T Nation

Just Turned 19, Very Low Testosterone!

Hello, I am 19 years old, and my testosterone levels are hovering around 2.0 (on a scale of 10-30, sorry I do not know the units). My endocrinologist figures I am secondary hypogonadic since I did the GNRH test, and I did produce LH/FSH. My levels of these hormones have also been relatively low.

Now in terms of the reasons for these numbers, I can’t help but think I have always been low on testosterone. I had very little interest in sexual activity as a teenager, and in fact the thought of being intimate with a girl seems a bit scary to me. Sex was never something I aspired to take part in, but I was able to masturbate to porn. I also had very little muscle growth (basically none) even though I started working out around 13. I also have very little body hair and almost no facial hair. If I do grow hair on my face it is patchy and thin. However, the kicker is that I started eating a low calorie diet with very little carbs and exercising excessively last summer and dropped about 10 lbs. I am 6 foot and I went from around 148 lbs to around 136 lbs (I was not at this weight for very long) This continued on until about November when I started to eat A LOT more food. I still exercised a lot though. During this period, and up to today I have had NO sex drive, I feel tired a lot, and I have fallen into a state of really bad depression. Lots of this depression is due to the fact that my favorite activity of bodybuilding has been taken from me (or rather I took it from myself), and I know that any efforts in the gym are basically useless. Lately I haven’t been exercising lots, just swimming and biking about 4 times a week.

My endocrinologist put me on 25 mg/day of clomid for 6 weeks starting in February. No effect. We then tried 50 mg/day for 6 weeks. No effect. He said since clomid can act as either an agonist or antagonist in some cases, my levels might come back to normal when I come off. I have been off for about 3 weeks now and I still don’t believe I am producing test. I go to his clinic in about 2 weeks to run a test were they measure levels of LH/FSH continuously for 4 hours and see if there is variability. I don’t quite understand this test, but he says it’s the next step, so I’m just doing what the professional says. Anyways, he says that after this test, and depending on the results he will give me a prescription for testosterone. I really want to take it, even though I know it’s for life. I will be able to get back to the life that I have put on hold ever since my levels dropped. I have felt like shit for a year already, and to me it just doesn’t seem like taking one minute out of my day to slap on some gel, or taking a shot once a week is such an inconvenience. It sure is not such an inconvenience that I am going to go through another year like this. At the moment all I think about is my low testosterone, and it has weighed down on every aspect of my life like you wouldn’t believe. I break down at least twice a week simply because I do not know what the hell to do. I’ve seen so many forums where people on TRT say “exhaust all of your options”, “wait it out”, “you’re too young for this”, but at the same time I question why the individuals offering this advice are on TRT themselves. Surely their lives must be better with it than when they had low testosterone, or else they wouldn’t be taking it. Furthermore, a large portion of the people on TRT had levels just below the normal range when they started. I am so far from normal that I can’t help but think getting me on the higher end of that suggested range would drastically increase my quality of life!

Could I maybe run a trial period for 4 months and see what it does for me? If I do not feel any better and come off, my body will just begin producing the minimal levels that I already have once again as far as I understand.

If anyone could offer me opinions/experiences related to treatment I would really appreciate it, especially young guys. Should I begin treatment and get on with my life? If so, what would you recommend for doseage/type of testosterone (gel, shots, etc.)?

Story sounds all too familiar. Stress - low calorie dieting - intense exercise…HPTA crash.

I had the same thing going on and bodybuilding has been taken from me too with chronic joint pain. I have been on TRT for three months and feel alot better but i still cannot fully lift weights.

The reason you hear people say that is because its a big step. Noone “Wants” to be on TRT for life. Especially at our age man. Its best to try and find the cause so you can live a full productive life without the help of any kind of Rx anything.

I know its tough but i would recommend exhausting all options literally before taking the plunge. There are a lot more knowledgeable people on here than me and im sure they can offer some better advice.

By the way i do believe the whole stress - diet induced hypogonadism is now considered an actual condition by the Endo Society.

Thanks for your input. Just out of curiosity, did your little body transformation take place after you started TRT, or was that what led to it?

TRT may not be the answer you seek being so young. You need to look at the whole picture with indept medical profiling. Many young guy who come to us have been on TRT and never needed to be in the first place. You need to examine the cause and not affect approach

I’ve never had sexual attraction to a girl (nor a guy, so that rules out homosexuality). This is not normal.

[quote]DERG03 wrote:
Thanks for your input. Just out of curiosity, did your little body transformation take place after you started TRT, or was that what led to it?[/quote]

My test hit rock bottom after dieting and “transforming” and never returned

Look for root cause is the solution to your issues not TRT at this point in time.

What is your prolactin level?

