21 Yrs Old, Low T for Years, Opinions?

Pharma / TRT Testosterone Replacement
1

21 years old, 190 cm, 90 kg (6’2’', 210 lbs)
dark hair on legs arms and abs, no chest or back hair, facial hair thin, bright, slow growing.
Started growing fast in puberty, didn’t grow anything since 17.
Bf always around 15%, grew steadily, good physique.
Fat mostly around abs and legs. No testicular pain.
Always done sports and ate well.

Starting to be lethargic in puberty, always sleepy, loss of libido and morning wood over time, anxious, never severe depression or anything like that, always sicky but no severe illnesses, no skin problems.
No drugs, no steroids, no chemicals, no cigarettes. Drinking few times a month now, collage…
As I said i always ate well but previous 12 months I’ve been really careful. I ate around 3500 kcal,everyday beef,chicken,lots of vegetables and fruits,eggs,nuts,oats,whey, lately no wheat at all. Training boxing or weights 3x a week last few years. Don’t wont to go into detail here since I’ve done my homework over years.

GP sent me to do tests and urologist said everything was ok:
2012

8:00
Total T 12.6 nmol/L 10-28
DHEAs 8.5 3-11
TSH 0,949 0,470-4,640
ACTH 28,9 7,2-63,3

17:00
ACTH 14 7,2 - 63,3

I’ve done some research following year and went to psychologist who prescribed me Wellbutrin xl 300 mg(dopamine reuptake inhibitor)I also requested new tests one month later, after which endo said everything was ok:
2013/10
13:00
LH 4.7 lU/L 1-8
FSH 1.7 lU/L 2-10 !
Prolactin 8.8 ug/L 4-18
Total T 13.6 nmol/L 10-28
Free T 509.0 pmol/L 174-729
Free T% 3.7% 1.0-2.7 !
SHBG 17 nmol/L 15-100
Cortisol 405 nmol/L AM 138-690, PM 55-248

It wasn’t good enough for me so I’ve payed for some more:
2014/1
8:00
E2 35.0 ng/L 0-47
TSH 1.02 mlU/L 0,34 - 5,60
T3 1.64 nmol/L 1,34-2,73
T4 87.77 nmol/L 78,38- 157.4
fT3 5.99 pmol/L 3.84 - 5.99
fT4 10.57 pmol/L 7.85 - 14.42
TgAt 0,2 IU/mL < 4 IU/mL
TPOAt 3,4 IU/mL < 9 IU/mL
PSA 0.60 ug/L 0.00 - 4.00
folic acid 42.1 nmol/L 10,4 - 42,4
Vitamin B12 816 H ng/L 191 - 663
Vit D 25-OH 62,6 >50
ECLIA mehod used

2014/6
10:00
Total T 5,85 nmol/L 6-28 !!!
SHGB 29,1 14,5 - 48,4
Insulin 43,8 17,8 - 173
B-HCG 0,4 <0,5-2,67
Total protein 67 66-81
Albumin 53,1 40-52
Ferritin 113,8 24 - 337
IgG 10 7-16
C3 0,9 0,9 - 1,8
C4 0,2 0,1 - 0,4
CEA 2,68 0-3
AFP 1,36 0-9
Progesterone 0,68 0,32 - 2,67
Cortisol 525,6 AM 171-536
androstendione 5,78 nmol/L 2.1 - 10.8
ECLIA method used

16:00
Cortisol 349 PM 82,8 â?? 441,6

Test were done in June. I stopped wellbutrin in April

I’ve done CBC, complete urine, all vitamins, minerals, liver enzymes, CRP, triglycerides, homocysteine, CBC…everything I found relevant and everything was pretty good. Only thing I remember few years back that was a bit high but in reference range was uric acid but I had no problems regarding that.

I want to detect cause of my condition so I can treat it. I don’t want to use any drugs or anything without knowing what is going on. On last test I was sure my total T is going to be higher that previous ones because I feel really good but now I am a bit scared.

Opinions please and what to do and look for next.

2

Thyroid seems mostly OK. Check your body temps as per the thyroid basics sticky. If low, suspect elevated rT3.

Your T levels are not horrible. Lower E2 would probably feel better. You are estrogen dominant. I suggest 0.5mg Arimidex/anastrozole per week in divided doses. See the stickies. That is a Rx drug and prospects of getting a Rx for that are poor.

What have your stress levels been like over these years? Accidents? Illnesses? Surgeries? Infections?

I think that your problem is really not low T. It is easy to get T tunnel vision.

Get cholesterol tested. We do see some young guys will very low cholesterol which can undermine your hormone and health. 180 is ideal. 160 and lower is associated with increased all-cause mortality. Sometimes a diet is too clean. Do you get EFA’s in your diet?

3

Thank you for fast reply, your posts are very informative,

I’ve done that thyroid test months ago and also few day ago, body temp seems to be in the range, it is not low.

My testosterone was around 370 ng/dl on first two tests.
On last one it is 170 ng/dl, calculated FT 3.14 ng/dL. It looks pretty horrible to me and I really hope it is coincidence.

Last few years were pretty good for me. Nothing serious,influenza here and there.

I’m not sure I did tests for cholesterol but I eat lots of fats. Red meat, eggs, nuts, fish oils. Fats are about 30% of my diet.

In month or two I will do Test, E2 and cholesterol. Anything else?
If my E2 is high again I will consider AI.

Is everything ok with my FSH? Can I be sure it’s not secondary?

4

Are fT3, fT4 typos?

Hematocrit?

Before thyroid labs, did Doc palpate your thyroid?

I do get after AI then next labs can be a course correction instead of a dead start.

5

No, they are free T3 and free T4 (Triiodothyronine, Thyroxine), results as listed.

Hematocrit 0.481 L/L 0.415-0.530

They didn’t look at my thyroid. When they looked at tests they said everything is fine.

Looking trough my medical history I found I had an infection(suspected meningitis) about 5 years ago which left me with thrombocytopenia to this day, Doc said people live with it without problems. Abdomen ultrasound showed slightly enlarged spleen. Since my problems started even earlier I wouldn’t contribute it to my present condition.