T Nation

Low T and Symptoms, 26 Years Old


#1

Hello everyone,

It’s been on my mind for a long time to post here so here I am! It is going to be a little long and detailed as i am giving as much information as I can.

Follow up and About Me:
I am a 26 years old guy living in Central Europe. I am 170cm tall, my weight is between 60-65kg. I work as a software developer.

Since the primary school I had interest in sport activities such as cycling, skateboarding, swimming.
Not to say that for the last two years of primary school we had a tough cookie physical training teacher who made us run a lot of times and pretty much did not let us to be lazy.

At the beginning of middle school at around age 15 i stepped my foot in gym with my friends to gain some strength and muscle. It was just a hobby but i did what i could 3 times a week in the gym. My nutrition was okay.

But even before this, I sensed something was wrong. Despite I ate and slept enough, I had a comfortable place to live and a peaceful environment I was often tired, and have had headaches often. I wasn’t overtraining because there were weeks/times I didn’t really do any activity (for example, during winter). What I noticed is my energy levels weren’t high, I got depleted easily. Just by going to school and coming home drained me and my concentration level was not high either.

I was never overweight, I was average but with a constant layer of fat. At that time I didn’t know what is it, but I started developing gynecomastia and purple stretch marks.

I did not really start developing facial hair or chest hair, they came pretty late around my age of 22.

I thought all this will go away with time but it did not.

2016
I could not bear with it anymore and decided to do everything I can. I went to the nearest hospital and explained everything.

2016.02, The doctor requested normal blood test plus Total Testosterone

  • Total Testosterone came low 7.8nmol/l, which is 225 ng/dl

2016.03, Another blood test

  • Please see the attached document.

Over the year:

  • Blood tests
  • Thyroid ultrasound - came OK, (little note: i know about iodine intake)
  • Adrenal gland ultrasound - came OK,
  • Testicles ultrasound - came OK
  • Head MRI (no contrast) - came OK (test should have been with contrast?)

They basically had no idea what they were doing and sent me every test I mentioned above in 2016.

2017:
I had been reading a LOT by myself to understand what am I going through.

2017.08:
The latest blood test, see the attachments. Test is still low and things are off.

Symptoms, everything comes and goes:

  • Headaches. Sometimes every other day, sometimes nothing for a week. Head MRI showed nothing though?
  • Constant fatigue, I am tired most of the times no matter how much I sleep. What I noticed is I don’t sleep well or deep.
  • No morning wood, sometimes there is.
  • I have desire for sex but it varies.
  • My stress level is high. I can’t really handle stressful situations.
  • No energy. Anything can drain me easily.
  • Concentration problems
  • Even though I try to eat clean and rich in nutritions, I story a constant layer of fat. Especially chest, hip. But my limbs are average/thin
  • Typical low T symptoms

Raw infos:

  • 26 years old
  • 60 - 65kg
  • Sport activities: swimming, cycling
  • Food intake: Around x4 times a day, oatmeal, fish, chicken breast, sweet potato, rice, veggies (veggie soup i like), apple banana other fruits, multivitamin, fish oil, peanuts or other healthy nuts, i cook with coconut oil
  • little hair on chest, underdeveloped facial hair (father has full beard)

So this is how I am now. I got rid off the gyno this year which I assume happened due the higher E2 and prolactin.
This thing is ruining my life since most of the times I feel awful. Needles to say the doctors here have no idea what they are doing or have to do so I am willing to get help elsewhere. I do understand that I will need to go to a professional.

But please, do advise me what shall I do.

Thank you!


#2

You’re test definitely low for your age, typically you see people your age 750 and up. Your SHBG isn’t considered low, but TRT will decrease it slightly making injecting twice a week important! A lot of doctors don’t understand that when your SHBG is somewhat low, bi weekly weekly injections simply don’t work out very well. If your SHBG was in the 30’s you could get away with once weekly injections. It’s going to be a long uphill battle to find doctors that know what they’re doing especially in the UK! The NHS is quite the joke and their protocols set you up to fail.

I also had constant headaches everyday before starting TRT, no more headaches now. Tons more energy and sleeping better also, everything in your life will improve after you find a good doctor.

https://naturalbiohealth.com/2015/05/06/shbg-critical-to-your-health/


#3

Hi spicy tuna. I also struggled with low testosterone symptoms around your age. Getting any help from GPs in the UK is a real struggle. For ages I thought I was just being weak mentally but I also got test results back with similar outcomes! Your best bet is to get on to one of the private clinics in the UK. I use one and I only pay about 100 quid a month. You’ve already had 2 blood tests come back low so it’ll be cheap to start. You do have to pay a doctor’s fee for consultation though (about 150 quid I think?)


#4

Thank you for your replies!

Sadly, i do not live in the UK. And here as i mentioned the doctors have no idea what they are doing.

To give you an example, the andrologist said “Your level is fine. Only come back to me when you can’t get it up anymore.”

Any ideas?


#5

Having the same problems myself here in the UK. @oly_ali

My TT came back at 10.1 and 8.4nmol/L, got referral to endo and now having to produce more tests because they think it’s cushings syndrome. Just a quick note to @spicytuna look into Cushings-syndrome as you can develop purple stretch marks as you mentioned! And has very similar side effects to low t.


#6

That’s interesting! I never had that…


#7

Need time of day for cortisol lab.

TSH is too high, should be near 1.0
fT3 is high
Check oral body temperatures as discussed below.
Suspect low body temperatures and reverse T3 [rT3] is blocking some effects of fT3. That would be adrenal fatigue, stress, over training, chronic inflammation are factors. This would also explain your low energy.

