T Nation

Bloodwork 18 y Low T -Options?


#1

Hi
I was here about a year ago. I’ve been running back and forth to doctors with no results. I’ve had a bunch of bloodwork done though.

I suffer from alot of low T symptoms, mainly however: HUGE loss of libido (consistent for 2-3 years), ED, inexistence of morning wood, fat gain (I use to easily stay lean) weaker physically, and feel weaker both physically and mentally, constant levels of low anxiety for no logical reason (I’m not worried in my mind, but my body feels at unease) foggy mind (my memory and conecentration is BAD, going from A-B grades to barely managing E)

age: 18
weight 74kg
height 5’11
bf 17-18%

I’ve got prolactin, thyroid, estradiol, testosterone, liver, kidney function, vitamin D, insulin function and blood values checked over the years:

Total Testosterone Reference: 230ngdl-866ng/dl - Values been hovering around 260-373ng/dl over the course of 2 ½ years. Latest ones at 323ng/dl, 280ng/dl, 260ng/dl.

SHBG 13-71nmol/L - values been around 15-20nmol/L Latest ones at 18nmol/L, 15nmol/L, 16nmol/L

LH- Been around 4-6iu/L on all tests. Latest ones at 4.8iu/L, 5.6iu/L, 4.5iu/L
FSH - Always been low 1.2-1.6iu/L. Latest ones at 1.3iu/L, 1.6iu/L, 1.2iu/L

Hemoglobin - Always been elevated, hovering around 160g/l. Latest test showed 150ng/dl.

EVF - Always elevated aswell, hovering around 0,50%, Latest test was 0,43%.
I think it’s because of dehydration, I will get this retested properly hydrated.

Estradiol - 19.5pg/ml

Vitamin D 88nmol/L

Thyroid: 3 TSH tests around 3-3.5. Latest one (complete) showed a more or less perfect thyroid function?

TSH 2.2miu/L (0.4-5miu/L)
Free T4 20pmol/L (10-22pmol/L)
Free T3 5.4pmol/L (3.3-6.5pmol/L)
TPO-AB <10 (0-35)
TRAB <1 (0-1.0)

Prolactin, 6.5 ng/ml, 33ng/ml, 16ng/ml (2-17ng/ml)

S-Glucose 5.3nmol/L
HbA1C 32mol (27-42mol)

S-DHEAS 9.3umoL/L (5.7-13umol/L)

P-Cholestrol 3.5mmol/L (2.9-6.1mmol/L)
HDL Cholestrol 1.3mmol/L (1.0-2.7mmol/L)
LDL cholestrol 2.2mmol/L (1.2-4.3mmol/L)
Triglycerides 0.5mmol/L (0.45-2.6mmol/L)

I would appreciate any welleducated thoughts and comments :slight_smile:

Thank you for taking the time to read.


#2

We have found that most guys who come here happen to have some degree of thyroid problems.

Do you use iodized salt or have vitamins that list iodine+selenium?
How much sea food do you eat?

TSH lab ranges are too wide.

TSH should be closer to 1.0
T3, T4, fT3, fT4 should be mid-range or a bit higher.

This is quite high: Free T4 20pmol/L (10-22pmol/L)

You can evaluate your overall thyroid function by checking oral body temperatures:

  • should be 97.7-97.8F when you first wake up, higher is OK, 97.3 is a problem
  • also check for 98.6F/37C mid-afternoon

Do you get cold easily?

Please read these stickies:

  • advice for new guys
  • things that damage your hormones
  • thyroid basics

Your cholesterol levels might be low which can reduce hormone production.

What is EVF?

Have your testes been examined by a doctor?
Sometimes a MRI is used to look for an abnormal pituitary gland. It is odd that LH is consistently higher that FSH. If there was a LH secreting pituitary adinoma that could create problems. LH has to be release in pulses. Steady LH levels suppress testicular function.


#3

Hi
I do have cold feet and hands. I remember I checked body temps before but it was an unreliable thermometer, I will remeasure with a new one.

I use iodized salt maybe 5-6 times a week.

