I recently had some hormonal bloodwork done and it came back with some odd/concerning-to-me results. Although Total Testosterone was normal (508 ng/dl), Free Testosterone came back very low (11.5 ng/dl). Prolactin, E2, LH and FSH were all within the normal range. I am seeing an endocrinologist soon but am very concerned at the moment as I am only 18 years old. I have been lifting for 3 years, currently weigh 215lbs @ 6’3, have a decent amount of facial hair (more than my father) and plenty of hair on my arms and legs, a very deep voice. Knowing all of that, I have over the past 3 or so months, developed a level of irritability that was not present before: I get angered easily. This is to the point where my close friends have noticed because I was a kid who literally never got mad, the anger is completely controllable and not an issue. I have made literally no progress in the gym in terms of physique in the past year yet have increased by bench from 225x4 to 225x11 in the past 3 months (my diet is very good and I train everyday).
I was wondering: how concerned I should be, what types of treatments exist for this, and what could cause this.
Also how am I making significant strength gains despite an extremely low free testosterone level?
TT is well below average for someone your age, no wonder no gains. Your FT is also trash.
You’re unlikely to get anything until some more years. Your body still has room to develop so your levels may improve anyway. Seeing a specialist for an opinion may be worth while. I would just closely track your hormones, vitamin content, and your sleep. Exhaust all low-hanging fruit before TRT.
There are only about one or two hundred things that could be causing a problem. What’s your workout routine? What is your diet? Really what is your diet? What else is going on? Smoking? Drinking? Binge drinking? Recreationals? And blood work when you have some.
@hardartery Good questions. Compare most people’s workout routine and diet to actual athletes and you’ll see a completely different worlds. Most overestimate everything. Although I still think he’s lower than average. Need to see the rest of the blood work.
There is very little chance an endocrinologist is going to shut down the HPTA of an 18 year old, with that said the only explanation for good TT and low FT is elevated SHBG which is not correctable in most cases. These are levels I would expect to see in a 50+ year old men.
Some doctors aren’t overly concerned with testosterone levels in range, but to a young man this has devastating effects because young men typically have the highest testosterone levels of anyone. TRT is mostly prescribed <300, which is the recommendations of the endocrine society and insurance companies have their own cut off points <300 and some <250.
The experts in testosterone are saying that men with thrive when FT is 15>, below this and men with start to decline and is usually seen in 50+ year old men. Your FT should be at the top of the ranges, the ranges go all the way to 26.5 pg/mL.
You’re not going to get TRT from a sick care doctor, most of all an endocrinologist. I haven’t heard you mention any symptoms of low testosterone like low libido or weak erections, in fact as you said you are making strength gains.
Your levels are already low given your age, I see often of men in this generation, it seems every new generation is seeing lower and lower testosterone and men in generally are becoming more irritable and mentally unhinged.
I believe in the next 20 years low testosterone is going to be very common, it surely has picked up in the last 10 years. You probably don’t need TRT now, but you will need it sooner rather than later in the trends continues which shows no sign of slowing down. As sperm counts drop, testosterone will follow.
You can’t expect everyone to look like the hulk or fill out like those buff muscular guys you see in the gym, genetics plays a role in muscle development. Genes will determine muscle potential, having optimal testosterone helps.
So far you have a single measurement. On the basis of this I wouldn’t necessarily conclude that you are low in T (hypogonadal) for your age. T can vary widely, ups and downs of up to 200 ng/dL over time are actually quite frequent. My lowest reading was 202 and my highest 397 within a time period of 5 years. You can find guys here reporting the same degree of variability and this is also in agreement with the scientific literature. Yes 11 ng/dL is lowish for your age but also not super low. About 30% of your peers have actually lower levels.
Your symptoms might point towards androgen deficiency but they can also be caused by many other reasons, physically and emotionally. Don’t underestimate the latter part especially when it comes to anger issues.
What you need to make a thorough assessment (of the physical part!) is a repeat measurement in 1 or 2 months of T including E2, SHBG, prolactin and a thyroid panel.
Im 30 years old and in similar situation with you.
I have 564 total T with 9ng/dl free t and all the symptoms. This is after I stimulated my t with dostinex. Before that I had 350 total t with 7.4 free T which is no very different. I will start TRT next month.
Endocrinologist visit will be a waste of time. He will not consider any treatment for you because you are in range. He will tell you you are fine, but you are not.
You can try to do everything naturally to fix T, if this doesn’t help you need to take decision whether to start TRT or not with all the risk and side effects it can cause, but also all the potential benefits. Nobody will make that decision for you.
I apologize to all but I am afraid I may have made a typo: my free testosterone is actually 11.5 pg/mL. (I got the units wrong). I am not sure how much this changes. Sorry again!
I’m sure everybody above already assumed it was a typo. Your numbers are well within the range of normalcy. Don’t let all that ‘you’ve got test levels of an old man’ horse crap get you riled up. At your age, you need to test it several times over a couple month period. Pay attention to your symptoms… not making ‘gym gainz’ is not a primary symptom and could be attributed to a ton of things. Be wary of jumping on TRT at your age. If you do, its likely private pay as I would be ashamed of an Endo that quickly scripted you.
Probably because you are in Bulgaria. But regardless why are you making blanket statements such as they above? You were just on here asking about a horrible protocol you were on and whether it was any good…?
I know what exactly the endo will tell him, because endos all over the world follow the same guidelines and I know what these guidelines say about testosterone in range.
Did you bother to read my post? I know what an Endo will tell him and rightly so. He needs further tests and evaluation… not you telling him ‘he’s not fine’.
Lets examine…
18 yet 215lbs at 6’3" … no issues there
Facial hair at 18… no issues there
Deep voice… no issues there
Irritability… no issues there; find me a teenager that’s not irritable
Bench increased to 225x11… that’s extremely good for an 18 year old… no issues there
He has not listed any of the major symptoms of low T except a complaint about physique and you tell him ‘he’s not fine’. Thats irresponsible. Just one of the many reasons I stopped following the TRT forum.
@blshaw Yes maybe you are right about this and it was right I added, that he should judge by the true symptoms as well - like energy, well-being, ability to focus, libido and so on. But he should not let the doctor tell him he is fine just because he is within range when in fact his numbers look clearly low for his age
I wouldn’t consider TRT at my current age simply to preserve fertility, does anyone have experience with HCG therapy? I don’t entirely understand how effective HCG can be in long term treatment.
I eat very clean and count macros (maybe I eat some ice cream sometimes but I am pretty proud of my dedication to my diet). Lift 7x a week, 8-12 rep range high volume heavy weights: Push/Pull/legs split with core on Sunday. I don’t smoke at all, I drink maybe once a month at parties where I still don’t overdo anything. I am waiting on some more comprehensive bloods and will get back to you there.
While your levels are not horrible I do believe this amount of work will only worsen them. Your body needs rest and recovery and if not provided will eventually lead to detrimental effects. Could also be a reason for your irritability. Just my $0.02.