T Nation

31 M - Low Free T & Libido


#1

New Belgian guy here, new to the forum. I read the thread "advice for new guys" and I wanted to make an intro. The post is a bit long, so I'll try to structure it in different sections:

  • Summary (active, healthy young man with libido issues)
  • Test results (bottom range (free) T, high SHBG. Everything else normal.)
  • A couple of stats
  • More background info (You can skim/skip this if you don't have much time.)

Summary
Basically I'm a healthy, active guy with no visible reason to have low T. My main issue over the last 2-3 years is that my libido has significantly decreased. It seems recovery from workouts (and nights out) has also worsened. Other than this, there aren't really any other symptoms/issues which are typically associated with low T. I have some stress at work but it's manageable. I try to work out and eath healthy. The last year or so I've added some supplements (zinc, fish oil, selenium, magnesium) and food choices (celery, broccoli, lemons, beet root juice...) to my diet but to no avail.

I really don't understand why this is happening so it would be great if you guys could give me some info on where to start. I might try to find another doctor here in Belgium (or Europe) specialised in this domain to do further testing. I would love to solve this issue the "natural" way, but that's what I kind of did the last 2 years. TRT is an option but preferably avoided.

Test results
I had two tests in january the last two years, which indicate borderline low (free) T and DHEAS and mid-high SHBG. I don't see any reason for that to happen. I mentioned to my doctor that these levels were low but he shrugged it off and told me that it's within normal levels, so not much help there.

Side note: I've had a low Gamma-GT (8 U/L) over the years (since my youth). This is a liver enzyme and I never have seen this linked to hormones so I don't think this is related to my issues now. Hematocrit is quite high (around 50), but always been high (45+).

A couple of stats

  • Age: almost 31
  • Height: 1m90 / 6ft3
  • Weight: 84 kg, 185 pounds
  • Waist: 33 inch (pants size)
  • Body hair: moderate hair on my chest, belly, legs.
  • Facial hair: moderate (goatee grows fast, patchy on my cheecks)
  • Head hair: it's thinning on the crown, and also general thinning on top. Slowly going bald (like my father).
  • Fat distribution: mainly in my gut (beer belly). Rest of my body stays lean. I'm relatively lean though.
  • Health symptoms: none. I've had chlamydia (solved with antibiotics) and dengue (just had to rest and recover) in recent years
  • RX/OTC Drugs: I've taken roaccutane (against acne) in my early twenties. Nothing serious besides that.
  • Diet: pretty healthy. Lots of vegetables and meat. Also eat bread.
  • Training: try to work out (lift weights) twice a week. I bike to work (40 mins total) every day. I go for a short run (30 mins) on Sunday.
  • No issues with aching testes.
  • Morning wood is still present in about 30-50% of days, but a semi-hard erection that disappears quickly. Used to be a very hard erection almost every day.
  • I use iodised salt and my thyroid hormone levels seems ok, so that shouldn't be the culprit. Vitamin B12 level was also good in my test.

More background info

Libido Issues
I've had ED problems with the last couple of girls I've been with over the last 2 years. Which is becoming very disheartening/embarassing and I've been avoiding sexual contact for that reason for the last 6-12 months or so. There are certainly some psychological issues at play here but low t is certainly contributing. My libido in general is quite low, I have little motivation for sex/women. It never was really high to be honest (always had a long refractory period) but now it's really problematic. With porn I can still get horny and a hard-on but often I turn to porn out of boredom/frustration. This is probably the main thing which is bothering me. The quality of my erections has also gone downhil a bit. Used to be a lot harder. Morning wood is still present, but less often than before.

Other Issues
I'm lifting weights and the progress is there, but it's going very slow. I'm not recovering that well. If I stick to 2 full-body workouts a week it's ok, but if I try to add a third I wear myself out very quickly.
After a night out, or not sleeping well I'm not recovering that great either. I did a city trip with some buddies with some friends where we went partying a lot and I was dead after a couple of days while they were just fine... Now I've always needed my sleep but this wasn't really normal. For some reason I'm very sensitive to caffeine and alcohol as well (moreso than before). I consume little of these substances so that's probably related to it.

Next step

This is where I'm stuck right now. Trying to improve my diet even further, avoiding plastic containers, trying organic food etc. But I don't think it's having much effect. I'm a bit overwhelmed by all the info out there, and been stuck in a 'passive' mode where I'm just waiting for it to get better...
I think my next step would be to get another blood test from a willing doc to get another blood test with some more things tested (E2, prolactine, ?, ...).

Seems there is a very pro-TRT (anti-aging) doc in Belgium, dr Thierry Hertoghe, but other tips to european docs would be greatly appreciated.


KSman is Here
#2

Acne and hair loss drugs are known to cause problems in some men with fragile HPTAs. I also have high shbg and low FT and having spent countless hours on learning about how these things work, it's my knowledge(which may be inaccurate) that bio-t is what accurately measures testosterone status and the knowledge of shbg is not accurate in the broad community. Some experts believe that shbg is not the cause for low FT, rather the bio-t is what it is and shbg inflates TT to figures higher than one would expect with low bio/free T. Your FT is definitely on the low side, cortisol needs to be done at 8am for better representative numbers. TSH is a little high, You can look at it further. Please read the stickies. remember that your course of treatment or lack thereof depends on your expectations and wants from life. For some, certain lifestyle changes can produce good changes and those are adequate for people with desk jobs and likes. That's why I say what I say with your expectations and wants. I'm also a noob and constantly learning so please take this as advice like it's meant to be.


#3

Please check oral body temperatures as suggested in the thyroid basics explained sticky.

Labs:
prolactin
LH/FSH
E2
free T3
reverse T3 -rT3

TSH is too high, see the thyroid basics sticky. Note references to stress, rT3, infection/inflammation.

SHBG is made in the liver and SHBG is increased when E2 increases.
Do not discount liver issues. Liver also clears estrogens from the blood.
AST/ALT?