T Nation

Extremely Low T + E


#1

Hello, I am new here. This is just my 2nd time posting. My name is Alex. I am 31 and from Markham Ontario.

May 25th 2015 blood test:
Testosterone Total: 2.3 nmol/L range: 8 - 32
SHBG 34 nmol/L range: 11-78
Testosterone, Bioavailable (calc): 1.0 nmol/L range: 4-17
Estradiol: <37 pmol/L range: 40-162

I have extremely low motivation, energy, extremely poor irritable mood, depressed, low libido, cognitive problems and poor memory. Other symptoms include collagen loss on my face w wrinkles around my eyes (from previous Resveratrol use), anhedonia, dark circles under my eyes, hypoglycemia, brain fog, night sweats, poor wound healing, among others.

I can hardly afford one of those specialty clinics but as a last resort I might have to because the last two endocrinologists I seen outright refused to help me. I felt so absolutely defeated and demoralized. I absolutely loathe most doctors due to their heartless treatment or lack there of. Though they seen me when my tests were near a bit better when I was taking royal jelly. But they really are two very heartless people. My anxiety was through the roof last time and he just tried to blame all my problems on anxiety. Regardless of what my tests showed.

I am just tried of being in this kind of state. I really need some serious treatment because my life is just passing me by. I have no real will or desire for anything. My anxiety is less severe than few months ago but my other issues still remain. If I stay away from stress my anxiety doesn't act up as much but doctor appointments start the cycle of stress all over again. Especially when they are as heartless as the ones I have been to.

What steps should I potentially take at this time?

Please any suggestions would be greatly appreciated!


#2

As you have a wide spectrum of problems, it would be helpful to see:

  • all lab work with ranges, there is more going on than low T
  • you do not have a diagnosis without LH/FSH
  • age, weight, waist size, height, fat patterns, hair patterns and loss

Please read these stickies:

  • advice for new guys
  • finding a TRT doc - you were there, but did you read it?

Check your oral body temperature when you first wake up and again mid-afternoon. Should be >=97.7 F and 98.6F
Have you always used iodizes salt?

When did your problems start? Any accidents a few months before? What medications in that time frame?


#3

[quote]KSman wrote:
As you have a wide spectrum of problems, it would be helpful to see:

  • all lab work with ranges, there is more going on than low T
  • you do not have a diagnosis without LH/FSH
  • age, weight, waist size, height, fat patterns, hair patterns and loss

Please read these stickies:

  • advice for new guys
  • finding a TRT doc - you were there, but did you read it?

Check your oral body temperature when you first wake up and again mid-afternoon. Should be >=97.7 F and 98.6F
Have you always used iodizes salt?

When did your problems start? Any accidents a few months before? What medications in that time frame?[/quote]

31 Years. 5’7, 130, Waist 32, fat mostly in my belly and legs, some hair loss on scalp on and off, some hair on legs and thighs, some hair on belly, had no hair on back or chest but that changed when I tried DHEA few years ago. Now some small chest hair and back hair is evident and does not go away. I do not take DHEA anymore. Some facial hair. facial hair usually grows slowly after shaving. Slightly blonde whiskers appeared after DHEA if I fail to shave.

My low hormones seemed evident when I was 20 but never was able to get anyone to look into it. Lot of it may be from damage done to me by Accutane. Huge amount of my health problems including depression started after Accutane and did not go away. I am honestly lucky to be alive.

Other test from last year:

Free Testosterone is 28 range: 31 -94 pmol/L
ACTH 2 <10 pmol/L
Cortisol AM 191 range: 170-540nmol/L -other times turned out 70 and another time 200,
Total testosterone 12.6 range: 7.6- 31.4 nmol/L
LH 2 2-9 IU/L
FSH 4 2-12 IU/L
Prolactin 8 <18ug/l
Norepinephrine 1.2 0.8-3.4 nmol/L
Epinephrine <0.1 <0.8 nmol/L
Estradiol 57 <157 pmol/L

Those results were when I was taking Royal Jelly and other herbs which helped modestly for my hormones but I cannot take Royal Jelly anymore due to horrid blood sugar fluctuations and die off reactions I receive when taking it due to underlying fungal infection. I suspect my LH and FSH are even lower now as my T and E are lower.

