26 Year Old with Low T

Pharma / TRT Testosterone Replacement
1

Hello everyone,
I have been reading on T-Nation for about 2 weeks, so i am very new to this. (bear with me)
Age: 26 / Male
Height: 5’10"
Weight: 157 lbs
Waist: 31
Body / Facial Hair: Facial hair currently thickening up from being patchy. (men in my family are slow to grow facial hair) My brother could not grow full beard until he was 29/30. For body i am averaging out. From 14-20 i had an ectomorph body type got up to 168 @ 22(5%ish bf) with 2 years of training from 135 ish.
Fat: I do not have a lot but abs are still visible. 11%
Testes: My left testicle does ache on occasion. Had a doc tell me years ago i had Varicocele (sp?) this week I had 2 days of pain and it went away.
Diet: I eat what i want no restrictions, poor diet overall. Unstable meal times, sometimes skip breakfast, etc. I have started to pre plan my meals more often lately and when i do that i actually eat well.

Activity: Very active job, physically demanding. Currently not doing any weight training.

Overall symptoms: Very tired throughout the day, low libido, brain fog like a mother… , lack of concentration, I need caffeine every morning before i can function sometimes throughout the day just to stay on point, general weakness, lack of physical ambition (way abnormal for me)
Restless sleep, etc. etc.

So, in lieu of all that i went to the Doc today to have some test done. I should have lab results back in a few days and will post results when i get them. I am interested in yalls take on the findings.

2

While waiting: Take your body temperatures and describe iodine intake history from iodized salt and in vitamins. See the advice for new guys sticky and thyroid basics.

Sleep problems. How about stress and how to you react to major stress events?

Any blows to the head or whip lash?

3

I use AndroGel, and have had AMAZING Results!!! Make sure your doc Checks ur Total and Free T levels. Kinda young for being too low.

4

WTF

5

[quote]KSman wrote:
While waiting: Take your body temperatures and describe iodine intake history from iodized salt and in vitamins. See the advice for new guys sticky and thyroid basics.

Sleep problems. How about stress and how to you react to major stress events?

Any blows to the head or whip lash?[/quote]

Yea, i did some reading on the thyroid in the stickies i will begin temps tonight and throughout next week.

I have not taken any iodine supps or iodized salt ever.
Currently i sleep anywhere from 5 - 7 hours a night and it is very poor quality sleep. I react to minor stress right now which is real weird for me. I am generally a real happy dude. Lately stress triggers me and i get frustrated as hell. My “normal” reaction to stress is pretty balanced, i am a realist and logically think through situations and move on through em.

No head trauma or whip lash in my history. I get my labs back tomorrow not sure if i can review them until mid week though.

6

Low T can make men moody and short tempered, intolerant. But your comments about stress seen to indicate some other possibilities. We will help you work trough all of this.

Does your job involve any exposure to chemicals or fumes? Fire retardants?

When did this all seem to start?

Any other health complaints or changes?

You working with a family doc or?

In the advice for new guys sticky you will see other info that we would like to see.

You seem to have a lot of resolve. There can be a steep learning curve.

7

[quote]KSman wrote:
Low T can make men moody and short tempered, intolerant. But your comments about stress seen to indicate some other possibilities. We will help you work trough all of this.

Does your job involve any exposure to chemicals or fumes? Fire retardants?

When did this all seem to start?

Any other health complaints or changes?

You working with a family doc or?

In the advice for new guys sticky you will see other info that we would like to see.

You seem to have a lot of resolve. There can be a steep learning curve.
[/quote]

I work for a uniform company (CINTAS) I am not exposed to anything of concern other than oily rags from a mechanics shop.
My lack of energy and low physical drive has been present for about a year and a half. I would say the stress levels have been present for maybe 9 months. My wife and I recently had a baby with complications. She had an emergency C section 9 months ago and gave birth to my son prematurely. He was 2 lbs at birth healthy now but scary time. As i’m typing this maybe this has something to do with my stress? Im working with NBH lifetime health in the austin area. I do not have a GP. I will re read through that sticky tonight before i hit the sack.
-Red

8

NBH looks interesting. As a rule, these types of clinics often supply all of the drugs/hormones and then at a hefty price compared to taking scripts to a pharmacy.

