T Nation

Low Test at 26


#1

Age: 26
Height: 5'11"
Weight: 202.4 - Bodyfat estimate is ~18%
Body hair/facial hair: I can grow somewhat of a beard, not very thick or a full beard. I would say average body hair on Chest/Stomach/Legs.
Testes ache or hurt? Ever? Not really
Depression: More depression after having taken Clomid for two weeks, never been depressed before then.
Libido: Pretty low
Get cold easily? a change? Not really
Dry skin, brittle nails? No
Use iodized salt? Some
Eat much sea food? Not very often, a few times a year.
Exposure to chemicals? I'm a HVAC Service Tech, so I would say that I'm exposed to chemicals quite often.
Ever used hair loss drugs? No
Rx and OTC drugs: Clomid (No longer taking), Letrozole (Currently taking).
General energy levels: I generally feel kind of tired, and out of it during the day. Wasn't always that way.
Difficulty gaining muscle / recent muscle loss: I've gained some muscle and lost some fat since I started working out almost 3 years ago. Not as much fat loss as I'd like, and I haven't really tried to gain muscle.
Weight gain (difficulty losing weight): I seem to gain weight easier than losing it. Mostly lower abdomen, lower back, and chest.
General diet: I would say that my diet is about 90% spot on. I've worked with a local guy to do my training/diet plan and I stick to it.
Concentration/focus/drive/memory: Not as good as it used to be. Seem to be in a fog a lot more lately
Confidence level/anxiety level: Not real confident, but anxiety is low.

Chest size/gyno?/chest sensitivity: nipples have been kinda puffy since high school.
Morning erections/ability to maintain erections : Morning's not very often, maybe once or twice a month. Maintaing is fine, had a couple issues a month ago.
Supplement history: Whey Protein, BCAA's, Multivitamin, Fish Oil, Yohimbine HCL.
Headaches: A lot when I was in middle school and high school. Not so much anymore.

Test Name Result Normal Range
Test, Serum 347ng/dL (348-1197)
LH: 2.4mIU/mL (1.7-8.6)
FSH: 4.1mIU/mL (1.5-12.4)
Prolactin: 8.6ng/mL (4.0-15.2)

That is my 2nd blood lab i've had done. My first one I didn't get a copy of but my Test, Serum was 326ng/dL same range

My wife and I are trying to have kids, and we know that she has PCOS. I decided I needed to get checked out as well just to be on the safe side. I contacted my GP who didn't want to do any blood work, and referred me to a Urologist office to have a Semen Analysis done. They did a Semen Analysis and also checked my Testosterone levels by my request due to libido issues/erection issue. First Test level check came back at 326ng/dL but that's all I know. Semen Analysis came back good so we found Fertility was not an issue.

They requested that I do another Test level check and also another Semen Analysis. That test is listed above, and same outcome with the Semen Analysis as before. My Urologist referred me to another one that was more qualified with HRT than him. I went to see him and he also told me that my fertility is not an issue but my Testosterone is definitely low.

Starting December 15th my new Urologist put me on a Clomid protocol of 25mg ED for 30 days. I took it for 10 days and I noticed some Eye floaters that I've never had before so I contacted him and he told me to stop taking the Clomid. My last appointment with him was January 12th, and he did not want to draw blood since I didn't complete the Clomid protocol, so he put me on Femara (Letrozole) 2.5mcg ED for 30 days. That brings me here today. Just trying to get some things figured out.


#2

wow... clomid out of the gate... with no baseline tests for E2, TSH, etc.

please tell me you have more tests results that you just haven't posted?

have you read through the stickies?
any questions/comments/concerns/clarifications that we can help with?


#3

Sorry, I do not have any other test results. I read the stickies before I posted, but before that I wasn't aware of asking for any other tests. Are these tests that the Urologist office can have done or would I need to find someone else.


#4

any willing doctor (assuming normal insurance coverage) can order the blood tests including your family doc (should he/she be so inclined).


#5

Alright, I will request to have those tests done my next appointment which is on Feb. 9th.


#6

You may want to call your doctor ahead of time and see if he/she can order the labs before the appointment so you can pick up the lab order and get the draw done. That way the results will be back by the time your appointment comes around and you can discuss the results, instead of having to wait for another follow-up to talk about the labs.

Saves you some time, and possibly money depending on your insurance.

It might make sense to stop by the office with the list of tests in the stickies so they know exactly what you want done, and there'd be no guessing on the part of the doc. Receptionists have a way of fucking up every message you want sent to the doctor!

Best of luck to ya!

[ctastrophe]


#7

also make sure you get a copy of your test results BEFORE your appointment. No need to waste time reading through them in the office.

get the results, post them here, then go in armed with knowledge so that you can have an intelligent two way conversation with the doc rather then being completely at his or her mercy.


