T Nation

Hormone Evaluation - Do I Have a Problem?

Long time lurker here that finally wanted to make a post. Just wanted some opinions on this situation being that I can sometimes be paranoid but also truly believe that theres something off with me. I am a 21 year old male, and I have been feeling extremely fatigued for the last 2 years and have gone to a few different family doctors to make sure that I don’t have any serious illness’, which thankfully I don’t. However, no doctor has ever been able to give me any information as to why I am so tired all the time. So I decided to look into hormones:

Information:
USA
Male
21 years old
5"10" 140 lbs
Regularly active, at least 4 days a week in a local gym with moderate weight lifting and cardio.

Lab Work: Keep in mind, I understand the lab work is incomplete.

May 22nd 2012:
Testosterone, Free and Total: 381 ng/dl Range: 348-1197

June 27th 2012:
Testosterone, Free and Total: 461 ng/dl Range: 348-1197
Free Testosterone(Direct): 14.8 pg/ml Range 9.3-26.5
T4, Free (direct): 1.29 ng/dl Range: 0.82-1.77
FSH: 2.3 mIU/ml Range: 1.5-12.4
Estradiol: 7 pg/ml Range: 3-70
Prolactin: 10.3 ng/ml Range: 4.0-15.2
TSH: 1.380 uIU/ml Range: 0.450-4.500
T3 Free: 3.4 pg/ml Range: 2.0-4.4

General Feelings/Symptoms:
-Brain Fog: Unsure, however I do feel as though I am having a hard time thinking or concentrating on things as well as I used to.
-Gyno: Very light gyno symptoms, I have always had puffy nipples and there is fatty tissue around that area but I do not have male boobs
-Fat Deposits: YES. I carry fat in my lower belly, around my triceps and around my hips, I have a lot of fat around my hips for such a thin person.
-Mood: I am more of a sensitive male, definitely a bit more sensitive than an average 21 year old male.
-Getting it up: I do not have strong morning wood and I do not have morning wood every day. I also take very long to recover after round 1.
-Body Hair: Almost non-existent. Little to none on my face, absolutely none anywhere else besides pubic and very fine, small hairs on legs
-Cold Sensitivity: Very sensitive to cold temperatures.
-Vision: I have always had poor vision and have been using contacts and glasses from the time I was a young child. Although some days I do feel as though my vision is reduced, this is normally the same days that I feel the “Brain Fog”.

**I do understand that I am young, however I feel as though I’m hanging behind. I have little to no muscular definition and have been on strict dietary and weight lifting regiments with no results besides wanting to throw up every single time I lift at the gym. I do not feel powerful or in control most of the time and am fed up with this feeling. I have toyed with the idea of running a cycle of test (I would obviously do more research if this was the route I were to choose) or an oral cycle of something like anavar (to see if this gives me a confidence boost that gets me past all of this) or an anti-estrogen only such as arimidex (at this point I’m just desperate). I just need some guidance.

I’m one year older with a similar free T level 15.98 (that works in spikes though)and I know how you feel. I too fondled with the idea of a cycle. Its stupid bro and will probably ruin your hormones even more. You’re not terribly low, but you are on the low side for your age. Cycles are reserved for people with years of training who have reached their genetic potential. Its frustrating, but hang in there.

As you know you need more tests (check stickies) your probably a bit secondary.

Have you ever had injuries to the head? How is you peripheral vision?

You have pretty much all the same symptoms as me including cold sensitivity and bad eye sight, I have tried a SERM which helped some and tried several peptides including PT141 and Melanotan 2 which helped with the libido issues. My testosterone was 333 but my estrogen was on a different scale but on the higher side. I will be watching this thread as well as mine because the doctors dont seem to know much and the people on this forum are often incredibly intelligent.

E2 is really too low now, so you cannot use an AI [aromatase inhibitor].

What labs produced those reports?

You have always been a low-T guy. Your libido and performance indicate that you are not deeply T deprived.

Your fat patterns are consistent with your lower T status.

Your not feeling well may be more than T. Your thyroid levels appear good, but do not make sense with you reports of feeling cold. Do you sweat abnormally?

What vitamins and supplements, with history?

Any loss of peripheral vision?

You have a degree of secondary hypogonadism, but we have to recognize that your LH/FSH probably has always been below average.