Sorry my bad, EVF is Hemacrotit.

Yes, testes have been examined, they were normal in size and ultrasound showed no signs of variceole.

I don’t have access to an MRI. Doctors aren’t in agreement that my testosterone is low in anyway.
Selftesting and self-medicating are my only options. Is there any other way I can test this?


#4

HTC would increase with dehydration, not decrease.
HTC and RBC do go down with low T levels.
However, can go down with some digestive issues that result in GI blood loss.

Free T3 5.4pmol/L (3.3-6.5pmol/L)
That is more than enough to normally support good body temperatures.
If temperatures are low, then we suspect that rT3 may be blocking fT3.
rT3 is increased by stress and there can be adrenal fatigue.

Your T levels are not normal for a young male.

This is worrying: Prolactin, 6.5 ng/ml, 33ng/ml, 16ng/ml (2-17ng/ml)
Prolactin can lower LH/FSH, lower T and lead to mood/depression [which might be just from the T levels]

Have you read the stickies yet?


#5

I will get prolactin retested again and write once I measured body temp 3 days.

I read the stickies:

-age 18
-height 5’11
-waist 84inches (just above navel)
-weight 164 pounds/74-75kg
-describe body and facial hair - alot of body hair, but it’s not thick, it’s very loose? (not dense) you can ‘see through it’ facial hair around mouth, cheek, very thin and seethrough
-describe where you carry fat and how changed - most of fat is carried around midsection stomach and lower back. I don’t have a beer belly, but if I gained weight it would create one so to say.
-health conditions, symptoms [history] i only had contact one time with the health care prior to this, although, when I was entering puberty my school doctor thought it was too early and wanted to give me some type of injection to slow it down. I can’t remember what it was.
-Rx and OTC drugs - Acne during teenage years, was prescribed 100 caps of tetrlacycline, 2x per day
-describe diet - varied from time to time, was more strict and iifym when training, but now I just eat homecooked food. Weight is kept the around the same, I don’t gain or lose. Usual food is rice/pasta/potatoes with some meat (chicken, beef, pork) and vegetables.
-describe training - use to gym, did stronglifts 5x5 for 3 months, and upper/lower for 6 months. Also 6 months where I was new and just played around. Now I just do muay thai 1x week or when I can muster the energy to go.
-testes ache, ever, with a fever? - never
-how have morning wood and nocturnal erections changed - erection quality greatly reduced. no hard morning woods, maybe sometimes i wake up with half a boner but rarely.

I hope this is useful to some degree.

If I measure my body temp and it’s showing up normal, would it be likely it’s not a thyroid problem then?

Thanks KSman


#6

Hi I missed some. Sorry for double post

Pituitary damage: No access to MRI. I don’t know…

Drugs and chemicals: Only drug I’ve used is tetracyline for acne.
I tried weed a few times.
Alcohol is 2x months approx, but a few beers and some vodka. I never drink to the point of drunk.
Never smoked in my life (cigarettes)

-other chemicals, toxins, pollution
-heavy metals
-fire retardants in furniture or fire fighter’s fire retardant clothes
^ Not that I’m aware of

Effects of other reproductive and related hormones - I’ve never touched AAS in my life. No preworkouts. I’ve only bought protein powder.

Damage to the testicles [testes] ref - Not that I’m aware of

Damage to the pituitary gland:
Not that I’m aware of. I do practice muay thai, but testosterone tests were taken before I started, I never competed. I only do light to light-medium sparring.

-hypothyroidism - will measure body temp
-adrenal fatigue - I could see if I can get a cortiol blood test?
-syndrome X aka metabolic disorder
-insulin resistance [and diabetes] - Don’t know, I know my grandmother had diabetes. Noone else in the living family I know of has diabetes though.
-influences of the digestive system - don’t know
-arterial disease and high blood pressure [BP]
-poor cell wall permeability - don’t know

Deficiencies:
Iodine : I eat with iodized salt relatively often.
Cholestrol : I’m not counting it right now, but I do get some cheese in, cream, eggs, butter, olive oil. I would be very surprised if there was a signficant defiency. I did go on a high fat diet for 3 months to see if it would boost my testosterone. It didn’t work.

