21 yr old w/224 total test, 7.4 free test, and all the symptoms that go along with it

[tdp32]

Hey everyone, first post here.

I will be 21 in July, and just recently went to an endocrinologist about some symptoms of low testosterone.

My lab results were as follows:
Testosterone total serum: 224 lo (240-836 ref range)
Testosterone free serum: 7.40 lo (8.8-27.00 ref range)
Estradiol: 18.20 normal
Prolactin: 12.2 normal
LH 3.0 normal
FSH 2.6 normal
SHBG 11 normal

I have never used any AAS. I have extremely unreliable erections, no morning wood, terrible mood, i have a receding hairline, always feel fatigued and have no stamina in the gym or otherwise and I have a real hard time improving strength and muscle mass and an even harder time keeping it (just a week or 2 off from the gym for any reason and there are drastic drops)

These symptoms have been present and getting worse over the last 3 years. In the past two years I have also gained a lot of fat in my ass, lower chest (slight gyno but mostly fat) and torso (no pot belly, but lovehandles).

I am college football player, so i'm basically forced to eat right and exercise, but the fat remains and continues to add on regardless of what I do, and so does my lack of strength, energy and overall motivation. Although I complete every set of my workout sessions, from the first rep to the last it all feels like a chore when I used to love it.

My endo prescribed me axiron, its a new transdermal that goes in your armpit. He started me at 30 mg a day (half the recommended starting dose), which I did for a few days. I noticed that about a 2hrs after applying, i would get hot flashes, get really depressed and moody, and my libido and erections were far worse than before.

Doc switched me to androgel, at an even lower dose, and said I still don't need any anti aromatase or anything of the sort. (Haven't started it yet, but kind of reluctant to)

I am seeing a new doctor next tuesday for a second opinion (I had other unrelated issues with this doctor) He lists one of his specialties as anti-aging and maybe he can offer me some better treatment.

Does anyone have any advice or recommendations on what the best TRT method for me would be? And also, any ideas, opinions or theories as to what might have caused this? Like I said this has been happening over the past 3 years or so.

I want to restore my test to normal ranges, but not those bull reference ranges they provide. I get the impression from my endo that as soon as I was in normal ranges he would stop regardless of how my symptoms were.

Sorry for the long post, and all replies are appreciated. need any more info just let me know.

[zaggahamma]

sorry to hear about your symptoms bro....too young o man for that...

very surprised your doctor didnt do thyroid test(s)....even did that before i started on trt at age 37..

as getting a second opinion is valid...you didnt even follow orders /instructions from the first....imo, you should have tried the androgel and at least had a couple of attempts to be able to look at...androgel is a common med that many of us here have started with..

this is all i can add right now but will bump for more opinions and be subscribed..

wish u the best bro....keep workin hard...you will beat this, you took the first step when you spoke to a doctor

[Bigfoot66]

He was wrong to tell you that once you were leveled he'd stop treatment. Once you start TRT your own T production slows or stops altogether.

I started with Testim and after a year my levels wouldn't go past 150 using two tubes daily. I am now on IM at 200 mg a wk with an AI EOD.

I agree with thyroid testing being needed...also your SHBG is kind of low which could suggest insulin sensitivity, which does affect mood etc. Mine fluctuates between 10 and 17.

This group of guys helped me a lot just by their posts and suggestions. Finally took plunge and joined and posted. Stay with this site and ask everything you want bc u will probably get more from here than your MD.

Hey everyone, first post here.

I will be 21 in July, and just recently went to an endocrinologist about some symptoms of low testosterone.

My lab results were as follows:
Testosterone total serum: 224 lo (240-836 ref range)
Testosterone free serum: 7.40 lo (8.8-27.00 ref range)
Estradiol: 18.20 normal
Prolactin: 12.2 normal
LH 3.0 normal
FSH 2.6 normal
SHBG 11 normal

I have never used any AAS. I have extremely unreliable erections, no morning wood, terrible mood, i have a receding hairline, always feel fatigued and have no stamina in the gym or otherwise and I have a real hard time improving strength and muscle mass and an even harder time keeping it (just a week or 2 off from the gym for any reason and there are drastic drops)

These symptoms have been present and getting worse over the last 3 years. In the past two years I have also gained a lot of fat in my ass, lower chest (slight gyno but mostly fat) and torso (no pot belly, but lovehandles).

