30 Yr Old Guy, Low T or ...?

Pharma / TRT Testosterone Replacement
1

I am 30 and in this midst of marital problems and actively looking for help to fix my low energy, libido and ED issues. Been a problem for 3 yrs (ED - sporadic) and 5 yrs + for general lower sex drive. I had some blood work done last year and was given the “normal range” bullshit. I am currently working with a doctor friend to find a new PCP to work WITH me in getting to the bottom of everything with new lab work and a team plan of action.

Total T: 491 ng/dl
TSH: 1.45

Age: 30

Height: 6 feet

Weight: 195

Waist: 33

Body / Facial Hair: Light torso, more dense on legs, patchy facial. Slight balding at front corners

Carry fat: around midsection, stomach and above hips.

Symptoms, conditions history: Vitamin D deficiency in 2012 put on Vit D-3 2000 units/day. (No clue where current levels are.) ED off and on for 3 years with no noticeable event where it began.

Diet: Pretty standard. Not much fast food, high protein, fair amount of carbs with too many sweets, not any kind of fat free diet or fasting.

Training: Weights 3 times a week for about 1.5 hours per. Walk/jog 2-3 miles 5 days / wk.

Wood: Rare morning wood, haven’t noticed nocturnally at all. Used to be pretty consistent with a morning wood.

Grow fast or slow and steady as teen: Same height since 8th grade

Testes ache or hurt (ever?): Sporadically and rare.

Mood: Lack confidence, mild to moderate anxiety, slightly irritable.

Depression: Yes, mild to moderate.

Libido: Low. Been that way for a while (read 5+ years). Sex 2-4 times per week with wife and ED problems have been an issue.

Iodized Salt: Not a lot of cooking at home, so not much iodized salt being used there.

Eat much seafood: No

Exposure to chemicals?: None that I am aware of.

Hair Loss drugs: Rogaine use for a few months, no results so I ceased.

Rx and OTC drugs: One a day multivitamin. Excedrin for headaches.

WBC 6.8 4.0 - 11.0 THOUS/CMM
RBC 5.07 4.4 - 6.0 MILL/CMM
Hemoglobin 15.0 13.5 - 17.5 GM/DL
Hematocrit 42.9 41.0 - 51.0 %
MCV 84.6 80 - 99 FL
MCH 29.6 25.0 - 35.0 PG/CELL
MCHC 35.0 32.0 - 36.0 G/DL
RDW 13.0 <15.0 %
Platelets 234 140 - 440 THOUS/CMM
MPV 10.3 9.0 - 12.2 FL

I have been monitoring my body temps for the last 5 days with an average waking temperature of 97.1 and an average mid day temp of 97.9. I haven’t started taking any supplements to try and address any of this yet.

Any input on a current course of action would be GREATLY appreciated. Iodine supplements starting before or after blood work? ED med’s? I’ve been on the 25mg viagra before with minimal success for the ED. Getting desperate here…my wife is becoming convinced that I’m just not in to her and that’s why the problems. Love her to death and just want to go back to feeling like my self again.

2

We are animals, we are controlled by our hormones. For many/most men, affection, love and desire are all tied to sexual desire. Not quite the way that women would like things. But if your sex drive is not right, both side of the relations ship suffer. For men, love and lust are not separable.

Hoping that you have studied these stickies:

  • advice for new guys, covers the technical jargon and basics
  • thyroid basics

You need to understand that the symptoms of [subclinical] hypothyroidism are to a large degree the same as hypogonadism. And to make things worse, one can lead to the other.

So we are faced with two possibilities. One is that you have a simple iodine deficiency. Second, you might have a fundamental thyroid problem. You can do lots of labs, but when there is reported evidence of low iodine intake, I suggest that one just get on with that and deal with it. Then later, after iodine deficiency [ID] is off the table, see what is left. When you do iodine replacement [IR], you need time for the effects to work before you do labs.

Also not that TRT on top of a thyroid problem can make things worse.

You need proper labs, pay out of pocket if need be, but not from your $$$doctor$$$ in that case. See stickies.

TT
FT
E2
DHEA-S
fasting cholesterol - do it, we are concerned if too low, doc might say to young for cholesterol problems [high]
fasting glucose
LH/FSH ← very important
– if low, test next for prolactin
— if prolactin high, get MRI to inspect pituitary gland [$$$$]
CBC
TSH
fT3

vit-D3: take 5000iu, walmart has 5000iu tiny oil caps

fT4 not T3, T4

Try to tell your wife that you lover her and that there seems to be some metabolic problems that are not allowing you to be yourself. Ask for her support and patience while you work on this.

Suggest:
IR as per sticky, start off on lower amounts and work up as your body tolerance allows
Plan you labs and find a doc who is interested in your health and vitality. Most have no idea why you are their if the cannot find a disease to deal with.
read, read, read
post all of your labs with ranges, we can see issues that docs do not

3

We are animals, we are controlled by our hormones. For many/most men, affection, love and desire are all tied to sexual desire. Not quite the way that women would like things. But if your sex drive is not right, both side of the relations ship suffer. For men, love and lust are not separable.

Hoping that you have studied these stickies:

  • advice for new guys, covers the technical jargon and basics
  • thyroid basics

You need to understand that the symptoms of [subclinical] hypothyroidism are to a large degree the same as hypogonadism. And to make things worse, one can lead to the other.

So we are faced with two possibilities. One is that you have a simple iodine deficiency. Second, you might have a fundamental thyroid problem. You can do lots of labs, but when there is reported evidence of low iodine intake, I suggest that one just get on with that and deal with it. Then later, after iodine deficiency [ID] is off the table, see what is left. When you do iodine replacement [IR], you need time for the effects to work before you do labs.

Also not that TRT on top of a thyroid problem can make things worse.

You need proper labs, pay out of pocket if need be, but not from your $$$doctor$$$ in that case. See stickies.

TT
FT
E2
DHEA-S
fasting cholesterol - do it, we are concerned if too low, doc might say to young for cholesterol problems [high]
fasting glucose
LH/FSH ← very important
– if low, test next for prolactin
— if prolactin high, get MRI to inspect pituitary gland [$$$$]
CBC
TSH
fT3

vit-D3: take 5000iu, walmart has 5000iu tiny oil caps

fT4 not T3, T4

Try to tell your wife that you lover her and that there seems to be some metabolic problems that are not allowing you to be yourself. Ask for her support and patience while you work on this.

Suggest:
IR as per sticky, start off on lower amounts and work up as your body tolerance allows
Plan you labs and find a doc who is interested in your health and vitality. Most have no idea why you are their if the cannot find a disease to deal with.
read, read, read
post all of your labs with ranges, we can see issues that docs do not