22 year old - very low test help me out

[adrenaline99]

Was feeling most of the symptoms of Low T, mostly fatigue, low sex drive, increased fat gain, and anxiety. And I wasn't progressing much in the gym (even with a flawless diet) so I got my hormones checked and my suspicion of low T was confirmed. Here are the results:

TSH, 3rd Gen 0.616 uIU/mL
T4 1.74 ng/dL
T3 2.8 pg/mL
Vitamin D 42 pg/mL
Estradiol 18.5 pg/ml
Testosterone, total 309 ng/dL
SHBG 25 nmol/L
LH 3.2 mIU/mL
FSH 3.3 mIU/mL
HCG, TOTAL, QN <2 mIU/mL
Testosterone reading three weeks later at the same time of the day: 256 ng/dL

What do these results indicate? And what would be the typical protocol for someone with these test results? I have an appointment in a month with an anti-aging doctor(since they seem to be the most knowledgable about hormones nowadays), but I want to know as much as I can in the mean time, just incase the doctor is an idiot and prescribes the wrong treatment. Because I know that happens a LOT. Thanks a lot for any advice!

[redz]

Did you cycle before this?

[steroid.com 1]

Not z only the question that redz asked, but we need to know everything about yourself.

Your medical history, med use, diet, exercise, supplements, head or groin injuries, body composition...and on.

We need to see much more labs than what you posted; this tells us little.

See kels sticky at the top of the form on finding a TRT Doc, in there you will see the labs we need.

If you didn't abuse aas in the past and are otherwise a healthy young man, you need to rule out pathologies and other serious medical conditions that can cause low androgen serum levels as guys your age aren't even done puberty yet believe it or not.

[adrenaline99]

I've never used AA's and have been a healthy person my whole life and have never been diagnosed with any serious medical conditions.

[steroid.com 1]

So your low serum levels are caused by...what?

There are many conditions like Pituitary tumors to cancer to diabetes to Thyroid conditions to testicular tumors...and on, that can cause low testosterone serum levels in young men and many of these pathologies are insidious in that you won't see symptoms till they are late stage.

Let me say this again; young men who haven't even peaked yet don't have low testosterone serum levels for no reason..something is wrong with you and you need a specialist to rule out disease.

[booku]

So your low serum levels are caused by...what?

There are many conditions like Pituitary tumors to cancer to diabetes to Thyroid conditions to testicular tumors...and on, that can cause low testosterone serum levels in young men and many of these pathologies are insidious in that you won't see symptoms till they are late stage.

Let me say this again; young men who haven't even peaked yet don't have low testosterone serum levels for no reason..something is wrong with you and you need a specialist to rule out disease.

I had a similar situation. I ruled out the pituitary tumor with MRI, and all testicular issues with an ultrasound. Also my thyroid panels were perfect. Started my therapy 12/29. Would you have done the same? or went another route of treatment? Mind you, my test levels were 70 and I was feeling terrible for a about a year.

[steroid.com 1]

If you thoroughly ruled out all pathologies and or other potential causes and there is no medical reason for your low serum levels than obviously TRT is a reasonable medically necessary mode of therapy

A young man must realize this is for life and some of the consequences that come with this commitment.

[kelkel]

Exactly what GD said. Find the causative factor and do not accept treatment without it. If you seeing an Anti-Aging Doc I'd assume he's A4M Certified and should be on his game and able to help. Don't settle for a bandaid.

Update this thread with results please...

[adrenaline99]

Ok, So I'm going into the A4M doc in a week, I was wondering if the above hormone tests are going to be sufficient enough for him to make a proper diagnosis, I've also ordered a prolactin test online so I'll have that in time. And I have all the hematology tests and blood chemistry tests as well as a lipid profile. Anything else I should get before then? I'll only be able to afford one appointment with him, he's insanely expensive and only accepts cash upfront so I have to be 100% ready for him to make a diagnosis. Thanks for any help guys, I'm excited to get this shit figured out, it's been an issue for years.