Some kind of action is needed, no need to delay. This problem is deep and persistent. This does not look like something that can be “fixed”. Other hormone systems also need to be investigated. The low testosterone state may be creating problems with thyroid or adrenals. DHEA-S and pregnenolone levels are needed.

As for the other questions, read the stickies.

You need to understand the root problems, but in this case, you might be better off with TRT laying down some decent baseline levels so the other problems can be evaluated in the context of appropriate FT, TT and E2 levels. You have baseline LH/FSH levels now, so no need to delay TRT.

The clomid experiment indicates what is broken. A MRI is needed to check out the pituitary gland. TRT will not interfere with that diagnostic pathway.

If there is no androgenic response to TRT, that is a diagnostic result which would drive tests for genetic abnormalities.

Read this:

Yeah, Did your doctor do a physical examination of your testicles? Were they palpable? A healthy testicle is about the size of an egg. While androgens do play a role in hair growth, so do genetics. If your dad and brothers have lots of chest hair and you have none, then that may be indicative of low testosterone. But, if they have lIttle, it may just run in the family. It’s more important to focus on diagnostic indicators that relate solely to testosterone—>your testicle size, morning erections (which have a strong androgenic correlation in the absence of vascular problems such as heart conditions or diabetes II; however, thyroid problems and sleep disorders also interfere with these) and a few others. Little muscle can be caused by low testosterone OR low GH. So many other symptoms blur together (I.e. Low libido, impotence, lethargy, depression, etc) that you need to see the forest for the trees and ask, what does testosterone influence that NO other hormone does? The worst thing you can do is go in and say you’re depressed or you can’t get it up. That’s likely to lead to a prescription of SSRI’s or PDE-5 inhibitors (Tadalafil etc).

If you are primary, you can have all of the LH/FSH in the world, but your testicles just won’t pump out the testosterone. You need to get copies of your bloodwork for your own personal records. If you want, you can post them here and board members can point out things to ask your doctor. Like KSMan said, you need an MRI to rule out adenomas and possibly a prolactinoma. However, if your genitals are undersized with a high LH/FSH level, that may be a testicular failure (primary hypogonadism). That may explain why the Clomid didn’t work and why the GnRh resulted in production of LH/FSH. Those tests are worthless unless you know how much testosterone was produced. Also, when you say doesn’t work, is this due to symptoms or lab results? Many people feel worse on Clomid but their testosterone levels increase dramatically. It sounds like your doctor is fairly smart in that he gave you a GnRh test plus a Clomid challenge. If you are primary, you need to start your TRT immediately (!).

And listen, I am RIGHT there with you. I am 24 (not 19) and it consumes me as well. For a year, I wanted to give up and just have a pity party about how shitty I felt. Maybe there’s not an easy solution but we owe it to ourselves, our families, and even God (with whom my relationship has been shakened), to exhaust every option available. It won’t magically get healed overnight. It’s just our chip on our shoulder or our cross to bear. Luckily for you, you have found a doctor that appears to care about you. The hardest step for you is over! Most of us, including me, are still looking for a doctor. Treatment isn’t the panacea, I’ve tried it myself, and its not likely to make us sexual behemoths or huge musclemen, but you will feel so much better. Hang in there; I know that it consumes your life because I missed out on the last year of college due to it. In fact, I passed the CPA exams with a 90 average on each section and I didn’t give a shiz. I accomplished my goal but I still didn’t feel “whole”; I still felt miserable. People will tell you to quit letting it consume your life or “just don’t think about it”, but ignore them. Research as much as you can. Learn everything you can about your body. Read other’s experiences and see what works and what doesn’t! You may find TRT changes your life. What works for some may not work for you; on the flipside, what doesn’t work for others just may work for you! Classic example-Androgel. You don’t have a GF so the pressure to perform is off. Trust me, that complicates the situation a ton! Be patient. Listen to this guy; but do your research so you know when this guy is wrong. Don’t be a know it all but just call a spade a spade. Don’t be afraid to leave and arrange a consultation with other doctors. I have 3-4 set up already. My insurance won’t cover it but I don’t care. I want to get better.

Most importantly, ask questions on this board. Listen to veteran posters and people who have basically gotten good results. KSMan gives excellent answers. PMgamer may have the most frustrating story of all of us! I read his story on a thyroid website and thought, wow, this guy has no luck. He overcame a lot and he’s back on his feet. While I am new to this board, I can tell there is not a negative atmosphere here as compared to other boards. However, educate yourself. I used Endotext.org, medical journals, and the AACE website to learn more. Anyways good luck, and keep your head up.

I think we may have lost this guy.

[quote]KSman wrote:
I think we may have lost this guy.[/quote]

Yeah…my bad. I went a little overboard…I’m still new here.