made: I increased my dietary fat intake to around 100g a day and have noticed a vast improvement in my intolerance to cold. I actually need to use my Air Conditioning now. I cut out artificial sweeteners entirely due to iodine concerns. I started using iodized salt instead of sea salt for the same reason. As previously mentioned, I have really toned down my training/working out.

-Started getting morning wood/nocturnals more frequently though they are by no means â??ragersâ??.

-My thoughts: I feel I did some serious damage to my body when severely dieting in January. I started reading the stickies here but quite honestly am extremely overwhelmed by all the information. I now realize that improving my testosterone is only one piece of the puzzle and will likely require substantial long term diet and lifestyle changes as well. Any guidance or information on my case would be unbelievably appreciative, as Iâ??m unsure of what my next step should be and am a bit lost.

Hello sir 23 and going throught the same things you. Stay on clomid for a full 6 weeks and see how you feel. At the end of 6 weeks you don’t feel better there is no reason to test your testostosterone, it’s very low and it will remain that way. The hpta restar protocols such as nolvadex, clomid, hcg, can only raise your test by 150 percent at max, even if you did raise your levels to that extent you will still be low. In the mean time get thyroid labs, take iodine according to ksman s ir protocol . If your urologist fails to see your issue I would move on to finding a male wellness doctor or try specialist.

Thanks for responding. It’s good to talk with people who are having similar problems. Have you taken iodine and has it helped with your symptoms?

Would my next step be finding either a solid endocrinologist or a general practitioner, getting blood work done to test my Adrenal and Thyroid functioning?

[quote]Tapatio42 wrote:
T-Nation: 27 years old, VERY low testosterone

Hi everyone,

-27 years old
-5â??10â??
-30â?? Waist
-Moderately hairy chest and back. Full beard. Hair thinning on top of my head.
-My fat is carried in the lower stomach area. I am pretty shredded everywhere else with pretty incredible bicep/forearm vascularity.

-Symptoms: No sex drive at all, ED, constant fatigue, weakness in legs, intolerance to cold, depression, anxiety, social isolation, frequent urination

-Medication: Clomiphene 50mg daily

-Lab Results: Iâ??m only including things that I believe to be relevant, please let me know if you need more:
Testosterone TOT: 37 (250-1100 ng/dL) L
Prolactin: 8.9 (2.0-18.0 ng/mL)
Sodium: 129 (135-146 mmol/L)L
Estrogens, Total: 138 (130 or LESS pg/mL)H
FSH: 2.7 (1.6-8.0 mIU/mL)
LH: 0.4 (1.5-9.3 mIU/mL)L
Cortisol, Total: 15.1 (mcg/DL)
FRT4: 0.66 (0.65-2.30 ng/dL)
TSH: 1.23 (0.40-4.00 uIU/mL)
TotT3: 0.58 (0.75-1.78 ng/mL)L

-Diet: In January, I wanted to lose some body fat and started a cut. I took things too far, my calories were entirely too low and I was overtraining as well. I was not eating sufficient amounts of fats or carbohydrates. Once realizing I took it too far (147 lbs in March), I began to slowly increase caloric intake in an effort to put on lean muscle mass. I am currently eating sufficient calories. My protein comes in the form of eggs, tuna, chicken breast, ground turkey, tilapia, salmon, cottage cheese, whey protein. My fats come from eggs, cheese, nuts, nut butter, salmon, ground turkey. Carbohydrates are primarily slow digesting. I was drinking a TON of diet soda but have since cut out artificial sweeteners entirely (3 weeks ago- Iâ??ve lost about 8 pounds in this time frame as well which is confusing. Evidence that artificial sweeteners really do slow down one’s metabolism, maybe?.) Supplements are whey protein (no artificial sweetners) and Quest Protein Bars (100% All Natural Line).

-Training: I was overtraining severely. High volume/intensity power and hypertophy lifting in addition to 2 20 minute HIIT workouts and 4 30 minute LISS cardio sessions. Upon realizing this may have caused some of my problems, I took last week off entirely from working out. (This was difficult to do!). I resumed training this week on a MUCH lighter basis- nowhere near the load/volume/intensity that I had been.

