23 Year Old, Low T Levels

Pharma / TRT Testosterone Replacement
1

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Hi everyone,

-age
23

-height
6’3:
-weight
220 lbs
-describe body and facial hair
Err, below normal body hair I think, can’t grow a thick beard

-describe where you carry fat and how changed
I’ve always carried fat in my hips and lower back.

I had a DEXA scan done the other week, which is pretty much the most accurate method. It showed I had 20.5% body fat overall. My arms and legs were pretty lean (<15%legs, <10% arms), but my trunk was much higher in fat (>25%). I’ve attached the scans.

-health conditions, symptoms [history]
I believe I have gynocomnastia. My nipples were puffy throughout high school, which everyone always told me was due to excess fat, or puberty. But flash forward 7 years later, and I still have puffy nipples.

I also used to get erections more often. I haven’t had morning erections in a few years, and getting it up for sex has been more difficult.

I also have been lifting pretty seriously for about 5 years now. I made good gains at first, and it’s be extremely slow going since. I’ve had my diet dialed in for good chunks of time, and have been getting at least 175g of protein daily for the last 4 years on most days. I admit I wasted quite a bit of time always trying to diet down, but I feel like I should have made more progress. I’ve watched friends start lifting and surpass me in size and strength quickly.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
I’m on no prescriptions at this time, and haven’t been for several years. I used to have exercise-induced asthma, but grew out of that by age 15.

-lab results with ranges
CBC With Differential/Platelet

WBC 5.3 3.4-10.8 x10E3/uL 01

RBC 5.21 4.14-5.80 x10E6/uL 01

Hemoglobin 16.2 12.6-17.7 g/dL 01

Hematocrit 46.3 37.5-51.0 % 01

MCV 89 79-97 fL 01

MCH 31.1 26.6-33.0 pg 01

MCHC 35.0 31.5-35.7 g/dL 01

RDW 13.6 12.3-15.4 % 01

Platelets 188 150-379 x10E3/uL 01

Neutrophils 53 % 01

Lymphs 33 % 01

Monocytes 8 % 01

Eos 5 % 01

Basos 1 % 01

Neutrophils (Absolute) 2.81.4-7.0 x10E3/uL 01

Lymphs (Absolute) 1.70.7-3.1 x10E3/uL 01

Monocytes(Absolute) 0.40.1-0.9 x10E3/uL 01

Eos (Absolute) 0.30.0-0.4 x10E3/uL 01

Baso (Absolute) 0.0 0.0-0.2 x10E3/uL 01

Immature Granulocytes 0 % 01

Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL 01

Comp. Metabolic Panel (14)

Glucose, Serum 7765-99 mg/dL 01

BUN 19 6-20 mg/dL 01

Creatinine, Serum 0.98 0.76-1.27 mg/dL 01 eGFR If NonAfricn Am 108 >59 mL/min/1.73 01 eGFR If Africn Am 125 >59 mL/min/1.73 01

BUN/Creatinine Ratio 198-19 01

Sodium, Serum 141134-144 mmol/L 01

Potassium, Serum 4.13.5-5.2 mmol/L 01

Chloride, Serum 10097-108 mmol/L 01

Carbon Dioxide, Total 2418-29 mmol/L 01

Calcium, Serum 9.48.7-10.2 mg/dL 01

Protein, Total, Serum 6.46.0-8.5 g/dL 01

Albumin, Serum 4.43.5-5.5 g/dL 01

Globulin, Total 2.01.5-4.5 g/dL 01

A/G Ratio 2.21.1-2.5 01

Bilirubin, Total 0.40.0-1.2 mg/dL 01

Alkaline Phosphatase, S 6839-117 IU/L 01

AST (SGOT) 260-40 IU/L 01

ALT (SGPT) 24 0-44 IU/L 01

Testosterone, Serum

Testosterone, Serum 378 348-1197 ng/dL 01

Comment: Comment 01

Adult male reference interval is based on a population of lean males up to 40 years old.

Luteinizing Hormone(LH), S

LH 4.9 1.7-8.6 mIU/mL 01

FSH, Serum

FSH 5.1 1.5-12.4 mIU/mL 01

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Estradiol

Estradiol 6.7 LOW 7.6-42.6 pg/mL 01

-describe diet [some create substantial damage with starvation diets]
I have had several periods where I’ve buckled down for 4-8 weeks and dropped significant fat. This has usually been in the 2000-2500 calorie range, always above 175g of Protein. Usually high fats, low carbs.

Whenever I try to eat in a surplus, I end up gaining a lot of fat. I admit this was from being too loose in what I ate. For example, last summer I ate too many bad things and went up to 235lbs. I saw myself in the mirror, and promptly dieted back down to 200. So I’ve had this history of yoyo dieting.

I actually started carb cycling for a recomp, and my weight has been a consistent 219-221 for the last 3 weeks. That’s eating 4100 calories on workout days, and 2700 on off days. I like this eating style so far.