-low dietary EFA’s - I’m not taking fish oil anymore. I did do it during the 3 months period of highfat diet. I rarely eat fish.
-other low trace minerals - I take a multivitamin. maybe not enough…
-sub optimal vitamin D - I supplemented with 4000iu of vitamin D during the 3 month period.
-anti oxidants. I try to eat vegetables with every meal. Usually something of: spinach, green beans, tomatoes, cucumbers, carrot, lettuce, brocolli. Usually a 1-2 handful of something out of those vegetables with every meal.


#7

Hi KSman. I took some temps the last 3 days

1st day: 97.7F
2nd day. 97.34F
3rd 97.88F

Afternoon temp on 2nd day 98.42F


#8

Body temps seem good. TSH still suggests something is not right.


#9

How would I go about the thyroid?

I’m wondering. How bad would it be to start TRT? I don’t see any obvious causes during these 2 ½ years.
If I understood right. With a proper TRT dose e.g 100-150mg/week and HCG 3x 200-250 IU per week. Fertility should be more or less the same prior to TRT and if I monitor my blood values. There should be low risks?

I’m feeling very bad. And I fail to perform in many different areas of my life and it has to change, it’s been too log.


#10

Hi guys
So this is my situation atm: On TRT 120mg per week for 5 weeks. Last 3 weeks bumped it up to 150mg/week.
I
inject every 3.5 days. As for other medications I have since 3 days ago
also started taking Milkthistle and Berberine (800mg/day). To hopefully
increase my SHBG.

I lift weights 6x days a week about 40-50min per session. And I have a quite physical job.

Lab results below is taken on the morning of third day after injection (I would inject on the evening).

I have all my Pre-TRT lab results on the first post.

Note: I donated blood 1 month ago. I will donate again in 1.5 months.

LABS:
Blood
Hematocrit 0,49 (0,39-0,49)
Hemoglobin 150g/l (134-170g/l)
MCV 96 (82-98FL)

Fat lipids
HDL Cholestrol 1,03 (0,8-2.1mmol/L)
Cholestrol 3,58 (2,9-6,1mmol/L)
LDL Cholestrol 2,36 (1,2-4,3mmol/L)

Glucose 5mmol/L

Hormones
TSH
1,3miU/L (0,4-4,0miu/L (This one really shocks me. I have always been
around 3-3.3TSH over the course of 2 ½ years. Dosen’t TRT worsen thyroid
function? This puts TSH in optimal range!..)
Total testosterone 138ng/dl (232-900ng/dl)
Estradiol (nonsensitive) <12pg/ml (<40pg/ml)

Liver
ALAT 0,3 ukat/L (0,15-1,1 µkat/L)
ASAT 0,53 (0,25-0,75 µkat/L)

Iron 14umol/L (9-34 µmol/L)

Kidney
Kalium 3,9umol/L (3,5-4,4 mmol/L)
Creatinine108umol/L (60-100 µmol/L)
Natirum 141nmol/L (137-145 mmol/L)

I have a few thoughts. Please write yours.

Obviously
my total T is very low considering the amount I inject 75mg every 3.5
days and I’m at 138ng/dl on the third day is awfully low.

  1. My medicine might be underdosed?
  2. My low SHBG clears the testosterone extremely fast?

Why is my TSH in the optimal range for the first time in ever? I
thoguht that TRT is suppose to worsen thyroid function not improve it? I
must say that on TRT I do feel alot more resistant to cold now. I use
to get cold really easily.

How should we proceed?

  1. Increase frequency to 3x a week injections?
  2. Increase dose?
  3. ?

Thank you very much


#11

your should get serum zinc checked aswell, low zinc can sometimes cause low testosterone i think


#12

Will - i am on trt

Bump!!
Ksman if you are here please chime in?
Is it possible my shbg clears out my testosterone SO fast? Or is it most likely my medicine is underdosed?