T Nation

New Guy Here. 24 Old Year Hypogonadism


#1

I have posted this post in 2 other forums but I didn't get much help and I am desperate.

Hello to everyone. I hope someone will read it and help. I appreaciate any help.

I am 24 old male. I am suffering from hypogonadism for very long time. I will provide latest labs but at first I want to tell you about my past.

I remeber going into puberty at age 13 or 14. I had normal erections, morning woods and wet dreams. My libido was good I was intrested in girls. After some time I noticed decerased sex drive at age maybe 15. At 16 it was completly gone I thought it is becouse I masturbated a lot(2 times a day) Then I remember that I wanted to get my drive back and try with girls. So I stopped masturbation. I could do without a masturbation for like half a year and my drive didnt came back at all. Then I masturbated once a month. At the age of 18 I finnaly decided to go to the doctor becouse I had almost no facial hair and after like half hour after masturbation I felt somthing like pelvic floor tension. The doctor has check my prostate and said that everything is ok. And he wanted me to get out. Then I compained about my very very low sex drive. He ordered a labs. The labs came with t levels below normal range I believe it was like 2.100 ng/ml. He examined my balls and said "yeah they are small thats why". It actually pissed me off he was a douche. Then I continued my battle visiting some doctors. One of them prescribed proviron which raised my total t levels to 3,100 ng/ml. I felt no diffrence and went to another doctor he prescribed pills which was called undrestol. Still no diffrence.

Then I finally got a better doctor who did some testings. When I first came to him my hormone panel looked like this:
(2010)
testosterone 2.320 ng/ml (2.490-8.360)
LH 4.22 IU/I (0-12,4)
FSH 16.32 IU/I (1.7-8.6)
prolactin 197 mlU/l (155,0-324,0)

He ordered new labs which came out strange.

(2011)

Testosterone 3.980 ng/ml (2.490-8.360)
LH 8.76 IU/I (0-12,4)
FSH 28.18 IU/I (1.7-8.6)
prolactin 170 mlU/l (155,0-324,0)
DHEA-s 229.40 (70.2-492.0)
e2=61,89 pg/ml

He ordered to do testicles usg. My testicles are small they are 3.4cm x 1,5cm. He prescribed t omadren 250mg every 2 weeks and he said that this is primary hypogonadism. He did check SHBG which was 23.6 (13.5-71.40). Thyroid levels were within the range.

There is still 2011 and my t levels are 8,550 after some t injections. And still nothing I dont feel drive at all. My lh and fsh drop to 0.I had MRI which indicated I had 2 micro benigin tumor in my pituitary gland which was realising prolactin. I also had kariotype test done and they said i am 100% man. I was taking testosterone less frequently becouse my doctor said that we will be dropping testosterone and maybe my body will kick in and produce it naturally. We then switch to testosterone entantan. We did the tests after 3 weeks after my last t dosage and t levels were varing form 2.7 ng/ml to 3.7 ng/ml.

There is 2013. I said I am done with trt and i started lifting weights and diet. I was desperate. The t injections did nothing to my sex drive which still was 0. I was for like 3 months without testosterone shots and the labs were:

Without trt.

Testosterone 3.860 ng/ml (2.490-8.360)
LH 5.99 IU/I (0-12,4)
FSH 16.25 IU/I (1.7-8.6)
prolactin 213 mlU/l (155,0-324,0)
e2=26.91 pg/ml
TSH 1.01 (0.30-4.00)

My endo was suprised. He said that I only need to watch for my prolactin levels. And prescribed bromocryptine which stops prolactin

Without trt.
2014/04 My levels t levels drop to 2,760 ng/ml (still no drive)
2014/09 My t levels increased to 4,970 ng/ml
2015/05 t levels 5,280 ng/ml

And my latest labs:

Testosterone 5.570 ng/ml (2.490-8.360)
LH 7.44 IU/I (0-12,4)
FSH 11.11 IU/I (1.7-8.6)
prolactin 120 mlU/l (155,0-324,0)
e2=39.91 pg/ml

Still no sex drive. Sometimes I do get morning wood but it is weak. I am also suffering from insomnia. I remember I had 1 day in may, when I woke up with a morning wood and alot of energy and I was attracted to female parts like butts... But it was all gone after 3 hours...