I am college football player, so i'm basically forced to eat right and exercise, but the fat remains and continues to add on regardless of what I do, and so does my lack of strength, energy and overall motivation. Although I complete every set of my workout sessions, from the first rep to the last it all feels like a chore when I used to love it.

My endo prescribed me axiron, its a new transdermal that goes in your armpit. He started me at 30 mg a day (half the recommended starting dose), which I did for a few days. I noticed that about a 2hrs after applying, i would get hot flashes, get really depressed and moody, and my libido and erections were far worse than before.

Doc switched me to androgel, at an even lower dose, and said I still don't need any anti aromatase or anything of the sort. (Haven't started it yet, but kind of reluctant to)

I am seeing a new doctor next tuesday for a second opinion (I had other unrelated issues with this doctor) He lists one of his specialties as anti-aging and maybe he can offer me some better treatment.

Does anyone have any advice or recommendations on what the best TRT method for me would be? And also, any ideas, opinions or theories as to what might have caused this? Like I said this has been happening over the past 3 years or so.

I want to restore my test to normal ranges, but not those bull reference ranges they provide. I get the impression from my endo that as soon as I was in normal ranges he would stop regardless of how my symptoms were.

Sorry for the long post, and all replies are appreciated. need any more info just let me know.

[tdp32]

Thanks for the reply,

My doc ran thryoid tests too and they all were within range. I can post them too if anyone thinks it would help

I plan on trying the androgel, I am just waiting for my script to come in at my pharmacy lol.

And thanks for the advice man. I'm not at all excited about TRT, but I don't see any other options at this point. I just hope by some miracle I can restore it and not have to be on it forever.

[zaggahamma]

He was wrong to tell you that once you were leveled he'd stop treatment. Once you start TRT your own T production slows or stops altogether.

I started with Testim and after a year my levels wouldn't go past 150 using two tubes daily. I am now on IM at 200 mg a wk with an AI EOD.

I agree with thyroid testing being needed...also your SHBG is kind of low which could suggest insulin sensitivity, which does affect mood etc. Mine fluctuates between 10 and 17.

This group of guys helped me a lot just by their posts and suggestions. Finally took plunge and joined and posted. Stay with this site and ask everything you want bc u will probably get more from here than your MD.

shbg and insulin sensitivity.....INTERESTING.....thanks for posting that...what is the way to correct this...with insulin or diet??

[Bigfoot66]

My PCP told me...and sure enough he had me take that blood test that measures sugar levels over 90 days...My level was 5.8 and 6.0 is considered diabetic. TRT not cause but explained low SHBG. According to Web one way to bring SHBG up is to split T dosages, which we did.

BTW JPK I looked at your stats and except for about 10 lbs we are at the same place sizewise. Interesting bc we seem to have similar T protocol...

shbg and insulin sensitivity.....INTERESTING.....thanks for posting that...what is the way to correct this...with insulin or diet??

[zaggahamma]

My PCP told me...and sure enough he had me take that blood test that measures sugar levels over 90 days...My level was 5.8 and 6.0 is considered diabetic. TRT not cause but explained low SHBG. According to Web one way to bring SHBG up is to split T dosages, which we did.

BTW JPK I looked at your stats and except for about 10 lbs we are at the same place sizewise. Interesting bc we seem to have similar T protocol...

yeh..well i wanna cut down 15lbs (3 or 4%bf) and keep it right there

[tdp32]

My doc never said once I got in normal range he would stop, thats just the impression I get from him. He was very hesitant to accept the fact that a 20 year old could have such levels. He made me get three separate blood tests before he finally believed it. That and the fact that he put me on the tiny doses.

The insulin sensitivity thing is something I was thinking about too. I did not fast before the test, I actually ate quite a bit. My triglycerides were pretty high, but the day before I had a terrible cheat day. But oddly, my glucose was at the base line low (70 out 70-99)

Also, the past three blood test I have taken have came back with abnormal MCV, MCH, AND RBC, with one test out of the three also having abnormal RBW AND MCVH. My iron and TIBC have all come back normal, so I guess there not considering iron deficiency anemia. I am still going to bring it up to my doctor though because they never asked me about any of it's symptoms, only if any one in my family had it. I have most of the symptoms of iron deficiency anemia, but never considered because my doctors brushed it off and chalked it up to african americans having abnormalities in those panels.

Any thoughts on correlation between these things?

I really appreciate all the helpful responses. Most of the time guys who answer on forums are dicks, but you guys are real helpful.