Feeling sick when training may be an adrenal issue. Get AM cortisol test done, you need to do that around 8AM. And test cholesterol and DHEA-S, which is made in the adrenals.

History of:
What drugs, Rx and OTC?
Any dietary extremes, low fat, avoid eggs etc?
Do you consume grapefruit?
iodized salt or sea salt?
Iodine in vitamins?

Do you get much sun exposure?
Vitamin-D? milk, vitamins …

OP Here

Never had any issues with head trauma or injury of any nature to my testicles.

Am I to understand that a few “cycles” of Nolvadex or something like that would help me in the gym?

Reply to KSMan:

-LabCorp Tampa and Burlington

-I have always been more “beta” than “alpha” and it never really bothered me until about a year or two ago when I started feeling tired. Then I noticed all the other symptoms.

-Sometimes at the gym I do not sweat at all until the very end, then I sweat profusely. However that is the only abnormal sweating pattern I’ve ever noticed besides the occasional nervous sweats.

-Vitamins : Currently I take 1000 mg of Vitamin C, 450 mg of Magnesium, 50 mg of Zinc and fish oil supplements daily. I have been taking these consistently for about a year. I supplement with whey protein semi-regularly and tried creatine many years ago when I first got a gym membership.

-I haven’t noticed a loss of peripheral vision that I can remember.

-Drugs: Rx Paxil when I was very young (elementary school) with a significant gap, then on to Prozac (high school) then before I graduated high school I quit cold turkey and haven’t felt a need to take any of that ever again. I have no mental disabilities or diseases, it was strictly for anxiety reasons (I was spooked by a lot of things as a kid and my parents felt it may turn into a real problem if I didn’t get it under control). OTC the only other thing I’ve ever taken was doxycyclin for about 6 months for acne when I was in middle school.

-No dietary extremes.

-I barley ever have grapefruit - is this a bad thing?

-No idea on the salt question or the iodine in vitamins.

-Light sun exposure, although i live in Florida and could easily change that.

-Never supplemented vitamin D before, don’t drink milk often but I do eat a lot of greek yogurt.

Two more things that I have noticed symptom-wise are that I have developed very large dark circles around my eyes, and puffiness underneath my eyes with a very heavy feeling surrounding both of them. And more concerning and surprising that I didn’t bring this up in the first post is my sleeping situation. Waking up in the morning is a battle of the ages, I literally have never had an easy time getting out of bed and sometimes it literally hurts my body to try and wake up. I feel as though I never get enough sleep even if it’s 12+ hours.

Thanks for the replies everyone, I’m feeling better now that someone is actually taking a few moments to take my situation seriously.

[quote]bigbizpbv wrote:

Two more things that I have noticed symptom-wise are that I have developed very large dark circles around my eyes, and puffiness underneath my eyes with a very heavy feeling surrounding both of them. And more concerning and surprising that I didn’t bring this up in the first post is my sleeping situation. Waking up in the morning is a battle of the ages, I literally have never had an easy time getting out of bed and sometimes it literally hurts my body to try and wake up. I feel as though I never get enough sleep even if it’s 12+ hours.

^^^This

You need to get an AM cortisol test as KSMAN mentioned - you may even want to get a 4x saliva test, which can be ordered online (search this forum for links, you can also google stopthethyroidmadness and go on there site for a link to a lab and a discount).

Be forewarned - if you do have a legitimate issue, its likely not going to be an easy fix and will take an incredible amount of work, research, and patience on your part. Just wanted to give you a heads up before your dive in, as it can be overwhelming at first but there are answers. I have dealt with similar issues for 2+ years now and am just now on the road to recovery after multiple doctors and countless hours of research.

I’ll definitely get that cortisol test ASAP. Maybe even this week.

-No idea on the salt question or the iodine in vitamins.

So you do not have a salt shaker or you do not know what is in it. ;{
If you take vitamins, look at the contents for iodine.

Circles under eyes:
Please get or post liver ALT/AST testes
You need a lot of antioxidants
Take fish oil caps

What toxins are you exposed to? In workplace?
What is your workplace environment?
Report your waking and mid afternoon oral body temperatures.

Rug: Thanks for the support, I’ll have that cortisol test up ASAP.