[phaedo]

How much do you exercise (weights, cardio, etc.) and how many calories do you eat a day?

I started TRT when I was 21, and in retrospect, my low T was a consequence of excessive exercise and restricted calories. Even with all the benefits of TRT, I would exhaust EVERY option before you jump on this therapy. It sounds good initially, but thought of pinning yourself for the next 65 years is a burden that you don't want to bear, unless you have to. Good luck at your doc appointment!

[adrenaline99]

How much do you exercise (weights, cardio, etc.) and how many calories do you eat a day?

I started TRT when I was 21, and in retrospect, my low T was a consequence of excessive exercise and restricted calories. Even with all the benefits of TRT, I would exhaust EVERY option before you jump on this therapy. It sounds good initially, but thought of pinning yourself for the next 65 years is a burden that you don't want to bear, unless you have to. Good luck at your doc appointment!

I exercise with weights 3-4 times a week and eat 2000-2600 calories a day. I got these tests done after weeks of not going to the gym and eating around 3k calories a day. I really suspect an underlying hormonal disorder due to the weird symptoms and body figure I've experienced ever since puberty i.e. insanely bad gynecomastia that I had to get surgery on, lack of muscle development, gaining fat while eating under 2500 calories, anxiety(was severe until I saw a psychologist for it), lack of motivation, sometimes minor depression, lack of facial hair, lack of confidence, always fatigued and I need 10+ hours of sleep to feel somewhat normal (waking up early is impossible), lack of concentration and memory problems, lower sex drive than normal and recently I've noticed I can lose my erections mid sex(fantastic). These are not symptoms that have come out of nowhere, I've had them since puberty and they have progressively gotten worse.

My general practitioner(what a bunch of bafoons these guys are, seriously..does he think I'm lying about all these symptoms or something?) always says I'm normal and all my blood tests are in range, I've been getting testosterone blood work done yearly since age 18 and it's always been in the low normal range and continues to decline. So now I'm dishing out the money to see an anti-aging doc who knows about how crippling a testosterone level like mine can be, especially at this age. And if pinning for the rest of my life means I won't feel like this anymore and actually have energy to get shit done I wouldn't mind one bit, hell I wouldn't mind pinning myself 5 times a day to feel like a normal 22 year old.

[Trific]

Welcome!

It sounds like you have a plan, good luck....I'd like to hear how it goes for you....you can just keep this thread going when you have more to report.

[phaedo]

Yeah man, I know what you mean. However, I would make SURE that low-testosterone (secondary hypogonadism) is indeed the root cause of your symptoms. Type up an Excel spreadsheet with all your labs and dates and we can view the trends of the numbers.

Also, have you had a full thyroid panel ran? (not just TSH, but FT3, FT4, and totals of both?). Have you had a ACTH stim test?

[steroid.com 1]

I exercise with weights 3-4 times a week and eat 2000-2600 calories a day. I got these tests done after weeks of not going to the gym and eating around 3k calories a day. I really suspect an underlying hormonal disorder due to the weird symptoms and body figure I've experienced ever since puberty i.e. insanely bad gynecomastia that I had to get surgery on, lack of muscle development, gaining fat while eating under 2500 calories, anxiety(was severe until I saw a psychologist for it), lack of motivation, sometimes minor depression, lack of facial hair, lack of confidence, always fatigued and I need 10+ hours of sleep to feel somewhat normal (waking up early is impossible), lack of concentration and memory problems, lower sex drive than normal and recently I've noticed I can lose my erections mid sex(fantastic). These are not symptoms that have come out of nowhere, I've had them since puberty and they have progressively gotten worse.

My general practitioner(what a bunch of bafoons these guys are, seriously..does he think I'm lying about all these symptoms or something?) always says I'm normal and all my blood tests are in range, I've been getting testosterone blood work done yearly since age 18 and it's always been in the low normal range and continues to decline. So now I'm dishing out the money to see an anti-aging doc who knows about how crippling a testosterone level like mine can be, especially at this age. And if pinning for the rest of my life means I won't feel like this anymore and actually have energy to get shit done I wouldn't mind one bit, hell I wouldn't mind pinning myself 5 times a day to feel like a normal 22 year old.

