Low T, Hypothyroidism at 20

Pharma / TRT Testosterone Replacement
1

I will start off by saying some information about me. I am a 20 year old male, 5’9 140 lbs sitting around 12% body fat. I have been lifting for 4 years and have had eating disorders for 2.5-3 years of my training. I used to binge and purge for around 2 years.

Although I haven’t thrown up in many months (can’t remember the last time I’ve done it), I do still binge multiple times a week. It is an everyday struggle for me that I always fail to overcome.

After some binges, I will fast the next day in order to help “fix” the mistake, but just end up binging again either the day after or 2 days after. I suffered an injury to my scapula that really just threw off the entirety of my lifting, I believe I got this injury from the action of purging (if you can imagine it, over the toilet, etc.)

I always try to tell myself that I want to get to a certain level of leanness so I can do a very long lean bulk (1.5-2lb/month), but always end up binging during my diet and spin my wheels. If you were wondering why I am still 140lbs after 4 years of “lifting”, my eating disorder as well as injury are the reason why.

On to the hormonal concerns. I had my blood work done about 1.5 years ago and received a TSH 4.14 (0.5-5.6). This was just a general blood work because I have been experiencing hypothyroid and low testosterone issues (very low libido, 60% erection, no morning wood, gaining weight on 1500-1600 calories, bowel movements 2-3 times every 10 days, depression, inability to concentrate, cold when others say weather is “just right”).

I don’t have the blood work from that blood test available anymore, but I have recently just received my blood work that I got from my endocrinologist (who said none of my issues had concerned him and he didn’t want to prescribe me thyroid medication because my TSH wasn’t above 10 and he wanted to avoid a lawsuit). I will post everything that I had received in this blood work and hopefully I can get some guidance and how it is looking.

HORMONE: MY RESULT (REFERENCE RANGE) [MEASUREMENT]

ACTH: 2.1 (<10)
FBS: 4.2 (3.3-6.0) [NMOL/L]
NA: 139 (135-146) [NMOL/L]
K: 4.2 (3.5-5.2) [NMOL/L]
ALBUMIN: 48 (35-50) [G/L]
TSH: 1.75 (0.30-5.60) [MIU/L]
FREE T4: 13.7 (7.2-21.8) [PMOL/L]
FREE T3: 3.9 (2.9-6.0) [PMOL/L]
THYROGLOBULIN ANTIBODIES: NEGATIVE
MICROSOMAL AB.: NEGATIVE
CORTISOL AM: 198 (185-624) [NMOL/L]
LH: 1.7 (1.2-8.6) [IU/L]
FSH: 1.8 {1.3-19.3) [IU/L]
TESTOSTERONE: 10 (5.0-27.0) [NMOL/L]
PROLACTIN: 6.3 (2.6-13.1) [UG/L]

I was really confused when my TSH had come back far lower than my previous blood test because I am experiencing all the exact same issues. For the THYROGLOBULIN ANTIBODIES and MICROSOMAL AB., they had no reference range and only said “negative”, which I don’t know what that means unfortunately. I know that the measure of testosterone in NMOL/L is uncommon, but I don’t know how to convert the number over to NG/DL. LH, FSH and testosterone are all low, no surprise for me there because of what I am already experiencing. I would really appreciate some guidance and what route to take, and why my TSH has come back much lower than the previous time even though all the same issues. If there is anything I have missed out that would help you, help me please let me know. Thanks.

-age - 20
-height - 5foot9
-waist - 30 inches
-weight - 140 lbs
-describe body and facial hair - hairy legs, little hair on arms and shoulders, very little facial hair (can go without shaving for 3-4 weeks)

-describe where you carry fat and how changed - carry a huge amount of fat in glutes/hamstrings and calves, everywhere else seems normal

-health conditions, symptoms [history] - no conditions

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever

-describe diet [some create substantial damage with starvation diets] - Diet is around 1500 cals/day with 130g protein minimum. Don’t track other macros because I am always getting a good amount of fat and carbs stay average

-describe training [some ruin there hormones by over training] - I train at least 3 times a week, 70 mins/session on average

-testes ache, ever, with a fever? - I seldom get a really strong pain in my left testicle (only left) that will be so bad I have to stand for the duration until it passes, usually lasts less than 5 minutes. . It feels like getting hit hard right on the nut.

