Zero libido, low T (21, male)

lxm

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Little bit of background, Im 21 years old. About 3 years ago I became completely unintrested in sex and relationships and women in general. My libido completely vanished and I could not for the life of me become aroused and horny.
(i.e. that huge noticable surge/flucuation of sexual hormones when seeing an attractive female, or when a female is flirting with you and being sexually suggestive)

Since then ive pretty much felt like an old man, not intrested in sex at all and would rather do something else, when out partying and enjoying myself and attractive girls show intrest, put themselfs on a plate I feel completely 'baseline' like its a chore, I have to 'push myself' to interact with them and when it ever comes down to sex etc they will become extremely aroused and I will feel nada, ill end up yawning, loosing intrest within 5 minutes of foreplay and go find something else to do. Recently with more steady partners its been causing real issues and its really effecting quality of life, Im 21 and want to start getting into relationships, and its really not fair me pretending to be intrested in partners just to keep them happy, I wish I could experience that crazy aroused state that I used to when a teen.

During day to day life ive also started to become unmotivated, with no intrest in setting goals, moving forward in life, I pretty much exist at 'baseline' and no more, im not depressed as my mood is fine.

Most recently ive started to experience night sweats, really cold soaking wet episodes, and also my memory has been really bad, putting down a set of keys then five minutes later searching the whole house for 20-30 minutes for them, only to find them in a simple place, also ive been finding it very difficult at work writing up the most basic of reports which has been causing issues.

I went to the doctors about 14 months ago (September 2011) and explained all of this, she ordered a blood test, it came back as 12.5nmol. she told me this was normal for a 21 year old male and my problems were mental.

I went away and decided to change my diet to contain a more balaced range of macros (carbs,fats,protien), eating fish, lean meats salad & veg along with healthy fats, I started doing cardio x5 a week and lifting weights x3 a week. I lost about 48lbs in weight (220lbs 30%bf to 170lbs 22% bf) from september 2011 - april 2012. I was still feeling terrible and although I had lost lots of weight I had zero muscle mass under what I had lost and at 170lbs held an extremely abnormal & disproportionate level of bodyfat. I then continued the lifting and cardio and struggled hugely. Between April 2012- August 2012 I went on a very consistant and strict working regime and mealplan with cardio and in the 16 weeks I made zero gains and failed to loose any of the extremely flabby fat stores I held. No matter how hard i tried I could not lift weights.

my current body comp; 175lbs, 6ft, 20% bf+?
Embedded Image Unvailable

In October 2012 I went back to the doctors, only this time to see a different person and explained everything to him, explained I had made all of these changes and there had been zero difference, he listened to me and took more bloods, then came back at 13.5nmol He decided to send me to see an endocrine specialist.

I visited the Endo at the start of january 2013, He looked at my body and noticed high levels of fat, and also stated he could feel non fatty tissue growth in chest he took bloods and the below results came back ;

BLOOD SAMPLE 1
C-REACTIVE PROTEIN = LT4 mg/l
ALT =25 u/l
BILIRUBINS =10 umol/l
ALKALINE PHOSHPHATASE =75u/l
ALBUMIN = 44 g/l
SODIUM = 144mmol/l
POTASSIUM =4.4mmol/l
UREA = 6.7mmol/l
CREATININE **60umol/l
ESTIMATED GFR = GT60ml/min

BLOOD SAMPLE 2
TSH = 0.78mU/l
TOTAL HCG = **LT1u/l
SEX HORMONE BINDING GLOB **12.7nmol/l
TESTOSTERONE = **10.6nmol/l
PROLACTIN = 126mU/l
FSH = 6.9U/L
LH = 6.4U/L
OESTRADIOL= **206pmol/L
FREE ANDROGEN INDEX = 84.25

He says he is confused that FSH/LH are a good range yet T levels are 'low end of normal' and estrogen is 'slightly high'

Is anyone willing to give theories and thoughts to my most recent bloods and outlook on my story/history ? What can be done to sort out my issues ?

Thank you.
 
Do you have Vit. D level?

Why confused. This is a picture of Mixed.

Also, include reference ranges for abnormal tests. Do you have any prior tests?
 
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"She told me this was normal for a 21 year old".

Did she listen at all to your symptoms or do a physical exam with her eyes open? You're curvy in all the right places.....for a woman.

I had a very similar body type as you - just fatter. Now that I've been on TRT for almost a year while I've lost weight it's the change in body composition that is the most dramatic. Now I work hard at the gym but the biggest change is my waist got smaller and my shoulders broader. I've put on quite a bit of muscle which was almost impossible before. I'm still fat but a much more "manly" fat....if that makes sense.

Anyway welcome.....
 
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Do you have Vit. D level?

Why confused. This is a picture of Mixed.

Also, include reference ranges for abnormal tests. Do you have any prior tests?

I have two prior tests as stated from my regular doctors, test levels @ 12.5nmol & 13.5mnol, I dont have the other values but I shall get them on friday. I have a further blood test booked on friday and have another appointment with the endo in 4 weeks, he has requested the following in the enxt set of bloods;

testostorone
SHGB / FA1
LH, FSH
TSH, FT4
Cortisol
(?)XXY karyotype please

I dont know why he said he was confused or unsure, the Endo seems to be justifying reasons for my hormones to be so messed up and seems to try and justify different reasons for him delaying me treatment..

