T Nation

Advice on Low T Restart?


#1

Hey guys I am 25 and I have pretty much every symptom of low T there is and here are my most recent labs:

Total T: 434, Range: 241-827 ng/dl
Free T: 7.6L, Range: 50-210 pg/ml
Test Free %: 1.76, Range: 1-2.70
SHBG: 41, Range: 13-71 nmol/dL
DHT: 48, Range: 16-79 ng/dL
Estradiol: 20.9, Range: 0-39.8 pg/ml
LH: 2.67, Range: 1.50-9.30 mIU/ml
FSH: 1.81, Range: 1.40-18.10 mIU/ml
Cortisol AM: 12.38, Range: 4.30-22.30 ug/dl
Cortisol PM: 13.29, Range: 3.09-16.66 ug/dl
TSH: 2.924, Range: 0.350-5.500 uIU/ml
Free T4: 1.10, Range: 0.89-1.76 ng/dl
Free T3: 3.4, Range: 2.3-4.2 pg/ml

Heres my story:

I have basically been on and off psychiatric medication (anti depressants mainly, but some others) for approximately 8 years in an attempt to treat tremendous levels of anxiety and the accompanying depression. This medication caused many of the same side effects as Low T gives people. Everytime I stopped my medication the low t symptoms would go away and I would feel heathy physically again but mentally I wasnt so I would always go back on the medication.

Fast track to two years ago I got upset and wanted to find the root cause of my mental troubles. I was told by a new doctor that it was adrenal fatigue so I went on hydrocortisone 10mg 2x daily for approx 2 years and went off of all psychiatric medication. It has now been about 6 months and I have tapered off of the HC completely and I am 100% medication free but I have Low T and Low T symptoms still and me and my doctor seem to think that being on the psych meds and the HC suppressed/confused my body and i need a kickstart to get things back into gear again.

I've never used any anabolic steroids in my life but I am coming here for help on how to restart my testosterone as I believe this is the cause for all of my symptoms including: zero libido, erectile dysfunction, low energy, low mood, poor focus, inability to concentrate, inability to lose fat (especially around midsection), muscle weakness, and no energy for life in general.

Having said all of this, my question is what do you guys think the best protocol would be in my case for a T restart? I seriously believe that there is nothing physically wrong with me and that in my case its just secondary hypo that I am dealing with as the symptoms always used to go away just not this last time. We are thinking of doing a hcg restart but I want your guys advice. Thanks in advance, pm me or post if you have seen a thread or talked to someone who went through a similar issue.


#2

If this is wrong,? -use [edit] in lower right corner above and fix it.
Free T: 7.6L, Range: 50-210 pg/ml
should be?
Free T: 7.6L, Range: 5.0-21.0 pg/ml
?
Free T: 76L, Range: 50-210 pg/ml

With younger men, prolactin should be tested as it suppresses the HPTA and can cause depressive symptoms. Prolactin can be from a prolactin secreting adinoma. If prolactin is elevated, a MRI is used to image the pituitary. The condition is typically well managed with 0.5 mg/week Dostinex/cabergoline. If advanced, can press on optic nerve and reduced width of peripheral vision is a symptom.

TSH: 2.924, Range: 0.350-5.500 uIU/ml
Free T4: 1.10, Range: 0.89-1.76 ng/dl
Free T3: 3.4, Range: 2.3-4.2 pg/ml

You have a degree of hypothyroidism. TSH should be near 1.0. The ranges are stupid and most docs do not know any better.
Have you been using iodized salt long term?

Check overall thyroid function by checking oral body temperature:

  • when you first wake up, should be 97.7-97.8 and higher would also be OK, 93.3 is way too low.
  • mid afternoon should also hit 98.6

fT3 and fT3 should be near midrange or a bit higher.
fT4 is lowish
fT3 is midrange+, if body temps are low, that suggests that rT3 is blocking fT3 and then do labs for rT3.

rT3 can be elevated by adrenal fatigue subsequent to:
stress, continued or major episodes
illnesses
accidents
chronic inflammation or infection

Please read these stickies:

  • advice for new guys, note 1st paragraph
  • things that damage your hormones
  • thyroid basics

As for HPTA restart; we need to do the above diagnostics to try to identify the root cause of the low-T symptom.
We can cover restart steps later. Please post iodized salt intake history and body temperatures. We do see a strong correlation of low thyroid function and low T here. And hypothyroidism can depress LH, FSH and T.

So you have labs for:
CBC
hematocrit
ferritin or iron
AST/ALT


#3

[quote]KSman wrote:
If this is wrong,? -use [edit] in lower right corner above and fix it.
Free T: 7.6L, Range: 50-210 pg/ml
should be?
Free T: 7.6L, Range: 5.0-21.0 pg/ml
?
Free T: 76L, Range: 50-210 pg/ml

As for HPTA restart; we need to do the above diagnostics to try to identify the root cause of the low-T symptom.
We can cover restart steps later. Please post iodized salt intake history and body temperatures. We do see a strong correlation of low thyroid function and low T here. And hypothyroidism can depress LH, FSH and T.

So you have labs for:
CBC
hematocrit
ferritin or iron
AST/ALT[/quote]

KSman, first of all thanks alot for your help, its much appreciated.

To answer your first question, its not typo, according to my labwork in front of me my Free T really is 7.6L with a ref of 50.0-210.0 pg/mL. I’m not sure what the L stands for but this number seems DRASTICALLY low if the low end of the range is 50… There is also a quite a long CBC section in my labwork and i can post everything here if need be… but everything on it is within the range.

As for the thyroid issue, I have been prescribed armour thyroid in the past to the point where my tsh got to very low levels (I believe 0.5 or lower) and it didnt have any impact on the way I felt at least in regards to the low T symptoms (I possibly felt more anxious and possibly had some hairloss as a result).

I really want to focus one thing at a time here and considering I’ve already gone down the route of thyroid treatment, vitamin infusions (to correct low levels of vitamins that I have/had), and many other types of therapies to correct imbalances (as per my labwork) I would like to attack the problem at its root and kickstart my system back into shape after being suppressed for so long.

Does anyone have any experience dealing with Test being suppressed as a result of other medications, not anabolic steroids? I also forgot to mention that while I was taking the hydrocortisone I received a shot of T just to see if it did anything in regards to my symptoms and it had no effect at all (but im not sure why or even if thats relevant at all here.)