28 Yr Old, Need Advice Regarding Low T

Hello, I need help or ideas as to why my testosterone levels are so low. I’m a 28 year old male, 5’8 165 lbs (was around 179 lbs when tests were done) Who went to a normal physical appointment. I have had high cholesterol and high liver enzymes for a while, but I asked the doctor if he could check my T level because I have been feeling lack of motivation, sex drive, and fatigue for months now. Well my T level came back at 91, which as far as I can tell is really low. I went away to another state for 3 weeks, so have not been able to follow up. I do have an appt next week to follow up, however I don’t want the doctor to prescribe me YET right off the bat, I would like them to follow up with additional tests which I will share with all of you. I have taken Test boosters like Bio forge, or Daa in the past. Have also tried Ashwaganda, Dopa Mucuna, L theanine, Ecgc, and pretty much all the nootropics (piracetam etc) at one point or another. I have been off everything for a while now. I regularly sleep maybe 4-5 hrs a night, and do have a stressful job. Is my high cholesterol, and other factors enough to explain that low a level of T? Thanks very much

First thing that comes to mind is medications. Past or present.

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The stickies will help you with what tests to run. Sleep and stress are huge factors…though not to this degree. Was the blood work taken first thing in the morning?

Nope, it was at 5:30 pm, after a long day of work. I know test levels are highest in the morning, but I wonder how much higher would it be. I haven’t seen any one here with a test this low.

Also my TSH came back at 2.30 (0.40 - 4.50 mlU/L)

TSH was 2.91 back in July (0.40-4.50)

TSH ideally would be closer to 1.0. However I do not see LH or FSH would would bring indication if the issue is primary or secondary hypogonadism. But yes, if you are not on replacement the LH, FSH, Total and free labs should be conducted in the AM. With that said your lipid panel is rather concerning.

Received additional lab results.

LH: 1.7 range (1.5 - 9.3)
FSH: 2.5 range (1.6- 8.0)
T4: 9.0 range (4.5 -12.0)
T3: 33.0 range (22-35 percent)
Free T4: 3.0 range (1.4- 3.8 )
Prolactin 5.1 range (2.0- 18.0)
Estradiol 29 range (=<39)

I have more tests coming because I saw 2 doctors. This doctor didn’t test the free test or total test. But from the looks of it I’m definitely secondary. Will update when the additional labs come in

saw another endo. took blood 4 days later at 10 am.
TESTOSTERONE: 368 (250-1100)
FREE TESTOSTERONE: 97.5 (35.0 - 155.0)
LH: 2.20 (<10)
FSH: 2.2 (<10)
SHBG: 19(10-50)
PROLACTIN: 5.4 (<15.0)
DHEA: 382 (80-500)
PROGESTERONE: 81 (32 - 307)
CORTISOL: 10.8 (5.0 - 25.0)
TSH: 2.54 (0.4 - 4.60)
FREE T4: 1.40 (0.80 - 1.70)

So this insurance endocrinologist calls me today and tells me that everything is fine and I am normal. He said I can follow up in a few months.

So my question is, how does testosterone go from an extremely low 91 up to low normal 368 in a months time? I have stopped taking any supplements or medication have been off for maybe 2 months. Also have taken vitamin D and lowered my cholesterol. So since my levels quadrupled in a months time, is my body recovering its natural test production? Should I monitor it in a month or so to see if it keeps increasing? and if I don’t improve maybe clomid would work.

The medications you were taking likely lowered your hormones and once it cleared out of your system your hormone levels went up. Synthetic drugs can wreak havoc on the body. In the end it’s your insurance that put on the brakes on TRT, doctors are shackled because insurance companies don’t want to shell out money, that’s why these ranges exist, to deny treatment. Defy Medical wouldn’t turn you away because they don’t take insurance as their cash pay only. Those numbers aren’t considered good for someone under 30, it won’t be long before you dip below these ranges. Recently these ranges were lowered, I can think of only one reason why, to protect the Viagra and Cialis markets. They can say your normal and prescribed you Cialis for erectile dysfunction when the real problem is low testosterone.