T Nation

Mid 20s - Trying to Explain my Symptoms


#1

Hi, I’m writing for an opinion on my situation. I am 26, sick and tired of the way my life is. I have: low energy, low concentration, confusion, forgetfulness, no energy to do simple tasks such as laundry, difficulty expressing myself under normal circumstances (while not on Status or HCG), mood swings, irritability, anger.

Bold symptoms present themselves in my mom and somewhat my brother.

-height: 6’5" - Taller than my family (father 5’11" mother 5’8" - uncles are not as tall as I am) Klinefelter Syndrome ruled out (see below)

-waist: size 35/36. wide bony hips.

-weight: 215

-describe body and facial hair: sparce chest hair

-describe where you carry fat and how changed: Fat only at abdomen, gynecomastia

-health conditions, symptoms [history]: None

-Rx and OTC drugs:
Natural testosterone booster (Status by BSN) Picture below
HCG started last November

-lab results with ranges:

Test 1: This was done on 1/05/2017 while I was on HCG
Reference Lab Testing

Collected 01/04/2017
11:30 PST

Procedure Reference Units
Range
Sex Hormone BG 36 nmol/L [11-80]
Testoster Tot/R 348 ng/dL [300 - 1080]
Testoster Free 60 pg/mL [47 - 244]
Testoster Free% 1.7 % [1.6 - 2.9]

LH .6 mIntl_unit [1.5 - 9.3]
FSH .9 mIntl_unit [1.4 - 18.1]
Free T4: 1.07 ng/ml
TSH: 1.02 mIntl_unit
Prolactin: 10 ng/ml
Cortisol AM: 25 mcg/dl [10 - 20]
PSA : .3 ng/ml

Taken when I was on Status

Total Testosterone 322 ng/dL
TSH: 1.15

-describe diet:
Protein shake in morning
Minimal Carbs
Whole Grains
Vegetables

-describe training [some ruin there hormones by over training]:
Lots of Basketball
Chest, Back, Legs, Shoulders at gym

-testes ache, ever, with a fever? No

-how have morning wood and nocturnal erections changed

Background:

As I enter my late 20’s I’ve come to terms with the fact that I’ve always had major problems… something I’ve totally been in denial about. I am desperate to find the cause so I can actually begin my life!

I struggle with energy issues and concentration issues, sleeping alot, hard to wake up/get out of bed, tired after a long nights sleep, not good quality sleep. Fat concentrated around abdomen, waist, hips. Weak upper body. Can’t get a good workout in without taking Status or HCG. For reference, I can max out at 260 lb squats and 135 lb bench.

Got into using Status by Blue Star Nutraceuticals, a natural testosterone booster, in 2014. Helped me in sports and concentration. Had testosterone checked late 2015, it was at 322 ng/dl. Did not withold from taking Status prior to this test. Fast forward to 2016: I witheld taking Status and had my test taken at an anti-aging clinic. Was in high 100’s. Note: I had been consistently drinking tea for the first time in years at this time. Was given HCG by this clinic. HCG worked great. Effects tapered off a bit though… got in altercations with people when I never had before. Got arrested. However, I still felt better. Shortly after starting HCG, I decided to get a Karyotype to test for Klinefelter syndrome, test came back 46xy.
I would take HCG 3 times a week of and notice effects would wear off on end of day 2 after an injection.

Other:
-When I was in school, I found that putting American Crew forming cream hair product in my hair immensely helped my concentration, creativity, and other intangibles (random, I know).

-Recently saw an endocrinologist. Concluded on trying out Clomid and ceasing HCG. MRI scheduled for April Blood tests scheduled for May

-Skin breaks easily. Bruise easily

-dad suffers from “dyslexia”, mom has many issues BPD, potential bipolar, some of the symptoms show in my brother, sister is a alpha female perfect shape pac-12 recognized dancer

Please ask any questions that would help you clarify the situation!

Chris

Status


#2

I won’t pretend for one second I know as close to as much as the people here but could it be estradiol? Could it be a liver problem (which would explain my anger and irratability)? Could I have gulp some sort of encephalopathy?

@KSman

Thank you for any replies


#3

Anyone? Please? Next steps or Lab reccomandations?


#4

Some people are busy at tax season…

hCG:
Where did you get it?
Arrived wet or dry? Added what to reconstitute?
How much injected?
How often injected?
IM or SC?

If hCG can’t work, LH induced with clomid probably will not work.

