24 Y/O Low T and Free T, High FSH

Pharma / TRT Testosterone Replacement
1

Been having libido, depression and body comp problems for a while, I suspected low test so I got some tests done and confirmed it. Questions from the sticky answered:

-age - 24
-height - 170cm/5’7"
-waist - 32"
-weight - 72kg/159lb
-describe body and facial hair - Very hairy legs, little body hair elsewhere. Not much facial hair.
-body fat - All in the stomach region, hard to say how it’s changed over time because I was super light up until a few years ago when I started putting on weight.
-health conditions - Asthma and hayfever since childhood
-Rx and OTC drugs - Asthma and hayfever meds, nothing too extreme
-lab results with ranges - below
-describe diet - Medium-high protein and fat, lowish carb. Only eat whole foods, only drink water and milk, also started green tea a couple of weeks ago.
-describe training - 5/3/1 three times a week, still not very strong and never overtrained. Current training maxes for squat/bench/DL are 120/70/135kg to give you an idea.
-testes ache, ever, with a fever - No
-how have morning wood and nocturnal erections changed - Used to have morning wood every day as a teenager, now it’s quite rare, maybe a couple of times a week if I’m lucky. Wake up multiple times a night (I’ve had moderate insomnia for years) and sometimes have an erection, maybe once every two nights.

Here are my lab results with ranges. Some figures were tested twice a week apart, so I’ve listed both figures:

1st Total Test: 18 nmol/L (10.0 - 33.0)
2nd Total Test: 14 nmol/L (10.0 - 33.0)
1st Free Test: 48 pmol/L (60.0 - 130.0)
2nd Free Test: 35 pmol/L (60.0 - 130.0) - This test was done unfasted, which can apparently cause a lower reading?
1st SHBG: 28 nmol/L (13 - 71)
2nd SHBG: 24 nmol/L (13 - 71)
TSH: 2.9 mU/L (0.40 - 4.00)
Prolactin: 8 ug/L (<15)
E2: 97 pmol/L (<150)
LH: 9 U/L (3 - 20)
FSH: 21 U/L (3-20)

American values for T and E2, will probably make more sense to you guys:

1st Total Test: 518 ng/dL (288 - 951)
2nd Total Test: 403 ng/dL (288 - 951)
E2: 26.42 pg/mL (<40.86)

As far as I can tell most of those results are normal, the only things standing out are low T, very low FT, and high FSH. I could easily be missing something though. I did ask for more detailed thyroid testing but the doctor flat out refused, “I’ve been a doctor for 30 years, your TSH is normal no further testing is required” etc.

I had testicular and prostate ultrasounds done, everything was confirmed to be of normal size and blood flow looked good.

I’ve been referred to an endocrinologist, but before I make an appointment it would be great to have some input from people here as to what my issues could be, and what treatment I may need. Thanks!

2

Any update ok your results? Im kinda in the same boat. High FSh seeing an endo after my urologist ddnt find anything on his end.

3

Thyroid is not alright, elevated TSH shouldn’t be ignored. These ranges are too wide, you need TSH closer to 1.0. Checking fT3, rT3, fT4 and antibodies will reveal hidden problems and an explanation for elevated TSH.

Check oral body temperatures using glass thermometer upon waking and 12 noon, should be 97.4 waking and 98.6 12 noon. You could also be iodine deficient, do you consume iodized salt or dairy products such as milk?

There’s a risk of CVD with levels below 440 ng/dL, poor sexual performance as well as physical. Your levels should be much higher given your young age, you’re below average for testosterone in your age group. Those with below average levels typically have more health problems throughout life.