19 and in need of HRT

[Glaim]

Initial bloodwork

TSH, SERUM <0.05 uIU/ml (0.70-6.40)
Testosterone, total 55 NG/DL (241-827)

Second Set of blood work

Testosterone, total 148 ng/dl (241-827)
TSH, SERUM 3.43 u/IU/ml
FSH, Serum 5.7 miu/ml (0.4-8.7)
Prolactin 6.53 ng/ml (2.10-17.70)

Okay, now the initial TSH I can explain due to my dabbling with T3 because I have a hell of a time losing bodyfat. I was just coming off of it. I've never used prohormones/aas, btw. After 3 weeks, my TSH returned to 3.43, but my T3 uptake/T4/etc. was depressed. I can't give exact levels as I'm still trying to get a copy of it. I just received a message on voice mail saying that my LH results came in as well and are "normal", so he is confused as to why my testosterone is low, as LH and FSH should be upregulated due to decereased testosterone.

He had an MRI done and the pituitary looked okay, so he's kind of on the edge of whether or not he wants to refer me to an endocrinologist for HRT. I want to hit him. I'm 19! Gah...anyways...any ideas folks? Should FSH/LH be high considering the low test? He's sort of out of ideas.

 

[pmgamer18]

It is hard to say you need to do a lot of tests before you take any meds for this. You could be secondary but there is a lot of tests you need read SWALE testing.
And here is a link the the AACE Guildlines. Reading this will help you understand more about this. You need to learn as much as you can finding a Dr. that knows how to test and treat this is not easy. Print this and give a copy to your Dr.
Phil
http://www.aace.com/clin/guidelines/hypogonadism.pdf

 

[Glaim]

re:

Well, I actually brought him the list of tests that Swale has done, and requested those. As most doctors are, he's pretty arrogant and said it was unnecessary. I exhibit all the traditional signs, been losing strength, gaining fat (even though I'm pretty strict with my diet), tired as hell all the time, little interest in sex, little body hair, irritable, etc.. Only thing I don't seem to have is the erectile dysfunction. I don't get random erections, but I have no trouble getting it up if need be.

 

[mxim]

when you have a high lh and fsh,it usually means the problem lies within the testicles(primary hypogonadism). i would get your sperm count measured as well to see if you are fertile. did you ever use steroids?if so,how long ago?
do you have a sex drive? wake up with erections?

 

[Glaim]

re:

when you have a high lh and fsh,it usually means the problem lies within the testicles(primary hypogonadism). i would get your sperm count measured as well to see if you are fertile. did you ever use steroids?if so,how long ago?
do you have a sex drive? wake up with erections?

I've never used steroids, which is generally considered a bad thing while taking T3...but I actually felt better and slightly stronger while using T3, oddly enough. I don't wake up with erections, and sex drive is next to nil. I can get an erection, but I'm either too tired or just have no interest in sex.

LH and FSH were both in the normal range, and I didn't have a pituitary tumor or any enlargement. Would that indicate some sort of issue with the hypothalamus?

 

[SWALE]

My recommendation: see an Endocrinologist. You need someone who knows far more than your PCP now.

The word "normal" has no value here, nor does a single LH. It's production is too pulsatile, and half-life too short.

 

[mranak]

I wish you had some free testosterone numbers, which are more reliable tests and the numbers mean more.

In my non-medical and uninformed opinion, you messed up your thyroid which in turn messed up your testosterone. I think that tyroid problems should always be resolved prior to dealing with testosterone problems.

Your thyroid situation has gotten better and your testosterone _seems_ to be recovering as well, but it is really hard to tell without a more accurate free testosterone result. Considering your age and situation, I would recommend against supplimenting with testosterone unless perhaps the intention is to then wean you off of it. Hell, even though you having done an AAS cycle, maybe PCT is appropriate, although your LH and FSH are normal.

 

[greatgro]

Those first bloodwork levels are SO low, I'd wonder how accurate they were. Maybe it was just a bad test.

 

[Glaim]

Re:

I actually had the bloodwork done at two separate locations, by two separate doctors. My understanding is that with T3 supplementation, T3 actually INCREASES total testosterone, but decreases free. So my having used T3 should have had the inverse effect and increased my test levels.

I tried to get him to measure for free test, but it's like pulling teeth with the guy. But regardless, with total test levels that low, wouldn't it be indicative of low free test as well? I'm hoping to be getting a referral here soon.

 

[Weatherlite]

You can still have decent free test levels when your total test is low. The body compensates by altering the SHBG levels.