KSMAN:

-I do not add salt when I cook at home, I cannot speak for restaurant dishes, but this is an easy fix, I will start to add Iodine to my diet immediately. None of my vitamins have Iodine in them at all.

-Liver Results from May 22nd 2012 Lab:

ALT (SGPT) : 34 IU/L Range: 0-55
AST (SGOT) : 29 IU/L Range: 0-40

-Cholesterol: Doc pointed out that this was high and suggested I eat more vegetables

LDL Cholesterol Calc: 121 mg/dl Range 0-99

I had the entire Lipid panel tested so any other results you are interested in please ask.

-What is the best method for me to take in Antioxidants?

-I am a technician at a best buy and a university student, I do not work with chemicals or in a toxic environment.

^^ to avoid confusion this was a username that I had but didn’t have access to it so I made this username. It must have signed in when I used my email address instead of username to sign in.

Do some research on anti-oxidants:
high potency B-complex multi-vit plus iodine
fish oil caps
5000iu vit-D3 tiny oil caps, Walmart has these.
vitamin-C

What is total cholesterol.

Ok will do. Already on the fish oil caps and vitamin C

Total Cholesterol: 190 mg/dl Range: 100-199

The cholesterol being a bit high was very strange as I do not regularly eat fatty/greasy foods.

Thanks again for your help and analysis.

Cholesterol=180 is ideal, higher is very OK IF HDL is good. Total cholesterol below 160 is associated with increased all-cause mortality; which means that all risks of dying are increased. Low cholesterol is unhealthy. Many doctors have swallowed the marketing hype of the statin drugs and think that lower is better.

So it seems as though that while it’s unlikely I have a serious problem with my endocrine system, I probably am suffering from a small hormone imbalance that can be helped by doing a few things:

  1. Get an AM cortisol blood test for further analysis
  2. Use Iodized salt when cooking and take a supplement of iodine
  3. Add vitamin D3 and B complex to supplement diet.

A few things I am wondering: If I am being too “needy” I apologize, please call me out on it.

  1. Would taking a liver supplement such as Milk Thistle help with the circles around my eyes and maybe help with energy levels?
  2. Would taking a cycle of Anavar (real Anavar) followed by a SERM such as Nolvadex help me at all at the gym with energy levels and results?
  3. Would a general practice doctor give me the time of day if I asked to speak to an endocrinologist regarding my lower test and FSH levels plus symptoms?
  1. Yes you need to check adrenals, Dhea-s cortisol. Test Vit D while you are at it.

  2. You really shouldn’t mess with cycles while trying to find the cause of your issue. Your HPTA may already be brittle and you can damage it. If you are secondary a SERM restart is something you can try in the future once you look for root causes and take care of that. That will also show how your HPTA responds and if your testes respond. If the SERM is not successful and you are secondary HCG monotherapy is the way to go for a healthy young man. First things first though.

  3. It’s tough, read the stickie on finding docs.

Docs will not Rx T for your levels.

Circles under the eyes: Is there a seasonal variation? Do you drive or use mass transit?

Anavar is an oral steroid and these have totally fallen out of favour, for those that know, because of liver toxicity.

If you do HPTA restart. Anavar has no place there.

Thank you guys so much for all the advice and taking the time to go through all this.

Ok will get these adrenal tests on Monday and should have results the next day, I’ll probably do another Testosterone and FSH/LH again as well.

How do I know when and if a SERM/HPTA restart is an option?

Circles under eyes:
No seasonal variation at all, puffiness and heaviness is worse in the morning but dark circles are consistent no matter what time. I drive, never use mass transit.

Do you have CBC [complete blood count] and blood chemistry data?
serum iron and ferritin?

Anemia or iron overload can cause this, as well as various liver conditions.

Found this: "I found out I have hemochromatosis, or iron overload disease. The dark circles are one symptom of it. Just because you have dark circles doesn’t mean you have this, but next time you have bloodwork done, ask your doctor about it and have your serum ferritin checked. "

Can be hereditary. But what is happening that some other condition is hereditary and circles under the eyes are a symptom.

I have CBC but everything is normal on that.

Any advice on when to seek HPTA restart via HCG or SERM?

Normal! That is BS, let use see the numbers. There is often a lot of useful info to be found in the “normal” range.

Whenever you are willing and able. Timing: Watch for complications with holidays, travel and vacations etc. You need to know what you are doing!!!