-describe training [some ruin there hormones by over training]
I’ve always done bodybuilding type training. I usually do a body part split, or a push/pull/legs split. I don’t switch between the two very often.

-testes ache, ever, with a fever?
No

-how have morning wood and nocturnal erections changed
No morning wood for the last few years (2-3). Sometimes in the middle of the night I wake up with an erection from a dream.

TO SUMMARIZE:

I guess what I’m looking for out of this forum is some advice on my next steps. I’ve been lifting consistently for 5 years now and I feel like I haven’t made any significant progress, and not for lack of trying. I had my blood checked yesterday morning, and found that my test level was 378. That might be normal for a 70 year old man, but I’m only 23. My FSH and LH levels are in the middle of the normal range. I also carry a lot of body fat in my hips and lower back. My sexual energy hasn’t been great for the last year or so, and I haven’t had morning wood for several years.

Note: I’m recently engaged, and my fiance and I would like to have 3-4 children someday, so I’m also concerned about future fertility (at least 2-3 years before our first child).

Should my next steps be to consult with a doctor? Would I be better off seeing a clinic? If I were to go on TRT, should I have my fertility tested before and during?

Thanks guys. Please ask any questions I didn’t answer.

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A more recent picture, the one in my profile pic was about 2 years ago when I was leaner. I felt like I gained muscle a lot easier then, and I didn’t carry a lot in my hips. I don’t think I’ve gained a lot of muscle since then, despite consistently lifting. I gain fat in my hips and lower back pretty easily now.

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One more taken today of my back. I think I gained thickness compared to my profile pic, but that was a whole two years ago.

Please don’t think I’m saying my only reason for exploring TRT is because I want more muscle. I’d also like to have better libido, better energy, and decreased fat in womanly places.

4

Have you read the advice for new guys sticky?
In the first paragraph I point out that thyroid/iodine issues are very common with guys who land here.

E2 is not inhibiting your HPTA. However, prolactin could and you can get that tested. Also check TSH, fT3, fT4

See the thyroid basics sticky. Consider your long term use of iodized salt and/or from vitamins that list iodine. Post your waking body temperature and mid-afternoon.

There is also a sticky on things that damage your hormones.

5

[quote]KSman wrote:
Have you read the advice for new guys sticky?
In the first paragraph I point out that thyroid/iodine issues are very common with guys who land here.

E2 is not inhibiting your HPTA. However, prolactin could and you can get that tested. Also check TSH, fT3, fT4

See the thyroid basics sticky. Consider your long term use of iodized salt and/or from vitamins that list iodine. Post your waking body temperature and mid-afternoon.

There is also a sticky on things that damage your hormones.[/quote]

Thanks for the reply KSman.

I did read them, but not well enough. I will take my temperature upon waking (5:15am) for the next week, as well as mid afternoon when I get home from work (3:30pm).

For the last 2-3 years I’ve been adding Iodized salt to my daily meats (chicken and beef). About a teaspoon or two. I’ve recently increased that since I’ve been eating a lot of rice and pasta to meet my carb goals. I usually add it to the water, and then some on the actual rice/pasta as I’m eating it.

I’ll look into getting prolactin, tsh, ft3 and ft4 tested soon.

Thank you

6

So…I just realized in my quest to save $1, I have been buying non-iodized salt recently from the store. I totally overlooked that, and also at that time I hadn’t realized the relationship between Iodine and the thyroid.

So I will be buying Iodized salt, but is there a recommended Iodine supplement I can order online or get in a store? I couldn’t find any at Walmart’s vitamin/mineral section. Is a liquid one like this good? Robot or human?
I see they have it on their website, maybe I missed it in store.

Also, I bought a nice thermometer and took my temp the last two days and will continue to do so, but here are the results so far:
97.9 AM
97.9 PM
98.1 AM

7

At what hour did you take those temperatures? Those would be very good waking temperatures.

8

Those are at 5:15am when I wake up, and 3:30pm in the afternoon.

I took a few more morning temps,
97.9
98.0
98.0

So I think my temps are good.

I will get those other tests done soon, (prolactin, tsh, ft3 and ft4). Any others based on my temperature results?

Looks like I can get the following done for $142

Thyroid Profile w/ TSH
Complete Blood Count w/ Differential
Comprehensive Metabolic Panel
Prostate-Specific Antigen (PSA)
Estradiol Sensitive
Testosterone (Free), Serum With Total
Lipid Profile
Insulin Growth Factor (IGF-1)

9

Can you get 98.6 in the afternoon? 97.9 PM was not good.

10

Okay I’ll take afternoon temps more. I haven’t seen 98.6 yet.

I just ordered all the tests so in a week I should have all the numbers you asked for.

Thanks for your help.