[zaggahamma]

My doc never said once I got in normal range he would stop, thats just the impression I get from him. He was very hesitant to accept the fact that a 20 year old could have such levels. He made me get three separate blood tests before he finally believed it. That and the fact that he put me on the tiny doses.

The insulin sensitivity thing is something I was thinking about too. I did not fast before the test, I actually ate quite a bit. My triglycerides were pretty high, but the day before I had a terrible cheat day. But oddly, my glucose was at the base line low (70 out 70-99)

Also, the past three blood test I have taken have came back with abnormal MCV, MCH, AND RBC, with one test out of the three also having abnormal RBW AND MCVH. My iron and TIBC have all come back normal, so I guess there not considering iron deficiency anemia. I am still going to bring it up to my doctor though because they never asked me about any of it's symptoms, only if any one in my family had it. I have most of the symptoms of iron deficiency anemia, but never considered because my doctors brushed it off and chalked it up to african americans having abnormalities in those panels.

Any thoughts on correlation between these things?

I really appreciate all the helpful responses. Most of the time guys who answer on forums are dicks, but you guys are real helpful.

my main thought is you have a doctor that sounds like he actually gives a shit and be lucky for that for one....

did u say u were going to post your thyroid numbers....

[Noles12]

my main thought is you have a doctor that sounds like he actually gives a shit and be lucky for that for one....

did u say u were going to post your thyroid numbers....

Exactly. I know of many docs who will just say you will be fine and your levels are close enough. Also others that will just put a 20 year old on 300mg of test a week. So far yours sounds a lot better than both of those.

[bass]

my main thought is you have a doctor that sounds like he actually gives a shit and be lucky for that for one....

did u say u were going to post your thyroid numbers....

i agree with JP as well. i hope you sort it our bro, that is young to have these levels! but don't worry see what this doc can do for you and if things don't get you where you need to then come back here for further instructions!

[sirupate]

I am sorry you are going through this at such a young age. How the heck are you managing to play college football given where you are at??? College football is tough stuff even at the DIII level. Hang in there. It make take some persistance on your part (and maybe several doctors) to get some answers and solutions. And, I don't think that half-normal doses of Axiron or Androgel are the answer....just guessing your doctor finds it hard to believe someone your age can be going through this, therefore prescribe conservatively. Keep us posted.

[tdp32]

Thanks everyone for the responses and advice

Here are my Thyroid levels, all of which came back normal:

T3H: 2.590 (0.700-5.700)
T3 Uptake percentage: 37.8 (24.3-39.0)
Thyroxine, Free (T4): 1.25 (0.80-27.00)
PSA 3rd Gen: 0.35 (<4.00)

In response to sirupate, that is another reason why the endo was skeptical about my test levels. Although I have these low levels, you would never be able to tell by looking at me. I'm 6'3 250lbs at about 15-18% BF. And although I am having trouble making and keeping gains, my numbers in the weight room and overall build definitely would not suggest someone who is having problems with testosterone.

Only reason I recognized a problem is because I have been this way since I was 16. I haven't surpassed any maxes on any exercises since my senior year of high school. Even though I had some great numbers, I have put in years of dedicated training and dieting only to barely put up those same numbers.

I play DII ball, and it feels like im playing with pros. I still start, but I know i'm not where I should be.

My androgel script should be coming in this morning at the pharmacy. I'll be satisfied if I don't get a reaction from it like I did Axiron. That stuff made everything 10x worse.

I'll keep you guys posted, and please keep the responses and advice coming, its helpin a lot!

[zaggahamma]

Thanks everyone for the responses and advice

Here are my Thyroid levels, all of which came back normal:

T3H: 2.590 (0.700-5.700)
T3 Uptake percentage: 37.8 (24.3-39.0)
Thyroxine, Free (T4): 1.25 (0.80-27.00)
PSA 3rd Gen: 0.35 (<4.00)

In response to sirupate, that is another reason why the endo was skeptical about my test levels. Although I have these low levels, you would never be able to tell by looking at me. I'm 6'3 250lbs at about 15-18% BF. And although I am having trouble making and keeping gains, my numbers in the weight room and overall build definitely would not suggest someone who is having problems with testosterone.

Only reason I recognized a problem is because I have been this way since I was 16. I haven't surpassed any maxes on any exercises since my senior year of high school. Even though I had some great numbers, I have put in years of dedicated training and dieting only to barely put up those same numbers.