#8

I actually just called this morning to have them order these labs below, and they just called me back to tell me that they couldn't add these labs because my insurance wouldn't cover them under my diagnosis. I have a feeling that I just need to find another doctor who is more knowledgeable.

-Total Testosterone, bound and unbound. Most typical, but limited value.
-Bioavailable Testosterone or Free Testosterone
-SHBG
-DHT
-Estradiol (E2) Ultrasensitive
-LH
-FSH
-Prolactin
-Cortisol
-Thyroid Panel (TSH, fT3, fT4)
-CBC
-Comprehensive Metabolic Panel
-Lipid Profile
-Vitamin D-25
-DHEA-S


#9

or you just need to discuss the diagnosis codes with your doc.

not sure if you can look these up or discuss with your doc, but these are the diagnosis codes my doc used to get the tests I needed... (all 17 vials worth)

244.9 257.2 780.79
250.00 272.4 788.41
250.01 601.9 253.3
255.4 780.4 255.8
783.9


#10

Still haven't had my other labs done. However, I did have another Lab for Testosterone done on Tuesday and they called me with the results.

Test: 287.14
FSH: 4.88
LH: 2.93

I forgot to get the ranges.


#11

I think you might need to find another doctor to talk to. This doctor is just scratching the surface with a feather. You need someone who will take a jack hammer to the job.

Your Test is on the low end, but you need to get more tests to try and find out if there is anything else off. Maybe a different doctor will be more helpful.

That list you made up is good and not over the top. Maybe just add in Thyroid antibodies tests to rule out autoimmune disease and Ferritin. That would be a good start.


#12

I had a follow up appointment with him today. He went over my lab results which I had posted already, and he said his lab range for testosterone was (175ng/dL - 750ng/dL).

He wanted me to have a Penile Doppler Ultrasound because he believes it might be a physical problem, and if that turns up normal that he wants me to go to a Sex Therapist for the issues I'm having. I've had more ED issues after starting Letrozole, and Cialis didn't really help much.

His other option was to put me on Andro-Gel for a few months to see if it helps any, and I didn't feel comfortable with using the Gel after everything I've read on here so he prescribed me AndroDerm @ 4 grams per day. I mentioned to him and showed him a print out of what I've been reading here and he basically told me that Injections are "old school" and not efficient and that anyone who does them over the Gel/Patch is doing it to abuse it, etc.

I also had them do another blood draw, to test the following:

-Total Testosterone, bound and unbound. Most typical, but limited value.
-Bioavailable Testosterone or Free Testosterone
-Estradiol (E2) Ultrasensitive
-LH
-FSH
-Thyroid Panel (TSH, fT3, fT4)
-Vitamin D

I plan on calling around today to find another Dr. in my area.


#13

Alright here is my most recent lab results:

Testosterone: 368.43 (175-781 ng/dL)
hFSH: 4.35 (1.31-12.09 mIU/mL)
hLH: 2.89 (1.50-9.30 mIU/mL)

TSH: 6.820H uIU/mL (.450 - 4.50)
T3: 106 ng/dL (71-180)
T4: 7.5 ug/dL (4.5-12.0)

Estrogens, Total: 67 pg/mL

Vitamin D, 25 Hydroxy: 25.9L ng/mL (30.0-100.0)

They put me on Androderm 4g/day.


#14

!!!!!!!!!!!!!!!!!!!!!!

In presence of normal T3/T4, this warrants antibody testing for Hashimoto's. T treatment may be premature before this is straightened out.


#15

So from what I'm reading, if it is Hashimoto's there isn't a cure from it is there? Just treatment with T4 or some form of desiccated thyroid medication.


#16

Well, you can get your thyroid removed...

But most people don't have to do that if they get it under control early enough with meds...T3 are better than T4 according to the worry-wards at STTM.

This discussion is premature before confirming or denying. Definitely would be in your best interest to have them done though.


#17

Gotcha! I was just curious so that I knew a little more information, just in case. Trying to find a new doctor however trying to get an appointment as a new patient sucks. Hopefully should have one this week.

Thanks!


#18

Gotta agree with VT. Your Thyroid labs look similar to mine, so get the antibodies test done to see where you are at. I have them positive and am on T4+T3, but Hashi's is unpredictable. It comes in waves you might be fine and under control for 6 months and all of a sudden your TSH will go from .5 to 6 within a couple of weeks when Hashi's flares up.

If you end up going in for blood work ask for

Thyroid Antibodies
Ft4
Ft3
TSH
TSI
Rt3

You really want TSI and Rt3 if you can get it because these could play an important role.

he basically told me that Injections are "old school" and not efficient and that anyone who does them over the Gel/Patch is doing it to abuse it

Your doctors comments translated into real English

I don't make as much money on shots so I insist you take Gels instead. How else am I ever going to keep up with the Joneses?