-Initial Doctor Visit: I finally got blood work done in August at an Urgent Care clinic because I had been ignoring my symptoms for too long (I donâ??t have a PCP). They almost laughed at me but were not laughing when they saw my results indicating low testosterone, elevated liver levels, and low sodium.

-Endocrinologist: I visited an endocrinologist who did an examination and ordered a pituitary MRI, liver ultrasound, and thyroid ultrasound. He was fairly certain I had a substantially large pituitary adenoma. The MRI and ultrasounds were all negative. He then referred me to a neurologist because he said there was a lesion on my right parietal lobe which could be causing my symptoms. I have yet to follow up with a neurologist because I donâ??t feel this is the root cause and feel the endo was just trying to pass me off.

-Urologist: A physician family member guided me to visit a urologist. He did a full examination (prostate as well, this is not fun). He asked if I ever wanted to have children and I said that I might. Because of this, he suggested Clomiphene as a more physiological approach to increasing my testosterone. I have been taking 50mg daily for the past 2 weeks. Prostate was enlarged. I am due to return for follow up blood work in October.

-Lifestyle changes I have since made: I increased my dietary fat intake to around 100g a day and have noticed a vast improvement in my intolerance to cold. I actually need to use my Air Conditioning now. I cut out artificial sweeteners entirely due to iodine concerns. I started using iodized salt instead of sea salt for the same reason. As previously mentioned, I have really toned down my training/working out.

-Started getting morning wood/nocturnals more frequently though they are by no means â??ragersâ??.

-My thoughts: I feel I did some serious damage to my body when severely dieting in January. I started reading the stickies here but quite honestly am extremely overwhelmed by all the information. I now realize that improving my testosterone is only one piece of the puzzle and will likely require substantial long term diet and lifestyle changes as well. Any guidance or information on my case would be unbelievably appreciative, as Iâ??m unsure of what my next step should be and am a bit lost.

[/quote]

We don’t normally advocate endocrinologists here, but if one told me I had a brain lesion after an MRI, I would definitely follow up on that…

You listed Clomid above your labs. Were you taking clomid when the the labs were done? If yes, then you have primary hypogonadism. The testes are failing to respond to the command. Also, clomid is increasing your estradiol.

TRT is your only option if the above it true.

[quote]Tapatio42 wrote:
Would my next step be finding either a solid endocrinologist or a general practitioner, getting blood work done to test my Adrenal and Thyroid functioning?[/quote]

GPs are usually more willing to run the necessary tests. BUT, you will need to educated yourself as much as possible to be able to articulate WHY you want these tests, because they most likely will have no idea about them.

I’m not the thyroid guru here, but it would appear to me that you do have some thyroid dysfunction going on.

Also, your morning (fasting?) cortisol level doesn’t look too bad, but a 4-point saliva test for cortisol will be much more revealing if there are any issues. With your sodium being so low, your aldosterone is probably low too. This will cause frequent urination.

A couple of easy tests that can be done at home. The pupil test is for aldosterone:

Get labs in accordance with the blood testing sticky.

Thanks for your reply!

I was not taking Clomid yet when the above labs were taken. I do plan on following up with a neurologist but I strongly disagree the endo’s thoughts of “Maybe M.S., maybe Lyme’s Disease”. I think he was just clueless.

My cortisol level was not fasting. I definitely agree that there is some thyroid dysfunction.

Your endo is open minded and if you have lesions on your temporal lobe I would seriously consider that you may have Lyme… The hormonal problems and your symptoms are consistent with Lyme… Ask me cause I have it…

Any other symptoms?

Stomach problems?

Ear problems? I.E hyper sensitivity to sound? ringing? Clicking? Movement ?

Neurological problems?

I know a girl who only had head aches and has Lyme…

The immune system plays a huge role in the severity of your symptoms as well as co infections…

Yes Kaynon he has something sub clinical going on with the thyroid but I suspect this is due to an rt3 issues and possible adrenal fatigue…

Suggest getting the western blot and if you have some money I would suggest biting the billet and ordering your labs from Igenex or getting something called a spot test which is a new development in the Lyme world and is also testing for antibodies in confections… Do yourself a favour and get this shit tested bro… The earlier it is detected and treated the better off you are… Trust me man

Thanks, guys. No other symptoms. I will definitely get tested for Lyme just in case but have assumed all along that this was due to my training/dieting. I agree that it’s better to be thorough to play it safe.

