22 Y/O with Basically No Testosterone

Pharma / TRT Testosterone Replacement
1

Hello all,
Been lurking for a while, first time posting. Had the typical low T symptoms for a while, finally decided to get a blood test - privately, as I am working 8 hrs away from home for the next 12 months.
Results where:
Total Testosterone: 1.6nmol/L (8.3-29)
SHGB: 39nmol/L (11-71)
Free Testosterone: 25.7nmol/L (255.0-725.0)
FSH: 3IU/L (<7)
LH: 1.0IU/L (<7)
OEST2: <70pmol/L (<150)
AST: 68U/L (<35)
ALT: 87 (<40)

All blood counts were within range, except RCC, which was low at 4.2 (4.5-6.5)

Unfortunately couldn’t request Prolactin, TSH, fT3, ft4, DHEA.

Age:22
Years Training: 2.5
Get cold extremely easily.
No Iodised Salt
Outer eyebrows are not sparse, complete body hair, one of the hairiest people I know. Went through Puberty pretty young, started shaving face at 14. No Libido, struggle to get or maintain an erection, no morning wood, lack of motivation and self confidence, for around 3 years now.
Was very overwieght, 110KG at 5ft 10in and no training. Cut to 70KG over 1 year of restrictive dieting and lifting weights. Bulked to 78KG over 9 months, and mostly gained fat with little muscle or strength. Basically all fat is located in lower gut/lower back.

Went to see doctor about test results, and she wasn’t concerned, and said if I wanted would refer me to Endo, after monitoring for 6 months to see if it improves itself. I thought she might have had a sense of urgency, considering that I have basically no T being produced. Am going to see another doctor as soon as possible, but I wanted a bit of advice?

Any help would be appreciated. Located in a small rural town in Australia.

2

your ast alt are elevated. Those are liver enzymes. You would benefit to see more blood labs. Like Complete metabolic panel (CMP), a1c, CBC, and the thyroid as you indicated.

With LH at 1 youre pituitary is very slow. LH sends signal to testes to produce T.
You def need further blood work before you get good advice.

I have fatty liver disease and my ast alt get elevated when I hit a certain weight. I lose weight and it goes back to normal, But in my case I know is fatty liver because of CAT scan and ultrasound.
You should also post any medication/drugs you took recently. Were you ever on TRT? if so maybe you just need a restart of the pituitary.

3

These have got to be the lowest hormone levels I’ve ever seen before, you should have no problem getting TRT. You’re secondary, testes aren’t being stimulated, fertility might become a challenge. You need to educate yourself as most doctors fail at administering TRT and put guys on terrible protocol with injections every 2 weeks, this sets guys up for failure. A single large injection causes your hormone levels to rise and fall during the week, these peaks and valleys produce good feelings in the beginning and later in the week feeling low. “You” need to inject T twice a week to keep levels more stable. HCG will be needed if you have any chance at having kids. Lots of guys who come here find TRT made them feel worse only to find out they also have thyroid issues, you should have a full thyroid panel performed.

About the T Replacement Category
TRT: Protocol for Injections
Stupid Things That Docs Do and Say

4

Now that you are clearly secondary hypogonadism [low LH/FSH] there is a need for further diagnostic labs to learn about the cause. Prolactin should be ordered and if that is elevated a MRI is thrn used to visualize the adinoma that must be treated. If ignored can get large and press on optic nerves. This is easily managed by 0.5mg /week Dostinex/cabergoline. A blow to the head can damage the pituitary as well. There can be other types of adinomas as well, prolactin is most common.

Are you shorter or taller. Early puberty can lead to lower stature.

Have you ever taken any hair loss oral medications?

It will be a struggle there to get proper TRT, most doctors fail and your health system discourages independent thinking.

Have you lost hair on lower legs? Low-T can do that, often see on older men.

You need iodine and must get a supplement with selenium as feeding iodine to a selenium deficiency can create real hard. Find a high potency B-complex multi-vit with trace elements including 150mcg iodine and 150-200mcg selenium?

Getting much sunshine or you need to take Vit-D3?

Evaluate you overall thyroid function via oral body temps as discussed below. This is very important.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

5

Low red blood count and hematocrit are expected to some degree with low-T and TRT improves these things. Other factors can be digestive issues and food sensitivities leading to slow blood loss from the gut. One should consider if AST/ALT are factors. Sore muscles from training can also increase AST/ALT and such training should be avoided and muscles fully recovered for lab work.

6

Thanks for the replies.
Currently take 3x Orange Triad twice daily, 4 Fish Oil tablets a day, 5g creatine mono a day. Type 1 Diabetic with great control (6.1 hba1c last check). Is this a possibility at all that it is purely due to over training? I train 6 days a week (PPLPPLR) for an hour lifting a hybrid bodybuilding and strength program. Is it possible if I stop training that my testosterone will come back normal if I stopped training for a week, or at my levels, is there something more serious wrong?
Orange Triad has Iodine and Selenium in it.
I am at around 15% bodyfat visually, tested at 13% by caliper.
Never been on TRT or taken any PED’s. Never taken hair loss meds. Average height, slightly taller than father, slightly shorter than brother. Work manual labor outside, and fully tanned, so vitamin d should be no issue.
Havent checked body temp, but will start soon.
I am eating around 2500 cal a day and maintaining weight. I fully track all macros and calories meticulously. Ensure 1g protein per pound, .5g fat per pound, and balance remaining calories with carbs or more protein and fat depending on mood. Compared to most, I am very aesthetic and fit.
No hair loss whatsoever.