T Nation

I'm Only 22. Help Me Understand What's Happening to Me?

Hello people, from all the different Testosterone replacement forums I have read, your forum always surprised me as to how much people here are knowledgeable in hormones and such, compared to the certified doctors I’ve been to, sad reality but true.

In the summer of 2015, at the age of 19, got a sports injury which resulted in a varicocele (enlarged testicle veins). Right after developing the varicocele, no differences in psychology and physiology were noticed, other than the fact that after 1 month of having the varicocele, the testicles shrunk ca. 50-70 % in size. Only after 1+ years mark, severe psychological and physiological changes were noticed to occur.

Psyhoclogil changes: Brain Fog, Depression, apathy, no motivation, no confidence
Physiological changes: Bone and joint pain, smaller less masculine bones, smaller hands, wider hip bones and smaller shoulders etc, less masculine and mature looking face structure, dry skin, cold hands and feet.

Ironically, due to the altered state of hormones, I did not only develop and mature physically since the age of 19 till today’s age of 22, but if anything I look less manly and less mature, look younger, but not in a youthful way, more in the way that as if I got a reverse puberty for the lack of a better term.

Here below, you can see a graph that shows how hormones changed throughout the time.

the unit for Testosterone is nmol/L, normal reference range (7 – 33 nmol/L)

the unit for T4 Free is nmol/L, normal reference range (10,0 – 22,0 pmol/l)

the unit for TSH is mU/l, normal reference range (0,3 – 4,0 mU/l)

Doctors do not comment on the hormonal changes and always give the same dismissive answer “The hormones are still in the normal range”. If anything I was referred to a psychiatrist, due to the belief that all my symptoms and problems are “my mind playing a trick on me”

God knows, and I know how I am a witness to the fact that prior to having a huge varicocele I was developing properly, was in Tanner stage of 4, needed to complete the final Tanner stage of 5. However, after getting the varicocele, and getting my testicle to shrink in 50-70% in size and after some time developing hormone decline which can be seen if one looks at the blood tests taking throughout the last 3 years, I see and feel how my health and looks are going downhill as if the aging process started already in my case.

Don’t know what to do, but existence is hell right now for me.

You will get fixed. No worries there.
It sounds like you are primary hypogonadism- meaning testes can not produce enough T. You should get an ultrasound of testes with Doppler to verify. Varicocele will def effect your t production.
You can see results of ultrasound to see if surgery can fix varicocele.

Dr suck. It’s not uncommon for then to dismiss your symptoms and prescribe mental drugs.

You are on it now and will get it fixed.

Your other option is TRT.

And your chart is interesting as I think that low T can be the cause of declining thyroid hormones.

Also start getting full labs.
Total t
Free t
Shbg
Prolactin
Tsh
Free t3
Free t4
CBC
CMP
Lipid panel

Hello Charlie12,

I had an ultrasound of testes, however, the comments from the doctor were that the testicles look healthy and normal. How can the ultrasound of testes tell if it is a primary or a secondary issue?
You mean if I was told that the testicles look damaged, that one could surely assume that it is the testicles that due to being damaged cannot produce the required testosterone levels?

I was operated on the varicocele 5 months ago, however, had no effect on the hormonal profile, if anything got a little bit worse. Don’t think that it is due the varicocele surgery, but just the progressive decline that is happening due to the unnatural/lowered testosterone levels.

I got full labs recently, will post them when I’ll be home.

Comments on the TRT: As to my knowledge the testicles don’t only make Testosterone but other hormones as well, such as inhibin B, oestradiol, insulin-like factor 3 and others. So if I start injecting testosterone, my testicles will atrophy completely and stop working. Wouldnt it mean that the other hormones which are normally produced by the testicles will be lowered because I’m not injecting them, but only testosterone injecting testosterone to compensate for the lack of production from the testicles?

In addition, the only way I can get Testosterone is through prescription and the fact that the doctors are not cooperative in this regard means that it’s just not an option, although it would have been the easiest way out, of course, so to speak.

In addition, I would inform you that I used Clomid for a month and it had no effect on the testosterone levels.

Cheers

Makes sense Clomid did not work. Confirmation u are primary. I think
adrenal gland produce certain hormones as well.

You can inject hcg to keep testes functioning.
You must find a Dr that is willing to help. Where do u live?
Also see finding a Dr sticky .https://forums.t-nation.com/t/finding-a-trt-doc/151012?source_topic_id=38

No doctor I been to, takes my situation serious, most of it due to the fact that “I’m too young”. Not even the private doctors. I’m from Europe btw.

Throughout the last 3 years, going to the doctors just wasted all my time and made me sit doing nothing. Because of this 2 months ago I tried running Clomid for a month but as you know already no results.

Also, I need to bring my testosterone back into place, as soon as possible, its just not healthy to have low testosterone for any longer amount of time, and also because there is still chance that my body will catch up on the growth and I will complete my puberty so to speak.

The doctors you have seen so far are idiots!
How can you possibly be too young, when you are feeling terrible and have the evidence in your blood results.
As you mentioned you have tried clomid with no effect and therefore need a doctor that will take your condition seriously and prescribe Testosterone.
Have you had a semen analysis?
Consider fertility and your options now, so that when you get prescribed T you are not delayed further.

I knew from your first post it sounds like classic UK doctors idiot bullshit, their too quick to send you to a psychiatrist not realizing when a man is deficient in hormones, this can cause emotional problems.

