You have secondary hypogonadism and the cause is not from high prolactin, so we can rule out a prolactin secreting pituitary adinoma as a cause. But you should still have a MRI to see if something there is wrong. Pituitary can be damaged from blows to the head, major whiplash etc.
Cholesterol is better near 180, do not let it get too low. <160 associated with increased all cause mortality. Cholesterol is the base for creating all of your steroid hormones and that included Vit-D3 which converts to hormone Vit-D25 and adrenal hormones DHEA, pregnenolone, cortisol etc.
Any dietary explanation re low cholesterol? Some guys can simply be that way.
At your age, you might be able to make your own T injecting hCG SC/SQ EOD.
You might also have sparse outer eyebrows.
Please self-eval overall thyroid function via last paragraph in this post.
fT3 is the active hormone and it controls energy levels and more.
TSH should be near 1.0
fT3 and fT4 should be near mid-range or a bit higher. Your fT3 is low.
Thyroid hormone lab ranges are bogus. Doc thinks you are perfectly "normal".
Have you always been using iodized salt [ - to support thyroid] ?
Cortisol looks good. It is important for minute to minute energy levels.
Some guys here have had panic attacks and TRT resolved that.
TPO suggesting some issues. You may be selenium deficient. Please find a good B-complex multi-vit with trace elements, including iodine 150-170mcg and selenium 150-200mcg.
E2 [estradiol] should be low with low FT from FT-->E2.
Have you ever had AST/ALT labs done [liver markers]
Do not test AST/ALT with any sore muscles, lay off training for those.
Do not go for this now, but when you start TRT.
On TRT with high TT and FT levels, E2=22pg/ml seems optimal for most guys. As you are at E2=20pg/ml now, you will need an aromatase inhibitor [AI] for sure.
In a case like yours and your age, there is a need to try to find and correct the cause of your Low-T. Low-T is the symptom, not the disease.
What was the time line for perceived loss of T?
Any blows to the head prior?
Starvation diets can be harmful to hormones and also can increase SHBG which is not good. Starvation can drive permanent [epi-genetic] changes. Training when starving makes things worse.
Concerned that your diet might be iron deficient at times. Are you eating red meat?
Your case with low FT and middle TT suggests that your SHBG could be elevated, increasing SHBG+T that inflates TT. SHBG+T is not bio-available. SHBG+T also decreases FT. But note that FT is highly variable, released in pulses with a short half-life. Your LH/FSH and low FT indicate secondary hypogonadism complicated by suspected elevated SHBG and E2 and SHBG+T may be increased by poor liver clearance. Some drugs, Rx and OTC can do some of that.
So you have sex hormone problems and some thyroid issues. Please post requested oral body temps so we can better understand thyroid function. We see low-T and thyroid issues here most of the time. And most of those thyroid issues involve iodine and lab numbers are mostly perfect as far as most docs see things.
These cannot be ignored:
Total Testosterone 112 (348-1197)
Free Testosterone 3 (8.7-25.1)
Any other medications? Supplements?
Look at pituitary.
Get body temperatures.
For TRT, go for frequent self-injections as that has least cost, 100% absorption and lowest T-->E2 potential.
Read this post more than once.
Where are you located. Affects diagnostic and treatment options.
When you resolve T and thyroid issue, your quality of life will be a lot better, insulin sensitivity should improve, A1C decrease and fat loss should occur with good fat profile/distribution changes.
Please read the stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman
- advice for new guys
- 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.