T Nation

28 YO Male Results - Low Test, Low FSH


#1

I’m a 28 yr old male. I was planning a cycle and decided to get blood
work done. I’ll post my results below but I’m showing low test at 255
ng/dL and low FSH at 1.4. I did one 8 week cycle 2 years ago. 500 mg
week test. I used HCG 250 IU every 4 days throughout cycle. I used an
AI. I did a month long PCT with Nolva 40/40/20/20 and Clomid
100/100/50/50. I don’t think I exhibit any signs of low test. I have no
problem with sexual function. Sure I’m tired a lot but I work pretty
hard. Anyone see anything else in these results that’s abnormal and have
any suggestions? I ordered these tests online and have not seen a
doctor yet.

CBC With Differential/Platelet

WBC 5.5 3.4-10.8 x10E3/uL 01

RBC 5.46 4.14-5.80 x10E6/uL 01

Hemoglobin 15.8 12.6-17.7 g/dL 01

Hematocrit 46.1 37.5-51.0 % 01

MCV 84 79-97 fL 01

MCH 28.9 26.6-33.0 pg 01

MCHC 34.3 31.5-35.7 g/dL 01

RDW 14.2 12.3-15.4 % 01

Platelets 169 150-379 x10E3/uL 01

Neutrophils 52 % 01

Lymphs 36 % 01

Monocytes 8 % 01

Eos 3 % 01

Basos 1 % 01

Neutrophils (Absolute) 2.9 1.4-7.0 x10E3/uL 01

Lymphs (Absolute) 2.0 0.7-3.1 x10E3/uL 01

Monocytes(Absolute) 0.4 0.1-0.9 x10E3/uL 01

Eos (Absolute) 0.2 0.0-0.4 x10E3/uL 01

Baso (Absolute) 0.0 0.0-0.2 x10E3/uL 01

Immature Granulocytes 0 % 01

Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL 01

Comp. Metabolic Panel (14)

Glucose, Serum 75 65-99 mg/dL 01

BUN 12 6-20 mg/dL 01

Creatinine, Serum 0.84 0.76-1.27 mg/dL 01

eGFR If NonAfricn Am 119 >59 mL/min/1.73 01

eGFR If Africn Am 138 >59 mL/min/1.73 01

BUN/Creatinine Ratio 14 8-19 01

Sodium, Serum 140 136-144 mmol/L 01

Potassium, Serum 4.4 3.5-5.2 mmol/L 01

Chloride, Serum 100 97-106 mmol/L 01

Carbon Dioxide, Total 24 18-29 mmol/L 01

Calcium, Serum 9.5 8.7-10.2 mg/dL 01

Protein, Total, Serum 7.0 6.0-8.5 g/dL 01

Albumin, Serum 4.8 3.5-5.5 g/dL 01

Globulin, Total 2.2 1.5-4.5 g/dL 01

A/G Ratio 2.2 1.1-2.5 01

Bilirubin, Total 1.1 0.0-1.2 mg/dL 01

Alkaline Phosphatase, S 85 39-117 IU/L 01

AST (SGOT) 25 0-40 IU/L 01

ALT (SGPT) 31 0-44 IU/L 01

Testosterone, Serum

Testosterone, Serum 255 LOW 348-1197 ng/dL 01

Comment: Comment 01

Adult male reference interval is based on a population of lean males

up to 40 years old.

Luteinizing Hormone(LH), S

LH 5.8 1.7-8.6 mIU/mL 01

FSH, Serum

FSH 1.4 LOW 1.5-12.4 mIU/mL 01

1 of 2

Estradiol

Estradiol 13.0 7.6-42.6 pg/mL 01


#2

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc
    *** HPTA restart**

E2 is low suggesting that FT is also low.

Have you ever used a hair loss drug 5-alpha reductase inhibitor?

PCT with that much Clomid+Nolvadex is wrong, but common bro-science. Should not stack SERMs or SERM+hCG as it creates a cesspool of estrogens that adex cannot control. See the HPTA restart sticky.

You can be tired from low thyroid function, common with guys here, or low cortisol.

Thyroid:

  • check overall thyroid function with oral body temperatures as per the thyroid basics sticky
  • have you been using iodized salt to support creation of thyroid hormones?
  • are your outer eyebrows sparse?
  • feeling cold easier?

Your choices can affect fertility. You can attempt to fix this or do TRT with blast and cruise. If you attempt to fix and succeed, doing gear again does not make sense.