Basically your doctors would never believe that a 22 year old would ever need hormones replacement for the simple fact that you are young, this blinds them to other possibilities, eyes close and blindfolds on. They will believe this even when labs indicated low levels of hormones, in reality these doctors simply don’t have an ounce of common sense or critical thinking.

You must find a doctor that does have common sense and is able to take one look at you and notice you look underdeveloped for your age. You need to go private and get the hell away from state healthcare (NHS), their useless in hormone replacement and couldn’t diagnose a cold!

Another thing your doctors haven’t considered, age related hormone levels. This is why they fail so miserably and the simple they have no training in male hormones.

TSH should be near 1.0
TSH probably elevated because you have not been using iodized salt. Thyroid hormones T3 and T4 contain 3 and 4 iodine atoms. Without iodine TSH increases trying to get the thyroid to work harder.

TSH is a control hormone.
The only active thyroid hormone is free T3, fT3.
fT3 comes from T4–>T3 conversion and T4 is a reservoir.
There is no receptor for T4
fT3 should be tested
T3 and T4 are inactive and most T4 and T3 are bound to binding globulins.
And reverse-T3, rT3 can interfere with T3 receptors blocking some fT3.

Confused yet? You can cut past all of that via oral body temperatures, see below.

Low thyroid function:

  • depression and mood problems
  • low energy
  • brain fog
  • low libido
  • low body temperatures
  • sparse outer eyebrows
  • getting fat
    — yes mostly the same as low T! You can have both.

Perhaps teste(s) can have vascular problems surgically repaired. But could easily be not enough.

You are not in USA, so this will be difficult to get managed properly.

During accident, was your head impacted? That can damage the pituitary and induce low LH/FSH aka secondary hypogonadism. LH/FSH labs can be useful.

Doctors will not think that T is low.
FT or Bio-T not tested. Sometimes TT is misleading.
With TT not low, docs may not see any point in testing further, you are “normal”.

How you feel is also largely affected by E2, estradiol, which opposes the effects of T in many ways. Higher E2 also reduces LH/FSH.

When young guys have problems like this, prolactin should be tested or as a follow up to lower LH/FSH numbers.

“Cheers” - UK - now its Europe…
We see a lot of iodine deficiency in UK as iodized salt is generally not available or promoted. But a few shops have it.

Clomid did not work. You cannot tell if problem was testes or pituitary. On clomid one can check to see increase in LH/FSH.

You will need a private doctor. NHS sucks.


Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re Thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab numbers and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

People, I have tried calling and writing to all the private endo`s that I could find, Everyone says “sorry, I cant help you in your situation”

I don’t want to sound vain, but this hypogonadal situation is not only affecting the way I feel but also the way I look. Prior to this my body was pretty athletic and “manly” looking so to speak, wide shoulders small hips etc. Now body resembles to someone who has klinefelter syndrome, narrow shoulders wide hips and etc. I mean there is NO way I suddenly got an extra X chromosome from mother nature. I used to look handsome too, girls would always give me compliments but now I just look younger, but in a more childish way.

It is crazy how ONE hormone can affect a man so much, after all, no wonder Testosterone is called the Man hormone. It literally makes a man feel and look like a man. Doctors won’t believe to the physical changes because they say "Your body won’t change after the age of 19, because by that time you are finished developing and the bones are fused so they won’t change."
But this is just silly, because bones are made of living cells too, and there is bone remodelling, so every second every bone in the body is being broken down and rebuild just like any other part of the body because everything in the body is made of living cells. I just can’t understand why is it so hard to accept/understand that if a hormone such as Testosterone goes below the genetically inclined level, the body will dysfunction. Yeah, yeah there is the “normal range”, but every body has its own “normal”. Why do we forget that a person is an individual with his own biochemistry.

So in a way it is as if I got a new identity, a new body, and I just feel like a shadow to my “old” self, no pun intended.

I soooo much understand the struggle of men who`s testosterone levels are below optimal/genetic levels. I feel the pain for ALL OF YOU men out there who are living through his hell. God help You guys and God help me, but the doctors just wont help.

You need to keep looking, don’t make it sound like somethings wrong with the way you look, they will think you have body dysmorphic disorder, this screams physiatric disorder and they will automatically send you to the physiatrist. Complain about the usual low T symptoms.

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My story seems to replicate yours in many ways. I would firstly get your varicocele treated via microsurgery to firstly rule that out before jumping on trt for life, make sure to mention you have pain/ worries about fertility to gp/urologist. There should be plenty of competent urologists in uk performing this, though it may be too late at this stage.

You need to search harder, have you tried a medical facilitor service like balance my hormones ?

I’m from Norway Paulo21, there is no such thing as “medical facilitator service” here, unfortunately.

I don’t know if it would be possible to get treated through a private endo in Britain for example. But as you would expect I have no idea who is a good endo for this issue and etc.

Hello people again,

I have 2 boxes of Androgel with me. With my levels being around 400 ng/dl. And my prior/healthy levels being around 600 ng/dl. Will Androgel be able to get my levels around 600-700 ng/dl ? And how many patches/satches should I use per day?

THANK YOU VERY MUCH FOR ANY INPUT IN ADVANCE !

Typically gels don’t get guys to high normal testosterone levels, overtime don’t be surprised if your levels unexpectedly start falling as your body stops absorbing the gel.

So gels is too not the best solution?

What da hell to I do hehe, low T is a hell. :slightly_smiling_face::smile: