27 yo, low test, looking for input

Pharma / TRT Testosterone Replacement
1

-age
27
-height
5’ 10’’
-waist
33-34’’
-weight
190
-describe body and facial hair
hair on chest, arms, legs. no hair on back, shave every 2 days
-describe where you carry fat and how changed
carry fat mostly around stomach
-health conditions, symptoms [history]
low energy, low sex drive, low motivation, brain fog
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
hair loss from forehead
-lab results with ranges
See below
-describe diet [some create substantial damage with starvation diets]
healthy, fruits and veggies, brown rice, 2000-2500 calories/day
-describe training [some ruin there hormones by over training]
run/walk about 20 miles/week
-testes ache, ever, with a fever?
testes ache after androgel, see below
-how have morning wood and nocturnal erections changed
less morning wood in the recent past

Some Background:
I am 27 years old, and have always struggled with low energy, depression, pessimistic thinking, lack of motivation, and weight problems since around 18 years of age. I always remember looking around me whether I was at school, work, or home and wondering how people were so happy all the time and always running around chatting with each other and full of so much energy. I’ve always have kept a healthy lifestyle and diet with no alcohol/smoking/or drug use and considered these symptoms to just be my “personality” and considered it normal. I just tried to ignore what was happening and power through it.
More recently the brain fog, memory problems, and energy levels had gotten so bad, I was literally dosing off at my desk at work before noon, even after a full nights rest. I had enough and the frustrations of not being able to live a normal life had gotten to be too much, I knew something was wrong and wanted to fix things. After doing some research, I went to my GP and he sent me to an endocrinologist. (My GP and other physicians prior wanted to put me on anti-depressants, which I refused, I had never been to an endo till now) I gave him the full story, and he wanted to get a full workup done at the lab to check cortisol, thyroid, test, and other levels. The results are below.
My testosterone came back low (185 ng/dl first time and 207 ng/dl the second test), and he said this is probably the cause of my symptoms. He prescribed my Androgel 1.62 w/ 2 pumps a day. The first day I took it I noticed a little difference, but the second day and after was simply amazing, I felt like a different person. I am going on to my second week and its has tapered off (I think this is due to my natural test production slowing down, I’ve felt some soreness in my testicles after the 2nd day), but still better than how I was before.
I am really hoping for the best and am really looking forward to feeling better but just wanted people on the forums to look at the labs and see if anything can be tweaked or if there is anything I should request from my endo in future visits, and what I can expect from week 2 and beyond.

I’m trying to read as much as possible from the stickies and learn as much as possible. Thanks!