#3

I’m 5’11’’ . my weight fluctuates daily between 194 and 202, depending on what I eat.
My handheld Omron body fat monitor just now read 15% and my body fat scale read 24% which seems way off to me. A tape test this week, subtracting neck circumference from midsection gave a result of 17%.
I believe the midsection, around navel circumference was 36 in. and neck 17 in.
I’m a ginger so my body hair is light. I can grow a pretty decent beard in 4 days, it’s not patchy. I just had a new tattoo done and the artist said it’s some of the thickest arm hair he’s ever shaved. My body isn’t covered or anything. grows on my chest and the normal places. For some reason I grow hair on one bicep but not the other, always thought that was strange.
Never taken hair loss or prostate drugs.
I was given a shot of solumedrol and on Prednisone for about a month in Aug/September for poison ivy / cellulitis.

Just took body temp by ear and reading 96.6 - 96.8.

I don’t sleep enough. I usually stay up past midnight, sometimes 2 am and wake up at 5:45 am. I often go a few days like this and then crash right after work or sleep long hours on the weekend. I also drink quite a bit of alcohol on weekends.

I’ve always been around 12% body fat with pretty consistent weight until about the last year. I completed my cycle in November 2014. I jumped up to 215 lbs from 195, again at about 12% and leveled off around 210 after PCT. I was then deployed to Iraq for 8-9 months January 2015 to September 2015. I maintained most of my gained strength for about 6 months and then it started to fall off but it was hard to keep a consistent gym schedule out there. I attempted to do a dbol only cycle out there. I didn’t want to be pinning in Iraq. I was on 50mg a day for about a week and then had to stop because we got word we were moving to a different area. I remember taking a bit of Nolva for maybe a week but didn’t do a full PCT.

I returned to the states at about 200 lbs. When I got back I got into a serious relationship and didn’t lift much the past year though remained active, exercising with work. I started putting on fat which was abnormal for me. By December/January 2016 I was 215 lbs again but not in muscle. Most of it in the abdominal area. I was weighed and taped and the medic said my abdomen was distended. I also started experiencing a swollen feeling in my neck / lymph nodes area and anxiety. I was tested for mono because I felt sluggish like I did when I had mono before but it came back negative. I had a thyroid panel done privately in January 16 and the results read in range. I then had the tests done through the Army and same thing. I had an ultrasound done on my neck which showed nothing unusual. I was supposed to be scheduled for a barium swallow test but it never happened. We started an intensive training cycle from spring to summer. The swollen neck feeling subsided so I wrote it all off as a symptom of stress/anxiety and getting older and forgot about it. I started dropping weight, 4-5 lbs lighter every time we came back from training out in the woods and by September was seeing my weight as low as 192.

The testosterone labs were taken around 4pm after fasting all day because that’s the only time I could get there after work. I know it should be taken in the morning but I’ve read total test should only drop about 30% over the course of the day and adding 30% to 255 would still read low. The test was also ECLIA not LC/MS.

I’m now considering trying to do a HPTA restart with HCG / Nolva but my medic is worried now and wants me to get tested through the Army and see if the PA will put me on TRT. Getting treatment through the Army always takes forever and I’d like to fix it on my own before I start down that road. Since my LH levels are normal, I suspect that I’m secondary. With low test, my LH should be high because my body should be screaming to make more test, right?

I’ll post the thyroid panel here but it’s from way back in January 2016 so it may not be very relevant.

Thyroid Panel With TSH
TSH 3.490 uIU/mL 0.450 - 4.500 01
Thyroxine (T4) 7.2 ug/dL 4.5 - 12.0 01
T3 Uptake 32 % 24 - 39 01
Free Thyroxine Index 2.3 1.2 - 4.9
Thyroxine (T4) Free, Direct, S
T4,Free(Direct) 1.15 ng/dL 0.82 - 1.77 01
Reverse T3, Serum 12.6 ng/dL 9.2 - 24.1 02
Thyroglobulin Antibody <1.0 IU/mL 0.0 - 0.9 01
Thyroglobulin Antibody measured by Beckman Coulter Methodology
Thyroid Peroxidase (TPO) Ab 10 IU/mL 0 - 34 01
Triiodothyronine,Free,Serum 3.6 pg/mL 2.0 - 4.4

I was taking a prohormone cocktail called Monstrosity during that first test cycle as well. During PCT I utilized peptides, GHRP-6 and Mod GRF 1-29 (CJC 1295 w/o DAC). In Iraq I also used SARMS. GW-501516, S4, Ostarine, LGD-4033. Last year I tried Clenbuterol for a couple days but didn’t like the way it made me feel and stopped.


#4

Okay I read your Thyroid thread as well as a few other things on the internet.

It sounds like my TSH being 3.5 is considered high or subclinical. and Free T4 should be in the top half of the range and mine also falls below that at 1.15 with a reference of 0.82 - 1.77 ng/dL.

