T Nation

Low Test? Klinefelter? Hypogonadism?


#1

Hi.

Since I can remember I have been struggling with the symptoms below (I am 22 now). Once, I even went to a doctor and he did a testosterone test. Apparently the results were okay but I have never got to see them or anything. I am just super confused how the testosterone levels could be “okay” when most of my symptoms are hormone related:

  • No or very very little facial hair + very little body hair, no hair on chest;
  • Gynecomastia - diagnosed by a doctor
  • Wide hips
  • Fat around the waist
  • Narrow shoulders
  • Lanky body (6ft5) + long limbs
  • problems with maintaining erection
  • Constantly sleepy and tired - could not to leave the bed; never woke up refreshed and energised
  • Can go a week without even thinking about sex
  • feeling down, low and grumpy, suicidal thoughts
  • Problems with concentration
  • bad coordination

Obviously I know that you wont diagnose me here but maybe people with similar symptoms and diagnosed low-t, do you think its worth pushing for another doctor and another set of tests?

Thanks very much.


#2

Without you posting labs everyone would be guessing as to what’s causing your symptoms, it would be like trying to diagnose what’s wrong with your car without diagnostic codes, labs or bust. Forgive me if I don’t take your doctors word on the subject, there are a lot of doctors out there that are idiots. The fact that you’re here suggests you are not alright even though your doctors says you are. Based on your symptoms I would say your hormones are out of balance and you’re just dealing with doctors who just don’t know how to help you, is this your GP saying that your testosterone levels are fine? USA or UK?


#3

Really does seem like Klinefelter’s.

You can have DNA testing done to determine this and the type.

Have you read this: https://en.wikipedia.org/wiki/Klinefelter_syndrome ?

https://www.nichd.nih.gov/health/topics/klinefelter/conditioninfo/Pages/diagnosed.aspx

You can also have semen tested to see if you appear fertile.
Are you testes normal?
Do they hang down or scrotum pulled up tight?

At your age I had no body hair and hardly any facial hair. Facial hair filled in my 30’s but still a sparse pattern. TRT changed facial hair a lot, body hair is now there, but light.

Labs:
TT
FT
LH/FSH <-- probably low
prolactin can be part of gyno
E2 [estradiol] can be part of gyno

I prolactin is high, that lowers LH/FSH and T. Cause typically a prolactin secreting pituitary adinoma which is then easily managed with 0.5mg/week Dostinex/cabergoline.

You are going to need TRT to restore quality of life [QOL].

Doctors are as a rule not very good at these things. You will probaby need an endo for the genetics.

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.


#4

Hey! Thanks for the reply. Yes, mine GP 2 years ago said my t levels were fine but didn’t show me the results. I was too embarassed to push for them. Booked another appt now and this time I will want to see every single result. And yes, I am in the UK.


#5

Hey.

Thanks for your reply. Really appreciate it. Booked an appointment with a GP now and just will push them for both testosterone tests and chromosomes’ tests.

I have read so many articles about Klinefelter’s and I do match all the symptoms except for the small balls/small penis part. In my case I have got average-sized testicles and an above-average penis.


#6

Klinefelter’s tends to show up in bloodwork as:

  • Low testosterone.
  • High LH / FSH.
  • High SHBG.

It’s probably worth getting a semen analysis done. Those with Klinefelter’s are generally completely infertile (azoospermia), though some produce very low levels of sperm (oligospermia).

The standard test for Klinefelter’s is a Karyotype. It can sometimes miss it, particularly if you’ve got the mosaic form (a mixture of XY and XXY cells).

There are similar conditions, such as Kallmann Syndrome, which have similar symptoms.