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TRT at 23 Years Old? Bloodwork Help

Hello,

I am 23 years old guy who lifts constantly since 6 years. (used to compete in powerlifting, stopped because of University). I train 4 times a week, my diet is clean(Eggs,rice, potato,chicken, red meat, veggies, daily orange, cheese) (Basically following a slightly modified Vertical diet.

Last year i was having some Sexual Dysfunction, my “general” doctor prescribed me Testosterone gel, which i suspected because he only checked my blood test, so i had an appointment with an Endocrinologist and he told me not do so at any cost.

So i decided to drop weight as i was around 22% body fat, I’m 5’8, was around 215 lbs, now i’m around 180 ( took me 14 months) my situation got better but not by much.

Maintaining an erection mid sex is a challenge and sometimes i just stop sex, i gain fast very hard, and lately it has been really hard for me to put on muscles and strength. (I squatted 475lbs, benched 305, deadlifted 525, when i was 18 years old in my first powerlifting meet) Since then everything i made 0 improvement.

Now i want to fix my situation for once and for all. My mood is most of the time crappy, low energy and my erectile dysfunction is easily noticeable which pisses me off a lot.

I get 7-8 hours of sleep every night.

Supplements i take are Vitamin d3, Cod liver oil and Creatine. nothing fancy here just the essentials.

I’m going to book an appointment with another Endocrinologist, but i want opinion from you guys here as well before i go just to have an idea what i should be discussing with him.

Since i am 23 years old and most likely he will refuse the idea of TRT totally.
As i said before, i train since years, following strict training programs, my diet is good, everything in my life is going good no extreme stress or so, I am doing my degree and training, no work or anything to make me really stressed. I can’t see any issue for this.

But waking up without a morning wood and having low energy, losing erection mid sex and in a “down mood” for most of the day isn’t something usual for a healthy 23 years old.

The photo here is from a blood test i did last week on the 7th of January.

Any help is much appreciated

TRT will make things worse for you. Your testosterone level is not a problem.
Your Free T3 level makes me highly suspicious (Along with your symptoms) of low cortisol.
Get a 24-Hour Saliva Cortisol test done. Blood test is meaningless for cortisol testing most of the time as it reflects bound, unusable cortisol; Saliva is the free cortisol and extremely accurate.
Amazon sells Diurnal Saliva Cortisol kits if your doc can’t order it.

Can you be more precise how is it going to make it worse for me please?
If it’s because i need to take it for life-time i know this already, and how shit the idea is, on the other hand it’s still better than my current situation.

I will definitely check the saliva test.

Appreciate the help

What’s a “Normal” Testosterone Level

You’ll find is very difficult to get a sick care doc to prescribe TRT to a young 23 year old especially with these numbers you’re getting, no way, never going to happen so don’t get your hopes up. No one can definitely say your levels are normal, androgen receptor sensitivity plays a role in how much testosterone your body requires to function normally.

If you’re very sensitive to testosterone, you won’t need much, however if your receptors are insensitive, you’ll need higher testosterone versus the next guy who is sensitive Free androgen index, no one who is skilled at hormones uses this test, the Free T can be known by either directly measuring or calculating, neither of which are entirely accurate and often overestimate.

I calculated your Free T by plugging in your Total T and SHBG score, but this calculation assumes everyone binds androgens identical. Your Free T is 16.48 ng/dL range 16-31 ng/dL and is a calculator that the endocrine society approves. I’m not going to tell you that these levels are normal for a 23 year old, testosterone peaks in our 20’s and by 30 it starts declining 1% every years beyond 30 and is low by the time you’re an old man hunched over with no energy.

Question, are you on any antidepressants or anxiety medicine?

Things that affect libido and erections:

  • Obesity
  • High blood pressure
  • Diabetes
  • Poor sleep
  • Medications
  • Stress/depression
  • Low testosterone
  • Infections
  • High prolactin
  • Low thyroid hormones
  • Alcohol & drugs
  • Surgery
  • Heart disease
  • High cholesterol

Post something in Training and we can help with your progress. An E2 number would be nice to know, but I doubt test is your issue based on the numbers. Got a porn habit? That can be a much bigger contributor to your stated problem.

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@bigboystrong

His freeT is perfectly fine. You are unfortunately using an incorrect ref range which is misleading.

Ref for calculated free T (Vermeulen) is 7ng/dl - 22.6 or 0.245-0.785 nmol/L

FT3 levels are perfectly fine. No reason whatsoever to believe that FT3 levels are a problem.

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You know that for a fact? I mean you can know his receptor sensitivity levels or if there is resistance at the cellular levels?

You presume to know and don’t actually know by simply looking at numbers on paper. It’s the position of the Endocrine Society that EDCs interfere with the body’s hormones. So I say again you can’t know his levels are normal by looking a numbers on paper.

Cost of hormone-disrupting chemical exposure in billions

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men: A Locally Weighted Regression Analysis.