Test/Procedure Result Normal Result
ESTRADIOL 24 0 - 39
Estradiol blood test N/A N/A
FOLLITROPIN 5.2 2 - 8
Free testosterone blood test N/A N/A
FSH blood test N/A N/A
LH blood test N/A N/A
LUTROPIN 7.9 2 - 9
PROLACTIN 10.1 2 - 18
Prolactin blood test N/A N/A
SEX HORMONE BINDING GLOBULIN 14 10 - 50
Sex hormone binding globulin blood test N/A N/A
TESTOSTERONE 185 -
TESTOSTERONE.FREE 39.6 -
Total testosterone blood test N/A N/A
@LABCATEGORY_CREATININE@ 0.76 1 - 1
@LABCATEGORY_FINGERSTICKVALUE@ 79 65 - 99
@LABCATEGORY_HEMATOCRIT@ 45.3 39 - 50
@LABCATEGORY_HEMOGLOBIN@ 15.6 13 - 17
BASOPHILS 16 0 - 200
BASOPHILS/100 LEUKOCYTES 0.2 -
CALCIUM 9.7 9 - 10
CARBON DIOXIDE 27 21 - 33
CHLORIDE 102 98 - 110
Complete blood count N/A N/A
CORTISOL 8 3 - 22
EOSINOPHILS 95 15 - 500
EOSINOPHILS/100 LEUKOCYTES 1.2 -
ERYTHROCYTE DISTRIBUTION WIDTH 12.3 11 - 15
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 30.6 27 - 33
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 34.4 32 - 36
ERYTHROCYTES 5.11 4 - 6
Free thyroxine blood test N/A N/A
GLOMERULAR FILTRATION RATE.PREDICTED 125 60 - 0
Glomerular filtration rate/1.73 sq M.predicted.black 145 60 - 0
LEUKOCYTES 7.9 4 - 11
LYMPHOCYTES 1849 850 - 3900
LYMPHOCYTES/100 LEUKOCYTES 23.4 -
MEAN CORPUSCULAR VOLUME 88.8 80 - 100
Metabolic panel N/A N/A
Microsome antibody test N/A N/A
MONOCYTES 387 200 - 950
MONOCYTES/100 LEUKOCYTES 4.9 -
NEUTROPHILS 5554 1500 - 7800
NEUTROPHILS/100 LEUKOCYTES 70.3 -
PLATELETS 247 140 - 400
POTASSIUM 4.2 4 - 5
SODIUM 141 135 - 146
TESTOSTERONE 207 241 - 827
THYROPEROXIDASE AB 16 0 - 34
THYROTROPIN 0.9 0 - 5
THYROXINE.FREE 1.3 1 - 2
Total cortisol blood test N/A N/A
TSH blood test N/A N/A
UREA NITROGEN 18 7 - 25
UREA NITROGEN/CREATININE 0 6 - 22
UREA NITROGEN/CREATININE NOT APPLIC 6 - 22

2

Your Dr is definetly trying, but going the HRT route at 27 with out knowing the LH, checking other parameters could be an option to act as a bridge, but you still want to explore for the underlying cause other wise the HRT may be masking something else which may be out of balance. The symptoms of adrenals, thyroid, testosterone, GH, e2 all over lap making it challenging for the medical professionals to find out which one it could be. I also start with person writing a super detailed bio, going over possible scenerio or causes. We all know filling out charts at Dr’s office is a royal pain in the ass when you do not feel good in the first place. By writing out a detailed bio they tend to remember more detail then whats on a bunch of question. The person is not rushed for time and can take 4-5 days or longer if need to do it. In the office you are handed a crap load of papers given 15 minutes and rushed through. Then one needs to have the proper diagnostic tools to know where the imbalance may be inrelationship to information presented in the bio. The bottom line Dr’s on right track just need more exploration. I NEVER suggest to the Dr to have the person on 5 grams of androgel for more then 7 days with out proper blood tests before increasing the dosage. I just want to kick endos who put people on gels and tell them to come back in 3 months. In the mean time the person quality of life goes to hell in a hand basket before you even knowing it. With in 3-4 weeks one shot know if they are gels are going to work. I tend to suggest Dr;s use compounded gels and rotate the site in order for the person not to hit saturation at one specific site. This has helped tremendously. If the person comes up hypothyroid and has access to androgel with insurance then I may suggest the DR start out with 10 grams right off the bat to see if will work then retest in 7 days

3

Thanks for the reply hardasnails,

I definitely feel less of an effect on androgel the second week than I did the first week. However, overall I would say I’m better than I was 3 weeks ago with prior to any medication.

4

Thanks for the reply hardasnails,

I definitely feel less of an effect on androgel the second week than I did the first week. However, overall I would say I’m better than I was 3 weeks ago prior to any medication. The brain fog is definitely creeping back but my energy has made a marked improvement.

5

[quote]stategold wrote:
Thanks for the reply hardasnails,

I definitely feel less of an effect on androgel the second week than I did the first week. However, overall I would say I’m better than I was 3 weeks ago prior to any medication. The brain fog is definitely creeping back but my energy has made a marked improvement.

[/quote]

Keep on about getting proper levels check through blood.

6

Cortisol is low. Might be adrenal fatigue.

Check body temp as per advice for new guys. Low cortisol can increase rT3 reducing effect of your fT3.