T Nation

30yr Old Male with Low Test


#1

Recently went to a free clinic that did free testosterone blood work. Results were not very detailed, stating Total Test was 276. Went to my normal doctor with the results and asked for complete blood work. Results given today on 12hr fast:

Component Latest Ref Range Result

Testosterone 300 - 1080 ng/dl 276(L)
Testosterone Free 47-244 pg/ml 59
Testosterone %Free 1.6%-2.9% 2.1
TSH .400-4.200 mcU/mL 2.354
Prolactin 2.0-15.0 ng/dl 12.4
LH 2.0-12.0 Milliunits/mL 4.9
Estradiol <=50 pg/mL 34
Cholesterol <=200 mg/dl 147
Triclycerides 0-150 mg/dL 92
HDL >= 40 mg/dL 42
SHBG 11-80 nmol/L 23

Personal Info:

-30/yr old male. 5'11 223 lbs, 21.5% bodyfat (as taken on a BodBod)
-Weight/fat mostly carried on mid-section and pecs
-Bodybuilding/Powerlifting for 10+ years
-High Volume training style
-No OTC or prescription drugs
-Mild PH use in past (11-oxo)
-No ED problems
-Lost 20lbs in the last 6 months by mildly reducing carbs and calories
-Strength has decreased with weight loss
-Low Energy levels

I have a meeting with my doctor next week. Trying to be as informed as possible for my visit.

Thoughts?


#2

Diet is to clean. Cholesterol levels are low an cholesterol is the precursor to steroid hormones.

You need a full thyroid panel.. Tsh over 2 is a sign of a problem.. could be heavy metals, could be idodine, inflammation In the body..

Do you have any other labs??

Read the advice for new guys sticky

Read thyroid basics..

Lh is not a great diagnostic tool although it does say to me that the pituitary is working well and the problem is in the testies or elsewhere..

Lh and fsh should have both been tested and should be tested before starting trt.

You need to figure out why T is low an then make a choice of which treatment you would like to use..


#3

There were some other tests done, however, none that I recognized from any reading i've done on here. My fat intake has probably been lacking a little bit, perhaps thats affecting my cholesterol.

I've read all the stickies. How do I determine if im primary or secondary? Also, what is everyone's opinion on HCG or Clomiphene with short term therapy to "re start" my system? I'm hoping my doctor is open to that, as I have no desire to start TRT unless there are no other options.


#4

Met with my doctor today. He felt my TT was "low normal" and didnt see a problem with my E2 or other levels. He wants to repeat the tests in a few weeks, and, if they come back with the same numbers we would discuss options. He mentioned Androgel as a possibility. I mentioned Clomiphene, and he was vaguely familiar with that treatment option but said he needed to ask some people first.

Basically, since i'm barely showing any symptoms or problems he didnt seem concerned that anything needed to be done; however, would consider treatment options if more tests came back the same.

Anyone have an opinion?


#5

I second what ACES said. We don't have your FSH values, but your LH is towards the lower end of normal, which would indicate you are mildly secondary hypogonadic. You need testing on your adrenals and thyroid to determine if they are functioning properly. I like that you mentioned trying a SERM to sttempt a restart, but success may be short lived if you have problems elsewhere, which you probably do.

Try to get more labs in accordance with the blood testing sticky.

Luckily, you aren't experiencing many sides associated with low T, so waiting for more labs wont be quite as painful.


#6

Do you think since i'm mildy secondary hpyogonadic that I "need" treatment?

I will contact the doctor and request more/different labs... and probably will request a referal to the Endo since he already is unfamiliar with my preferred treatment options.

You are right, waiting wont be to painful... but I cant help but think how much better my overall happiness would be if I was a little better off with my E:T levels!

Speaking of which, my E:T ratio is about 7.3 ... what is a good ratio to strive for?


#7

Sorry. I've been in transit.

35-40:1 is the ratio we recommend here.

You'll realize how many symptoms you didn't even notice you had once you start to improve that ratio.

If by "treatment", do you need TRT? It would benefit you without a doubt, but it comes with it's own complications. I think the goal of anyone who is secondary should be to NOT be on TRT. After you get more blood tests and determine where the deficiency is, be it thyroid, adrenals, or just low pituitary output, then you can decide what route you want to choose. I think a visit to an endo would do you well.


#8

How much do you weigh?
How old are you?
What are your symptoms?
If your not eating healthy fats start eating them!

What is your diet like? Most of our foods are toxic!!

Adrenal fatigue or emotional illness is hugely contributing to disease in the world.

Your thyroid needs to be addressed and I don't think an Endo is going to do anything for you!!

You need to try repairing your body as a whole.

I recommend seeing a homeopath or better yet going to a wellness clinic and getting someone who can teach you how to heal yourself!!

Nothing good will come easy!! You have to really want it and most want the quick fix which is only suppressing the problem.. It will show its face in another light!! One with thyroid or adrenal problems may not be able to handle the metabolic demands of TRT you need to work on these issues first..

Can you please read the advice for new guys sticky and answer those questions so we know more.. Details about someone do matter!!

Good luck in good health

Edit: I don't know if your primary or secondary.. You could look at this as primary because lots of lh is being made and total t is low..I think you are just run down.. Possibly emotionally? Maybe you always have been in the mid range.

What time were these labs taken?

Have you been working in toxic environments?

Lets retest prolactin and the thyroid

Tsh

Ft3

Ft4

Tgab

Tpo

Tsi these three are antibody testing I reccmend them if your considering iodine loading.

Read lab testing sticky and read a couple posts down in the thread some experienced guys leaving advice on what to check.

Read the thyroid basics sticky..


#9


#10

Kanyon 311, thank for the response. Here is an update....

Sought the help of different doctor and an endocrinologist. First doctor refused to do anything other than exogenous test. The edocrinologist was a joke. He told me my Total T was "low normal" and not worth treating. He suggested I improve my BMI (lol, i'm 6'0 225 and compete in powerlifting) and have checks done for sleep apnea for my fatigue. Didnt see any problems with any of my labs and didnt understand the concept of using Clomiphene.

After much research I found a very well qualified Urologist. He was 2 hours away, but I was told he treated Low T with Clomiphene so I decided to give him a shot. Met with him today, and i was thoroughly impressed. He has any and treatments available (pellets, injections, patches, HCG, arimidex, clomid, etc etc...) He looked at my labs, said "you need T3, T4, FSH and more testing done." Says my E2 levels are "ok" and my Total T is NOT ok. He seemed extremely knowledgeable, easy to work with, and very up to date on current treatments. Didnt hesitate to prescribe me Clomid. He suggested 12.5mg every day and re-test all labs in 30 days. At that point he would decide if I need Arimidex. I told him I wanted to try 12.5mg every other day and he said no problem. He felt clomid was a "long term" solution and says he's never seen a case when clomid is stopped Total T remains elevated. He said many years down the road (10+) i'll probably build a tolerance and need to go on exogenous test. He also felt I my TSH levels were slightly to high and wanted to get more testing for my thyroid.

The pharmacy gave me 50mg tabs and said use a pill cutter to 1/4 them. Says 50mg is the only dose available. Cutting these things is not accurate at all, I wont get a precise dosage this way. They just break... not cut.

What do you guys recommend for Clomid dosing? How quickly do you suspect i'll notice the affect, and do you suspect i'll need Armidex?

Thanks for the help