No Morning Wood, Low Free Test / High E2 ?

Pharma / TRT Testosterone Replacement
1

Hi all,

I haven’t had morning wood in years despite being very young. I just turned 23 a few months ago.

I am very physically active and in great shape. I lift weights regularly and do lots of sports and cardio. I am 10-12% bodyfat. I am otherwise fully healthy so I don’t know what the problem could be and why this is happening.

Symptoms of concern: no morning wood, lowered sex drive (still get horny at times… but nothing like when I was in high school), weaker erections (I’d still give them a solid 7-8/10… but when in high school i was off the scales hard… 10/10 if not 11/10), have not had a spontaneous erections (i.e. “no reason boner”) in years.

Despite the above symptoms, I have a lot of muscle mass (avid bodybuilder - 5’11, 185 lbs at about 11% BF), do not have man boobs, gyno, or puffy nipples, I have tons of energy, and no mental fog. All of this combined - with my testicles being a very decent size and very hard to the touch - has me hopeful that my body IS still capable of producing adequate testosterone. However, it makes my negative symptoms (non-existent morning wood for years on end, etc) all the more complexing

I suspect this is all hormonal of course… but I have never ran a cycle that could have throw my hormones off. The only thing I have ever “taken” is protein powder which I am sure is fine. I have now started zinc supplements, however, to try and get the wood back. So far, this has yielded no success.

My E2 seems to be in the high range of normal and my free test in the low range of normal. I think these two things could be related. Either way, I suspect this is the cause. Everything I am reading suggests you should not be in the low range of normal for test / high range of normal for E2 as a 23 year old male in excellent physical condition. Yet, as my results are all “in normal range”, my doctor is convinced I am fine.

I had one thorough test done recently. The results are below. This was done after finally demanding to be referred to an endo. Prior to this my GP would only test for testosterone and also FSH+LH+TSH(which of course is not enough on their own to tell the whole story). These results are also posted.

I am getting another thorough reading done in the coming months and will post the results. I am in Canada so the wheels move slowly with the medical system. On the plus side, all my tests are free.

A few questions:

  • Would and AI like arimidex be something to pursue?
  • Should I continue with zinc supplementation(I started today) or will this risk seeing future tests giving a false reading?
  • Could this be thyroid related even if my TSH seems normal? I do sweat a lot. Although I have no idea if that is due to an overactive thyroid or me just being a sweaty guy.
  • Is my low range free test / high range E2 fine? Or is it a problem? I think the latter. Doctor seems to think former.

Thanks to all for any help!

Test results follow (all tests taken in the AM; for each test I have provided the entirety of what was tested for):

.
.
.

May 1 2013 Test Results

  • DHEAS: 8.8 umol/L (ref range 2.3 - 18.7)
  • Prolactin: 11 ug/L (ref range 3 - 13)
  • LH: 3 IU/L (ref range 1-9)
  • FSH: 2 IU/L (ref range 1-19)
  • TSH: 1.88 mU/L (ref range 0.3 - 5.6)
  • Total testosterone 18.8 nmol/L (ref range 6.1 - 27.1)
  • Free testosterone: 333 pmol/L (ref range 110 - 660)
  • Bioavailable testosterone: 7.8 nmol/ L (ref range 2.8 - 15.5)
  • SHBG: 44 nmol/L (ref range 13 - 89)
  • Estradiol: 132 pmol/L (ref range 40 - 160)

The less thorough tests that follow were done at a different lab, thus the different reference ranges

January 19 2013 Test Results

  • TSH: 1.38 mIU/L (ref range 0.35 - 5)
  • LH: 6 IU/L (ref range 2-9)
  • FSH: 2 IU/L (ref range 2-12)
  • Free Testosterone: 37.4 pmol/L (ref range 31 - 94)

January 12 2013 Test Results

  • TSH: 1.38 mIU/L (ref range 0.35 - 5)
  • Total Testosterone: 22.3 nmol/L (ref range 7.6 - 31.4)
  • Free Testosterone: 46.6 pmol/L (ref range 31 - 94)

June 2012 Test Results

  • Free Testosterone: 42.8 pmol/L (ref range 31 - 94)
2

Free testosterone is a problematic test - it does not have a clear interpretation or correlation with symptoms. Bioavailable T is better. In any case, your free testosterone isn’t low.