-how have morning wood and nocturnal erections changed - No morning wood and I don’t know about nocturnal erections.

2

Get testes examined for cancer. It is a young man’s disease!!!

TSH dropped. Did you introduce a source of iodine that you did not have before such as iodized salt and/or vitamins that list iodine?
fT3 and fT4 should be mid range, these are low and the problem is with the doctors

Please read the thyroid basics sticky.
Report waking and mid-afternoon body temps.
Describe long term intake sources of iodine.

Describe stress in your life and how you react.
Your eating disorders are a major source of stress.
1500 cals sounds like starvation, drives a need to binge

How do you feel and how is general health?

3

My endo visually and physically examined my testicles and said both seem normal. I haven’t noticed any different in shape or size and there are no lumps/bumps. Would you still recommend I have them tested for cancer?

There has been no change in my diet and specifically no change in iodine intake. I have read he thyroid stickies ( thank you for the information). I wake up cold almost every morning but I will get a thermometer and check it. I don’t eat anything with advertised iodine so I do not know my iodine intake.

Stress for me has massively increased after finishing high school at the age of 18 (almost 21 now). I started working in our family restaurant 7 days a week for 5 months. I worked with my father and he and I would argue and fight almost everyday. A couple of times we would fight so much to the point of me breaking down.

My relationship with my father used to be almost void(much better now), my mother has been sick for as long as I can remember and my family has had financial issues my whole life. These financial issues lead to me taking out $10k cash advance on my credit card to pay for back rent on the restaurant, another $3k to pay for mortgage and another $1.7k to pay for a down payment on our family’s new apartment.

In May of this year, my father got assaulted in the restaurant and the people who did it burnt the place down afterwards, we lost the business from that. A couple months after we lost the business, we got evicted from our house and were forced to move into an apartment (previously mentioned). After all the debt taken out to try and save the house and business, they both get taken away from us. I have a lot of financial stress, stress about eating disorder, stress about other family members issues, stress about my body being in constant pain all day.

I used to be very stable mentally, but a lot has changed and weakened my psyche. I had always prided my self and been grateful to the fact that I had such a smooth and clear mental focus, I don’t now. I often forget words I’m trying to say mid sentence, lose focus very easily and have trouble paying attention.

General life is dull, nothing to look forward to. Work 10 hours a day, Monday-Friday and 4 hours Saturday. Try to lift 3 times a week at the very least.

Do you have any thoughts on my low LH/FSH, and testosterone? I have always thought that between my low T, hypothyroid, and depression one of them caused the other(s) or they are all connected in some way. Is that possible to be like that?

4

In the thyroid basics sticky, look for Wilson’s book reference. Buy and read the book. You sound like you could easily have adrenal fatigue.

Need those body temperatures!

Your history and stress is huge and that could be the root of your health issues. May be compounded by iodine deficiency.

What time of day was the cortisol lab done? Did you wake up a long time before that or?

What country are you at?

5

I had the blood work done 8am, I was awake at 6:30am for it. I live in Canada. I too believe that either stress or depression are the root causes of all my issues.

Do you have any insight on my male hormones that I had done; LH,FSH, Test.

6

You have primary hypogonadism, suspected hypothyroidism and adrenal fatigue.

If you were on TRT now, you would probably crash. You need to focus on thyroid and adrenals. Best action now would be reading Wilson’s Book. Adrenal fatigue is too complicated for posts, you need the book.

And at your age, we should see if your HPTA can recover when other issues are addressed.