T Nation

Test Levels Falling Despite HCG, Extensive Testing with No Answer


First off a little about me, I am a 25 year old male who is for the most part in good shape. 6’4 and 225lbs, Type A personality with tons of drive and active. My problems started around 3-4 years ago when I first noticed a large reduction in my libido even with attractive females. Erection quality and length became unsatisfactory along with ejaculate volume. This brought me to my first doctor who associated with at the time “performance anxiety” (later I learned this was a huge mistake). I used 5mg every other day for a few months and things went back to normal however, that primal urge to fornicate has never returned. Since then, my erections have gotten worse, my hair has thinned in sporadic areas, feel tired constantly and sometime depressed (even though I have tons going for me). I used to wake up at 6am ready for whatever the world threw at me, now I’m lucky to climb out of bed by 7:30-8 even with adequate sleep. The ends of my eyebrows are still there just way thinner than they used to be. Morning wood is gone, along with some penile sensitivity. Along the way the following has been done to try and diagnose my issues:

Blood Testing (complete array of everything under the sun, labs to follow beneath)
MRI of the Brain (this was to check for Pituitary Adenomas) Results were negative
Urine Collection
Cortisol Testing with Saliva
Holter Monitor for an irregular heartbeat I’ve had since around 20 (resting rate is around 90-95BPM)

From my latest blood test results are of the following:

DHEA- 3.020 (1.330-7.780 ng/mL)
FSH- 0.9 (1.5-12.4 IU/L) this has baffled many doctors
LH- 3.3 (1.7-8.6 IU/L)
Prolactin- 7.3 (2.1-17.7 ng/mL)
Testosterone- 223 (258-836 ng/dL)
Bio Available Test- 115 (70-240)
Estradiol- 15 (11-38)

TSH with reflex to T4- 0.71 (0.27-4.20 ulU/mL)
Thyroid Peroxidase (TPO) AB- negative
T4- 6.3 (4.5-12)
T3 Uptake- 32 (24-39)
T3- 121 (71-180)

Vitamin D was low at 39.3 (30.0-100)

LDL- 98 (0-99)
HDL- 55 (<39)
Triglycerides- 84 (0-149)

Currently Supplementing:

Vitamin B12- 500mg per day
ZInc- 50mg per day
Vitamin D- 5000iu per day
Vitamin C- 500mg per day
Magnesium- 250mg per day
Spirulina- 2 capsules
Omega 3- 2 capsules
Folic Acid- 25mg

Currently Prescribed-
hCg- 1000iu injected 2x per week. (have been on this for the past 2 months and have seen no improvements and same sub 300 test level)
Cialis- 10mg as needed (have great erections on this, testicles drop further down, feel all around better with way better circulation in legs)

I am blessed to be in an area with tons of doctors in the Midwest. I am currently being seen by a urologist that specializes in male reproductive health. He has an open mind and realizes I have a problem, however no treatment is working and I’m ready to pull my hair out. I just want to feel like a 25 year old male. Doing poorly in the gym with limited gains, fat deposits in love handles and waistline only. Mental fog and lack of concentration get worse every day. If someone has an answer or feels that I should get on TRT I would appreciate any insight.



You are better off having the free thyroid fT3 and fT4 hormones tested.
What has been you history of using iodized salt?
Feeling cold easily?

Your thyroid labs suggest something is not right. Is your thyroid enlarged, asymmetric, sore or lumpy? Thyroid needs selenium to work properly and selenium deficiency can lead to pathologies.

Please eval you overall thyroid function via last paragraph in this post.

250iu hCG SC EOD is sufficient for a LH replacement dose.
What were your LH/FSH lab results before hCG?

Have you had a semen analysis to see if you appear to be fertile? The outcome will steer your TRT options.

Your failure to create T with hCG has too possibilities:

  1. Your hCG is bad, you can do a pregancy test kit and should be positive.
  2. Your testes do not work, primary hypothyroidism.

The only situation where primary can be fixed is if there are surgically correctable vascular abnormalities.

“I used 5mg every other day for a few months and things went back to normal”

  • EOD of what?

Many who come here have low-T and thyroid issues.

Many who come here are young like you. And those guys land here, probably making the incidence of such problems appear to be greater than in the general population.

Training when thyroid is not right and with low-T can be harmful to the adrenals as one’s energy levels are low and compensation with sheer will power and adrenalin is not sustainable.

And your low-T, height and age means that you should also be screened for:

  1. fertility
  2. https://en.wikipedia.org/wiki/Klinefelter_syndrome

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.