T Nation

Age 20: Possible Hypogonadism

Greetings T-Nation,
I have been suffering from what I believe to be low testosterone for several years now. Let me give you some background:




5’3" (mom is 5’0", dad is 5’4")





-describe body and facial hair

Pubic hair and armpit hair, but little facial hair and chest hair. Lack of arm and leg hair.

-describe where you carry fat and how changed

I have always carried fat on my chest and hips. I have struggled for years to get it off.

-health conditions, symptoms [history]

None whatsoever, besides a family history of heart disease. I have slightly elevated cholesterol despite a 95% clean diet and regular exercise.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever

I took cimetidine (prescription heart burn med) when I was a teen, but that masked my the underlying cause (very poor diet).

– real dangers! see this http://propeciahelp.com/overvi

-lab results with ranges

Lab Results:

TSH 1.69 0.35 - 4.00 mcIU/mL

T4 Free 1.1 0.8 - 1.5 ng/dL

Testosterone, Serum 358 348-1197 ng/dL

Luteinizing Hormone(LH), S4.1 1.7-8.6 mIU/mL

FSH, Serum 2.7 1.5-12.4 mIU/mL

Estradiol 12.0 7.6-42.6 pg/mL

-describe diet [some create substantial damage with starvation diets]

I eat 1.0-1.2g/lb per BW of protein, 0.4g/lb per BW of fat, and the rest in carbs. I am currently cutting and eating 1300 cals a day. My TDEE is only 1600 due to my lack of LBM. When I bulk, I eat 1800-200 and gain mostly fat around my midsection (gain very little muscle despite perfect macros and tracking).

-describe training [some ruin there hormones by over training]

I trained 4x-5x a week using Norton’s PHAT for the past 3 years. The last year I dropped it to 4x a week (dropped hypertrophy leg day), and the last couple of months I have only done 2 strength days a week (since school started).

-testes ache, ever, with a fever?

Never had testicle pain.

-how have morning wood and nocturnal erections changed

Rarely have morning wood. I have never been a girl-chaser and never had the “unmistakable” teen libido.

Extra info: From 13-17, I ate very poorly and alternated between eating junk/fast food every day for months at a time, to starvation diets (probably around 1000 calories). I was never happy with my body and went from 20%+ BF to 10% BF, but always looked like shit (since my body would use my LBM for nourishment). I strongly believe that this contributed to my lack of development. At 17, I began eating well and lifting weights. I also began to recomposition my body through diet–this time using the right approach, with moderate deficits/surpluses.

Despite living a very healthy lifestyle from 17+, my gains in the gym have been mediocre. I think I only gained 5-10 lbm in that time, and I have always been tired/depressed, even with proper rest.

Anyways, I believe I have hypogonadism caused by pubertal delay or by my previous starvation diets since I have only begun to get some facial hair. My voice never really dropped and the lack of progress in the gym for the last 3 years, along with my body storing fat in the typical female areas, is wreaking havoc with my social life.

I have talked to my doctor but he didn’t take my concerns seriously. He just saw that my genitals were properly developed and sent me on my way. He was supposed to have ordered a testosterone serum test but I found out that he never did after I gave a blood sample and recieved results on everything (CBC, thyroid, etc) but that. I had private labs done and came up with the results above.

Any advice is appreciated.

Please read the advice for new guys sticky and note other causes. You will see there that I identify cimetidine as the poster child of endocrine disrupters. Nasty shit!

Please post all lab data in list form with lab ranges.

FSH=2.7 is really the indicator of what you pituitary is calling for and your testes are doing what they are been asked to do. So what is keeping LH/FSH low.? We know that it is not E2 as that is low. The prime suspects left are prolactin from a pituitary adenoma, or an adenoma that simply affect ability to produce LH/FSH. There could be an another reason that cannot be identified. So a prolactin lab is suggested. Do not have sex or wack off for a few days prior, do not hug puppies or cuddle excessively, these all increase prolactin.

If you took a trial of a SERM such as Nolvadex and T, LH/FSH levels uncreased that would demonstrate that the top end of your HPTA is bascially workable and perhaps this could be also an HPTA restart attempt.

Body temperatures are the best indicator of thyroid function. Read the thyroid basics sticky and check body temps and eval your long term use of iodized salt in your self and parents. Checking your body temperature can be more useful than what most docs do.

It would also be interesting to check IGF-1 to eval growth hormone status.

Starvation can also whack your hormones.

Low DHEA and T is a predictor of heart disease in males.

There are two major constants as issues:

  • finding a doc who knows or cares about things that are not diseases
  • how do you pay for these things, insurance is useful, but can also limit what gets done

You may need to do your own labs, easy in the USA in most states.