Been lurking this place for the past few years but have never posted.
My health problems are extensive but I’ll try and keep things short. My situation, in chronological order:
Developed bilateral varicoceles at 15 years old — a year later, depression, low libido, erectile dysfunction, loss of muscle mass, brain fog + adhd diagnosis, sensitivity to cold, etc, all followed.
Went to family physician with above symptoms; all labs normal apart from 320ng/dl total testosterone w/ 45 SHBG, and thus low free testosterone. Doctor said it was fine, so I decided to pursue testosterone via the private sector.
Spent four years on trt using various protocols with little to no success: testosterone mono, testosterone + hcg, testosterone + hcg + ai, high dose test with above range levels, low dose test with mid-range levels, tried keeping e2 @ 22 pg/ml with ai, tried letting it fall where it falls, etc, etc — all not no avail. I always spent multiple months on each protocol with bloods every four to six weeks. Towards the end of my time on trt, my serum am cortisol dropped below range, four point saliva was low across the day, TSH was rising to the 3-4 region, progesterone was undetectable and I had the classic symptoms of adrenal insufficiency and hypothyroidism. I decided to cease therapy to see how I felt off testosterone.
Now, age 26:
Been off testosterone for just over a year.
Current symptoms include:
Always feel cold, body temperature is low (96.4 waking, rising to 97.8 by mid-afternoon), pulse is 55 bpm despite doing no cardio / not being fit, sex drive is absent, diffuse hair and eyebrow loss, erections are inconsistent, daily heart arrhythmia (diagnosed benign premature ventricular contraction), exercise intolerance (feel like I’m going to pass out upon exertion), lightheaded upon standing, loss of muscle mass, rapid skin sagging / facial aging / under eye bags.
Current labs, one year post-testosterone:
TSH: 3.1 (0.27 - 4.2) mIU/L
Free T3: 5.16 (3.1 - 6.8) pmol/L
Free T4: 14.5 (12 - 22) pmol/L
T4 Total: 82.9 (66 - 181) nmol/L
rT3: 10 (10 - 24) ng/dl
Anti-Thyroidperoxidase: <9.0 (<34) kIU/L
Anti-Thyroglobulin: 14 (<115) kIU/L
AM Serum Cortisol: 542.0 (113 - 570) nmol/L
DHEA Sulphate: 8.270 (5.73 - 13.4) umol/L
FSH: 1.6 (1.5 - 12.4) IU/L
LH: 5.99 (1.7 - 8.6) IU/L
Oestradiol: 55.3 (41 - 159) pmol/L
Testosterone: 19.2 (8.64 - 29) nmol/L
Free Testosterone - Calc: 0.340 (0.2 - 0.62) nmol/L
Prolactin: 551 (86 - 324) mU/L
Progesterone: 1.5 (0.7 - 4.3) nmol/L
Have had the above labs run four other times and they mostly looked the same.
TSH above 3, elevated prolactin and low body temps suggest hypothyroidism. Even though cortisol and dhea-s look solid, many of my symptoms also suggest adrenal dysfunction and, as mentioned prior, serum am cortisol was always below range on trt — usually around 120 nmol/L (113 - 570).
My plan is to trial levothyroxine, starting with 25mcg per day, increasing the dose every four weeks based primarily on body temperature and pulse, but will also get bloods run too. If I don’t convert well I will transition to armour thyroid. Everything is self-treated as no doctor in my country will touch me with everything being within range.
If anyone managed to make it through the wall of text, I’d greatly appreciate some input.