11

Alright I got my results back.
TSH 2.780 (.450-4.500)
T4 4.3 (4.5-12) LOW
T3 34 (24-39)
Free Thyroxine Index 1.5 (1.2 -4.9)

Testosterone Serum 336 (348-1197)
Free Testosterone 9.1 (9.3-26.5)

From original blood test:
Testosterone Serum 378
LH 4.9
FSH 5.1
Estradiol 6.7 (7.6-42.6)

Morning temps have been 97.0 almost every time
Afternoon temps are always 97.2 - 98.0 for the last week.

So what do you think my steps should be? I have been adding iodized salt to my foods the last 2 weeks.

I also have many other stats from this lab, so just ask if you want to know a level of something.

12

Iodized salt will not fix iodine deficiency, please read the thyroid basics sticky.

fT3 and fT4 would have been much more useful.

“”"
Free thyroxine index

The Free Thyroxine Index (FTI or T7) is obtained by multiplying the total T4 with Tuptake.[2] FTI is considered to be a more reliable indicator of thyroid status in the presence of abnormalities in plasma protein binding.[2] This test is rarely used now that reliable free thyroxine and free triiodothyronine assays are routinely available.
“”"

High TSH and low T4 really suggests iodine deficiency. Is your thyroid sore, enlarged [neck looks thick there], asymmetrical or lumpy?

13

Sorry I didn’t realize until after the test and I was reading some more that fT3 and fT4 are more useful.

My thyroid is not sore, at least today. It doesn’t look asymmetrical to me. My neck doesn’t look particularily thick there.

Should I use that Iodoral you recommended in the sticky?

50mg a day for 2 weeks, and then drop to a lower dose. Maybe get tested again in 1 month?

Thanks again for your input. It’s greatly appreciated.

14

Well iHerb ships very fast. I got my 180 tablets of Iodoral yesterday so I started the dosing.

I’m tracking temps and will report back.

15

Well I started Supplementing with 50mg Iodide every morning on 12/10. My temps have been much higher than they were before. I’m already seeing:

12/10
97.8 am, 97.7 pm

12/11
98.3 am, 99.4 pm

12/12
97.5 am, 97.2 pm

12/13
98.5 am, 98 pm

12/15
98.3 am, 98.6 pm

12/16
96.8am (cold for some reason)

Does it seem like I’m on the right track to restoring my Iodine levels?

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I’m going to get tested again next Monday. I’ll have been supplementing Iodide for a month at that point.

17

That all seems reasonable. In my case, I really was feeling better and more alert within a few days. But results will vary!

18

So after 2 weeks of 50mg Iodine a day, 2 weeks of 12.5mg Iodine a day, and 1 week of 12.5mg every other day, my levels have changed a bit.

Original Test
11/13/2014
LH: 4.9 (1.7-8.6)
FSH: 5.1 (1.5-12.4)
Testosterone Serum: 378 (348-1197)
Estradiol 6.7 (7.6-42.6)
No Thyroid numbers

12/4/2014
Testosterone: 336 (348-1197)
Free Test: 9.1 (9.3-26.5)
TSH: 2.780 (0.450-4.5)
T4: 4.3 (4.5-12)
T3 Uptake: 35 (24-39)
Free Thyroxine Index: 1.5 (1.2-4.9)

1/12/2014
Testosterone: 326 (348-1197)
LH: 5.1 (1.7-8.6)
FSH: 5.2 (1.5-12.4)
TSH: 3.920 (0.45-4.5)
Free T4: 1.13 (0.82-1.77)
Free T3: 3.0 (2.0-4.4)

From research, it appears I should be shooting for (Correct me if this is wrong)
Test
TSH 1.3-1.8
Free T4 1.2-1.3
Free T3 320-330
Free T3* 3.2-3.3

So based on this, my Free T4 and Free T3 are pretty much fine. However my TSH remains high. A quick google search suggests sublinical hypothryoidism (elevated TSH, normal Free T4 and T3).

The big questions:
Would a lower TSH raise my testosterone?

Based on my FSH and LH levels, would you suspect I’m fertile? My fiance and I want up to 4 kids, starting in the next 2-3 years. I don’t want to jeopardize this.

So should my next steps be:
-See an Endo about my thryoid? Would they even do anything for elevated TSH?
OR
-Skip the endo and see a TRT doctor for raising my test levels?

19

Bump for any advice :slight_smile:

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We have some pretty similar numbers. Thyroid numbers were a little worse than yours, but testosterone and lh/fsh almost identical.

I did everything I could naturally and levels are still basically the same. With iodine my TSH more than doubled, so it did not work well for me. I think you should attempt temperatures again for a while without iodine and see what happens. Seems like your TSH went up as well using it.

I found a doctor who is mostly competent and we’re doing a clomid restart. I have no expectations but figured might as well try that first. I’m taking 25mg EOD for now. I have a log for it in the forum if you want to see how it works for me.

My last testosterone test was on halloween and it was 407 (348-1197)

I’m on dessicated thyroid now so thats in check.