T Nation

Years of lLow T Symptoms


#1

Hey guys!

After reading through the stickies and some threads, I decided to open my own.
So before I talk about me a little, I'll post my labwork and other physical stats.

age: 26
height: 73inches/185cm
waist:31.8inches/81cm
weight:167lbs/75kg
describe body and facial hair: generally not very hairy, legs are an exception.
describe where you carry fat: belly and lower back.
health conditions, symptoms [history]: No energy,motivation,sleeping problems, no libido, weak erections, fighting with mild depression all the time.
describe diet: I watch my kcal intake practically every day and try to eat a balanced diet. A 2500kcal day usually looks like about ~250g carbs, ~150g protein, 100g fats.
describe training: pretty low volume push pull legs 2x week. coming back from a back injury though so haven't been very active lately.
testes ache: Had a testicular torsion about 10 years ago. Very rarely it aches for a day. Havent put much thought into that though since it really happens so rarely.
morning and nocturnal wood: nocturnal wood regularly, morning wood is VERY rare. Even night wood is no steel rod though. Maybe 7-8/10 hardness)
Medications: 50mg L-Thyroxine every day for ~7,8 months now (due to a knot on my thyroid)

Lab results:

First are from August (done by my "thyroid"-doctor)

Parathyroid hormone: 6.7 (12-88)
Vit D3: 56.7 (10-51.9) (taking a d3 sup)
FT3: 3.96 (2.3-4.1)
FT4: 2.13 (0.56-1.31)
TSH: 0.34 (0.35-3.5)
anti-TPO: <40 (<40)
TAK: <100 (<100)
TRAK: <1 (1)
TG: 2.7 (1-70)
Calcitonin: <1.5 (<15)

These results are from October:
E2: 21pg/ml (<20-47)
LH: 3.1 mIU/ml (1.24-8.62)
FSH: 3.7 mIU/ml (1.27-10.0)
Prolactin: 6.7 ng/ml (2.64-13.4)
DHEA-S: 434.1 ug/dl (85-690)
Testosterone: 5ng/ml (1.75-7.81)
TSH basal: 0.13 uIU/ml (0.35-3.5)
Cortisol: 152.7 ng/ml (67-226)
SHBG: 29.6 (13-71)
GH: 0.03 ng/ml (0.003-0.971)
FAI: 58.6 (15-95)

The endocrinologist that did these tests evaluated in the letter to my families physician that he excludes hypogonadism and that he sees no reason for all my symtpoms and his diagnostic is done with this.

My families physician (who is also gynaecologist) argues, that you can not simply 'treat only lab results' but have to treat the patient and gave me a receipt for testosterone gel, which I am to use 7d/wk (which results in roughly ~35mg/wk) and see if my symtpoms get any better.


Ok! So honestly, I just don't know what to do or believe anymore. All I know is that I haven't had a rock hard steel erection for 6 years now, my libido is down the drain ever since, I never have alot of energy, small problems feel like a heavy burden and my sleep is pretty miserable. I can't really remember the last time I really felt like a man. I mean, I look at woman and still think they are sexy and all, but it's just not the same feeling..like it has become more of a rational thing than anything else.
I should add that I have been in psychotherapy for 4 years now. I don't take any anti-depressants and I am not heavily depressed.
All kind of doctors have been telling me for years that 'it's all in your head' but as you can see that advice has not brought me alot of success.

I come to you for help now, because I have no idea how to proceed. I don't necessarily want to start trt, although I wouldn't mind IF it helps me to feel like my old self again. And even though I normally have trust in my families physician, my lab results really do seem to be pretty damn normal so I wonder if trt is really the right way to go here.

What do you guys think? Any ideas on my situation is deeply appreciated!
Thanks!


#2

Young virile males make around 10mg T per day. Transdermal T is not absorbed very effectively. If you absorb 10%, you have to apply 70mg/day. Many with thyroid problems simply do not absorb and have to self inject, which is 100% delivery and the least cost method.

You cannot take just a little bit of T as your system will reduce production, its a replacement program.

Any blows to your head or whiplash prior to things going bad? Pituitary can be damaged.
Any reduction in width of peripheral vision, should be around 180 degrees.

Were you using iodized salt for years before the nodule was found on your thyroid?
Were your body temperatures low and are they now? - see thyroid basics sticky

CBC lab data?

Future labs on TRT:
TT
FT
E2
PSA — not needed at your age
CBC including hematocrit

Your LH/FSH levels are consistent with your TT levels. SHBG is low enough, that FT should be middle range.

At you age, there are some alternatives:

  • inject 250iu hCG EOD SC and see if T levels increase, if levels are high normal and you feel better, good result. If T levels increase and you don’t feel better, problem is more than T levels [unknown based on labs]. Some can do hCG instead of T + hCG

  • take 12.5mg nolvadex per day and after a month, test LH/FSH, TT, FT, E2. If LH/FSH are up, the top end of your HPTA is somewhat functional and you can process from there to attempt a HPTA restart. If LH/FSH do not increase, something is wrong.

If you do TRT without {SERM or hCG} you will probably become sterile, do not accept T only as your TRT.


#3

As far as I can remember, there were no blows to my head or anything similar. I am actually pretty sure things started to get worse after I broke up with my first gf when I was 20. I had to fight for ~2 years to get over it, lost alot of weight (which I regained later on) etc. My problems did not occur spontaneously though! Especially the sexual related ones really creeped up on me very slowly. I did not notice a change until the damage was already done.

No loss in peripheral vision, pretty much 180 degrees.

I have been using iodized salt for at least 5 years now and was diagnosed with the nodule jan 2013. I’m not sure if my mother used iodized salt as well when I was younger, but chances are high! However, mother and father both have a past of severe thyroid problems.

My nodule has become smaller and my thyroid is in normal rage (size) again as well.
I cant measure my temperatures at the moment but I will get a fever thermostate soon and measure it.

My physician also prescribed me tamoxifen upon telling him that I fear gyno.

I don’t have any recent CBC lab data. Will do next time I do blood test.

Now, what I don’t really understand: So you basically think that my results are pretty normal right? (assuming FT are normal range from my results)
So, when my results are not even in the lower range of things, can they really be the cause of all of this? Are there people that need “high” level of testosterone to feel good mentally and physically?

I ask this because even though you say I seem to be midrange, you advice me to use one of these protocols! Do you think something like an “HPTA restart” would even be adisable at my hormonal levels?
Not to dismiss your input, just want to understand the reasoning behind it!

Thanks for your time KSman, it really is appreciated!


#4

TT, LH and FSH all seem mid range.

Thyroid problem symptoms are similar to low T symptoms.
Thyroid problems can lower TT, LH and FSH

Lets see what your body temperatures suggest.

Did you loose weight when you started thyroid meds? What other effects from the thyroid meds?


#5

Ok so I got a fever thermometer yesterday and measured late afternoon and this morning several times.

morning temps were between 95.9 and 96.4. (9am)

late afternoon were 98-98.3 (7pm)

When I started L-Thyroxin, I didn’t notice any change at all. No mood or energy changes. No changes in weight, nothing. Was surprised about that as well. But I guess that might be normal since my levels were ok according to the doctor even before treatment.

So yea according to the thyroid sticky my temperatures are definitely low. I don’t know if this has anything to do with it, but come winter my hands are getting very cold, even at home. sitting at the computer is enough for my hands to get so cold, that I sometimes have to use a heating pad. This does happen most every day.