3

[quote]seekonk wrote:
Free testosterone is a problematic test - it does not have a clear interpretation or correlation with symptoms. Bioavailable T is better. In any case, your free testosterone isn’t low. [/quote]

Not low but rather low-end in some of these tests, best case average. This only worries me given my E2 is on the high end and… of much greater concern and the main driver for my worries… I have had no morning wood in years and lowered libido / erection quality compared to a few years ago. I realize these things naturally decline with age but at age 23 I feel I should still be in my “peak”, no?

4

Yes, you shouldn’t have to worry about erections until at the earliest your 40s or 50s.

You probably still have nocturnal erections without realizing it. Morning erections are just nocturnal erections you happen to wake up in the middle of.

People with your T levels do not usually have problems with libido or erections, so at least keep an open mind that something else may be involved. For example, psychological factors can also interfere with libido and erections. Self-monitoring (i.e., worrying about your libido or about the quality of your erection) in particular is a well known libido/erection killer. For someone prone to anxiety or rumination, this can become a really bad problem.

5

[quote]seekonk wrote:
Yes, you shouldn’t have to worry about erections until at the earliest your 40s or 50s.

You probably still have nocturnal erections without realizing it. Morning erections are just nocturnal erections you happen to wake up in the middle of.

People with your T levels do not usually have problems with libido or erections, so at least keep an open mind that something else may be involved. For example, psychological factors can also interfere with libido and erections. Self-monitoring (i.e., worrying about your libido or about the quality of your erection) in particular is a well known libido/erection killer. For someone prone to anxiety or rumination, this can become a really bad problem. [/quote]

Fully acknowledged and accepted! Luckily, as said above, I can still obtain erections easily. I also still have a healthy enough libido. Although, also as said above, I am for sure not as horny as in high school / erections are not quite as hard as then / they aren’t quite as easy to achieve although I certainly don’t have trouble getting it up.

It is just the total lack of morning wood in years that worries me. Surely, I would have woken up during a nocturnal erection at least once or twice over the years? :S I used to get them all the time. A total lack of spontaneous erections just also seems odd. At 23 I feel these things all in conjunction are a bit strange.

6

Most people are horniest as teenagers, so it is not abnormal to see some change. The question is whether it is a problem for you.

To check if you have nocturnal erections, you can do the postage stamp test or something similar. Google it if you don’t know what that means.

7

[quote]seekonk wrote:
Most people are horniest as teenagers, so it is not abnormal to see some change. The question is whether it is a problem for you.

To check if you have nocturnal erections, you can do the postage stamp test or something similar. Google it if you don’t know what that means. [/quote]

I don’t mind the libido dip. That isn’t a problem for me. But the lack of morning wood is, if only mentally, as not having morning erections I know can be linked with ED. I do not have ED - knock on wood it stays as such! - but the link just makes it somewhat unsettling. Then seeing my E2 in the high-normal range, combined with test being okay but certainly not spectacular just makes me want to ensure everything is functioning as it should be. In particular my free test, which in some results was in the low normal range despite being 23 in great physical shape with all tests being done in the AM.

8

Something you can try to check this is to drink lots and lots of water before bed, so you’ll wake up several times during the night to go to the bathroom. If you’re like me, you’ll have nocturnal erections during some of the awakenings in the second half of the night. (I never have morning wood either independent of how high my T is, endogenous or exogenous.)

9

Need:

fasting cholesterol, can be a problem if too low!
fasting glucose

ALT/AST liver markers.

LH and FSH are low. FSH is the better indicator as it is steadier and LH changes a lot. FSH seems consistent.

Thyroid: TSH was a problem on first labs then down. You need to check your body temperature to get an indication of overall thyroid function. Many who come here are iodine deficient. Have you always used iodized salt? Read the thyroid basics sticky. If temps are low, you should follow up with TSH, fT3, fT3, rT3. T3 and T4 are rather useless. We are interesting in the free hormones. Variations in one’s thyroid binding globulin make the value of T3 and T4 rather vague. We want to see TSH near 1.0, rT3 lower not high, fT3 and fT4 near mid range. The “normal” in the ranges is rather meaningless, but most doctors do not understand that. Doc palpates your thyroid. Does your neck appear thick there?

Read the advice for new guys sticky! CAREFULLY. You are looking for causes of your low T, so you need to be considering the possible issues in that sticky.

Zinc will not do much. Anastrozole/Arimidex could be used now to deal with the E2 as you explore other things that might be the cause. Dose suggested in the new guys sticky.