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

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What we know is that the clinical presentation of androgen deficiency is best correlated with freeT.

The freeT ref range you provided is just wrong and could mislead a 23 year old to go on TRT, and thats an issue.

His calculated freeT is at about 60% of the range, so is his free androgen index in the result of the blood test.

His T is at 473 ng/dl. If SHBG would be higher his T would also be higher as freeT determines the setpoint.

So I rather say that the HPTA works just fine and speculate that the cause for the relatively low SHBG needs to be identified and fixed rather than flooding the system with exogeneous T.

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You don’t even know is his testing is the Equilibrium Dialysis, Ultrafiltration or Direct Immunoassay, the later is notoriously inaccurate and can overestimate. I wouldn’t want to hang my hat on that testing method.

I think you’re hung up on the numbers are not considering other variables which were stated. I simply gave him information to absorb and so he can make his own decision. He did one blood test, his levels could be lower tomorrow, even lower the next day and higher the next day.

This plays out over months and years and his average levels if this is the highest he will see on all lab testing, means his averages are actually lower. An example, if his highest is 474 ng/dL and his lowest is 289 ng/dL, his averages are somewhere in the middle.

So I’m sorry you can’t tell anything from a single lab test, things become more clear with a higher frequency of lab testing.

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Nope. If he has low cortisol, Free T3 will pool in the blood because they cannot enter the cells.
It MAY be ok, but this is why I am suspicious based on his symptoms and normal Testosterone level.

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No. The problem is that exogenous testosterone inhibits the HPTA, the adrenal gland (cortisol production is reduced) and also suppresses the immune system. If you have low cortisol, TRT will NOT work. You will get depressed, fatter and lose muscle. You will get ED/reduced libido as well.

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Guys, first of all i really appreciate every comment and every tip you gave here.
second, i totally forgot to mention that since last october i started taking Concerta 54mg for ADHD treatments. To be fair in the period of October, November,December. it wasn’t one of my worst periods to be honest. so I am not sure about it affecting something. I’ll post some tests here i did over the last 2 years so you guys can actually take a look, i didn’t take only 1 test.

Those are 4 tests i included here, you can see the date up right.

Surprisingly, from 1 test to another my SHBG was getting higher and my Free Androgen INDEX was getting lower and lower… but also with the crazy low SHBG and high Androgen i was feeling pretty much the same as i do now.

Yes, i have just mentioned in my last reply, i do take Concerta 54mg daily since october for my ADHD issue.

Honestly not, really rarely.

Regarding training I’m doing Beyond 5/3/1 right now, really enjoying it and progressing slowly at the moment.

I took Concerta back in 2013 and did pretty well on it, I was diagnosed with ADHD at age 7, but TRT has made me a multitasker and my memory improves on TRT and don’t feel like I have ADHD on TRT.

Concerta can have side effects, it was shown that methylphenidate can negatively affect testosterone and fertility rate of the male mice by decreasing the number of leydig cells and reducing the body weight.

Whether this is seen in humans is another story. There is another study which showed Concerta reduced testosterone at puberty and delayed puberty in adolescents. Those who take prescription medications are guinea pigs, I was a guinea pig and now have low testosterone because of 30 years of clonazepam usage.

That’s what i thought as well, i read about it in google and so, a lot of mixed opinions, what do you think about my other tests?

Well I think you have hyperthyroidism, your TSH looks suppressed and maybe the Concerta is causing it and maybe somehow that’s affecting testosterone. I had hyperthyroidism on Ritalin and lost 32 pounds in 28 days doing nothing but sitting on my but on my time off, in fact my bed was soaked just from sleeping.

My mattress was ruined. I don’t understand why SHBG is low, it should be higher in hyperthyroid patients. You got some weird stuff going on. When your SHBG increases, Total T increases and Free T decrease.

The Concerta is a suspect in all of this crazy blood test results.

I’m wondering if all of this started after starting on the Concerta. I’ve read that scientists think there may be a connection between ADHD and sex hormones. If it’s true then this is easier to explain.

But the thing is as i have said before.
Only the original Test i have posted in the first place was with concerta.
The other 4 we’re before concerta.
I am more confused than worried right now.
Doctors in germany are almost impossible to give TRT, i know it’s a life time decision and they know their shit, but something needs to be done regarding my situation.

HRT docs are under attack worldwide, the institutions with all the power go after these docs prescribing TRT and thyroid hormone to people with normal levels, but medical literature shows people with normal levels symptomatic, these HRT docs treat them, they improve and feel normal.

That because the toxins in the environment are known to block hormones action on the body’s tissues. That doesn’t stop these docs from losing their licence for making the average docs look incompetent and pathetic while the patients being treated feel better.

When you do that you threaten the power of these organizations that run our medical system, you will end up on the losing end.

Your T is perfectly fine. As SHBG moves up T also moves up.

Go to a physician which is specialized in thyroid disorders. Internet won’t help you. Too many people throwing in their uneducated opinion.

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