26 YO Low Test - What direction to head?

Hey everyone. New to these forums and to finding out I have low test. Been having symptoms for years, but just recently got the time to get blood work done. 26 y/o male been having symptoms of Low T - poor sleep, constant fatigue, absolute no sex drive. I train very seriously, lift 4-5x a week, and my nutrition is spot on. Currently 183 pounds around 14% BF and aiming to get sub 10%. Just been having poor recovery and feel my adrenals are shot also. Below is my lab work, I�¢??ve remarked on all the abnormals, if there are no reference intervals that means it�¢??s in normal range for the common labs.

I don�¢??t know if my problem is in the pituitary, since my LH/FSH and test are all low/borderline low? Or if the problem is in my adrenals since almost all those labs are low/borderline low as well? Should I looking at improving my adrenal function? Trying a HPTA restart with clomid/hCG? Or go straight to TRT? Don�¢??t think I need an AI right now as my E2 levels are perfect.

Any feedback/insight/advice/what should I do next would be great! Thanks for all the help in advance.

CBC:

WBC 5.1
Hemoglobin 15.3
Hematocrit 44.3
MCV 88

CMP:

Glc 87
BUN 16
Cr 1.16
Sodium 139
Potassium 4.3
Chloride 101
Carbon Dioxide 25
Calcium 9.8
AST 36
ALT 34

Lipids:

Total Cholesterol 134
Triglycerides 55
HDL 38
LDL 85
VLDL 11

Hemoglobin A1c 5.3

Thyroid Panel

TSH 2.070 (0.450 - 4.5)
Free T4 1.30 (0.82-1.77)
Free T3 3.7 (2-4.4)
Reverse T3 19.7 (9.2-24.1)
Thyroid Peroxidase Antibody 6 (0-34)

Adrenal Panel
Aldosterone 5.6 (0-30) Borderline low
ACTH 27.5 (7.2-63.3) Borderline low
Cortisol AM 14.1 (6-19) Low
DHEA Sulfate 144.9 (138.5-475) Borderline low

Vitamin B12 1287 HIGH (211-946)
Folate 13.2 >3
Vitamin D 25 Hydroxy 28 LOW (30-100)
Magnesium 2.1
Selenium 144 (79-326)
Zinc 149 HIGH (56-134)
Ferritin 39 (30-400)
Iodine 69
Homocystein 5.8
ESR 2
CRP <1.0

Total Testosterone 438 (348-1197)
Free Testosterone 6.8 LOW (9.3-26.5)
FSH 3.9 (1.5-12.4)
LH 3.3 (1.7-8.6)
Prolactin 13.6 (4-15.2) I had orgasmed ~30 hrs prior to test, don’t know if it’ll affect it
Estradiol 18.8 (7.6-42.6)
PSA 0.2

bump…would really like some advice.

bumping again…

This might be a stupid question, but did you ask your doctor what he/she thought?

I am not sure why you believe your adrenals are problematic, they seem fine? I would try Clomid 50mg/day along with 10,000IUS of vitamin d3 t3 times per week for 3 months. Your thyroid is good.

[quote]Playboy wrote:
This might be a stupid question, but did you ask your doctor what he/she thought?[/quote]

I wanted to get a full understanding of my picture before I went to a doctor. I know many people are much more knowledgable and experienced than some docs. The wisdom here is priceless!

[quote]Retinoid wrote:
I am not sure why you believe your adrenals are problematic, they seem fine? I would try Clomid 50mg/day along with 10,000IUS of vitamin d3 t3 times per week for 3 months. Your thyroid is good.[/quote]

Well all my adrenal labs are low and I just feel constantly drained, have many of the symptoms of adrenal fatigue. My DHEAS is not even mid range either. And I just recently started vit D this past week

Total and HDL cholesterol are a little low. cholesterol is the mother hormone. Eat some eggs and red meat.

Vit D and 50mg micronized DHEA, then retest after a month or so. Get DHEA-s to the top of the range and see what it does for T. Make sure you retest E2 as well.

[quote]dhickey wrote:
Total and HDL cholesterol are a little low. cholesterol is the mother hormone. Eat some eggs and red meat.

Vit D and 50mg micronized DHEA, then retest after a month or so. Get DHEA-s to the top of the range and see what it does for T. Make sure you retest E2 as well.[/quote]

yep this was exactly my plan. I’m a vegetarian, but still get enough fats through other sources (80-100g a day) from fish oil, nuts, peanut butter, olive oil etc.