Clomid dose, try 25mg EOD, not more. Many doctors Rx insane amounts.
If you feel bad quite fast, its the Clomid, switch to Nolvadex it works the same, but many Docs are insanely loyal to Clomid which means that they will not do any deductive reasoning.

LH=.6, FSH=0.9 indicates that your HPTA is repressed or damaged. hCG can do that, but then we expect to see useful amounts of T.

Are your testes normal?
Any changes with hCG?

Please provide Thyroid labs results with ranges. Ranges always needed. All the more for FT. Also see last paragraph in this post. Many here have thyroid issues and scoring normal on thyroid labs is not the issue.

I am trying to find out what you mean by 46xy, google results not clear.

TRT would really change your life and virilization would improve a lot.

I also suggest that you get a semen sample tested to see if you are fertile now.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • 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.


#5

@KSman you are a true American hero.

Thank you for getting back to me. I haven’t made up my mind on the clomid yet.

hCG:
Where did you get it?
Arrived wet or dry? Added what to reconstitute?
How much injected?
How often injected?
IM or SC?

-Total T Clinic
-Not sure-- Clinic would mix
-50units (I will update on what unit, but for reference, the injections came in a insulin style syringe and was filled 50/100)
-3 times a week
-SC

About the hCG, I had been taking it about 1 month when I had the test results done.

Are your testes normal?
Any changes with hCG?

-Yes
-Yes, got bigger

Will provide thyroid labs.

I am trying to find out what you mean by 46xy, google results not clear.

46xy, as in the number and type of chromosomes. One in 500 men have an extra x sex chromosome making them 47xxy affecting size of their hips, height, and production of testosterone.

You’re right about the Clomid-- my in-network endo was adamant about it. I’m concerned I’ll have a hard time getting an Rx for Nolvadex because when I asked if there were Clomid alternatives he said simply “no”.

My next steps: I will talk to my GP about getting Thyroid tests. And possibly a Liver panel while I’m at it.


#6

It is much more important to get the body temps to eval thyroid function. Please see last paragraph in my first post for more.

SERMs all have the same effect. Clomid was the first and papers were written to study the effects SERM on male hormone system. When other SERMs came along there was no need to repeat the same clinical research to show what a SERM can do, but docs can’t see past the paper in front of their faces. Deductive reasoning and critical thought was not part of the curriculum. Print that for your doc if needed… If you feel OK with clomid, you are good to go.

46xy means that you are normal and OK?


#7

Okay, I will follow those directions and report back with what I get.

Yes, 46xy is normal and OK.


#8

@KSman

Body temps hover around 97, morning afternoon and night. Seen as low as 96.5 and high as 98.2. After 20 checks, most readings fall a little north of 97. 98.2 was outlier.

On a scale of 1-10 I believe I’m suffering from an 8+ Adrenal Fatigue because of lifestyle now.

Still doesn’t explain the lifelong poor muscle mass, unexplained height, low T/energy/etc, irritability outbursts

One thing I forgot to mention: I had delayed puberty. Armpit hair at 17/18, {sparce} chest hair at 24/25/26. It’s still coming in tbh. Brother had the same thing for good measure

I live in Southern California, surely the good weather doesn’t have anything to do with it??

I reached out to labs and they informed me I already had my Thyroid done in January. Was there anything missing from that test that would be useful?

Regarding ranges, I was not given any for Free T4, TSH, and Prolactin


#10

Klinefelter Syndrome is a primary form of hypogonadism, and is associated with high levels of LH and FSH, whereas yours are low.

Incidentally, karyotypes can sometimes miss the mosaic form, where some cells are 46XY and others are 47XXY. This is because only a few are checked, and cells that are frequently replaced (such as in blood), tend to become 46XY over time.

Kallmann Syndrome is a secondary form of hypogonadism that has similar symptoms to Klinefelter’s. That might be worth investigating.

https://en.wikipedia.org/wiki/Kallmann_syndrome


#11

Graemsay, I do not believe to have Klinefelter syndrome because

  1. My testes are of normal size
  2. The karyotype came back 46XY

I haven’t ruled out Mosaicism so a semen analysis is in order to confirm or refute.

You bring up a good point about Kallmann syndrome. Although I think it’s unlikely because I do not experience anosmia or hyposmia. Also I do not have a cleft palette or other craniofacial defects.

I believe my issue to be hormonal-- an HPTA problem.