I think my puberty proces stopped and this is fked up. I look young altrough I am 24 years I look like a 18. Sometimes they ask me for id. I have pubic hair and arm pit hair but my facial hair looks awkward. I have testicles with volmue of 8ml. My penis is 5 inches but it is thin. According to tanner scale I am at the second stadium... of puberty

If you read what I have written I have questions:

1.What should I do to get my drive back? I have no sex drive since 16.
2.Can it be possible that my puberty procces stopped ? Maybe it will eventually come back?
3. Should I do more labs? If so, what labs?

Regards.


#2

"Thyroid levels were within the range."
Thyroid lab ranges are quite meaningless, please post lab results with ranges.
Have you always used iodized salt?
Do you get cold easily?
Dry skin?
General hair thinning?
Thyroid sore, enlarged, lumpy or asymmetrical?

Dostinex/cabergoline is often used to manage prolactin secreting pituitary adinomas, 0.5mg/week.

You are somewhat primary. Were your testes checked for vascular abnormalities?
When will the ultrasound results be available?

You have a lot of reading to do to gain the knowledge and understanding that you need. As you have seen, you cannot be passive with your health care as the doctors are mostly idiots,

Please read these stickies:

  • advice for new guys — note the first paragraph — provide more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

It might be helpful if we knew where you are located.
What is you insurance situation or out-of-pocked budget?

Testosterone 5.570 ng/ml (2.490-8.360)
LH 7.44 IU/I (0-12,4)
FSH 11.11 IU/I (1.7-8.6)
prolactin 120 mlU/l (155,0-324,0)
e2=39.91 pg/ml

Above, your T is greatly improved. Reducing prolactin seems to have increased LH/FSH. But again, you are exhibiting some primary hypogonadism to a degree because LH/FSH are elevated. So you have been mixed primary/secondary. Your E2 is too high and that is also holding you back. Suggest that you take 0.5 mg anastrozole per week in EOD dosing. You would need to get or make a liquid preparation to allow for dispensing small amounts.

DHEA-S is a bit low for your age group.

Please post all labs with ranges in list format. There may be something going on other than the hormones listed above.

You gave some of these already. Because of problems with pituitary, we need to look at other hormones too.

TT
FT
E2
LH/FSH
prolactin
CBC
hematocrit
AST/ALT
AM cortisol
IGF-1
vit-D25
fasting cholesterol [could be too low]
fasting glucose
DHEA-S
TSH
fT3
fT4 [please not T3, T4]

If you get effective T levels, your virilization should resume. Facial bone structure will not change at this point.


#3

re: sex drive, have you considered seeing a psychologist/psychiatrist in addition to your hormone supplementation?

You have to appreciate that something like sex drive is as much behavioral as it is biological: our bodies aren’t exactly a machine where we crank up the T level and all of a sudden we start behaving and thinking differently. You’ve gone through (this was the same for me) your early adulthood without the type of normal sex drive that people tend to develop with. And yet you kept developing. The upshot there is that your brain has its “normal, I am this person” types of behaviors and routines.


#4

Hello thanks for the reply.

I need to do new thyroid labs. Back in 2010 my endo did 2 tests for thyroid
TSH 3.17 ulU/ml (0.30-4.00)
FT4 1.70 ng/dl (0.60-1.80)

Yes I have always used iodized salt.
I was 2 times sick in this year so I don’t know if its easly. And also I noted something strange. When I was sick and my body was recorvering I would get morning wood at the end of sickness. I don’t normally get morning erections, very occasionaly.

No dry skin. Good hair. Didn’t had the thyroid usg.

I had my testes ultrasound from 2011. And I can translate becouse I am from Poland.
"Right testicle with homogenic structure size. 34x15mm epididymis valid. Left testicle also homogenic structure size 34x16mm epididymis valid.

I am from Poland. My insurance can cover some of the costs, the rest I can do on my own.

