T Nation

28YO - Super Low Energy, No Interest in Women + Sky-High E2


#1

BASIC DATA

  • Age: 28
  • Height: 6’1"
  • Weight: 165 lbs
  • Daily Supplements: Liquid Vitamin D3, K2, B12; Magnesium, Multivitamin, Calcium, Fish Oil.
  • Never taken any steroids or illegal drugs.

Body hair light mostly. Facial hair mostly around chin area but less on side (cheeks)

Body type - see picture below.

ADVANCED

I’d say, I grew up fast.

No changes or issues noticed in terms of testes.

Yes, had minor gyno a few years ago. It was never an issue appearance wise but I still got it check out because I didn’t know what it was back then. - Also had itchy nipples a lot of times in the past and always when I was doing some physical activity and sweating. I thought it was related to the type of shirt I was wearing.

THYROID HORMONES

The salt I have used for the last 4+ months is Himalayan salt that is not iodized. For those same 4+ months, I have also been using a multivitamin that contains 150mcg Iodine and 75mcg Selenium.

To assess whether I have “Thinning of outer eyebrows”, I have attached pics of both eyebrows.

BLOOD TESTS

05/2017

  • Vitamin D - 61 ng/ml

12/2016

  • TSH basal - 1.6 μU/ml (0.40 - 4.00)
  • Cholesterol - 181mg/dl

07/2013

  • Cholesterol - 133 mg/dl (140 - 240)
  • LH - 3.0 mU/ml (1.5 - 9.3)
  • FSH - 1.8 mU/ml (1.5 - 20.4)
  • Prolactin - 12.6 ng/ml (2.5 - 17.0)
  • Estradiol (E2) - 58.37 pg/ml (11.9 - 39.8) - SKY HIGH!
  • Testosterone - 7.00 ng/ml (3.00 - 8.27)
  • Free Testosterone 19.6 pg/ml (9.0 - 27)
  • SHBG - 37 nMol/l (10.0 - 57.0)
  • DHEA-S - 18.50 μMol/l (4.60 - 16.10)
  • Cortisol - 23.7 μg/dl (4.3 - 22.4)
  • Vitamin D - 17.50 ng/ml (30.00 - 100.00) - See most recent blood test - fixed Vitamin D deficiency already!

SYMPTOMS

All issues I also had in 2013 (when I did the first test), but since T was high, I dismissed it and doctor said the E2 isn’t an issue.

All symptoms were also present during times of regular gym workouts/not going to gym at all/eating clean/eating like crap/cutting/bulking/high stress/zero stress.

Super low energy - meaning it’s hard to do anything. Feeling both mentally & physically exhausted.

Unable to focus - without caffeine (which I only started using about a year ago), I get nothing done. I don’t mean very little, but literally 30 minutes of work done per day.

Zero interest in women - I do get horny when I am already touching a women, and erections are not a problem but getting to that stage is difficult. When I am not already horny (e.g. already in an intimate situation), I have zero interest going after women. I see attractive women and feel absolutely nothing - at best I will think about what are the pros and cons of meeting this girl in front of me. Is it worth the effort? The animalistic part is completely missing … it’s all based on logic.

Overthinking extreme - same as being unable to focus. Caffeine helps but without it almost zero interest in anything. Nothing makes sense, no point in doing anything. Once I drink caffeine, everything suddenly starts to make sense. I am motivated.

Cold/(Sometimes) Freezing Cold Hands & Feet - This is an issue on most days, sometimes it’s so extreme that I shower multiple times per day or have warm water running over my hands.

Other symptoms I can relate to:

  • Social withdrawal - “I would rather not go out
  • Gum disease, the ugly killer
  • Why do really hot looking women and girls now look like art instead of lust?
  • Brain fog, no one knows what that means but everyone knows if they have it!

NEXT STEPS & WAY FORWARD

Body Temperature - I know, I need to track this. My question is since I haven’t slept well for the last week or so, would I first need to fix this before tracking body temperature or is it unrelated?

Blood Work - I will initially have to pay out of my own pockets. Again, same question as above - whether I can get test done right away or first need to get back to regular/good sleep schedule?

Would TT, FT, E2 be sufficient here to or would LH/FSH/PSA as mentioned in the sticky also be needed? DRE I had done by my urologist about 1.5 years ago - no issues.

Thanks,
MK89


#2

Hey so have you tried getting your Estrogen in check? I use DIM with good results. Also sounds like maybe you have hypothyroid symptoms because what you said about the cold hands.


#3

Yeah for sure check out KSMan’s thyroid advice.
https://forums.t-nation.com/t/thyroid-basics-explained/185344


#4

Just do body temps, waking and mid-afternoon
Eyebrows say things are OK, feeling cold does not.
TSH=1.6 indicates something is up.

Do not need PSA.

Some guys freely convert DHEA–>E2 inside their adrenals. We know that from guys taking too much DHEA supplement. Might be a factor for you. Otherwise we are concerned that liver may not be clearing estrogens properly. Despite “Testosterone - 7.00 ng/ml (3.00 - 8.27)” your low body and facial hair suggests that you are weakly virilized. In such cases we expect that TRT will complete virilization. Your tallness and fast growth suggests that FT levels, FT–>E2 and E2 levels were low. Closing of long bone growth plates is largely driven by E2 levels and that is why most women are short and why most tall women are small breasted. Does this help you? -no, but shows that you may be fitting an understandable pattern. But what changed? - see stickies below.

Labs:
TT
FT
SHBG
E2
LH/FSH
prolactin
AST/ALT
CBC
hematocrit

Cortisol is worrying. What time of day was that and how long since waking up?

Why was cholesterol so low now recovered? Extreme diet?

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

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#5

Thanks for the replies - I wanted to wait until I have the blood test results until I reply.

The lab test results just arrived.

Thyroid

@KSman KSman, I’ve tracked body temperature and it has consistently been lower than mentioned in the stickies. I have already started to supplement with 50mg Iodine and 200mcg Selenium daily for the last 6 days.

Blood Work/Hormones

The labels are in my native language, but I think it should all be clear what it means. If not, let me know and I’ll explain it.

Things to note that might be important:

  • Blood test was done in the morning/fastened.
  • Been on a cut for 3+ months & lost quite a bit around the waist (probably good for E2 values). Caloric deficit is only minor, I don’t feel that the cut impacts my mental well-being/could go on forever.


#6

Cholesterol needs to be higher, diet may have done this. Please do not eliminate fats.

Your SHBG=90.72 is worrying. AST/ALT are not showing a liver problem. But something is going on with the liver. SHBG is made in the liver. What have you changed? Started a new medication? Have been ill? With E2=28.8, SHBG should be lower.

High SHBG has made FT low and created a lot of SHBG+T that inflates TT and is not bio-available. Your TT is really over-stating your T status.

How much vitamin-C are you getting?

Did you read the stickies?
Things that damage your hormones?


#7

@KSman, thanks for the prompt reply.

To answer your questions.

I think you might have read the old cholesterol results from 2013. Latest test in December 2016 was 181, at which point I did not even eat eggs, avocados, coconut oil regularly (all of which I eat on a daily basis now).

Nothing that comes to mind. Only 2 urinary tract infections the last few years for which I took antibiotics for 2 days each.

Vitamin-C: I take Vitamin-C powder (ascorbic acid) in water, at least 3000mg per day
Yes, I read the stickies. Nothing that I can think of that would’ve damaged my hormones.

Next Steps/Way Forward

Really unsure what next steps I should take.

  • Additional/more blood tests?
  • Tests done on the liver?
  • What about the overall low T?

Thanks for all the responses, really helpful,