Some fire retardants are dangerous:

“”"
As of June 1, 2006 the State of California began prohibiting the manufacture, distribution, and processing of flame retardant products containing pentabrominated diphenyl ether (pentaBDE) and octabrominated diphenyl (octaBDE). PBDEs are ubiquitous in the environment and according to the EPA exposure may pose health risks. According to U.S.EPA’s Integrated Risk Information System evidence that indicates PBDEs may possess liver toxicity, thyroid toxicity, and neurodevelopmental toxicity.
“”"
I researched this problem when a group of fire fighters in Florida were required to wear ‘fire pants’ at all times while on duty. There were severe signs of endocrine disruption. It is the bromine compounds that are dangerous.

9

97.7 with temporal scan this am. I will get an oral thermometer tomorrow. On my route i only have one guy in FR garments. Do you think touching one set of clothes a week would cause this? That cant be enough contact to cause this can it?

10

No, that FR exposure would not be a problem. I have to wonder about the people that cut&sew those items.

97.7 AM temperature is a good number if oral confirms. Good to have mid afternoon temp as well. We see so many thyroid issues here that it make sense to screen all the cases.

Stress can wear people down. Ones life style stress, job, family, sleep patterns etc are major factors. But the effect of illnesses, accidents, job loss, divorce, death of someone you care about; these can create adrenal fatigue.

Lab data will be a good start. You will need the complete report with ranges. If the report can be emailed to you, that would be useful.

11

KSman,
Thanks for all your help thus far, your input is much appreciated.
I am picking up a oral therm today. And will update with labs and temps when I get my results from doc.

12

Labs were done 4 hours after sausage and cheese biscuit with a dr pepper.
RANGE

Ferritin = 101 12-282
Vitamin D, 25 OH = 15 30-100 ( optimal )
Glucose = 71 65-100
creatinine = .9 .8-1.4
sodium = 138 133-146
potassium 4.2 3.5-5.3
cholesterol= 150 <200
triglycerides = 210 <150
total testosterone= 492 292-1052
SHBG= 62 16-94
FT= 6.7 4.8 - 25
dhea sulfate=375 240-549
tsh= 1.0 .5-4.7
free t3= 3.4 2.3-4.2
free t4=1.23 .73-1.95
estradiol=35 <63
psa total = 1.6 <4.0

There are more but i don’t think they are what you would ask for.

-Red

13

You need 5000iu vit-D3 per day, tiny oil based caps. Walmart has those. Take a large number of these in the first week to load up. Take 30 caps in the first week.

Cholesterol is getting too low. Can you offer any reasons? 160 and below are associated with increased all-cause mortality and also undermines the steroid hormone systems.

fT4 is a bit below mid range which is considered optimal.

With E2=35 you are getting estrogen dominant VS your FT. This also increases SHBG that is reducing your FT.

Any other data? ALT, AST?

14

ALT= 15 7-56
ast= 14 5-35
not sure why my cholesterol is so low.
I will have a physical copy of my labs tomorrow i will upload a picture then.

15

Ok got back from the Doc today. He suggested
200mg test cyp
DHEA 50mg ( he says this is not terribly low but would like to see it at 500 at my age )
Vit D
B12
test come with an AI and HCG if i want HCG to protect my testes.

Wanted to get your take on this KSman will this help eliminate my symptoms do you think this RX is accurate?
-Red

16

Going to an Endocrinologist on Wednesday next week. I want to do some further digging. Not really exciting to think about TRT at 26.

17

If you are doing TRT, follow sticky ‘protocol for injections’. Do not start 200mg T per week.

DHEA 50 is too much, try DHEA 25

Do not do anything until you have LH/FSH

Most docs will not treat your condition with TRT.