If you find a good anti aging Doc and one who is a member of A4M than you should be in good care. Keep us posted in this thread on your appointment, blood work, diagnosis...everything.

You're on the right path my friend

[adrenaline99]

I would just like to know what other tests I should get, I want to have all of them done so he can make a proper diagnosis...I only get one appoointment with him, im thinking just ACTH and Prolactin..to rule out pituitary tumors, which seem somewhat likely due to the FSH and LH levels being low normal and test being where its at.

[steroid.com 1]

I would just like to know what other tests I should get, I want to have all of them done so he can make a proper diagnosis...I only get one appoointment with him, im thinking just ACTH and Prolactin..to rule out pituitary tumors, which seem somewhat likely due to the FSH and LH levels being low normal and test being where its at.

Read the sticky at the top of the forum on Finding a TRT Doc by kel, you will see all the labs you will need to make a proper assessment.

[adrenaline99]

Read the sticky at the top of the forum on Finding a TRT Doc by kel, you will see all the labs you will need to make a proper assessment.

Alright cool looks like I'll have all of them. This forum rocks, I really appreciate your guys' input. Really glad I found this forum. I'll follow up in a week and let you guys know how my visit went.

[adrenaline99]

Quick update, just did a prolactin and cortisol test. Prolactin was fine but cortisol was very high, and the test was at 3 pm and i woke up at about noon. It was 30.8 Ug/dL with a reference AM = 6.2-19.4 and PM = 2.3-11.9. Is that considered like REALLY high? Hmmm, every sex hormone is low and my cortisol is high, could this suggest a cortisol releasing pituitary tumor? Should I get my ACTH tested?

[adrenaline99]

Another update, Just finished the visit with the A4M Doc, he ordered a bunch more tests and a pituitary MRI, the tests include:

CRP
Homosysteine
B12
Magnesium
DHEA
IGF-1
Reverse T3
TPO
Salivary cortisol
PSA
U/A
Urine ntx
Sperm count

He said if none of these tests suggest an underlying, treatable condition causing secondary hypogonadism he's going to start me on a trt protocol, consisting of 100mg test cyp subQ weekly, 1000 IU HCG weekly, 0.5 mg Arimidex weekly.

[steroid.com 1]

Another update, Just finished the visit with the A4M Doc, he ordered a bunch more tests and a pituitary MRI, the tests include:

CRP
Homosysteine
B12
Magnesium
DHEA
IGF-1
Reverse T3
TPO
Salivary cortisol
PSA
U/A
Urine ntx
Sperm count

He said if none of these tests suggest an underlying, treatable condition causing secondary hypogonadism he's going to start me on a trt protocol, consisting of 100mg test cyp subQ weekly, 1000 IU HCG weekly, 0.5 mg Arimidex weekly.

You're in good hands.

Thank God for A4M Doc's...not kidding.

They are on the cutting edge of healthcare.

[adrenaline99]

Update*

Got those tests back including MRI...everything was normal...with the exception of DHEA being low-normal at 222 (80-500) range. After lots of talking with the doc it is apparent that I've had this issue for many years..been getting my testosterone tested yearly since I was 17....been having symptoms since middle school. It has tanked from 400 at age 17 to 250 now at 23. We think the recent steep decline is due to undereating and overtraining. He said he can't pinpoint a specific pathological cause and I should start TRT sooner rather than later. I'm personally fine with starting, especially since my personal physician is my dad so he can prescribe the hrt protocol that the A4M doctor specificies so that makes it a lot easier. Any opinions? What do I do now? Just hop on the HRT train without a specific diagnosis? I've had sooo many tests and nothing points to an underlying cause..I'm really confused.