FRT4: 0.66 (0.65-2.30 ng/dL) - free T3, should be mid scale (.65 + 2.3)/2 = 1.475
TSH: 1.23 (0.40-4.00 uIU/mL) - does not look bad by itself
TotT3: 0.58 (0.75-1.78 ng/mL)L should be mid scale 1.265

Looks like hypothyroidism
intolerance to cold then makes sense

Body temperatures and iodine intake? see thyroid basics sticky

Would be good to have fT3 and rT3

Is your thyroid enlarged, asymmetrical or lumpy? Neck appears thick around your larynx? Ever feels sore?

Post those liver numbers, and do you have total cholesterol numbers. We can be skilled at reading labs, but only what you show us. We often pick up on things that docs overlook.

Starvation and over training can cause problems. That and other stresses can increase rT3 that then blocks fT3.

frequent urination: do you have fasting glucose lab numbers? Concern is diabetes. Any numbness or tingling in your feet?

[quote]KSman wrote:

Looks like hypothyroidism
intolerance to cold then makes sense

Body temperatures and iodine intake? see thyroid basics sticky

[/quote]

Initially I thought hypothyroidism as well, however my intolerance to cold has all but disappeared since I increased my dietary fat intake. I will buy a thermometer and take temperatures anyway, though. About a month ago I switched to iodized salt and apply it very liberally to everything I eat.

[quote]KSman wrote:
Is your thyroid enlarged, asymmetrical or lumpy? Neck appears thick around your larynx? Ever feels sore?
[/quote]

Thyroid is not enlarged and feels fine. Thyroid ultrasound was normal, as well.

[quote]KSman wrote:
Post those liver numbers, and do you have total cholesterol numbers. We can be skilled at reading labs, but only what you show us. We often pick up on things that docs overlook.
[/quote]

The following liver tests were taken on my initial visit to the Urgent Care Clinic:

Calcium 9.7 (8.6-10.3mg/dL)
Protein, Total Serum 7.1 (6.1-8.1g/dL)
Albumin 4.9 (3.6-5.1 g/dL)
Globulin, Calculated 2.2 (1.9-3.7 g/dL)
A/G Ratio 2.2 (1.0-2.5)
Bilirubin, Total 0.6 (0.2-1.2mg/dL)
Alkaline Phosphatase 50 (40-115 U/L)
AST 51 (10-40 U/L)
ALT 63 9-46 U/L)
EGFR Non Afr American 93 (<=60 mL/min/1.73m2)
EGFR Afr American 107 (<=60 mL/min/1.73m2)

quote]KSman wrote:
frequent urination: do you have fasting glucose lab numbers? Concern is diabetes. Any numbness or tingling in your feet?
[/quote]

I don’t have fasting glucose lab numbers, however diabetes is something i have NEVER considered before, and I’m definitely going to investigate that route further. No numbness/tingling in feet, but weakness in legs. I’m sure I can google this, would Diabetes affect Testosterone levels or would that be part of another physiological issue?

Diabetes can effect hormones levels…

You need to heal that liver… Do you drink alot?

St. John’s wort lowers estrogens helps with depression and will help the liver

Milk Thistle from the seed will help you to clear estrogens and help the liver functions.

I suggest going to see a naturopath who uses biomaridian testing… I’m guessing you are pretty toxic right now and need to heal the body as a unit and not just look for a quick fix.

I still think Lyme is a possible factor and don’t want you to loose site of this… How long have you been feeling this way man?

[quote]iw84aces wrote:
Diabetes can effect hormones levels…

You need to heal that liver… Do you drink alot?

St. John’s wort lowers estrogens helps with depression and will help the liver

Milk Thistle from the seed will help you to clear estrogens and help the liver functions.

I suggest going to see a naturopath who uses biomaridian testing… I’m guessing you are pretty toxic right now and need to heal the body as a unit and not just look for a quick fix.