“primary hypothyroidism can cause subnormal responses of LH to GnRH. GnRH is produced in the hypothalamus and signals the release of LH. When this subnormal response is present, as in the case of men with hypothyroidism, LH will not be able to carry out its function at an adequate level.”

So… since I have low total test. LH should be elevated to signal my body to make more? However it is not, it is reading normal or in range at 5.8 with a reference of 1.7-8.6 mIU/mL.

I understand how GnRH signals LH but not how primary hypothyroidism would affect that signalling unless the pituitary is too busy making excess TSH to produce LH. I guess I don’t understand how hypothyroidism affects testosterone production. Cholesterol?

“Steroid hormones are all derived from cholesterol. So what performs [cholesterol --> pregnenolone]? Notice that cholesterol is been consumed. This is done inside the mitochondria that consume cholesterol in the blood stream. If fT3 levels are low, body temperature drops and mitochondria do not feed on cholesterol at the same rate.”

So hypothyroidism causes low levels of pregnenolone due to the conversion of cholesterol not taking place. So the adrenals don’t have enough to convert to DHEA and in turn testosterone?
Could I attempt to supplement with DHEA? If the conversion of cholesterol to pregnenolone isn’t taking place. Supplementing exogenous DHEA should raise test levels, yes?

“At the pituitary, GnRH stimulates the synthesis and secretion of the gonadotropins, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These processes are controlled by the size and frequency of GnRH pulses, as well as by feedback from androgens and estrogens.”

My FSH was also low at 1.4 with reference of 1.5-12.4 mIU/mL.

so how do I fix GnRH?

“leptin and insulin have stimulatory effects and ghrelin has inhibitory effects on gonadotropin-releasing hormone (GnRH) secretion from the hypothalamus.”

GHRP-6 and Mod GRF 1-29 are ghrelin mimetics. It’s been almost 2 years since I’ve taken those peptides though.

“Ghrelin and ghrelin mimetics work by activating the ghrelin receptor, also called the growth hormone secretagogue receptor (GHS-R1a). Elevated ghrelin levels act towards increasing GH levels by stimulation of ghrelin receptors in the pituitary. Injection of GHRP-6 or any GHRP stimulates GH release in essentially the same way as fasting-induced elevation of ghrelin levels.”

Why would it stimulate growth hormone but inhibit GnRH? I feel like producing LH/FSH and in turn releasing testosterone would work in synergy with GH?

“FSH stimulates sustentacular cells to release androgen-binding protein, which promotes testosterone binding.”

I know I didn’t have free test measured but you said E2 is low so you suspect free test would be as well. If FSH is responsible for testosterone binding, and I have low FSH, wouldn’t free test be high…er?

I did experience a Traumatic Brain Injury (concussion) in January from jumping out of a plan and landing rough.


#5

Below is what I plan to give to my Army doc to better explain myself. In the meantime, should I try to start supplementing Iodine? Something like liquid Ionic Iodine (as Potassium Iodide)? What dosage would I start with?

I have low body temp, 96 range all the time, and high/subclinical TSH levels (3.5). That would be indicative of primary hypothyroidism. In primary hypothyroidism, your thyroid is being stimulated properly by FSH from the pituitary gland. However, it isn’t able to produce enough thyroid hormones (T3/T4) for your body to function properly. This means that your thyroid itself is the source of the problem.

Basically how that effects low testosterone is that Steroid hormones (testosterone) is derived from cholesterol via this pathway:

Cholesterol --> pregnenolone --> DHEA --> testosterone

This conversion starts inside the mitochondria that consume cholesterol in the blood stream. If free T3 levels are low (hypothyroidism), body temperature drops and mitochondria do not feed on cholesterol at the same rate. So hypothyroidism causes low levels of pregnenolone due to the conversion of cholesterol not taking place. In turn the adrenals don’t have enough to convert to DHEA and in turn testosterone.

I would therefore like to have blood tested for each of these steps in the conversion.

A Lipid panel for Cholesterol.
DHEA and DHEA Sulfate
Pregnenolone

A thyroid panel to recheck TSH plus free T3 and free T4. Last one too old.

Total test, free test, LH, FSH, estradiol, plus SHBG retaken in the morning by the more accurate LC/MS method.

Cortisol, Prolactin, and IGF-1 to check other hormones that have feedback with the pituitary gland.

LH response to GnRH injection blood test to help determine if pituitary gland can correctly respond to gonadotropin releasing hormone (GnRH) from the hypothalamus.

Iodine deficiency is the most common cause of primary hypothyroidism but elevated TSH levels for too long can permanently damage the Thyroid and its ability to produce T3/T4. How would you test for this damage?