Help, Problems at 25

Pharma / TRT Testosterone Replacement
1

Severe gynecomastia → since age 12

Age 18 → lost about 50 pounds, gynecomastia still present and also suddenly lost about 50% of pubic hair

Freaking out I went to an endocrinologist who ran every thing there is to run including a PCR (normal XY), full hormone panel- all returned normal and I was discharged. She basically dismissed everything I said.

7 years later, nothing has changed and I decided to repeat labs on my own. I got the following results:

    LH 2.76 (0.57-12.07 mIU/ml)
    FSH: 1.19 (1.37-13.588 mIU/ml)
    Estradiol: 34 (11-44 pg/ml)
    Progesterone: 0.3 (<0.1-0.2 ng/ml)
    Testosterone, Total: 5.29 (1.56-8.77 ng/ml)
    Testosterone, Free: 14.74 (8.80-27.00 pg/ml)

I have many, many other symptoms of low T.

How can I have CLEAR hypogonadism and yet normal testosterone?

Can I do anything to lower progesterone since that may be the cause of the problem?

Suggestions? By the way, still awaiting new Prolactin and Cortisol.

2

You have progesterone and prolactin confused. I note that you are getting that tested.

LH is volatile, FSH is the better indicator of your LH status that LH itself.

FT is good, but it is also moves around a lot and you might have hit a peak.

Any thyroid labs? thyroid basics sticky

Check cholesterol to see if too low. 180 is ideal.

Need more info about you. - see advice for new guys sticky.

I suspect that lowish T is a symptom, not a cause. You need to find out what is wrong with your metabolism. Your T levels do not explain anything.

Describe symptoms.

You are very estrogen dominant. If you get E2 down to lower 20’s, you will feel better and T should then increase. See the stickies. 0.5 mg anastrozole per week in divided doses would be good to try. Hard to get an Rx, but with history of gyno, might happen.

Can you post those old labs? We can find things in labs that docs often overlook.

4

Please try to find those lab results.

In general: You need to test prolactin. If elevated, you may have a prolactin secreting pituitary adinoma which can be imaged with a MRI. If you are loosing peripheral vision, should be near 180 degrees, the adinoma would be large enough to press on your optic nerves. Typically treated with oral 0.5mg cabergoline/Dostex per week. Elevated prolactin decreases dopamine which can lead to mood/depression issues beyond the secondary effects on T.

High E2 can be from liver problems. Are ALT/AST elevated?

Are you exposed to tropical diseases there?

You are very estrogen dominant. Can you get Rx for 0.5mg/week anastrozole in divided doses?

You read that sticky?

  • blows to the head when young?

Any thyroid labs?
READ THE thyroid basics sticky

  • check body temps as directed
  • have you always been using iodized salt?
6

Give me the 8%#2 data!

Thyroid function tests, liver function tests measured two months ago were all within normal reference ranges

Thyroid reference ranges are a joke and a source of on-going misery and suffering.