T Nation

What Would You Do

Hey guys this is my first post on this forum and so I apologize right off the bat if I’m not doing it right.

I’m 24 years old, 155 lbs, 5’6, and I think that I have low T (maybe a hypo thyroid as well but IDK). The main reason I am here trying to address my low T issue is because I am going back to school on Jan 6th to finish up pre-recs for medical school. I wasn’t able to give it my all in college a few years ago due to anxiety issues, depression, etc. I did not know what my T levels were until just recently and now believe that my past performance in college has to do with the fact that I may have had low T for years now (I was a good student in highschool and first 2 years of college). I want to address my low T symptoms (mood, well being, joint pain, fatigue, etc.) so that I can start back college and give it 100% this time around… Below is my story and I hope that you guys can provide me with some solid advise:

This past July, I tore my Achilles’ tendon playing basketball. The surgeon that I met with kept saying over and over that he sees the injury often in in guys that are in their late 30s or 40s, but rarely in their 20s. He asked me if I had taken steroids in the past which I admitted to. I took 1 pill of dbol every day for a month back when I was around 21. No testosterone base or anything, and I stopped taking dbol after I ran out (Stupid I know). After my discussion with the surgeon, I figured that I should get some blood work done. I went to my pediatrician (I didn’t have a primary physician until just this week. I never really needed to actually get one, b/c she helps me with pretty much anything I need) to get some blood work done. The results were drawn in the morning somewhere between 8-11 and came back as follows:

FSH 4.7 MIU/mL on a scale of 1-12
LH 4.2 mIU/mL on a scale of 2-12
T4 free 1.7 ng/dl on a scale of .7-1.9
Total Testosterone 436 ng/dL on a scale of 280-1000
TSH 1.99 mclU/mL on a scale of .32-5

My pediatrician said that my testosterone was within range and that I was fine, but I convinced her to send me to an endocrinologist. Now at this time I was on the CKD diet at 1600ish calories a day and lost 0 lbs after 9 weeks (other than water which I put back on over the carb up weekend). I thought that maybe I had a thyroid issue as well b/c I couldn’t loose weight so I asked the endocrinologist to run a few tests on me including a T3 free reading. The endocrinologist said that my testosterone level was within range and refused to test my T3 free (So I don’t really know if i’m hypothyroid or not. It’s just a hunch). My blood was drawn in the late afternoon around 3 PM and results came back as follows:

T4 Free 1.88 ng/dL on a scale of .89-1.76
TSH .884 uIU/mL on a scale of .550-4.780
Prolactin 5.9 ng/mL on a scale of 2.1-17.7
Anti Microsomal Antibody <10 IU/mL on a scale of <35.0 being normal
T3 Total .82 ng/mL on a scale of .6-1.81

Since the endocrinologist was not of much help (She said nothing was wrong with me), I decided to go to a Low T clinic My blood was drawn in the evening and came back as follows:

Total Testosterone: 181 ng/dL on a scale of 350-1000 (I’m a little skeptical about this reading). By now, I quit doing the CKD, hadn’t been lifting weights for about 2-3 weeks. These factors and the fact that the blood was drawn in the evening are the only things I can think of that would result in such a low reading, but again I am still a little suspicious.
Total PSA .31 ng/mL on a scale of <4.0 being normal
Free Testosterone 4.93
SHBG 15 nmol/L on a scale of 10-50
TSH 1.34 mIU/L on a scale of .4-4.5
FSH 5.7 mIU/mL on a scale of 1.6-8.0
LH 5.3 mIU/mL on a scale of 1.5-9.3
Prolactin 7.2 ng/mL on a scale of 2-18
Estradiol 23 pg/mL
Glucose 93 mg/dL on a scale of 65-99
Urea nitrogen 16 mg/dL
Creatinine 1.26 mg/dL on a scale of .6-1.35
eGFR non-afr american 79 mL/min/1.73m2
eGFR african american 92 mL/min/1.73m2
Bun/creatinine ration N/A
Sodium 140 nmol/L on a scale of 135-146
Potassium 4.5 nmol/L on a scale of 3.5-5.3
Chloride 104 nmol/L on a scale of 98-110
Carbon dioxide 25 nmol/L on a scale of 19-30
Calcium 9.2 mg/dL on a scale of 8.6-10.3
Protein total 6.9 g/dL on a scale of 6.1-8.1
Albumin 4.4 on a scale of 3.6-5.1 g/dL
Globulin 2.5 g/dL on a scale of 1.9-3.7
Albumin/Globulin ratio 1.8 on a scae of 1-2.5
Bilirubin total 1.5 mg/dL on a scale of .2-1.2
Alkaline phosphatase 69 U/L on a scale of 40-115
AST 23 U/L on a scale of 10-40
ALT 29 U/L on a scale of 9-46
White blood cell count 6.6 thousand/uL on a scale of 3.8-10.8
Red blood cell count 4.98 million/uL on a scale of 4.2-5.8
Hemoglobin 15.1 g/dL on a scale of 13.2-17.1
Hematocrit 45.1% on a scale of 38.5-50
MCV 90.6 fL on a scale of 80-100
MCH 30.3 pg on a scale of 27-33
MCHC 33.5 g/dL on a scale of 32-36
RDW 14.6% on a scale of 11-15
Platelet count 169 thousand/uL on a scale of 140-400
Absolute neutrophils 3399 cells/uL on a scale of 1500-7800
Absolute lymphocytes 2376 cells/uL on a scale of 850-3900
Absolute monocytes 581 cells/uL on a scale of 200-950
Absolute Eosinophils 211 cells/uL on a scale of 15-500
Absolute Basophils 33 cells/uL on a scale of 0-200
Neutrophils 51.5%
Lymphocytes 36%
Monocytes 8.8%
Eosinophils 3.2%
Basophils .5%

