TRT needed?

Hi there,

Wanted to get some opinions. I'm 25 years old about 5'6" and 180lb (down from 198lbs about 7 months ago). Low energy, libido pretty much non existent at this point, find motivation hard to come by and generally feel fatigued all the time. Also have brain fog and irritbility, though they come and go a bit.

Been to an Endo for the thyroid antibodies and other then antibodies she told me everything else was "normal" despite the symptoms. Have not sent her my latest testosterone results yet.

I've had labs done would be interest in what you all think. Labs were always done around 7-8AM

Free testosterone Range: 35.0-155.0 pg/ml
80.3 Nov 2016
78.5 May 2017

Total testosterone Range: 250-1100 ng/dl
346 Nov 2016
323 May 2017

SHB Range: 10-50 nmol/L
17 Nov 2016
17 May 2017

PROLACTIN 2.1 - 17.7 ng/mL
7.5 ng/mL January 2017

TSH Range: 0.40-4.5
1.59 Feb 2017
1.22 May 2017

Free t3 Range: 2.3-4.2
3.3 Feb 2017
3.4 May 2017

Free T4 Range: 0.8-1.8
1.2 Feb 2017
1.2 May 2017

Thyroglobulin antibodies Range: < OR = 1
83 Feb 2017

TPO antibodies Range: <9
2 Feb 2017

TSI Range: <140
<89 Feb 2017


Vitamin D was low as well, been taking 5000iu daily to supplement since the beginning of the year. I've been going back and forth on whether I should pursue getting TRT. If I do want to should I find a different Endo or get into a urologist?

Thanks in advance!

Quote:

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Originally Posted by Scooky

Hi there,

Wanted to get some opinions. I'm 25 years old about 5'6" and 180lb (down from 198lbs about 7 months ago). Low energy, libido pretty much non existent at this point, find motivation hard to come by and generally feel fatigued all the time. Also have brain fog and irritbility, though they come and go a bit.

Been to an Endo for the thyroid antibodies and other then antibodies she told me everything else was "normal" despite the symptoms. Have not sent her my latest testosterone results yet.

I've had labs done would be interest in what you all think. Labs were always done around 7-8AM

Free testosterone Range: 35.0-155.0 pg/ml
80.3 Nov 2016
78.5 May 2017

Total testosterone Range: 250-1100 ng/dl
346 Nov 2016
323 May 2017

SHB Range: 10-50 nmol/L
17 Nov 2016
17 May 2017

PROLACTIN 2.1 - 17.7 ng/mL
7.5 ng/mL January 2017

TSH Range: 0.40-4.5
1.59 Feb 2017
1.22 May 2017

Free t3 Range: 2.3-4.2
3.3 Feb 2017
3.4 May 2017

Free T4 Range: 0.8-1.8
1.2 Feb 2017
1.2 May 2017

Thyroglobulin antibodies Range: < OR = 1
83 Feb 2017

TPO antibodies Range: <9
2 Feb 2017

TSI Range: <140
<89 Feb 2017


Vitamin D was low as well, been taking 5000iu daily to supplement since the beginning of the year. I've been going back and forth on whether I should pursue getting TRT. If I do want to should I find a different Endo or get into a urologist?

Thanks in advance!

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Looks to me like you are on the low end for test, I think the lowest "normal" level is 350 but at your age it should be higher.

It sounds like you'd be a candidate for TRT but given your age I would maybe try other options first, once you start TRT you will be doing it for the rest of your life.

One thing I would try to tell your doctor; "treat the patient, not the numbers", if he or she is half way decent they will get it

Best of luck

Quote:

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Originally Posted by Sh0tsf1red

Looks to me like you are on the low end for test, I think the lowest "normal" level is 350 but at your age it should be higher.

It sounds like you'd be a candidate for TRT but given your age I would maybe try other options first, once you start TRT you will be doing it for the rest of your life.

One thing I would try to tell your doctor; "treat the patient, not the numbers", if he or she is half way decent they will get it

Best of luck

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Thanks for the reply!
I was thinking about asking to try clomid before going into injections and the sort. From what I've been reading some have success with that alone.

Other than low total T your labs look fine. At least free T is not bottomed out so there's one positive thing. Would have been nice to see LH/FSH for pituitary function as well as cortisol. Other than that, you've covered all the bases regarding BW.

Have you suffered any head or testicular trauma in the past?

Quote:

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Originally Posted by kelkel

Other than low total T your labs look fine. At least free T is not bottomed out so there's one positive thing. Would have been nice to see LH/FSH for pituitary function as well as cortisol. Other than that, you've covered all the bases regarding BW.

Have you suffered any head or testicular trauma in the past?

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Never suffered any traumas. I've never had LH or FSH tested. Cortisol I have had done, 2 saliva tests. One ame back a bit higher then normal so the endo had me do a dexamethasone suppression test, cortisol came back normal for that. Can get values if you'd like them.

Edit*
Are there any other tests I should have done? I can order the LH and FSH tests myself and get them done tomorrow.

Well, I'd want the LH/FSH as they determine pituitary function which is where it all starts when it comes to T production. Established baselines is what you'll use to chart your course forward.

I assume your hormone tests are first thing in the morning?

Alright, I'll have them done. Thanks!

Yea, I've always gotten them done between 7-8AM.

You're young so exhaust all avenues before you embark on a TRT protocol. Seldom is low T idiopathic at your age, there's usually a reason.

Got the FSH and LH results back, they look normal

FSH Range: 1.6-8.0
3.2 May 2017

LH Range: 1.5-9.3
2.3 May 2017

Should note I had these drawn a little later then I normally do. It was just after 10AM this time.

Yes, in range but LH still lower end resulting in lower overall T levels. Time doesn't matter for these tests.
You're in a tough spot scooky. You need to make decisions based on how you feel, not a number on a chart. Take a minute and google the "Adam Questionnaire" and see how you do.

You're young and if everything is ruled out (cause wise) and it appears to be idiopathic you may consider clomid therapy first. It's a form of TRT that stimulates the pituitary to produce more LH/FSH which in turn results in more T being produced downstream. Fertility wise it may be a wise choice for you if that is a concern. Do some research on it. Look up Dr. Jeffrey Dach, read some of his writings on it.

I'd rather try the clomid route first I think. Fertility is a concern. Don't want kids now but may later on. According to that quiz there's a good chance I have low T.

Getting into a doctor would be my next step then. Just not sure if I should try my endocrinologist again or go through my primary and see what he says, maybe get a referral to a urologist?

I'll look up that Dr now as well. Thanks for the resources and taking the time to reply!

Edit*
Just realized, I was actually reading his writing on clomid treatment for low T just the other day. Lol

I'd easily opt for a Uro over Endo anyday. But in reality any doc who knows hormones and has taken an interest is all you really need.