I still think Lyme is a possible factor and don’t want you to loose site of this… How long have you been feeling this way man?
[/quote]

I haven’t drank a drop of alcohol since January.

I’ve been having symptoms like no sex drive, depression, intolerance to cold since January. However for about the past three months, everything intensified big time such as extreme fatigue/lack of energy/weakness in legs.

After reading all the stickies and doing tons of research, I believe I have some direction of which way to move:

Possible Causes:
? Adrenal Fatigue
? Resistance Caused by RT3
? Diabetes
? Celiac?s/Vitamin B12 Deficiency (Absorption)
? Lyme Disease (Unlikely)

Tests Needed:
? Adrenal:
o Aldosterone
o Cortisol four sample saliva testing

o DHEA
o DHEA-S
o Pregnenolone

? Thyroid:
o Total T3
o fT3
o fT4
o Total T4
o rT3
o TSH
o Thyroglobulin Antibodies
o Thyroid Peroxidase

? Diabetes
o Glycated hemoglobin (A1C) test
o Fasting blood sugar test
o Random blood sugar test

? Lyme Disease
o Western Blot

? Others
o C-reactive Protein
o CBC
o Cortisol
o DHT
o Estradiol
o Ferritin
o FSH
o Glucose (Fasting)
o Homocysteine
o IGF-1
o Iron, Total Binding Capacity 

o Iron, Binding Capacity 

o LH
o Magnesium, RBC
o Metabolic Panel with Lipids (Fasting)
o Progesterone
o Pregnenolone
o Prostate Specific Antigen (PSA)
o SHBG
o Testosterone Free
o Testosterone Total
o VITAMIN B12 

o Vitamin D, 25-OH
o Vitamin D, 25-OH D3 



Any input on causes for symptoms would be appreciated!! What do you guys think about my lab list, will it be comprehensive enough? Also, would I be able to get all of these tests done at a GP, or would I have to go to someone more specialized?

i would also consider a test for lyme disease along with its co-infections. it is something you definitely want to rule out.
i have lived with lyme for a decade and have suffered all of your symptoms.

Thanks, Floyd. What other tests besides Western Blot do you recommend? How are your symptoms now and how long did it take you to figure out it was Lyme?

The would recommend testing for lyme and its co-infections (babesia, bartonella, ehrlichia). The best lab for testing is I-Genex in Palo Alto Ca. It took me about 3 years to figure out that I had Lyme, and over 2 years of serious treatment before I felt “normal” again. I strongly urge you the get tested so you can rule this out.

I went to an Internist to see her take on things. She agreed with the need for many of the above tests including Adrenal functioning (unfortunately did not have the saliva test), western blot for lyme disease, fasting glucose for diabetes, thyroid functioning including RT3.

She also wanted to test for heavy metal toxicity. Anyone have any experience with this? I have to do two separate 24 hour urine collections in which I collect each and every drop of urine over a 24 hour period. These are to test for arsenic, lead, mercury, cadmium, and aluminum in addition to aldosterone, cortisol, M-Hydrodxycoritcosteroid, and M-Ketosteroids.

I like how the GP is trying to think of different possibilities and explanations. When asked, she told me her gut is that my adrenal glands are what’s causing everything. It’s going to be a fun weekend of pissing in a container! What are your guys’ thoughts on the metal toxicity?

Hey man, Im 25, had low T since I was 19. Back then I used to eat shit-loads of tuna, which I later came to find out was full of mercury. At that time I had a total T of 200. I stopped eating all kinds of fish after finding that out. Over the years I’ve slowly increased my T, which I believe has mostly been due to detoxification. I think toxicity would be worth looking into, provided you’ve done the basics; zinc, vitamin D, high protein, high fat etc.

Good luck mate :slight_smile:

DUDE, very funny that you bring that up. I usually eat a TON of canned tuna and various other uncanned fish (salmon, tilapia, etc.). Over the past 3 days, I’ve noticed that I have felt better and was trying to figure out why and now I realize have not eaten canned tuna in 3 days. I wonder if this is a potential explanation? The urine test is looking for mercury among other things so hopefully that would be an easy fix! Do you think that would affect my other issues such as Thyroid levels and Liver functioning being off?