T Nation

Low Testosterone, 19 Years Old


#1

Ok I have been a longtime T-Nation reader and have posted a few times a while back. I am a 19 year old college student/athlete. I have a relatively good diet and training regiment. Last year was my freshman year in college and it all went well except I was sick a lot. Beginning in January of this year, I seemed to get sick every other week but I was able to work through it and just attributed it to be the result of stress and living in a dorm.

Beginning in around April of this year I began to lose weight for no apparent reason and have not stopped since (I went from about 250 down to where I am now at 220). Since this spring I have constantly been very tired and just don't feel like being social, going out with friends, working out, etc. Two weeks ago I went to the doctor and had blood work done.

He said that everything was normal except my testosterone was "a little low" and that if I want I can come back in and have it retested. Since then I have browsed this board and tried to educate myself the best I can. I have included my lab work (I understand that its not complete, however this is all the doctor tested for at the time).

Total Testosterone : 467 Reference : 230-1720 (This is for a 20 year old male, they didn't have one for a 19 year old
TSH : 2.94 Range: .34-482

These are the only things he tested for that I believe any of you all would be interested in. I know it is not much so I have put together a list of what I am going to request when I go back in to get more labs done. Please let me know if yall would add anything to this list or if I can take something off it.

-TSH
-T3
-T4
-Cortisol
-Pregnenolone
-DHEA
-DHEA-S
-LH and FSH
-TT
-FT
-E2
-DHT
-PSA

I read another post where an individual similar to myself posted and KSMAN requested the following information so I have included it

height 6"3
weight 220
waist size 36

when did this start? January 2010
after an accident? No, however I play football so I am constantly subject to minor head injuries
reduction of peripheral vision? dont think so
describe body and facial - hair Seems normal

I would appreciate any input or advice.

Thanks


Low T, Now What?
#2

Don’t forget to have them test your vitamin D levels - D25 OH. Most of us are deficient, and low levels could affect your immune system. You could start supplementation with gel caps - 5000 iu per day is the typical recommended dose.

KSman may have other suggestions.


#3

Total T3 and Total T4 won’t tell you much of anything.

You really need those + Free T3, Free T4, Reverse T3, and Thyroid Peroxidase and Thyroglobulin Antibodies.

Check out the blood test sticky.

Are you on insurance? If so, try and get as many tests as you can talk the doctor into.

If not, focus on the important ones (imo):

Total T4
Total T3
Free T4
Free T3
Reverse T3
AM Cortisol
Pregnenolone
DHEA-S
LH and FSH
TT
FT
E2
DHT
PSA
ferritin
Vitamin D3, 25-OH


#4

DHT is a waste of time+$ at this point.

Using iodized salt?

Symptoms and TSH : 2.94 smell like hypothyroidism

describe body and facial hair: You are a hairy beast or little hair?

How do you react to stress?
Any major crisis lately?

What Rx or OTC drugs? alcohol? weed? stimulants?

Testes ache/hurt? ever?


#5

Thanks for all the input.

Yes i have insurance - great insurance

I am moderately hairy, cant really grow more than a thin goatee and a mustache at this point but I have hairy legs and a hairy groin.

No major trauma…just a series of events that have been stressful. I work part time, go to school and play college football so that is stressful on a daily basis.

I handle stress relatively well, although I do feel physical pain when im really stressed out.

No RX or OTC drugs. Haven’t drank for over 3 years, never any drugs. I drink coffee on a semi regular basis.

Only time the testes have hurt is when I have had blue balls.

I forgot to add this to my earlier post but I have never used any type of steroids, pro-hormones, etc (this was the first thing my doctor asked when he got my test results). I have supplemented creatine and ZMA before bed, although I don’t believe those could be related at all.

Also, I wanted to mention that I am relatively strong, or I used to be before all this started happening.

Bench - 335
Squat - 525
DL - 600

All of these numbers have decreased significantly (Cant bench 300, Squat over 450, DL over 545) although some of this decrease can be contributed to injury (lower back)

Thanks once again for all the help, it really is appreciated.


#6

The lab list: Test DHEA-S, DO NOT test DHEA

When can you do the labs?


#7

Going in tomorrow morning to have everything done.