At your age, low T is a symptom of a condition, not a condition itself.

Your cholesterol is very low and will undermine your ability to make steroid hormones. Maybe you are too skinny.

E2 is high for your low body fat.

TT would be lower, but your SHBG in inflating it with SHBG+T.

MORE TEMPERATURE DATA? AFTERNOON TEMPERATUUES?

You are self described iodine deficient. Yes, labs look good. What are your plans for iodine?

DHEA should be OK to support T production.

So your HPTA is been inhibited to some extent by E2, that elevates your SHBG and lowers FT while inflating TT result. Low body fat and low cholesterol contributes. With your age, prolactin should be checked as well in search of something suppressing your HPTA.

Endo will probably say that you are normal. You must stress your symptoms and changes.

18

[quote]KSman wrote:
If you are doing TRT, follow sticky ‘protocol for injections’. Do not start 200mg T per week.

DHEA 50 is too much, try DHEA 25

Do not do anything until you have LH/FSH

Most docs will not treat your condition with TRT.

At your age, low T is a symptom of a condition, not a condition itself.

Your cholesterol is very low and will undermine your ability to make steroid hormones. Maybe you are too skinny.

E2 is high for your low body fat.

TT would be lower, but your SHBG in inflating it with SHBG+T.

MORE TEMPERATURE DATA? AFTERNOON TEMPERATUUES?

You are self described iodine deficient. Yes, labs look good. What are your plans for iodine?

DHEA should be OK to support T production.

So your HPTA is been inhibited to some extent by E2, that elevates your SHBG and lowers FT while inflating TT result. Low body fat and low cholesterol contributes. With your age, prolactin should be checked as well in search of something suppressing your HPTA.

Endo will probably say that you are normal. You must stress your symptoms and changes.

[/quote]
I have slacked off with temps a bit. The first 2 days all temps were normal. Will start taking temps again.

I am going to request LH/FSH test on Wednesday at the endo.
I don’t really want to do TRT at ALL at my age so I am intending to probe and fix the “condition” whatever it may be.
This is what i have concluded thus far.
Poor diet = Low T
Poor sleep = Low T
Vit D deficiency = Low T
Low cholesterol = low T ( not sure why this is low I dont eat a clean diet at all )
B12 deficient
Possible pituitary issues?
E2 too high
DHEA too low
Thyroid ruled out thus far (based on my limited understanding)
Maybe low testes production due to something funky with LH/FSH ?
Im going to have to do some reading on the iodine deficiency because i am clueless there. The only indicator for low iodine is body temp?
My only other conclusion is my body has low production of hormones. To me this will be the only way i would do TRT if all of my other hormonal functions check out.

19

It is hard to eval iodine status. If intake has been poor, then more may be helpful. The attraction of iodine replenishment is that it fixes problems that result from iodine deficiency. Your labs look great. Many who come here have such issues, perhaps you do not.

20

Went to the Dr today… Very frustrating. First Dr Simon XXXXXX ended up being a woman. Strike 1.
Even better i giver her my previous labs discussed why i was there and she says " total testosterone 492, perfect." Strike out.
Perfect? WTF? I told her at my age that was low, but i was more concerned with my Low FT and E2 imbalance. I explained to her that i was interested in finding the cause of these low numbers but from our conversation she concluded my T levels were not only normal but perfectly optimal for my age. I flat out told her “Doc i completely disagree with your assessment.” “Look i’m not interested in getting on T im interested in figuring out why my levels at my age are so low.” I will be finding a new endo for sure, on the other hand she gave me the tests i wanted.
LH/FSH another PSA, TT,FT ft4, b12 serum, another vit D and another E2. She did a few more I’m unfamiliar with for pituitary and thyroid markers. If this Dr. thinks i am normal at my age how can she truly diagnose a cause of my “normal” low FT levels and the imbalance that is so obvious?

On another note it is almost impossible now a days to get a doctor to actually speak to you over the phone about labs and such.