Help Interpreting Labs & Symptoms - 19M

Pharma / TRT Testosterone Replacement
1

I’m a 19 Y/O male, 140 pounds, 5’8, and have been experiencing the following symptoms for about a year:

Low libido, noticeable fatigue, lethargy, lack of motivation, inability to concentrate, bouts of anxiety/depression, mild ED (although this has been getting a bit better), irritability, lack of quality sleep, cold hands and feet (this has also been getting better), inability to put on muscle despite good diet and weightlifting, moderate to severe gynecomastia, no morning erections

Furthermore, I feel like my puberty was stunted. My voice is still pretty high, I have no facial hair, minimal leg/arm hair, and have had gyno for 6 years.

I have been lifting heavy for one year (symptoms started happening a couple of months after I started lifting), but haven’t seen any changes to my body composition (still skinny fat with minimal muscle).

I had some blood tests done, but couldn’t get all the recommended ones because of a lack of money to pay for them (no insurance).

TT - 480 (300-1080 ng/dL)

Calculated free T - 85.9 (47.0 - 244.0 pg/mL)

SHGB - 42.1 (14.5 - 56.2 nmol/L)

Prolactin - 13.9 (4.0 - 15.2 ng/mL)

TSH - 2.580 (0.53 - 3.59 UIU/mL)

E2 - 10.1 (10.0 - 42.0 pg/mL)

Please let me know how my lab results and symptoms are looking. I know it isn’t much to work with, but this is all I could get done given my current financial situation.

I also talked to my GP, and he just said it’s psychological and referred me to a mental health clinic.

Thanks for the help. Much appreciated.

2

Punch him right in the nose. That piece of shit.

How dare he. There are many conditions that can stunt puberty. Read this. Read the entire thing. Delayed Puberty (for Teens) - Nemours KidsHealth

By the way did you take labs in the morning?
Any drugs? Medications? Hard injury?

Go see a good pediatric Endocrinologist. Do not ignore your symptoms. Your gp needs a mental health clinic.

Am sorry you are going through this at 19. You can’t turn back time…but now is the time to have a sense of urgency.

Also kallmann syndrome

Here’s an excerpt from the link above

Delayed puberty can also happen because of problems in the pituitary or thyroid glands. These glands produce hormones important for body growth and development.

Some people who don’t go through puberty at the normal time have problems with their chromosomes, which are made up of DNA that contain our body’s construction plans. Problems with the chromosomes can interfere with normal growth processes.

Males with Klinefelter syndrome are born with an extra X chromosome (XXY instead of XY). This condition can slow sexual development.

1 Like
3

I have looked into Kallmann and Klinefelter’s but don’t think either of those fit my current ailments. The only reason I mentioned the stunted puberty is because I’m in college - it seems like everywhere I look, I see guys my age with really hairy arms/legs, facial hair, and deep voices. However, my arm/leg hair is pretty thin, and my voice has sounded basically the same for the past three to four years (rather high).

Do you think the high-ish TSH level could be correlated to the delayed puberty? I’ve heard that optimal TSH should be 1.0, and anything above 2.0 is when symptoms start becoming noticeable.

Thanks for the reply.

4

Also forgot to reply to one of your questions:
Labs were taken at 8 am. No medications. No recent injuries. I’m generally a pretty healthy person despite these clear problems.

5

This is complicated stuff. You need a pediatric Endocrinologist that knows what to check for.

Unless ur TSH was excessively high like way over 5 I don’t think that would cause the issue.

TSH can vary during puberty.

You need to check pituitary and adrenal functions. And other stuff an Endocrinologist knows about. That’s a hormone specialist.

Your testosterone is low . Free t low . And it makes sense your estrogen low because testosterone is low. You need to investigate cause esp at your age. Can be testicles too. If you were 40 maybe you can jump to trt

6

Thanks for the response. Once I get some more money, I’ll schedule an appointment with an endocrinologist.