#8

Went in this morning and the doctor approved for most of the tests to be done. He balked at a few but I was able to convince him on most of them. They should have all the tests back by Wednesday of next week. He wants me to see a urologist so I will be looking for one that is accepted by my insurance. I will update when I get my labs back


#9

Urologists have a very narrow world view. These things affect your brain. If you have adrenal or thyroid issues, that doc will not be useful.


#10

Ok would a Endocrinologist be a better choice? my doctor mentioned seeing one but told me that a urologist would be able to see me faster.


#11

A urologist with a fellowship in ANDROLOGY and fertility is the best choice and most of those guys are booked up with most of their patients being hypogonadal.

www.impotencespecialists.org is a good place to look.


#12

At your age, you need someone who will try to understand the root cause and address that.


#13

Ok I finally got my labs back. Please remember that I went in with the list of tests talked about earlier and my doctor did most of them but not all.

Here are the labs

LH - 3.6 Ref: 1.4 - 7.7
FSH - 4.4 Ref: 1.5-14.0
Hep B surface antigen - Neg
Hep B core antibody IGM - Neg
Hep A Antibody IGM - Neg
Hep C Total Antibody - Neg
Cortisol AM - 6 Ref: 7-13
Estradiol - 45 Ref: 0-56
Prolactin - 3.7 Ref: 2.5-17.0
t3 Total - 126 Ref: 87-178
BBV Capsid IOO Antibody - 10 Ref: 0-19
Free Test - 11.7 Ref- 9-30
Total Test - 508 Ref: 240-950
Thyroglobulin AB screen - 2.4 Ref: Less than 4.0
Thyrogobulin Tumor Marker - 6.2 Ref: ???
25-hydroxy D2 - 10
25-hydroxy D3 - 58
25-hydroxy D Total - 68 Ref: 30-74
CMV IgM - Negative

Thats all I got back. I am still trying to find a endo. Any advice or comments would be appreciated

EDIT ----THIS BLOOD WORK WAS TAKEN IN THE MORNING


#14

After further examining my labs, it appears that I have more estrogen running through my veins than Jessica Simpson, Wtf?


#15

yep. Very high E2, and extremely low Cortisol (if the test was before 3pm).

You probably also have a problem with Reverse T3 with such a bad Cortisol number.

I would look at treating your cortisol and start on Arimidex to control your E2. The Cortisol should help with your thyroid function, and the aromatase control should help with your Test.


#16

Like he said!

Did you get a rash with the weight loss?

Any reduction in peripheral vision?

The prolactin level is close to what is obtained one day after a 0.5mg dose of cabergoline.

Using iodized salt?


#17

I had a weird rash this summer for about a week but I don’t know where it was located on my body or if it was even related. Sorry but I just can’t remember.

I don’t know if I have had a reduction in peripheral vision, however I was prescribed glasses this summer for nearsightedness.

I have not been using iodized salt, unless our cafeteria uses it in our food, I will ask.

Thank you everyone for the responses, I really appreciate it.


#18

Look straight ahead and move your hands off to the side. You should be able to see motion out around 180 degrees. A growth on the pituitary can press on optic nerves which can affect peripheral vision.

A MRI of your pituitary would detect or rule out physical damage or a growth.

Edit: Old guys gave expected age related hormone problems. For young guys, sometimes one has to look for the unexpected. This is standard procedure for some docs.


#19

I don’t seem to have any vision issues. At this point I am just looking for a specialist near where I go to school. The nearest specialists seem to be in Wichita, KS. Any recommendations? is it better to find a doctor fresh out of school or one that has been practicing for a long time? (my reasoning for this question would be that the younger doctor would be more up to date on current methodology, while an older one would be more experienced). Once again, any help is appreciated. This is an interesting situation to be going through and not one that I expected to experience at 19, but then again whats life without a few challenges, right? It has been a huge help to have yall here to give some insight.


#20

UPDATE

I found an endo and have an appointment for Monday. I also got a second evaluation from another gp. The AT staff at my university sent me to this guy just so I could get a second opinion (they paid for it). This guy turned out to be a retired bodybuilder and was at least somewhat knowledgeable. He brought up HRT without me asking about it, and although I seriously hope I don’t have to go that route, its nice knowing that i found someone who is open to and somewhat educated on the subject.

Thanks again for all the help. Ill check back after I see the endo