T Nation

Primary or Secondary Hypogonadism? Not Sure What Route to Take


#1

I have been skimming the Tnation forum for quite some time, I have spent a considerable amount of time researching , reading member’s posts and gaining as much knowledge as I can.
Here are some statistics about me :

Age: 28 Years
Weight : 192.1 lbs
Height : 6ft1
Years Training : 7
Total Cycles : 4
Compounds used : Testosterone Cyptionate, Tesosterone Propianate & Anavar.

I would also like to add that I never did any sort of PCT for my first 3 cycles due to my lack of knowledge and recklessness. This could possibly have damaged my HPTA.

From January 2017 to May 2017 I was self injecting a TRT dose of 250mg/week for Test Cypionate.
Blood work done on 5.3.2017 Shows the follwing results:

Total T: 1026 ref range: 250 -1100 ng/dL

Free T: 206.5 ref range: 35 – 155.0 pg/mL

E2: 27 ref range: <OR= 29 pg/mL

SHGB: 30 nmol ref range: 10-50 nmol/L

LH: <0.2 L ref range : 1.5-9.3 mIU/mL

FSH: < 0.7 L ref range :1.6-8.0 miU/mL

TSH : 1.69 ref range: 0.4 – 4.5 mIU/L

T3f: 4.0 ref range : 2.3-4.2 pg/mL

T4f: 1.5 ref range : 0.8-1.8 ng/dL

After the Results I took HCG @ 1500 iu for 10 injections total Every other day. While on the HCG, I felt better than when I was on cycle. My mood, my skin, my sleep , was probably the best it had ever been. About a month later I got some more blood work done:

7.6.2017 Blood Work

Total T: 150 ref range : 250 -1100 ng/dL
Free T: 20.1 L ref range: 35 – 155.0 pg/mL
E2: 10 ref range: 7-50 pg/mL
FSH: 1.6 ref range: 1.5 – 12.4 mIU/mL
LH: 1.2 ref range: 1.7 – 8.6 mIU/mL

Because my T levels were so low I decided to do a cycle of Test propionate @ 500mg/week for 6 weeks. First injection was 7.16.2017 and last injection was 8.30.2017.

Exactly 12 days after my last injection I got more blood work done on 9.12.2017 with the following values:
9.12.2017 blood work

Total T: 164 ref range: 250 -1100 ng/dL
Free T: 26.2 ref range: 35 – 155.0 pg/mL
E2: <5 ref range: 7-50 pg/mL
FSH: 2.1 ref range: 1.5 – 12.4 mIU/mL
LH: 3.9 ref range: 1.7 – 8.6 mIU/mL

The following day I began my PCT , which consisted of 1000 IU’s of HCG EOD for 3 days, I waited 4 days then started SERMS which consisted of : Clomid & Nolvadex at the following doses:

Clomid: Week 1 50mg/day ; Week 2; 50mg;day ; Week 3: 25mg day
Nolvadex Week 1 : 40mg/day ; Week 2 : 40mg day ; Week 3: 20 mg /day.
I got more blood work done on 10.12.2017 with the following results:

Total T: 336 ref range: 250 -1100 ng/dL
Free T: 68.426.2 ref range: 35 – 155.0 pg/mL
E2: DID NOT DO
FSH: 4.0 ref range: 1.5 – 12.4 mIU/mL
LH: 6.3 ref range: 1.7 – 8.6 mIU/mL
TSH: 3.64 ref range: 0.45- 4.50 mU/L
T3f: 3.4 ref range 2.0 – 4.8 pg / mL
T4f: 1.2 ref range 0.8 – 1.7 ng/dL

My TSH levels show hypothyroidism. I have never supplemented with iodine and never really cared of that much salt in my food. Could this be due to a Selenium deficiency?
A.M Body Temperature this morning: 96.5 degree

Despite having done this PCT I am experiencing the following
1- Feeling sluggish and tired all the time
2- No Libido Whatsoever, cannot maintain erection & never wake up with morning wood
3- Depression - Feeling of hopelessness
4- Increased Sensitivy to Cold
5- Face is almost always dry when I wake up
6- Low motivation, can barely get myself to workout or do anything

How can I find out if I am primary or secondary Hypogondigal ? Considering Taking Small doses of HCG for a month and retesting Total T, Free T, FSH and LH to see if I am primary or secondary.

I also have Hypothyroidism based off of my last TSH lab results. What could this be due to ?

I’m not sure when my next move is. I do feel quite stupid for having messed with my hormones with the supervision of a professional. I did see an Endoctrologist who confused me. He advised against taking Iodine , no clue why.

As of now I am considering the follopowing options

Option 1 - Attempt HPTA Restart with Power PCT & Supplement Daily with Selenium and Iodine to treat Hypothyroidism. Take HCG for a month and get lab work done afterwards. Based off of results I will then know if I am primary or secondary.

If primary, I will go TRT.

If secondary then I will most likely go for Option 2 - HCG Monotherapy.

Has anyone on this forum had success with HCG monotherapy in the long run ?

