Some background information:
Just turned 20 years old, sophomore in college, lifting for two years, 175 lb’s and 8% body-fat, very active, recruited for division 1 track and field (which I no longer do), been eating in a calorie surplus of ~250-500 cal/day - (high healthy fats, high lean protein, low carb), get 9-10+ hours of sleep/night, drink from bpa free containers, no drug use.
Over the past year or so, I’ve had many symptoms of low T, including: low libido, extreme lethargy/tiredness, lack of motivation, extreme anxiety, sad thoughts, higher pitched voice. For a 20 y/o at my activity level, I would think my T should be much higher - right now it’s the average for an 80 y/o. I’m very into bodybuilding and don’t want to live my young life with low T.
The first blood test where I got testosterone checked (early last year), it was in the medium to high 300’s (I don’t remember the exact number). This was back when I was a runner in college. I decided to take some time off from running and recheck my bloods (late last year) to see if it may have been due to over-training. I was on Accutane at the time which may have elevated my liver enzymes/cholesterol. Here are the results:
-
HDL Cholesterol: 46 (>45 mg/dL)
-
FSH: 4.3 (1.6-8.0 mIU/mL)
-
LH: 5.0 (1.5-9.5 miU/mL)
-
T3 Total: 103 (86-192 ng/dL)
-
T4, FREE: 1.2 (.8-1.4 ng/dL)
-
TSH: 1.96 (.5-4.3 miU/L)
-
ESTRADIOL: 30 (< OR = 39 pg/mL)
-
T3, FREE: 3.8 (3.0-4.7 pg/mL)
-
VITAMIN D3: 41 (30-100 ng/mL)
-
Testosterone, Bioavailable: 176.9 (110-575 ng/dL)
-
Sex Hormone Binding Globulin: 26 (10-50 nmol/L)
-
Albumin Serum: 4.3 (3.6-5.1 g/dL)
-
Testosterone Total: 533 (250-1100 ng/dL)
-
Testosterone, Free: 89.8 (46-224 pg/mL)
It’s now been the good part of a year since this last blood test. I decided to see an endocrinologist to see if they could do something for me, here are the results from that (been off Accutane for two weeks):
-
CHOLESTEROL, TOTAL: 165 (<170 mg/dL)
-
Out of Range - HDL CHOLESTEROL: 35 L (>45 mg/dL)
-
TRIGLYCERIDES: 77 (<90 mg/dL)
-
Out of Range - LDL-CHOLESTEROL: 113 H (<110 mg/dL (calc))
-
CHOL/HDLC RATIO: 4.7 (<5.0 (calc))
-
NON HDL CHOLESTEROL: 130 H (<120 mg/dL (calc))
-
COMPREHENSIVE METABOLIC PANEL
-
GLUCOSE: 87 (65-99 mg/dL)
-
Out of Range - UREA NITROGEN (BUN): 22 H (7-20 mg/dL)
-
CREATININE: 0.92 (0.60-1.26 mg/dL)
-
eGFR NON-AFR. AMERICAN: 120 (> OR = 60 mL/min/1.73m2)
-
eGFR AFRICAN AMERICAN: 139 (> OR = 60 mL/min/1.73m2)
-
Out of Range - BUN/CREATININE RATIO: 24 H (6-22 (calc))
-
SODIUM: 141 (135-146 mmol/L)
-
POTASSIUM: 4.2 (3.8-5.1 mmol/L)
-
CHLORIDE: 104 (98-110 mmol/L)
-
CARBON DIOXIDE: 25 (20-31 mmol/L)
-
CALCIUM: 9.2 (8.9-10.4 mg/dL)
-
PROTEIN, TOTAL: 6.6 (6.3-8.2 g/dL)
-
ALBUMIN: 4.1 (3.6-5.1 g/dL)
-
GLOBULIN: 2.5 (2.1-3.5 g/dL (calc))
-
ALBUMIN/GLOBULIN RATIO: 1.6 (1.0-2.5 (calc))
-
BILIRUBIN, TOTAL: 0.6 (0.2-1.1 mg/dL)
-
ALKALINE PHOSPHATASE: 174 (48-230 u/L)
-
Out of Range - AST: 64 H (12-32 u/L)
-
ALT: 32 (8-46 u/L)
-
Out of Range - ESTRADIOL: 56 H (< OR = 39 pg/mL)
-
IGF 1, LC/MS: 387 (108-548 ng/mL)
-
Z SCORE (MALE): 0.9 (-2.0 - +2.0 SD)
-
FSH: 2.4 (1.6-8.0 mIU/mL)
-
LH: 4.2 (1.5-9.3 mIU/mL)
-
PROLACTIN: 8.7 (2.0-18.0 ng/mL)
-
T4 (THYROXINE), TOTAL: 6.1 (4.5-12.0 mcg/dL)
-
TSH: 4.03 (0.50-4.30 mIU/L)
-
Testosterone, Total, LC/MS/MS: 385 (250-1100 ng/dL)
-
Free Testosterone: 68.9 (35-155 pg/mL)
My endocrinologist ordered a testicular ultrasound and a few bio-markers for tumors. Luckily, my adrenal bio-markers and cortisol came back in the normal range. I don’t have anything wrong with my testicles either. My estradiol also dropped down to normal range.
I’d like to add that I’m lifting intensely 6 days/week and have been doing so for the past 2 years. I’m very lean at 175 pounds and am very muscular - I know this isn’t typical for someone with my testosterone levels.
I’m wondering what you guys think of my blood results and what possible treatment options I have? The doctor wants me to stop all supplements before seeing me again for the next checkup in 7 weeks. He thinks my “BulkSupplements Creatine” is laced with pro-hormones (which it is not). He also does not think that my testosterone is causing my symptoms.
The way I see it is that I have two options;
Option 1: Start a 6 week cycle of LGD-4033 w/o PCT and go to follow-up to retest blood a week after stopping - encourage doctor to prescribe TRT
Option 2: Keep on training until follow up - as normal - and see what my T levels are and likely not get TRT
Option 1 scares me because I don’t want to suffer from no PCT and lose all my gains + I don’t know if TRT is safe enough at 20 years old and don’t want to die early/suffer heart problems.
Option 2 scares me because I don’t want to suffer with these low T symptoms, especially in my early years which are supposed to be optimal in terms of testosterone and good times.
I reckon with these levels, I probably will be on TRT at some point in my life, what are the negatives of starting at such a young age? Should I ditch the endo. and go with a cllnic such as defy? Which option seems like a better choice? What do you guys think? I would greatly appreciate advice from someone very experienced in this matter.
Thanks so much.