We have lots of guys come here with problems like this, often a lot worse. So you are not alone. Reading the stickies is the best thing that you can do now. There is a lot to absorb and you will not get it all first pass.

10

[quote]KSman wrote:
Need:

fasting cholesterol, can be a problem if too low!
fasting glucose

ALT/AST liver markers.

LH and FSH are low. FSH is the better indicator as it is steadier and LH changes a lot. FSH seems consistent.

Thyroid: TSH was a problem on first labs then down. You need to check your body temperature to get an indication of overall thyroid function. Many who come here are iodine deficient. Have you always used iodized salt? Read the thyroid basics sticky. If temps are low, you should follow up with TSH, fT3, fT3, rT3. T3 and T4 are rather useless. We are interesting in the free hormones. Variations in one’s thyroid binding globulin make the value of T3 and T4 rather vague. We want to see TSH near 1.0, rT3 lower not high, fT3 and fT4 near mid range. The “normal” in the ranges is rather meaningless, but most doctors do not understand that. Doc palpates your thyroid. Does your neck appear thick there?

Read the advice for new guys sticky! CAREFULLY. You are looking for causes of your low T, so you need to be considering the possible issues in that sticky.

Zinc will not do much. Anastrozole/Arimidex could be used now to deal with the E2 as you explore other things that might be the cause. Dose suggested in the new guys sticky.

We have lots of guys come here with problems like this, often a lot worse. So you are not alone. Reading the stickies is the best thing that you can do now. There is a lot to absorb and you will not get it all first pass.[/quote]

I got my fasting glucose tested this December 2012 when I thought my lack of morning wood might be due to being diabetic. As I have/had no other symptoms of being diabetic, however, and my results appeared normal I dismissed this as being a possible cause. My fasting glucose was 5.4mmol/L. Reference ranges listed were “3.0 - 6.0 normal fasting glucose; 6.1 - 6.9 impaired fasting glucose; >6.9 provisional diagnosis of diabetes mellitus”.

FSH and LH - You make a good point that these often fluctuate as I have found in my research these are pulsatile hormones. I will still push for the pituitary examination but I doubt these are the problem for a few reasons: a) I have pretty normal total testosterone both times it was measured… which leads me to believe I have enough LH b) although my LH was 2 in my most recent test… it was 6 in the one before which is quite decent. as levels fluctuate, I am not too concerned at present (although I will still push for the pituitary exmination); c) FSH seems to hover around 2 consistently. It is my understanding, however, that this is only related to fertility. Is this correct? If so, how would sperm impact my morning wood?

TSH: I thought my thyroid would not be a problem as the TSH comes back pretty normal in every test. Is this mistaken? My readings since December 2012 are: 1.88, 1.38, 1.38, and 1.3. I will for sure read the thyroid stickies. How do you check body temperature? Simply with a thermometer? If so, which kind is best?

Cheers!

11

[quote]KSman wrote:
Need:

fasting cholesterol, can be a problem if too low!
fasting glucose

ALT/AST liver markers.

LH and FSH are low. FSH is the better indicator as it is steadier and LH changes a lot. FSH seems consistent.

Thyroid: TSH was a problem on first labs then down. You need to check your body temperature to get an indication of overall thyroid function. Many who come here are iodine deficient. Have you always used iodized salt? Read the thyroid basics sticky. If temps are low, you should follow up with TSH, fT3, fT3, rT3. T3 and T4 are rather useless. We are interesting in the free hormones. Variations in one’s thyroid binding globulin make the value of T3 and T4 rather vague. We want to see TSH near 1.0, rT3 lower not high, fT3 and fT4 near mid range. The “normal” in the ranges is rather meaningless, but most doctors do not understand that. Doc palpates your thyroid. Does your neck appear thick there?

Read the advice for new guys sticky! CAREFULLY. You are looking for causes of your low T, so you need to be considering the possible issues in that sticky.

Zinc will not do much. Anastrozole/Arimidex could be used now to deal with the E2 as you explore other things that might be the cause. Dose suggested in the new guys sticky.

We have lots of guys come here with problems like this, often a lot worse. So you are not alone. Reading the stickies is the best thing that you can do now. There is a lot to absorb and you will not get it all first pass.[/quote]

After reading the stickies as advised I realized I should post this. Some of it is in my OP as well:

In your case/thread opening post:

-age: 23

-height: 5 11

-waist: 32 inches

-weight: 185 lbs at 11% bodyfat (weightlifter)

-describe body and facial hair: lots of body and facial… typical Middle-Eastern genetics I suppose haha. Have to shave daily.

