Need Advice with Extremely Low Testosterone Results

I’ve dealt with low sex drive and inability to maintain an erection for years now. I can’t remember the last time I woke up with morning wood. There’s a bunch of fat on my belly that I can’t get rid of, and I quickly hit a wall when it comes to working out and trying to increase my lifts. I’m 27 years old, so my age shouldn’t be a major factor. Here are my results:

Bioavailable T: 15.5 (normal range: 83 to 257 ng/dL for men 20 to 29) !!!

Free T: 7.9 (normal range: 5.05 to 19.8 ng/dL for men 25 to 29)

Total T: 65 (normal range: 240-950 ng/dL) !!!

LH: 3.9 mIU/mL (normal range: 1.7 - 8.6 mIU/mL)

FSH: 3.4 mIU/mL (normal range: 1.5 - 12.4 mIU/mL)

Blood was drawn at 8:40 a.m.

Clearly, my Total T and Bioavailable T are incredibly low – Total T is so low that it barely exists! Because FSH and LH were relatively normal, what do you guys think is the next step for me? Do these results mean anything to you guys? I’ve got a urology appointment in a few weeks and an endocrine appt pending, but I’d really love to know more about these results, so I can ask pertinent questions.

Also, my TSH W/REFLEX TO FT4 was 5.84, which the lab says is a slightly elevated thyroid. I don’t know if that matters at all. And my erythrocyte sedimentation rate by Westergren method (used to determine the amount of inflammation in the body, usually caused by arthritis) was 36, well above the normal range. Again, I don’t know if that matters, but it’s another thing that was abnormal.

Id say you’re a prime candidate for TRT. With that low of TT you must feel like absolute garbage.

Testicles looked damaged, with normal LH you should be producing more testosterone.

Any medications?

No other major medications. I take Imitrex for occasional migraines, but that’s once every couple of months or so.

What’s the fix for damaged testicles? Will TRT be enough to fix most of this?

You have no idea! It’s a metaphorical kick to the nuts every time I try to increase my lifts and can’t. The last thing I tried was lifting to exhaustion while eating 3500+ calories a day – all I did was gain a bunch of fat.

I’ve looked at the side effects of Imitrex and most of them have similar side effects to low testosterone, dizziness, drowsiness, weakness and some even more severe. It’s a drug, there’s a reason why a prescription is needed = side effects need to be managed be a doctor.

Drugs affect everyone differently and it could be why your T is so low even if you take it infrequently. If your testicles are indeed damaged, there’s no fix. Careful training with low T, you can damage your adrenal glands!

TRT won’t work if you have thyroid issues, full thyroid panel or bust.

Be sure to read the ‘things that damage your hormones’ - below

Describe how you perceive thyroid and low-T problems started and progressed.

Post all available lab work in list format with ranges.
Do not skip “normal”

Most guys who come here have some degree of thyroid problems, so low T and low thyroid function can seem connected. But your TSH ranks with the worse we see here.

TSH should be close to 1.0, this is why you do not not have energy and are overweight. If you have not been using iodized salt long term, that can easily be the cause.

Eval your overall thyroid function via oral body temperatures - see below. And note that this is at two different times per day, most guys miss that detail

Thyroid lab ranges are stupid and doctors mostly just follow that. I can be hard to find a doctor who understands thyroid function and is not an idiot robot.

Hypothyroid symptoms:

  • most of the same as low T
  • sparse outer eyebrows
  • dry skin
  • brittle finger nails
  • generalized hair thinning, not MPB

Thyroid labs:
fT3 ← the only active thyroid hormone
fT4 - please not T3, T4 or indexes etc
rT3 - reverse T3
AM cortisol - at 8AM or 1 hour after waking
Fasting cholesterol
Fasting glucose
Do not be dehydrated for fasting labs, drink water
CRP - general inflammatory marker, not cardio as mistakenly stated
homocysteine - cardio vascular inflammatory marker

Training with lot T and low thyroid function requires adrenalin to overcome low natural energy and this stresses the adrenals.

Your testes are not working and your pituitary is not increasing LH/FSH to compensate. So this is mixed primary/secondary hypogonadism.

Do you testes seem normal or smaller now?
Any aches? Handing normally?

Every used an oral hair loss drug?

TRT restores metabolic demands and when thyroid cannot support this, some will feel worse. Both problems need to be addresses.

Most of the time we see that guys with low thyroid function are very poor transdermal T absorbers so you need to seek T injections and avoid creams and gels which are also most costly and absorb only 10% at bests.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • 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 numbers 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.


Thanks for the huge response! I’ll keep my comment brief. I’m currently reading the material you linked, and I’ll make a new post in a few weeks once I have future labs finished. When I post, I’ll include everything, including normal ranges and other miscellaneous info.