I don’t have latest CBC but here is my CBC from 2014/04 And these are the values that are low. The rest values are in the attached image

WBC 3.0 [10^3/mm^3] (4.0 -10,0)
lymphocytes 1.1[10^3/mm^3] (1.2-3.2)
monocytes 0.1 [10^3/mm^3] (0.3-0.8)

In earlier tests sometimes wbc and lymphocytes are normal but my monocytes are always low 0.1-0.2

I will try to get more tests becouse I didn’t do any test for liver and free T or IGF


#5

[quote]MinusTheColon wrote:
re: sex drive, have you considered seeing a psychologist/psychiatrist in addition to your hormone supplementation?

You have to appreciate that something like sex drive is as much behavioral as it is biological: our bodies aren’t exactly a machine where we crank up the T level and all of a sudden we start behaving and thinking differently. You’ve gone through (this was the same for me) your early adulthood without the type of normal sex drive that people tend to develop with. And yet you kept developing. The upshot there is that your brain has its “normal, I am this person” types of behaviors and routines. [/quote]

I am not taking any hormones right now. I am thinking about going into trt. And for the sex drive I am 24 years old and can’t feel any urge to have sex with a girl, womans parts like tits or boobs don’t turn me on. Althrough I had one day when I woke up with a morning wood with a lot of energy, like something has unblocked and I felt attraction to female parts. It was amazing this feeling, but after 1 day it was gone…


#6

[quote]24nation wrote:

[quote]MinusTheColon wrote:
re: sex drive, have you considered seeing a psychologist/psychiatrist in addition to your hormone supplementation?

You have to appreciate that something like sex drive is as much behavioral as it is biological: our bodies aren’t exactly a machine where we crank up the T level and all of a sudden we start behaving and thinking differently. You’ve gone through (this was the same for me) your early adulthood without the type of normal sex drive that people tend to develop with. And yet you kept developing. The upshot there is that your brain has its “normal, I am this person” types of behaviors and routines. [/quote]

I am not taking any hormones right now. I am thinking about going into trt. And for the sex drive I am 24 years old and can’t feel any urge to have sex with a girl, womans parts like tits or boobs don’t turn me on. Althrough I had one day when I woke up with a morning wood with a lot of energy, like something has unblocked and I felt attraction to female parts. It was amazing this feeling, but after 1 day it was gone…[/quote]

I don’t think you are understanding what I’m saying: I get that you’re not having those feelings and urges. What I’m saying is that your hormone levels may not be what’s to blame. And I’m not insinuating that you’re attracted to men: just that the sense of being “attracted” is something that fell by the wayside for you for several years of your developing an identity and behavior–that that type of thing isn’t necessarily corrected by hormones without also having given consideration to your psychological development. And that in that respect, instead of getting on a medication that will require you to use it for the rest of your life, it might be advisable first to try talking to someone with expertise regarding this type of thing and see where that leads. You’re 24, still young–talking to a psychologist/psychiatrist at worst would not hurt your situation and could potentially help it a great deal.


#7

TSH 3.17 ulU/ml (0.30-4.00)
FT4 1.70 ng/dl (0.60-1.80)

TSH should be nearer to 1.0
T3, T4, fT3, fT4 should be near mid range or a bit higher.

Please check packaging for that salt.
If you are not iodine deficient, you should do a lab panel for thyroid autoimmune problems.
Thyroid autoimmune problems can be driven by selenium deficiencies.

Please read the thyroid basics sticky and post you oral body temperatures as described there.

Your problems are obviously hormonal.


#8

[quote]KSman wrote:
TSH 3.17 ulU/ml (0.30-4.00)
FT4 1.70 ng/dl (0.60-1.80)

TSH should be nearer to 1.0
T3, T4, fT3, fT4 should be near mid range or a bit higher.

Please check packaging for that salt.
If you are not iodine deficient, you should do a lab panel for thyroid autoimmune problems.
Thyroid autoimmune problems can be driven by selenium deficiencies.

Please read the thyroid basics sticky and post you oral body temperatures as described there.

Your problems are obviously hormonal.

[/quote]
Thanks you for replying. I think there is still hope for me. I understand now how important thyroid is. I will check again all hormones that you suggested and I will post the results as soon as I will get them.

Checked my salt it is definitely idozied. I have my medical history from endo and my tsh levels were diffrent each time the lowest they have been is TSH 1.01 and the highest 3.45

I will check my body temperatures tommorow.