One of the best moods I had was in the middle of an ACTH stimulation test. Thoughts came more clearly and even some interest returned for a brief time. This may have been due to rise in cortisol levels as well as blood sugar fluctuations.


#4

2 months ago is when things hit rock bottom and I had severe symptoms of adrenal crisis. constant over the top stress reactions to any little thing. It felt like a fight or flight warzone almost every waking minute. Like a PTSD on-going scenario. This was when I was withdrawling from valium a bit too quickly but also was taking Resveratrol.

Resveratrol I had to stop because it was making my joints hurt and it made me suffer collagen loss on my face which ended up giving me some very unappealing wrinkles. I was also taking pregnenolone at the time and ended up stopping due to mood inconsistencies. Dose was maybe around 20-40mg every other day for a few months. Trying to recall.

Some history of Vyvanse and ritalin use because stimulants are some of the few substances to actually give me sufficient energy and motivation to go about my day. These were doctor prescribed. These days I almost never use them because I am trying to function without them. They would too often leave me feeling worn out any time they wore off.


#5

I don’t use table salt. I use pink sea salt generally.


#6

Pink sea salt tastes good, but no iodine.

Assume that you are iodine deficient. Doctors do not ask about this.

Check your oral body temperature when you first wake up and again mid-afternoon. Should be >=97.7 F and 98.6F
Check your oral body temperature when you first wake up and again mid-afternoon. Should be >=97.7 F and 98.6F
Check your oral body temperature when you first wake up and again mid-afternoon. Should be >=97.7 F and 98.6F

Refer to thyroid basics sticky.

Collagen loss is also a hallmark of a low T catabolic state. Do you have “tenting” went you pinch up the skin on the back of your hand? TRT can fix this.

Lets see what body temperatures indicate.

Your stress reactions also suggest that adrenal fatigue could be a consideration. In any case, your lack of vitality seems to make many things a struggle and the state of male hormone awareness in Ontario certainly is a very heavy weight on your mood.


#7

[quote]KSman wrote:
Pink sea salt tastes good, but no iodine.

Assume that you are iodine deficient. Doctors do not ask about this.

Check your oral body temperature when you first wake up and again mid-afternoon. Should be >=97.7 F and 98.6F

Refer to thyroid basics sticky.

Collagen loss is also a hallmark of a low T catabolic state. Do you have “tenting” went you pinch up the skin on the back of your hand? TRT can fix this.

Lets see what body temperatures indicate.

Your stress reactions also suggest that adrenal fatigue could be a consideration. In any case, your lack of vitality seems to make many things a struggle and the state of male hormone awareness in Ontario certainly is a very heavy weight on your mood.
[/quote]

The thing about thyroid is that my TSH has been at 5.4, 6, 4.5 and once at 3.3 or so. Free T3 was once on the higher number spectrum as well. Despite these numbers doctors downright refused thyroid treatment except one.

I do have T3 and Efra. But they made me irritable and increased anxiety. I felt very edgy on them.

Suppossedly if my adrenals are too weak then the body cannot handle Thyroid treatments. And there has not been any doctor willing to give me Cortef.

My psychiatrist may be willing to give me Cortef but he says he needs to learn more about it. If I can come across useful concrete information about Cortef helping depressed people, or the general health benefits and safety involved with physiological dose treatments he may be able to consider it during our next appointment.

I do not experience any tenting. The skin goes back to where it was quite quickly.

Another thing to note in case I didn’t mention it is Accutane induced severe problems for me when I was 18 and is likely very responsible for long term low hormone levels. This is something that most doctors are still not willing to acknowledge despite this garbage medication being pulled from the US market. Meanwhile it’s still poisoning our youth here in Canada. Because of course acne free skin is such a blessing compared to… developing intense depression, anxiety, mood disorders, hormone disorders, IBS and you name it.


#8

36.2C temp 97.16f 9:42pm this evening.

I will test again tomorrow.