-describe where you carry fat and how changed: I carry most of my fat on my buttocks and love-handles. This has been the case as long as I can remember and I think may just be genetic as all of my family is like this, although perhaps my higher-end E2 may play a role as well

-health conditions, symptoms [history]: no history report

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: no Rx or OTC drugs. Never any hair loss drugs or prostate drugs. As I am a bodybuilder I will also add I am 100% natural and always have been. Never taken any drugs or supplements save protein powder (which I am confident is fine).

-describe diet [some create substantial damage with starvation diets]: varies between cutting and bulking cycles (bodybuilder) but my diet is always very healthy. All food groups and macros covered, lots of fruits and vegetables to ensure all my vitamins, calories are always in a very healthy range although again it varies between when I am trying to gain vs lose weight.

-describe training [some ruin there hormones by over training]: Gym 4x per week. Cardio 3x per week. I am very active but certainly would not consider it over training. I never feel tired or taxed. Workouts are only ever an hour max. I do my cardio and lifting on separate days. If anything, my level of activity I think would only help my cause and not hinder it.

-testes ache, ever, with a fever? Never

-how have morning wood and nocturnal erections changed: Morning wood = never. and this is why I am here. nocturnal erections: unsure of their frequency. After receiving advice to drink a lot of water to wake up in the middle of the night to pee I did indeed have an erection at about 4:00am… but it was not overly hard or large. Nothing close to what I would dub a full erection and far short of what I woke up with every day in high school. It went away almost immediately after waking. I have no ED and can always get it up for sex without issue.

12

the thyroid world is way bigger then tsh.

Ft3
Ft4
Tsh
Tgab
Tpo for hashimotos
Tsi for graves
Iodine or selenium deficiencies
Rt3 inactive form of t3 sits in the receptors of t3 and doesn’t allow it to work
T3 is the most biologically active thyroid hormone.

E2 is cleared at the liver get these tested as ksman said

Cortisol<~~~ this can mess with ur wood. Stress is a bitch.
C peptide
ACTH
Insulin
Igf-1 while ur at it cause if the liver is having trouble igf-1 could very well be low. Not saying this is your problem as far as morning wood but I think ur going to find elevated liver enzymes. Do you drink? Where do you carry body fat?
Go see a naturopath get a 4 time cortisol saliva test.

13

E2 132/3.176= 35.96. This is high but not concerning and without any signs of high E2 this may be the number you are suppose to be. I wish I has your labs… You could try an Ai low dose but make sure you are being monitored!!! You need estrogen!!

14

[quote]iw84aces wrote:
E2 132/3.176= 35.96. This is high but not concerning and without any signs of high E2 this may be the number you are suppose to be. I wish I has your labs… You could try an Ai low dose but make sure you are being monitored!!! You need estrogen!! [/quote]

I will get the tests you mention in your other posts.

If I go on an AI at a very low does, monitor myself, and it happens to bring my morning wood back with seemingly no negative side-effects… should I simply assume I just was converting a bit too much T to E and continue on a low does? Or should I continue to go through various sorts of testing?

If you say you “wish you had my labs” I assume you mean you think my readings are pretty decent? Thoughts on my free testosterone being a tad low i.e. lower 1/3rd at age 23 with all readings being at 8AM? This combined with my higher-end E2 makes me think converting too much T to E might be the problem. Some have suggested pituitary but I somewhat doubt this because:

  1. My testicles are a very healthy size, shape, and hardness. Would this not indicate they are getting adequate signaling from the pituitary? I haven’t had morning wood in years… surely they would have decreased in size and/or hardness by now if the pituitary was the problem?

  2. Although my LH checked in as 2 on my most recent test… it was 6 on the test prior which is quite good. As LH can fluctuate a lot, the reading of 2 certainly has me on notice… but also not ready to push the panic button just yet or finger the pituitary as my main suspect.

  3. Although my free testosterone is a bit lower than it likely should be (perhaps too much conversion to E?)… my total testosterone both times it has been tested has been quite decent (22.3 nmol/L and 18.8 nmol/L, respectively). Surely, this would not be the case if the pituitary was not functioning as it should be?

  4. FSH has been more consistent coming back at the low end both times at 2. But it is my understanding that this hormone is merely related to fertility. If so, why would it even impact my lack of morning wood to begin with?