I play DII ball, and it feels like im playing with pros. I still start, but I know i'm not where I should be.

My androgel script should be coming in this morning at the pharmacy. I'll be satisfied if I don't get a reaction from it like I did Axiron. That stuff made everything 10x worse.

I'll keep you guys posted, and please keep the responses and advice coming, its helpin a lot!

this(you) very well could represent someone that has just never had high test and although you appear healthy at those stats....your hard work MAY have yeilded and even moreso athetic body/performance

just my .02

[tdp32]

Yea I hear you. When I said this way though I only meant size and lifting wise. All the symptoms really began about half way through my freshman year in college (18 and change). Thats when everything started declining and for the life of me I can't figure out why.

[zaggahamma]

Yea I hear you. When I said this way though I only meant size and lifting wise. All the symptoms really began about half way through my freshman year in college (18 and change). Thats when everything started declining and for the life of me I can't figure out why.

well bro i hope this doctor continues to work with you and you continue to turn it around and bust some ass

keep us posted

[tdp32]

Just picked up my androgel script today.

My original doc (the endo) prescribed me androgel 1% at 1 pump per day (1.25mg androgel per day)

I'm gonna start it today and will get back to you guys in a week or sooner if I have a similar reaction that I did on axiron.

[lifter65]

hope you have luck with that, im just worried that only 1 pump may not be enough

[tdp32]

yea i dont know if it will be either. I think he's tryin to avoid the reaction I with axiron.

Is it possible that some people don't handle transdermals well? It's only been a few hours since I applied and I'm gettin hot flashes again, no mood or libido change like with axiron though.

[lifter65]

i would give it a week or two

[zaggahamma]

never heard of a ridiculously low dose....i believe the minimum 5mg usual daily dose yields half of the average healthy male and he is telling you to do ONE FIFTH OF WHAT WOULD YIELD HALF OF A HEALTHY LEVEL....not sure wut he's thinking here

[tdp32]

yea i think its a little pointless too. Thats what i mean by his skepticism. Im going for my second opinion on tuesday. Depending on what he says I'll adjust my dose or go with what he suggests.

I'm all for being careful and not rushing these things, but this doc is pushin it a little. I've been dealin with this shit for a while now and want to at least take steps in the right direction. As it is I had to wait two weeks for him to get back to me, and then 5 days for him to even call this new androgel script in for me.

[tdp32]

Been a week so far. I only went 3 days with the 1 pump dose. I had my second opinion appointment on tuesday where I was hoping to get switched to injections. Doc just told me to up to the normal dose of 5mg a day.

Not noticing anything, although I didn't expect to. I definitely don't like the gels though. Too many restrictions on when to take it, when I can shower, when I can workout, and when I have to worry about contact with others.

My next appointment isn't until July 19th, so I am going to follow his instructions until then, but regardless I want to switch to injections. Every appt I have I go in there with the goal of getting switched to injections, but I always back off and don't outright ask for them. Besides manning up about it, any one have any other suggestions on how to get switched to injections rather than an increase of androgel?

[lifter65]

tdp!! look your 21, your gonna hate being on injections realizing its for your whole life, thats maybe 60-70 years of injecting, again your 21 and trt is last resort, you need to go see dr crisler asap man im tellin you, i just went and im 19 and he WILL get me fixed up, theres other options beside trt at our young age, please take my advice you will be glad you did

[zaggahamma]

no doubt crisler is the man but everyone cant go to him...imo...

op, yes i hear you....i'm trying to remember how i made the segue into asking for injections(which was always my desire as well)...heres an idea...

JUST DO IT

[lifter65]

jpkman... yeah haha that has been my advice to everybody since i saw him lol

[zaggahamma]

jpkman... yeah haha that has been my advice to everybody since i saw him lol

yes i saw several....r u gettin commission?

[lifter65]

yes i saw several....r u gettin commission?

haha no lol, im just giving the best advice i can, which i honestly believe is go see him, itll save people from the bullshit of doc shoppin and bad protocols

[tdp32]

I'd love to see Dr Crisler, but I live in NY and rely on insurance to pay for all my treatments. My moms a nurse with Oxford, so my insurance is pretty good, no referrals, 10 dollar copay, and I never pay for any prescriptions, even brand name.

Does anyone have experience with reimbursement from insurance after seeing Dr Crisler?, cause his prices are a little outrageous.