Hopefully someone else can chime in as well. I heard KSman is very knowledgeable so I’d love to hear what he thinks. I just want to get as many opinions as possible before pursuing further action.

7

Your doctor could use some more education, low E2 is bad for bone mineral density and in your case estrogen is low because testosterone is low. Low E2 is a smoking gun testosterone is low and you doctor doesn’t even see it.

This bring me to my next comment, GP’s should keep their noses out of areas of medicine for which they have zero knowledge and no training and you should have been referred to a specialist who deals in hormonal issues.

Not that the hormone specialists will be any better, the majority of doctors are stupid when it comes to hormones and big pharma who runs these medical schools is to blame.

Your SHBG is making things worse, it’s binding up a lot of your testosterone, free testosterone is near the bottom of the ranges. Men and women can have psychological problems as the result of low hormones, stupid doctors know absolutely nothing. Rinse and repeat, we see doctors every day scoring an F in hormones.

Most men need Free T to be 3/4 or higher up the ranges.

8

What would be your recommended course of action other than seeing an endo, as the other commenter suggested?

Would TRT help at all? I know I’m only 19 but I’m beginning to feel hopeless that I’ll never feel like a man.

9

The majority of endos are hormone ignorant, your location? I prefer to recommend a private specialists because that’s really where the hormone experts have resided for decades, sports medicine and anti-aging have been prescribing testosterone for 50+ years and the insurance based medicine has only just begun which is why most doctors are TRT ignorant.

Medical school doesn’t pay enough attention to hormonal therapies as it pertains to TRT, endo’s usually do thyroid and diabetes, not TRT.

10

Austin, TX

11

I’m a patient with Defy Medical who offers telemedicine, Dr Saya has been doing TRT for 20+ years and was once an insurance endo who left the worthless insurance healthcare that prefers to wait for disease to strike before doing anything.

He wants to get to the younger crowd and change things earlier rather than seeing you come in broken and riddled with disease at 50. My consult with Dr Saya was very different from any other endo visit, he asked me things no other doctor asked and told me things about myself I never knew.

It averages out to $1300-$2000 yearly, he doesn’t take insurance. Pay as you go, so not all up front.

12

I’ve heard of Defy. Need to get some money first, though, so it may be awhile. I’m a college student, so most of my money goes to textbooks and food. Hopefully I can turn that around ASAP. Thanks for the response.

Do you think I would be a candidate for TRT, though? Just based off of my lab work.

13

You really need to back off the trt option. Investigate! Yes you may need it. But it’s rare.

It is a huge decision for a young man to go on trt. Some become infertile. You have decided to take care of yourself. U can give it a few more months.

14

Sorry about that. You’re right about the endocrinologist. I need to exhaust all options before resorting to TRT.

15

Pediatric Endocrinologist. Try to find a very good one. Research. We have some guys where an Endo actually prescribed testosterone. Myself included. An 41.

Your hormone system very complicated. Diseases need to be ruled out. I have no doubt you will fix this.

Here’s some lab suggestions.

LH
FSH
Total t
Free t
TSH
Free t3
Free t4
Dht
Dhea-s
Acth
Am cortisol
Lipid panel
CBC
Metabolic panel
Ferritin
Igf 1

16

Will do. Had a CBC a month ago and all was normal. Thanks for great info. I really appreciate it.

17

If you can get testosterone higher, that will increase E2. I suspect your SHBG is overstating your testosterone status, do you have an LH test?

I believe your actual testosterone production is quite low which your low E2 cold be indicating.

Total T+SHBG → Free T → estrogen.

18

I don’t have LH or FSH tests.

Any recommendations for increasing test naturally? I already eat healthy, lift four times a week, and supplement with Vit D.

19

Avoid things that increase SHBG, medications and alcohol to name a few.

20

I don’t take any medications and drink alcohol around 2-3 times a year for family gatherings.