[quote]lancerevo wrote:

[quote]Retinoid wrote:
I am not sure why you believe your adrenals are problematic, they seem fine? I would try Clomid 50mg/day along with 10,000IUS of vitamin d3 t3 times per week for 3 months. Your thyroid is good.[/quote]

Well all my adrenal labs are low and I just feel constantly drained, have many of the symptoms of adrenal fatigue. My DHEAS is not even mid range either. And I just recently started vit D this past week
[/quote]

Your DHEA is on the low end because your T is low and your body isn’t producing enough. Just get enough fats, cholesterol (not cooked/oxidized to death cholesterol), sleep, protein and take the Clomid. What are your sluggish adrenal issues other than overall tiredness? The better adrenal support steroid would be pregnenolone.

[quote]Retinoid wrote:

[quote]lancerevo wrote:

[quote]Retinoid wrote:
I am not sure why you believe your adrenals are problematic, they seem fine? I would try Clomid 50mg/day along with 10,000IUS of vitamin d3 t3 times per week for 3 months. Your thyroid is good.[/quote]

Well all my adrenal labs are low and I just feel constantly drained, have many of the symptoms of adrenal fatigue. My DHEAS is not even mid range either. And I just recently started vit D this past week
[/quote]

Your DHEA is on the low end because your T is low and your body isn’t producing enough. Just get enough fats, cholesterol (not cooked/oxidized to death cholesterol), sleep, protein and take the Clomid. What are your sluggish adrenal issues other than overall tiredness? The better adrenal support steroid would be pregnenolone. [/quote]

Isn’t taking dhea more powerful than preg? And I thought T is low bc dhea is low - doesn’t dhea convert into t?

I pretty much have all the symptoms of sluggish adrenals. Hard to fall asleep, hard to stay asleep, always tired, very poor recovery (DOMS 4 days after work out for example, feel like is never have full energy in the gym, body always hurts everywhere), feel very wired after 10 pm.

[quote]lancerevo wrote:

Isn’t taking dhea more powerful than preg? And I thought T is low bc dhea is low - doesn’t dhea convert into t?

I pretty much have all the symptoms of sluggish adrenals. Hard to fall asleep, hard to stay asleep, always tired, very poor recovery (DOMS 4 days after work out for example, feel like is never have full energy in the gym, body always hurts everywhere), feel very wired after 10 pm.
[/quote]

What’s your consumption of caffeine and other stimulants like? Any amount can cause problems when you have adrenal issues. Following one of my blood tests that showed lower than normal testosterone and higher than normal cortisol, I took a week off from the gym and a month off of all stimulants and both my testosterone and cortisol levels improved following that. Maybe stopping stims and/or deloading might help you too?

[quote]Tinashun wrote:

[quote]lancerevo wrote:

Isn’t taking dhea more powerful than preg? And I thought T is low bc dhea is low - doesn’t dhea convert into t?

I pretty much have all the symptoms of sluggish adrenals. Hard to fall asleep, hard to stay asleep, always tired, very poor recovery (DOMS 4 days after work out for example, feel like is never have full energy in the gym, body always hurts everywhere), feel very wired after 10 pm.
[/quote]

What’s your consumption of caffeine and other stimulants like? Any amount can cause problems when you have adrenal issues. Following one of my blood tests that showed lower than normal testosterone and higher than normal cortisol, I took a week off from the gym and a month off of all stimulants and both my testosterone and cortisol levels improved following that. Maybe stopping stims and/or deloading might help you too?
[/quote]

I don’t drink caffeine at all on a regular basis. Only time is sometimes for pre work outs, and that too it’s like 1-2 times per month when i’m feeling more tired than usual.

I just recently took 8 days off 3 weeks ago - didn’t really help much. still back in the same position. My issue really is under recovery, and how can I expect to grow if I have to take a deload/week off every other week lol.

What’s your diet like? I know you said you’re a vegetarian. Simplecarbs will make things much worse, you’ll “crash” much more easily and much harder. You mentioned you’re getting fish oil, but how much? Hate to break it to you but taking 1-2 caps per day will result in minimal benefit, especially in your situation. I’d be getting liquid fish oil and taking 3 teaspoons bare minumum per day, shooting for at least 3g EPA/DHA combined.