I felt much better when I was taking it.

Any input would be highly appreciated.


#2

Update on Blood Work

I got some more blood work done on the 2nd of November and I have partial results that I would like to share:

11.2.2017

E2: 25 ref range 7-50 pg/mL

FSH: 4.8 ref range: 1.6-8.0 miU/mL

LH: 6.6 ref range: 1.5-9.3 mIU/mL

Prolactin:: 15.3 ref range 2.5-22.5 mIU/mL

DHEA-S: 320 ref range 280-640 ug/dL

TSH: 3.65 ref range: 0.4 – 4.5 mIU/L

T4f: 1.3 ref range:0.8-1.8 ng/dL

T3f: 3.6 ref range: 2.3-4.2 pg/mL

Total t & Free T : Still Waiting for Results

Also, I figured out why my TSH is so high. I have been a daily user of something called Kartom. I’ve been taking it for the past 3 years of my life, every single day.

Interestingly enough, there seems to be a strong relationship between Kratom and hypothyroidism.

So long-term use of Kratom -----> Hypothyroidism —> Hypogonadism !!

I can thank Kratom for my feelings of fatigue ,depression, anxiety, low energy and loss of sex drive.

I hope someone on here finds this informaion useful… Stay away from Kartom.

Any input/ suggestions would be much appreciated.

I plan on slowly tapering off of Kratom and stopping it suddenly can cause severe withdrawal symptoms.


#3

Your PCT methods are typical but deeply flawed.

Your diet allows for deep thyroid deficiency unless you are eating lots of seafood. Selenium is needed to support normal thyroid function, otherwise there is free radical damage and possible thyroid autoimmune disease.

Please do not ask questions until you have some understanding of the stickies that cover almost everything.

Low oral body temps and good fT3 numbers suggest that you could have elevated rT3 blocking effects of fT3. Do pay attention to these terms in the thyroid basics sticky: stress, over training, illnesses, infections, adrenal fatigue.

Your thyroid issues easily explain low energy etc. With low energy and getting through training with adrenalin we often see adrenal fatigue.


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
  • HPTA restart
  • finding a TRT doc
  • thyroid basics

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

Ksman,

Thank you for your input.

I have printed and read your Thyroid Stickies several times.

So you’re telling me is that my Low oral body temperatures is possibly indicating a selenium deficiency due to a lack of seafood in my diet , Correct ?

On 10.10.2017 I got some blood work done with values that might be useful:

Microsomal TPO Antibody : <10 Ref Range : <=34 IU/mL

Thyroglobulin Antibodies : <20 Ref Range: <=40 IU/mL

I have been supplementing with Selenium these past 2 weeks on a daily basis.

My oral body temperature this morning: 97.4 ( highest its ever been in the morning)

However Yesterday’s blood work still shows TSH Levels of 3.65.

I suspect my long term use of Kratom to be responsible for my high TSH levels and constant feelings of fatigue/depression & Low sex drive.

Per your response , I will do the following:

1- Adding Seafood to my Diet, mainly salmon

2- Supplement with Fish oil

Should I get my rT3 Levels checked to confirm what you said ?

What testing can I do to find out if I indeed have adrenal fatigue.

I read on a post you recommend Wilson’s book on Adrenal fatigue, I am going to get it and read it.

Should my focus be to fix my thyroid issues before attempting to increase my testosterone ?

I see you’ve helped hundreds of forum members pertaining to Low T issues and again I appreciate your input.


#5

You need iodized salt for iodine. Some seafood also provides iodine. Seafood is not a source of selenium.

Find a high potency B-complex multi-vit that has trace elements including 150-180mcg iodine and 150-200mcg selenium and it should not list iron - a men’s formula.

Please check oral body temps at both times specified. Should be avoiding talking, walking, eating and drinking for a while.

As you have been avoiding salt, you should get iodine for a while and see where things go from there. You really need to be getting selenium if taking larger doses of iodine.

Yes, rT3 will be helpful. Note that if you increase T4, T4–>rT3 can result.

You are not alone, many guys here have profiles and stories similar to yours.


#7

Fair enough.

I purchased Nacsent Iodine Online and have been taking 25mg/day.

Also a multivitamin and Selenium.

I will check oral body temperatures and post as soon as I get them.

In determining whether or not I am primary or secondary Hypogonigal, Do you suggest taking a small dose of HCG EOD and retesting levels in 1 month ?

If T Levels don’t increase ----> Primary ----> and I will hope on TRT right away

if T Levels do Increase slightly ----> Secondary -----> HCG Monotherapy ?

Do you think HCG Monotherapy can be a long-term solution for my situation if I am secondary hypogonadigal considering that I am only 27 years of age.

Could not taking a proper PCT after being on a cycle of AAS caused permanent damage to my HPTA ?

I cannot remember the last time I had morning wood.

I would like to note that I have never had T levels above 450 ng/dL.

I want to delay hoping on TRT as long as possible, and fertility is still a concern for me.

Thank you again.