A lot of data, I know… So the PA at the Low T clinic said that my testosterone reading was low enough to treat me, but that they cannot treat anyone below the age of 25 due to their company policy. So I took the results back to my pediatrician who thought that the testosterone reading was a fluke and said it didn’t make since b/c my FSH and LH are within normal ranges. She said that I don’t need treatment, but after standing my ground she decided to refer me to another endocrinologist. I think I know how this is going to play out. I feel like she’s just sending me on a wild goose chase and knows that no doctor will touch me with a 10 feet pole due to my age. I became really frustrated at this point and started to take steps to prepare to take things into my own hands (self medicate). I know that I want to have kids one day and so I got in touch with another primary care physician this past Friday who wrote me a prescription so that I can store my sperm. Unlike my pediatrician and the endocrinologist that I previously met with, the primary care physician agreed that I have low T (however, I shared my result of 181 ng/dL with him, not the 436 ng/dL). While this is all good and dandy, he seemed uncomfortable with treating me. He decided to send me to an endocrinologist on the 27th of this month.

Now, at this point I have taken the first few steps in treating my self in the event that the new endocrinologist tells me that nothing is wrong with me (I have the ability to store my sperm and think that I know a couple sites to order gear from. I’m sure that I can find a trt protocol as well). However, I don’t really know EXACTLY what is wrong with me and I need your guys’ help for a diagnosis. While I know that my readings are low for my age, what if it is an issue with my adrenals, pituitary, hypothalamus, etc.? I don’t want to just start this life long journey of TRT if it’s an issue where I can just jumpstart my HPTA via clomid for example… Thus, when I meet with the new endocrinologist on the 27th, what kind of things should I discuss? What kind of tests should I ask for? e.g., adrenal tests, hypothalamus tests, etc. Also, I know that there are some real smart guys on here. Based off of my lab results what do you guys think is wrong with me? A hypothalamus issue, adrenal issue, etc.? Also, what do you guys suggest, should I start on TRT, try to kick start my HPTA using clomid, etc.?

Also, if the new endocrinologist does not treat me and I decide to go on TRT, I don’t even know where I would go to get the necessary tools to self medicate (test, hcg, bac, arimidex, clomid). I have heard of pinnacle labs. I know that this is a stretch, but I would appreciate it if someone would reach out to me regarding where to find the tools or their experience with pinnacle labs.

Also, if this helps I have taken the following drugs before and in prescribed dosages for legitimate reasons: vyvanse, adderall, vicodin, oxycodone, wellbutrin, zoloft. Again, I took a few dianabols (1 a day for a month) when I was 21ish. I also took a few test boosters and maybe even a pro hormone back then. I do drink alcohol and smoke cigarettes occasionally on the weekends. I’ve smoked pot before, but that’s as far as I’ve gone and am willing to go.

Anyways, I hope you guys can help me out. Again, I want to get some type of relief before my classes start and that emotional stability is my number 1 priority at this point.

Like you said, there’s a lot of data there and I’m far from an expert, but I’ve had a huge amount of success with TRT. It basically turned my life around (I have an older thread on this forum you can look up for my history. Also check out my thread on the diet forum).

If you’re committed to treatment, I really don’t recommend that you self treat. Too many risks and it’s also illegal. I’ve been working with a doc that I found through an online service and it’s been fantastic… took just two weeks to start treatment (most of that time was just getting the labwork done because I was busy). Super affordable, too.

OT1138, thank you for your input. I have looked online and made a few calls to local anti-aging health clinics, low T centers, a few online resources online. Most of the anti-aging health clinics use pellets, the low T centers wonâ??t touch me until I turn 25, and the online recourses wonâ??t tuch me until I turn 30 or so… So Iâ??m kind of stuckâ?¦ OT1138 (and anyone else on this site), would you be willing to provide me with your online resource or point me in the right direction?

Don’t even think about starting TRT because of that 181 result. It looks like it’s either a lab error or a fluke, unless you’ve developed primary hypoganadism in between the 2 tests. You need to test again in the early morning to see where it’s at. If you order the test online, your doctor won’t see it so you won’t have to worry about trying to get a low number so that he will prescribe TRT. Your first test showed normal LH and FSH and a low, but not hypogonadal T level. The second test doesn’t look right because the higher LH and FSH readings should have given your T levels a slight increase over the 436.

Be cautious with low T centers or anti-aging clinics. Most of them don’t issue you prescriptions. They sell them to you at an inflated cost.

Check out this thread of a 24 year old guy whose labs were similar to your first results.

Freddy77,

I hate to admit it, but I think I agree with you about the low T centers and anti-aging clinics. I think that’s why I have been hisitant on jumping the gun and self medicating via TRT. I really want to rule everything else out first. Adrenals, pituitary, thyroid, etc.

I have actually read that post before. I then started googling clomid and have read tons of posts about people like FaceOfBear who had great luck initially. However, it seems like most of the guys are then robbed of their libido soon theirafter. Would I be able to talk to Dr. Eugene Fuchs about my case as I live in Ohio?

Also, where/who would you recomend for ordering tests online. Can you provide me with a link?

Also guys,

I started taking my daily temperature in the morning. It was 95.9 Monday morning at 7.30 am. Today, Tuesday morning at 7.30 am, it was 95.7. 4 hours later at 11.30 am it was 96.3.

I’ve read on this site that waking up with a temperature lower than 97.3 suggests that there is a thyroid issue. I decided to measure my temp upon waking up and three hours after wards, and three hours after that in order to try to rule out an adrenal issue (Dr. Rind’s temperature graph (found this on stopthethyroidmadness.com)).

Any thoughts on these numbers guys?