25 Male Struggling. What Comes Next?

[TripleC]

Male, just turned 25 years of age. 5’10” and 143 lbs with 29”/30” waist (as measured by my pants).

I am lean, and any fat is carried in my lower abdomen, but I normally do not carry much fat.

My health has been declining since early high school and became progressively worse with age. I have constant muscle knotting and pain (most severe in my neck and back), brain fog and difficulties concentrating, dietary sensitivities. I have mood swings and fairly consistent irritability with no explanation why. I have constant fatigue and lethargy and have trouble staying asleep.

My libido and drive have plummeted. I rarely am interested in intercourse.

I’ve researched, read, and tried a million different things for my health. I’ve considered thyroid issues, lyme disease/tickborne illnesses, autoimmune issues, leaky gut/crohn's disease/other GI disorders.

I’ve made dietary changes, tried tons of different supplements, with no real long term improvement.

I’ve seen a number of doctors and specialists in the last 2.5 years to no avail. Most labwork is good and offers no explanation. Testosterone keeps coming into question, which led me here.

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I’ve had blood work taken and the full labs are attached to this post

Some Quick results:
Free Testosterone has ranged from 9.3 to 11.5 ------- UNITS: pg/mL ----- Reference Range: (9.3-26.5)
Total Testosterone has ranged from 291 to 520 with most in low 400s ------- UNITS: ng/dL ------ Reference Range: (348-1197)
Pregnenolone: 60 ------- UNITS: ng/dL ------ Reference Range: (<151)
DHEA-S: 350-375 ------- UNITS: ug/dL ------ Reference Range: (164-531)
Vitamin D, 25-Hydroxy: 30-35 ------- UNITS: ng/ML ------ Reference Range: (30-100)
LH: 3.1 ------- UNITS: mIU/mL ------ Reference Range: (1.7-8.6)
FSH: 1.9 ------- UNITS: mIU/mL ------ Reference Range: (1.5-12.4)

I currently see a doctor who is pretty open minded. He will order lab tests and is open to treating with my input. He just prescribed topical generic testosterone gel. I haven’t picked that up because it’s in limbo with my insurance. Since seeing him though, I’ve been reading the forums a lot and I’m not sure that’s the best route.

My main questions:

1) Do you think TRT is appropriate right now in my life? I know the dangers and I really don’t like the idea of starting at 25. However, I’d do it in a heartbeat for the rest of my life if I could see an improvement in quality of life.

2) Doctor prescribed TRT cream. I’ve read very mixed opinions on this. Would it be better to go ahead and request Test Cyp now before starting the cream? I think would do injection 2x per week subcutaneously.

3) Doctor is open to HCG as well, but didn’t prescribe yet and didn’t seem too urgent about it. Do you think I should go back to him and request TRT with HCG right away?

4) Should I request any more labs that might offer insight into my poor health? I’m primarily concerned about ruling out all other possibilities before TRT. Any suggestions?

Thank you all very much for any help.

[BallSak]

You are definitely in need of some hormonal balance... A restart could be worth a try, but your thyroid probably needs help as well. Didn't see any free T3 numbers though. Fixing your thyroid makes a huge difference in how you feel if you are hypo and will positively affect your testosterone ...but your testosterone does have a long way to go.

What does your doctor suspect the root cause is? Have you had any head injuries?

[TripleC]

You are definitely in need of some hormonal balance... A restart could be worth a try, but your thyroid probably needs help as well. Didn't see any free T3 numbers though. Fixing your thyroid makes a huge difference in how you feel if you are hypo and will positively affect your testosterone ...but your testosterone does have a long way to go.

What does your doctor suspect the root cause is? Have you had any head injuries?

No free T3 labs, just free T4 which was middle of the scale.

Doctor has no idea. I've had probably 2-3 concussions from sports in middle/high school.

Any ideas?

[kelkel]

Agree ^^. Work on your thyroid first. Hypothyroid causes hypogonadism. A more modern range for TSH is .3 - 3.0 by the way. Do some research at Stop the Thyroid Madnessâ„¢ - Hypothyroidism and thyroid mistreatment.
Also know that elevated cortisol will also suppress testosterone ..

[TripleC]

Agree ^^. Work on your thyroid first. Hypothyroid causes hypogonadism. A more modern range for TSH is .3 - 3.0 by the way.
Also know that elevated cortisol will also suppress testosterone..

My most recent TSH reading from 9 months ago was 2.96. Too high?

I've read that site extensively. Have bottle of Lugol's iodine and previously bought dessicated T3 to try but didn't notice much. That was a while back though and I wasn't diligent with dosing.

[kelkel]

Look at where your 2.96 falls on the more modern scale I posted. You need to examine your other thyroid values to make a determination. My TSH runs high as well but all my other numbers fall mid range. My point is to try and fix everything else before jumping on TRT, especially at your age.

If you do start something, consider clomid. Discuss this with your doctor and do some research:

http://www.ncbi.nlm.nih.gov/pubmed/22044663