#9

Toronto, I am from Canada also, B.C. It was a huge fight for me to get on TRT. Even so they have me on such a low dose I only have a couple of good days a week. Don’t know about Toronto but here I couldn’t even go to another doc because they aren’t taking new patients.

Hang in there and keep looking, it’s been a 2 year struggle for me. If things don’t get better I’m heading to the states to get treatment, I cannot keep living like this.


#10

Similar temperature at 5am, afternoon and evening. 36.2 c which is 97.16F. Once in a while it is at 97.34 F such as right now.

I managed to get an Endo appointment on Thursday. I’m feeling really edgy and uncomfortable. This is the guy who refused to treat me when my Free T was 8. But with these new results I imagine he has to do something.

My body does feel really cold a lot of the time. I also find myself shaking certain times in the morning. Likely due to poor glycemic control.

I’m sure he may try to investigate the cause of all this. Hopefully he isn’t old fashioned to the point where he feels Accutane cannot cause long term damage to the endocrine system because it certainly has even though it was over a decade ago. I was never the same since then. I wish I was able to find the proper studies indicating this. But things got worse 2 years ago. That’s when I really crashed hard. I wonder what type of advanced tests to get? I personally would like a pituitary MRI but I don’t know if I can convince him to agree to it. I also have very poor circulation and pains in my neck. Though very likely all low T related.

If you guys have any suggestions on reputable studies to print out for my doctor please let me know. I will be immensely grateful. I plan to print him out a few depression related studies indicating Low Testosterone.


-Low T linked to Major Dep Disorder : “The partial androgen deficiency of aging males (PADAM) is responsible for a variety of behavioral symptoms, such as weakness, fatigue, decreased libido, depressive mood, lack of motivation and energy, lower psychological vitality, anxiety, irritability, insomnia, decreased work and sport performances, difficulty in concentrating, memory impairment and low dominance. Psychological and behavioral aspects of PADAM overlap with signs and symptoms of major depression.”


#11

The thyroid issue I think is a very real one. I have had some mixed results w Efra (compounded t1 t2 t3 t4) and Cytomel T3 treatment. Usually they made me extremely edgy and irritable. But my body may not have been able to handle them due to poor adrenals.

About a month ago T3 made me sleepy when i took it in the morning. But then one day in between I became more productive and energetic.

The thing with thyroid is that this doc in particular may brush it off simply due to my TSH not being above 5. So I don’t know what to do about it. Maybe some self treatment at low doses here and there.

Are there times when T3 or Efra synergize well with particular Testosterone treatment? Or what I can do to make them work more effectively?

My biggest issue is likely poor adrenals, but I don’t think he will give me cortef. I wish he would because I think it would change my life but what can you do.


#12

Doc only ordered some basic tests. Nothing comprehensive.

He prescribed me AndroGel. It might be covered by OHIP, if not they will change it to something else.

I guess I start tomorrow :). The doc has no idea what he’s doing though. Such a rush rush 5 minute appointment. So I will have to do it on my own. Follow up will be 3 months from now. This is coming from one of the so called top dog Endo’s on all of Ontario. What a joke!


#13

I think that you are really missing the point about iodine!

Refer to thyroid basics sticky.

Refer to thyroid basics sticky.

Refer to thyroid basics sticky.


#14

I have read the thyroid sticky. I have switched to iodized table salt and am consuming more salt. I been concerned about thyroid health for a long time actually. I do have iodine in tincture form which I intend to use soon but after I get my tests done. I have to go get bloodwork done tomorrow. Selenium I have as well.

My TSH has always been between 3 and 5.5. Averaging around 4.5. But none of these worthless docs consider it clinical which is ridiculous considering no one with TSH above 3 can be considered truly healthy. Even above 2 should indicate something is not quite right.

Problem with thyroid meds I have tried is that I haven’t been able to tolerate them majority of the time. Making me extremely edgy, wired and anxious. This may be due to my poor adrenals unable to support it. Thus it’s a more complex picture.

I am getting low dose cortef next month though so I can finally try to treat adrenals and thus be in a better position to do something about my thyroid health as well.

With my hormones across the board being low it’s quite a bit to handle.