T Nation

Working Towards Diagnosis, What Am I Missing?

Thank you for taking the time to read this post and for any input given on it, I truly appreciate it! I will try to speed this up and simplify things as much as I can.

*I am 25 years old
*Always looked much younger than my age and told I look like a teenager when I am almost 30. (Also no facial hair and low low body hair elsewhere.)
*Diagnosed hypothyroid years ago.
*RECENTLY diagnosed hypogonadal with a side note of (testicular failure). - No injury or infections to testicles.

After a whole lot of back and forth and fighting to find a Dr. That would actually work with me I have finally been put on TRT. Here is my current protocol.
*Test Cyp IM @ 200mg (1cc) weekly
*HCG @ 250 IU 3x weekly (mon,wed,friday)
*Exemestane @ 25MG 3x weekly (mon,wed,friday)

Just got my bloods back which were taken 4 days after injection and here is where I am at.

Labs as of 05/10/15
*TT = 1672 ng/dl
*FT = 416.3 pg/ml
*E2 = 28 pg/ml
*FSH = 0.7 mIU/ml
*LH = 0.2 mIU/ml
*Progesterone = 0.6 ng/ml
*Prolactin = 6.8 ng/ml
*IGF 1 = 146 ng/ml
*GH = 0.1 ng/ml
*ACTH Plasma = 26 pg/ml
*Cortisol = 21.0 mcg/dl
*TSH = 2.45 mIU/L
*T4 FREE = 1.7 ng/dl
*Hemoglobin = 16.1 g/dl
*Hematocrit = 49.2%
*Albumin = 5.0 g/dl
*Cholesterol Total = 210 mg/dl
*HDL = 63 mg/dl
*LDL = 137 mg/dl
*Non HDL Cholesterol = 147 mg/dl
*Triglycerides = 48 mg/dl
*Vitamin D, 25 Hydroxy =
VD, 25-OH, D2 <4
VD, 25-OH, D3 32 ng/ml
VD, 25-OH, Total 32 ng/ml

Thyroid Panel from 03/11/15
*Free T4 index = 3.0
*T3 Uptake = 36
*T4 Total = 8.3 mcg/dl
*TSH = 0.54 mIU/L
*Cortisol = 13.8 mcg/dl

Sorry for so much info, I am hoping to eliminate as many questions and unknowns as possible. Basically I am seeing a fluctuation in thyroid and cortisol.

I feel like garbage. I am so tired, having ED or at least suboptimal erections and a fluctuating libido and a pinch in prostate area but both the Doc, and the Endo say everything is good… What am I missing here?

Thanks so much for the help in advance!

Well looks like no one will respond but in case anyone that can help me is reading this, I’d like to explain my main reason for concern with my health.
Even on the dosage of Test Cyp and HCG I am on, I am still unable to put on lean mass and I am almost skin and bones. I eat very clean and I eat over 1000 calories above maintenance and I include over 150g of protein per day. My diet and training sh I understand be enough to grow and put on weight yet I am still so skinny and weak. This leads me to believe I have more going on that I am missing so again, any input is very much appreciated. Thanks again in advance. Hoping someone can help.

I’ll weigh in but I should caution you that I’m no where near as knowledgeable as many here.

You need to post the ranges that are considered normal with your blood work. For example, your TT is 1672 when most tests indicate normal as somewhere between 300 and 1100, so that sounds high, but, it could be a different test. Same with the Free T levels - mine are something like 20 with low being around 10 so that number of yours sounds wrong indicating a different test using different ranges. I assume the E2 number is Estradiol and 28 seems borderline high. For me, higher Estradiol hurts my libido, as does lower Estradiol. So, post the ranges where you can.

Your dosage for TRT is high. How long have you been on it? Mine is 140mg weekly but I started on 110mg. At that level, you should definitely be shooting twice a week, 100mg every 3.5 days. Otherwise, after about three or four days, your T levels will be low and you will feel poorly.

Be patient. Someone will weigh in and give you some solid advice. Based on your information, you may have some thyroid issues, but there are others that know this stuff inside and out and they will get to you. In the meantime, post your height and weight and whatever dosage you are taking for hypothyroid, and post the normal ranges listed on your blood tests. Also, read some of the stickies at the top of the forum. They’ll help you make sense of it all. And, be patient.

Good luck!

Too much testosterone.

Please read these stickies:

  • advice for new guys
    — note the first paragraph

  • protocol for injections

  • thyroid basics
    — have you always used iodized salt and/or vitamins that list iodine?
    — check your body temperatures as per the sticky.

So you are young and started TRT without first checking LH/FSH?
LH/FSH while on TRT is useless as these will go to zer0

Are you now thyroid meds?