Personally when I have fish oil I take at the very least 2-3 tablespoons per day, often more. Make sure you’re getting adequate B vitamins (perhaps a B100 supplement would help) and all your minerals too; eg iron, zinc, magnesium (especially important for the adrenals). You could also try drinking herbal tea or taking supplements; licorice is supposed to help with the adrenals.

You’re very low on D. You said you just started supplementing, but you’ll go nowhere fast if you’re only taking like 1000 units per day. I would honestly supplement anywhere up to 20,000 units per day for a week, then drop it down to 10,000 after. Retest after a month or so, you want to be at the higher end of the scale. Take at the very least 5000 for maintenance, I take probably 7000-8000 to maintain.

[quote]Tinashun wrote:
What’s your diet like? I know you said you’re a vegetarian. Simplecarbs will make things much worse, you’ll “crash” much more easily and much harder. You mentioned you’re getting fish oil, but how much? Hate to break it to you but taking 1-2 caps per day will result in minimal benefit, especially in your situation. I’d be getting liquid fish oil and taking 3 teaspoons bare minumum per day, shooting for at least 3g EPA/DHA combined.

Personally when I have fish oil I take at the very least 2-3 tablespoons per day, often more. Make sure you’re getting adequate B vitamins (perhaps a B100 supplement would help) and all your minerals too; eg iron, zinc, magnesium (especially important for the adrenals). You could also try drinking herbal tea or taking supplements; licorice is supposed to help with the adrenals.

You’re very low on D. You said you just started supplementing, but you’ll go nowhere fast if you’re only taking like 1000 units per day. I would honestly supplement anywhere up to 20,000 units per day for a week, then drop it down to 10,000 after. Retest after a month or so, you want to be at the higher end of the scale. Take at the very least 5000 for maintenance, I take probably 7000-8000 to maintain. [/quote]

thanks for the reply! I do take 2 caps fish oil, but I have the ultra fish oil that have a EPA/DHA of 1.25g per capsule. Also I eat a lot of other omega 3 foods (nuts, olive oils, peanut butter). And The only simple carbs I get are fructose when I eat fruits and lactose when I drink 2 cups of milk in the morning. The rest are complex, from veggies, beans/legumes/lentils, dairy products etc. Those foods mainly make up my diet, I get around 180-200g protein, 90-100g fat, and rest carbs.

I tested all the minerals written in the OP. I was high on B12 and Zinc (take B vitamin supplements for the past year), also Mag came back ok but still recently started supplementing with ZMA as another way to get better sleep.

I’ve had very conflicting advice on Vit D and the amount to take. Currently I’m taking 5.5K units/day. Plan on restesting in a month and if still low will up it to 10K u/day.

Along with all the above supplements, I’m going to get a sleep study to rule out sleep apnea as the cause of the low t and constant fatigue and get an MR Brain to rule out any pituitary causes.

Just wanted to give an update and if see if anyone can offer any new advice

After the OP lab test, I started DHEA, Vit D and Vit C and re tested my labs

Total Test: 475
Free test: 5.8 (Decreased)
Vit D: 41 (Increased)
DHEA: 235 (Increased)
Estradiol: 15

Any further recs? I have an appointment with an endocrinologist coming up.

bump

bump…again…

Seriously…no body?

I went got a sensitive E2 test and came back as super low at 4 on a range of 3-70. I’m assuming this is because of the low T? Should I be worried about this?

I’m seeing an endo in 2 weeks. My plan of action is Clomid, if that doesn’t work then hCG, if that doesn’t work then TRT.

Any advice?

Cholesterol [137!!!] is the raw material for the cascade of your steroid hormones: T, E1, E2, E2, pregnenolone, DHEA, progesterone, cortisol, vitamin D and others. Total cholesterol of 180 is thought to be idea. Cholesterol of 160 and below are associated with increased all cause mortality. Eat lots of eggs. I think that your low cholesterol is a major problem for you.

Vitamin D25 is a steroid hormone. You can’t live without it. You can do lab work or take 5,000iu in small oil based gel caps. [I see that you are already on that path]

Do not take 50mg clomid. That is the dumbest advice I have seen here. Read the advice for new guys sticky and get some facts.

fT3 and fT4 are great. So why is TSH that high? Possibly your rT3 is blocking your fT3. If so your body temperatures might then be depressed. Read the thyroid basics sticky and eval you iodine intake and check waking and mid afternoon temperatures. If you are not using iodized salt, you are deficient. Crap like Himalayan sea salt is useless.