15

[quote]seekonk wrote:
Something you can try to check this is to drink lots and lots of water before bed, so you’ll wake up several times during the night to go to the bathroom. If you’re like me, you’ll have nocturnal erections during some of the awakenings in the second half of the night. (I never have morning wood either independent of how high my T is, endogenous or exogenous.)[/quote]

Seekonk this doesn’t sound like a good plan. Not sleeping the whole night is not going to help lh production or T levels and all for what? To see an erection that he may or may not have? I think you prolly k ow more then me about trt and I have read ur posts and u do offer rational advice just on this occasion I wonder if this is a smart move.

16

Fsh holds a steadier level and shows better what kind of signals are being sent down.
Lh moves around a lot and not a good indicator.
Yes you could try an AI but what happens if you end up with worse issues.
Prolactin read this: Prolactin - Wikipedia
Your labs are fine bud. I wouldn’t worry to much but I would check out other things.

17

[quote]iw84aces wrote:
Fsh holds a steadier level and shows better what kind of signals are being sent down.
Lh moves around a lot and not a good indicator.
Yes you could try an AI but what happens if you end up with worse issues.
Prolactin read this: Prolactin - Wikipedia
Your labs are fine bud. I wouldn’t worry to much but I would check out other things.
[/quote]

What worse issues could I end up with if I went to an AI? I definitely don’t want to make things worse. And as I still am fully functioning as far as being able to get it up when it is time for relations - it is just the morning wood that has been missing for years now :S - I for sure don’t want to risk anything.

You say not to worry. Is a total absence of morning wood fine? A few things I have read indicate this… but most say otherwise. If the former it would certainly be welcome news lol!

18

[quote]iw84aces wrote:

[quote]seekonk wrote:
Something you can try to check this is to drink lots and lots of water before bed, so you’ll wake up several times during the night to go to the bathroom. If you’re like me, you’ll have nocturnal erections during some of the awakenings in the second half of the night. (I never have morning wood either independent of how high my T is, endogenous or exogenous.)[/quote]

Seekonk this doesn’t sound like a good plan. Not sleeping the whole night is not going to help lh production or T levels and all for what? To see an erection that he may or may not have? I think you prolly k ow more then me about trt and I have read ur posts and u do offer rational advice just on this occasion I wonder if this is a smart move.[/quote]

In case it wasn’t clear, I suggested doing it for just one night as a test to see if you get nocturnal erections. One night of waking up more is not going to kill your T production and it may give you some peace of mind.

I also suggested the postage stamp test. Have you done it yet, or do you prefer endlessly worrying and posting about it.

19

As I suggested 5:10 yesterday:
Thyroid levels, re-read above
Anastrozole, no harm if done right. Read the advice for new guys sticky for low dose and info re over-responders.

LS and FSH are both release together. FSH is a better indicator of average HPTA’s pituitary function. Yes FSH is more focused on fertility… but that is not the point.

re-read my 5:10 from yesterday and do not miss any points please

20

[quote]seekonk wrote:

[quote]iw84aces wrote:

[quote]seekonk wrote:
Something you can try to check this is to drink lots and lots of water before bed, so you’ll wake up several times during the night to go to the bathroom. If you’re like me, you’ll have nocturnal erections during some of the awakenings in the second half of the night. (I never have morning wood either independent of how high my T is, endogenous or exogenous.)[/quote]

Seekonk this doesn’t sound like a good plan. Not sleeping the whole night is not going to help lh production or T levels and all for what? To see an erection that he may or may not have? I think you prolly k ow more then me about trt and I have read ur posts and u do offer rational advice just on this occasion I wonder if this is a smart move.[/quote]

In case it wasn’t clear, I suggested doing it for just one night as a test to see if you get nocturnal erections. One night of waking up more is not going to kill your T production and it may give you some peace of mind.

I also suggested the postage stamp test. Have you done it yet, or do you prefer endlessly worrying and posting about it. [/quote]

I did the water test. Haven’t had the chance to go buy postage stamps yet but I plan on doing so.

Water test: woke up at 4AM to pee. Had an erection but not close to what I would deem “strong” or “full” i.e. it was not standing at the same upward angle it would when aroused when awake, was not fully hard but rather weak and malleable, was not as big as when my member is fully engorged with blood, and went away almost immediately after waking. All the opposite of what my morning erections where in high school as those were raging. But alas, I have no idea how rigid nocturnal erections should be and if what I experienced was fine or not.