T Nation

Thoughts on My Situation? Age 20


#1

So I just turned 20, and am tired of feeling sluggish all through highschool, winded after running up the stairs once, or lifting a box, etc. Been exercising on and off for around 3 years, keep very active at work (40 hours on foot always), and am around 12-14% body fat, 5’10" 175 lbs. I had Bloodwork done for my thyroid as my family has Hashimotos pretty bad on both sides, and got the results. They failed to do anything other than the TSH for my thyroid which came back at 2.7. My total testosterone came back at 426ng/dl with a free test of 57. I was born with only one testicle as well, and didn’t have to shave until 19 (still only shave every 3 weeks). Doctor told me I was ok, though I have confirmed I have gynecomastia (noticed in 7th grade, assured it would disappear, yet it’s growing.) so my endo wants to give me Tamoxifen. Assures me I have nothing wrong hormonally. Decided to see an anti agongclinic which insurance covered. I was given NatureThroid and some vitamin d/potassium for 6 weeks until they will draw my Bloodwork again including t3/t4 etc. The Dr. has also approved me for seeing her to receive TRT, assuming I will pay the $150 every 3 months and pay for the testosterone sans insurance (insurance won’t even let me see her for testosterone if my level is above 190ng/dl) so here is my questions:

  1. Should I try to tank my levels prior to the test via not sleeping, eliminating days, overtraining, etc directly prior to my next blood draw?
  2. The Dr says she will give me TRT or HCG in case I want to have kids, assuming she will PRESCRIBE me testosterone right? If that’s the case I should be able to fill it at the cheapest pharmacy(she said it may cost $110 a month which seems way to high, thought?)
  3. Should I just pay for the visit $150 without tanking levels and just get my prescription and eat the $150 every 3 months in effort to improve my life?
  4. Could I quit the Testosteone after a few months, and see my levels drop to such low levels that insurance would then take action?

In all honesty $150 every 3 months and paying out of Pocket for Test E or Test C is not that bad assuming its under $110 a month for a decent supply? My life as it is is very boring:
Very anxious and worrisome
Muscles feel weak including grip
Could not improve cardio despite trying very hard over 6month+ periods
No desire for relationships
Very apathetic

On top of that I don’t think my family feels it’s a very big issue however as I work and am 20 it’s a decision I really have to make.

Does anyone have any idea if that seems reasonsble: $150 for a visit every 3 months to an anti aging clinic?
The doctor has been in practice for over 20 years

Thanks ahead!!


#2

Where are you located? Affects diagnostic and treatment options.

Please post lab work with ranges:
TT
FT
LH/FSH
prolactin
E2 - estradiol
CBC
hematocrit
cholesterol - can be too low
AST/ALT

Thyroid: TSH can be up from low iodine. What is your history of using iodized salt? If not using iodized salt, you might not need thyroid meds. I have never seen reported that a doctor has asked about iodine. Iodine deficiencies should not be treated with a lifetime of thyroid meds.

Hashimoto’s: There are two risk factors, iodine deficiency and selenium deficiency. Production of T4 also produces free radicals that are cleaned up by enzymes. But that cannot happen without selenium. The free radicals injure thyroid cells and the immune system cleans up the wreckage and can then start to recognize regular thyroid cells as foreign and create hostile antibodies. With your family history, selenium supplementation is not optional.

You can look for a multi-vit that has trace elements including 150mcg iodine and 200mcg selenium. mcg = microgram = 0.001mg

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
  • 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.


#3

That means nothing. The biggest problem with male hormone care is the doctors. You cannot be passive with the doctors and need to arm yourself with knowledge.


#4

Thanks for the reply.
Here is some more info

TT: 426 ng/dl (range 175-781)
FT: 57.6 (range 35-92.6)
Estradiol: 23.42 (range 0-47)
LH: 3.3 (range 1.24-8.62)
FSH: 4.92 ( range 1.27-19.26)
Prolactin: 7.5 ( range 2.64-13.13)
Hematocrit: 47% (range 38.6-49.2)
Cholesterol: not tested??
AST : 22(range 13-39)
ALT: 45 (range 7 - 52)

CBC Results

WBC 4.8 (4-11)
Red Bloodcell 4.84 (4.34-5.6)
Hemoglobin 15.5 (13-17)
MCV 96.9 (80-100)
MCH 32 ( 26-34)
MCHC 33 (32.5-35.8)
RDW 12.6% (11.9-15.9)
Platelet 198 ( 150-450)
Mean plat volume 9 (6.8-10.2)


#5

Mild secondary hypogonadism, prolactin is not a cause and does not need to be tested again. E2 is not elevated and not a cause of.

We see so many of the TRT guys and candidates here with thyroid issues, that is seems easy to reach for cause and effect. Thyroid affects every cell, tissue, organ system, immune function and brain. Most of the symptoms of low thyroid function are the same as low-T. Many have both. As your T is not super low, your problems might be more dominated by thyroid.

FT changes a lot and average might be lower than 57.6, typically in this situation, TT is the better indicator of T status - when you read the pattern.

Your elevated MCV may be suggesting Vitamin B12 and/or folic acid deficiency.
Get the multi-vit that I suggested earlier.

Please do not let thyroid issues slide.
You can certainly respond to questions re history of iodized salt use straight away.


#6

[quote=“KSman, post:5, topic:230371, full:true”]
Mild secondary hypogonadism, prolactin is not a cause and does not need to be tested again. E2 is not elevated and not a cause of.

We see so many of the TRT guys and candidates here with thyroid issues, that is seems easy to reach for cause and effect. Thyroid affects every cell, tissue, organ system, immune function and brain. Most of the symptoms of low thyroid function are the same as low-T. Many have both. As your T is not super low, your problems might be more dominated by thyroid.

FT changes a lot and average might be lower than 57.6, typically in this situation, TT is the better indicator of T status - when you read the pattern.

Your elevated MCV may be suggesting Vitamin B12 and/or folic acid deficiency.
Get the multi-vit that I suggested earlier.

Please do not let thyroid issues slide.
You can certainly respond to questions re history of iodized salt use straight away.
[/quote]ok thanks for the info. As for iodized salt that seems to be the ONLY type of salt I use in my household it seems like.


#7

We had one guy who checked his salt container to find out it was not iodized. Similar packaging.

If you have been getting adequate iodine long term and have TSH=2.7, you should have labs checking for thyroid autoimmune markers.

Do get your oral body temperatures which can be more informative than basic labs.


#8

Yeah I use Mortons Iodized salt. I’m getting more thyroid labs in 6 weeks but I’ll check my morning body temp over the next few mornings.


#9

Going to work on getting my temps over the next few days my thermometer has been broken. To add a correction, when I said previously my free test levels were 50 I meant that the scale they gave was at 50. When I converted it using the SHBG number it was around a 10 ng/dl free test level.