High prolactin: Ask for a trial of Dostinex/cabergoline. Often 0.5mg/week and dosing 0.25mg twice a week would be good. Then see how LH/FSH and T change later. They may have missed an adinoma. If cabergoline works, that is also your diagnosis. Prolactin contributed to your gyno.

CRP indicates inflammation. Have you been sick lately? Are your gums swollen?

Can you find a range for SHBG? There is a written note…

cushings is a possibility

Your Vit-D25=30.30 is low. Please try to find 5,000iu Vit-D3 capsules and take 25,000iu for five days, then 5,000iu.
https://www.ncbi.nlm.nih.gov/pubmed/21872808

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 number 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.


#8

In the morning around 7.45 - 8 AM

I will do that.

Even thought I am certain about my iodine intake, but as per the thyroid sticky says, I bought Iodoral/12.5mg and extra selenium in case.

Sadly, it is not available in my country, at all. Only Bromocriptine is available in pharmacy, but it is causing unbearable side effects even at low dosages.

Because most of the things are in range, it is really hard to ask for more tests (unless you go private). I am told “nothing is wrong, you are healthy, you look healthy” by doctors and family members, but i know how i feel (i think many can relate to this).

I have not been sick in the past half year, and even that was just flu. In fact, i rarely get sick.
Not swollen.

17.3 - 65.8 nmol/l
The doctor’s note says “low”.

Ordered, will follow this protocol.


#9

@KSman

Body temp in the mornings in the past days:

  • 36.6 C
  • 36.4 C
  • 36.5 C
  • 36.6 C

I have been taking Vitamin-D3 capsules as you wrote.

Today i went back to doc, and he put me on Clomid 25mg/EOD and asked me to get blood work done again after 3 weeks. Is this protocol correct? I was reading here and shouldn’t 12.5mg/EOD would be better?


#10

With clomid ask that they also test E2, LH and FSH to see what the clomid is doing. If LH/FSH too high, E2 will probably be bad.

Often 12.5 EOD is a good dose and 25 EOD can be too much. But if you read some BB and steroid forums, 50 or 100mg would be better - NOT!

97.7F is 36.5C
so morning temperatures seem OK
should also check to see that you can hit 37C mid-afternoon


#11

The doc will get the blood test including those, already talked on it with him.

Shall I go with 12.5mg EOD then? I worry too that 25mg EOD will be too much.

I’ll check and post PM temps.


#12

12.5mg EOD may be a good choice. Doc might get annoyed that you are taking things into your own hands.


#13

Update:

Body temp in the afternoons:

  • 98.6
  • 98.5
  • 98.4
  • 98.6

So far two weeks on Clomid 12.5mg EOD:

After 3 days (2x 12.5mg) I started feeling better, then started feeling good. Clear head, strong morning wood, desire, more energy.

At day 11, all of those above started decreasing. Back to foggy head, no morning wood, lower energy.

Is the dose too low or is it actually too much and E2 built up? I will have blood work in 2 weeks.

What shall I do?


#14

SERMs often cause high T–>E2 inside the testes from high LH/FSH. Many need 12.5mg EOD or less. Sometimes you cannot have higher T and lower E2 with any dose.

Aromatase inhibitors do not work inside the testes, anastrozole cannot fix that. Herbals may fail. AI drugs do not do anything to lower existing E2, only modulate T–>E2 production. Serum E2 is a balance of production and liver clearance.

SERM’s typically increase E2 levels, while hiding E2 from selected tissues. Your liver still sees high estrogens and typically then creates more SHBG to scavenge sex hormones.

Many on T+hCG+AI do not have any problems getting pregnant. When trying for a pregnancy, one can switch to T+SERM+AI or do that occasionally for a fertility tune-up.


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 number 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.

Clinical research has been done with males+SERMs and males+AIs to understand how the HPTA responds. From a functional medicine point of view, FDA approval is not a major factor. But insurance may reject.

Anastrozole is a lot less expensive at 1mg/week than “herbals”.

Clomid simply does not provide an effective TRT result for many guys for several reasons. Clomid and other SERMs are drugs. T is a natural human hormone.


#15

Body temps should allow for good energy. E2 can be the problem and fits timeline. And T levels may not have been very high and one can react to the acceleration when levels are modest. Hang in for those labs.

With SERMs:
TT
FT
E2
LH/FSH to see what is really happening with pituitary.

If LH/FSH and E2 are elevated we can expect that anastrozole will not solve the problem and SERM dose then needs to decrease or switch injected T. While SERMs hide E2 from selected tissues, liver sees estrogens and may be expected to increase SHBG thus changing FT:TT balance.


#16

Decrease how? Like switching to less frequent dosage, E3D 12.5mg?


#17

When SERMs lead to high E2 levels, SERM dose needs to be less. If T levels then are not acceptable, T injections are the only option.


#18

So i am back!

And the fresh bloodwork is here.

The 12.5mg Clomid EOD worked.

But my prolactin is high and i dont really know how to describe how i feel. I feel better in many ways, I have more energy, i rarely have headache now, the hair allover my body is growing faster. But i feel worse in others, i think i am moody-bitchy and easy to be triggered.

Could it be because of the side effect of clomid or the raised E2 (31 pg/mL)? I started taking DIM to try to control E2.

Can someone help to read the bloodwork and suggest what should i adjust to get better results? Thank you everyone so far :slight_smile:


#19

Most guys don’t feel well on clomid, you’re having a typical response. Some can have great T levels on clomid but not feel right.


#20

Yes i noticed that. I have better energy levels but i can easily be moody and just not up to anything. I also noticed lower sex desire. How to combat these? And why is my prolactin out of range?