T-Nation: 27 years old, VERY low testosterone
-27 years old
-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.