@KSman


#12

Free Thyroxine FT4 0.7-1.9 ng/dl

Mid point is 2.6/2=1.3
fT4=1.07 is a problem, but normal range so docs see nothing.

Your early morning body temp is how low your body temperature gets and mid-afternoon should be peak temperature. These need to be done and reported distinctly.

I does not mater if your thyroid was tested in the past, the number do matter. Body temperature is more conclusive.

You have not picked up on the importance if iodized salt?
If not using, can be major cause of problems.
Use needs to be long term. Timeline?


#13

@KSman Thank you for continuing to work with me on this.

Okay, I will report body temps distinct with times.

I have a hard time believing I have been iodine deficient my whole life considering I live in an affluent neighborhood and put thought in to my diet.

Nonetheless, I’m going to begin outside iodine supplementation shortly, probably Iodoral and selenium.

Other symptoms:

-thinning outside eyebrows (hair is sparse towards the end)
-major fat deposits around hips and abdomen. This fat protrudes a good 2 - 3 inches on both sides. And even though I am active, it just will not go away!


#14

@chrisj I don’t think that you have mosaic Klinefelter Syndrome because your gonadotropins are too low. The fact that you responded to HCG would suggest that you’re secondary, not primary.

There are other forms of hypogonadotropic hypogonadism other than Kallmann syndrome, such as the very rare (and wonderfully named) fertile eunuch syndrome.

If you’ve had this problem since an early age, then you might have Eunuchoid proportions or habitus. This can be checked easily with a tape measure.

The upper and lower body segments should be about the same height. Measure from the ground to the top of your pubic symphysis (the top of the pelvic girdle at the front). If you’re white, this should be about half your height, blacks have longer limbs, whilst Asians’ are shorter. Low testosterone during adolescence will increase the length of your limbs, and the lower segment could be 2" / 5 cm or more longer than the upper.

Normally arm span is about equal to height, someone with Eunuchoid proportions will have one that’s at least 2" / 5 cm wider than their height.

In my case, I’m about 6’3" / 190 cm. My lower segment is about 100 cm / 39.5", and my upper segment is about 90 cm / 35.5". My arm span is around 6’7" / 200 cm.

A fertility test isn’t a bad idea. Klinefelter syndrome is associated with azoospermia and severe oligospermia, but so are other conditions.


#15

Thank you for the input, Graemsay. I will take that into consideration


#16

Easy to be deficient:

  • using sea salt
  • non-iodized salt sold in USA on same shelf as iodized with similar packaging

#17

@KSman

I went ahead getting Iodoral. So far, I’ve seen some results.

I took the opportunity to get blood work done at an independent lab. I have been on Clomid for roughly two weeks:

COMPLETE BLOOD COUNT

WHITE BLOOD CELL 3.6 L [3.9 - 11.1 K/ul]

RED BLOOD CELL 4.95 [4.2 - 6.0 M/ul]

HEMOGLOBIN 15.2 [13.2 - 18.0 g/dl]

HEMATOCRIT 44.5 [38.5 - 54.0 %]

MCV 90 [80.0 - 100.0 fl]

MCH 30.8 [26.0 - 34.0 pg]

MCHC 34.3 [31.0 - 37.0 g/dl]

RDW 12.3 [11.0 - 15.5 %]

PLATELET COUNT 200 [140 - 400 k/ul]

MPV 9.7 [7.5 - 11.6 fl]

TUMOR MARKERS

PSA, TOTAL 0.590 [0.0 - 4.0 ng/ml]

ENDOCRINE EVALUATION

FSH 2.6 [1.5 - 12.4 mIU/ml]

LH 6.5 [1.7 - 8.6 mIU/ml]

ESTRADIOL (E2) 10.2 [7.6 - 42.6 pg/ml]

TESTOSTERONE, TOTAL 475 [280 - 1100 ng/dl]


#18

Man, based on your first post, it’s like your describing my early 20s… exact same symptoms as you, and I’m 47xxy/KS.

The bloodwork doesn’t mean much to me, as I don’t understand it… but, I’d have that karyotype test done again by the best Urologist in the country to be sure. They took 11+ vials on 2 separate occasions when I had mine done.

Good luck


#19

@9killer thanks for the reply. Are your testicals small? I’m hesitant to
retake a karyotype because mine aren’t.

Chris


#20

Each of mine is the size of a cherry. I’m not sure if that’s small or big. Yours?


#21

That’s small. You can reference this chart. https://goo.gl/images/w68wzQ
Mine are 25 mL