And jpkman, I'm definitely sackin up and askin my doctor for injections. My only issue is that I won't be around here to see him for much longer. My next appoint isn't until July 19th, and I leave for football around August 5th or so.

I want to get through the the trial and error and dose adjustment phase before I leave, so do you think it would be a good idea to call up by doc before the appointment and ask to be switched? I have legitimate complaints about the gel, but idk if thats a good idea or not.

Ne thoughts?

[sirupate]

no doubt crisler is the man but everyone cant go to him...imo...

op, yes i hear you....i'm trying to remember how i made the segue into asking for injections(which was always my desire as well)...heres an idea...

JUST DO IT

I think I cited the cost of my Androgel scrip to the doctor and told him I thought injecting would be more cost effective. Now, my copays for the gel weren't too bad, but my employer was getting a heck of a bill for the remaining cost.

[lifter65]

tdp.. havent submitted it yet so dont know if it will be covered
you saying his prices are rificulous really isnt true, hes the best doc your gonna find and with him there is basically no chance of failure, if you really want to be fixed you will go see him, ive been down your road and its a dead end

[tdp32]

$465 for him to talk to me + transportation to michigan is a little ridiculous, no matter how good he is.

How long ago were you diagnosed n how many other doctors did you see? What were your test levels and what prescriptions have you tried before going to Crisler. And what has he done so far?

[lifter65]

ive been livin with it for 3 years, diagnosed beginning of the year, saw 6 different docs, got put on trt with just test, i had to battle for the test, doc didnt have a clue what to do, had me on 150 mg e3w, doc crisler is trying an hpta restart with me, saying pure test is last resort at my age, when im an old man my legs wouldve looked like sliced cheese

[lifter65]

ive been livin with it for 3 years, diagnosed beginning of the year, saw 6 different docs, got put on trt with just test, i had to battle for the test, doc didnt have a clue what to do, had me on 150 mg e3w, doc crisler is trying an hpta restart with me, saying pure test is last resort at my age, when im an old man my legs wouldve looked like sliced cheese

[tdp32]

Had my follow up appointment with my doctor a couple days ago. I upped the dosage on my own for about 2 weeks and then returned to the normal dose, and I had a test level in the 500 range for free and in the 15 range for serum levels.

My doc is satisfied with these numbers, even though it was only up from 224 and 7 respectively. I definitely shouldn't have upped the dosage on my own since my numbers might have reflected numbers from the higher dose.

Other problem, my doc isn't too into shots. He was extremely reluctant even though I gave him my legitimate issues with transdermals to him. He insisted that I try Testim instead, and I am now on one 5mg tube of testim per day. Although I still want injections, I am going to give Testim a full try without adjusting the dosage at all.

Should I start looking for another doctor, or do you think I might be able to change his mind about injections?

He's reasons for not wanting to try injections were that it was not as natural as transdermals. He mentioned the highs and lows in test levels as you inject and near the next injections as one of his biggest issues. He just kept saying it wasn't as natural.

Any ideas, suggestions, and opinions are welcomed and appreciated.

Thanks

[tdp32]

My symptoms have not improved btw. Most noticeably erection issues and fatigue/mood. Doctor is convinced it will take longer and is satisfied with my still somewhat low levels for a 21 year old.

I forgot to mention that he also put me on cytomel, 5mg twice a day. My numbers were within range, but "not optimal and not where he likes them to be".

If he understands the importance of optimal levels and not just normal levels, i assume he would have the same logic in my testosterone levels.

I can't remember what my thyroid levels were, but as soon as I get a hold of them I will post them.

Thanks again.

[bass]

yup big mistake you adjusted on your own! but stay on prescribed dose and when you do the next blood work it will show lower, then he may up your dose! but i doubt he'll put you on injections since he made it clear he is not in favor of it! perhaps its time to look for another doc!

[zaggahamma]

not much difference in testim and androgel.....

you saw zero improvement with your therapy so far?

[tdp32]

None man. Even when I increased the dosage on my own for those 2 weeks. Only thing I notice is a little change in the gym. I don't feel like quitting after a few sets anymore, but I still don't have the energy I need for the kind of workouts I have to do. Other than that, I feel the same as day one. But according to my doc, since my levels are within range (even though its still low) I am fine.

If I look for another doc, should I just flat out tell him I've tried transdermals and I want injections? If I see no improvement on the testim with my current doc I think I might have to give him an ultimatum lol.