Firstly he said that its normal for male T levels to start declining after late teens (i.e. its normal for my T levels to start dropping now) I then questioned this and stated 'so if im at my peak now at 10.7nmol, its only going to go down from here ? so if I feel this bad now how will I feel in 5, 10 , 15 years time, He gave me a funny look as if he didnt like me questioning his judgement.

The last 3 blood results have shown a decline in T levels
September 2011 - 12.5mnol
October 2012 - 13.5nmol
January 2013 - 10.7nmol


Secondly he said that I shouldnt really be feeling as horny as I did when I was a young teenager, that spontaneous arousal is really only during puberty and that I shouldnt worry. I know this is rubbish right away and that at 21 I should be going wild with women, I dont want to blow my own trumpet but I get lots of attention and offers from females but I dont care about them and show no intrest. I feel like an old man at 'baseline' I have pretty much zero sexual homronal flucuation at all!!

"She told me this was normal for a 21 year old".

Did she listen at all to your symptoms or do a physical exam with her eyes open? You're curvy in all the right places.....for a woman.

I had a very similar body type as you - just fatter. Now that I've been on TRT for almost a year while I've lost weight it's the change in body composition that is the most dramatic. Now I work hard at the gym but the biggest change is my waist got smaller and my shoulders broader. I've put on quite a bit of muscle which was almost impossible before. I'm still fat but a much more "manly" fat....if that makes sense.

Anyway welcome.....

Thank you for the welcome, I thought a picture of my body may help people on here see my situation, I do not have the body of a man and i feel more womanly by the week.. I start gossiping more with the females at work, I feel more confortable sitting with them now than with the 'guys', Ive started to feel a little emotional now and again with lack of assertiveness etc.

The original visit to my doctor back in september 2011, no she didnt listen to any other symptoms, and after the test level of 12.5 she sent me on my way, that is why I went away and changed my lifestyle, and when nothing changed I went to the male doctor who understood my problem.




TOTAL HCG = **LT1u/l Range = 1-5
SEX HORMONE BINDING GLOB **12.7nmol/l Range = 17.6-48.8 nmol/L
TESTOSTERONE = **10.6nmol/l Range =9.9 - 27.8
OESTRADIOL= **206pmol/ Range = 0-156
 
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What's up with the psoriasis rash thing you have going on? Any of the doctors mention that? Probably unrelated, but thought I would bring it up.
 
What's up with the psoriasis rash thing you have going on? Any of the doctors mention that? Probably unrelated, but thought I would bring it up.

I have psoriasis (plaque) and get it treated with UVA/UVB phototherapy, ive recently enjoyed 8 months remission (100% clearence after final treatment session) and it has only just returned recently. Im back on UVB light treatment for it
 
Have you suffered any blows to the head or your balls? are you exposed to high doses of environmental estrogens? Did you have a 'manly' body before?
 
Another case of low SHBG leading to excess free estrogen.

I have the same story as you do, but this condition is extremely rare and not may doctors understand why supplementing with testosterone will not fix it.
 
Have you suffered any blows to the head or your balls? are you exposed to high doses of environmental estrogens? Did you have a 'manly' body before?
3 - 4 years ago I got extremely drunk one night and ended up found laying in the side of a country road in the early hours with cuts & bruises, no idea what had happend to me, but after that I experienced extreme pain whilst urinating and ejaculating, painscale = 11/10 every single time, so much so that It would feel like volts of electricity flushing down my thighs. I put up with this for 2 years and finally went to the doctors last may and turned out to be a urethral stricture with extreme narrowing half way down the penis urethra. This was sorted via operation and ive not had the same problems since, My endo expresses view that he does not think they are linked.

From the ages of 0-7 I was a normal skinny boy then suddenly without reason I started putting on alot of weight, my parents were lost as to why this was as I was very active, by the time I was 9 years old my weight in stones matched my age upwards.

Another case of low SHBG leading to excess free estrogen.

I have the same story as you do, but this condition is extremely rare and not may doctors understand why supplementing with testosterone will not fix it.

Hopefuly my endo ( a young registrar) consults with his seniors...
 
Another case of low SHBG leading to excess free estrogen.

I have the same story as you do, but this condition is extremely rare and not may doctors understand why supplementing with testosterone will not fix it.

I don't know James....I too have very low SHBG and TRT did the trick for me. While I'm very sensitive to E2 and seem unable to tolerate even normal amounts TRT saved my life.
 
3 - 4 years ago I got extremely drunk one night and ended up found laying in the side of a country road in the early hours with cuts & bruises, no idea what had happend to me, but after that I experienced extreme pain whilst urinating and ejaculating, painscale = 11/10 every single time, so much so that It would feel like volts of electricity flushing down my thighs. I put up with this for 2 years and finally went to the doctors last may and turned out to be a urethral stricture with extreme narrowing half way down the penis urethra. This was sorted via operation and ive not had the same problems since, My endo expresses view that he does not think they are linked.

From the ages of 0-7 I was a normal skinny boy then suddenly without reason I started putting on alot of weight, my parents were lost as to why this was as I was very active, by the time I was 9 years old my weight in stones matched my age upwards.



Hopefuly my endo ( a young registrar) consults with his seniors...


sounds like something happened to you before you even had a chance to hit puberty. Hard to say if its genetic or environmental.
 
I don't know James....I too have very low SHBG and TRT did the trick for me. While I'm very sensitive to E2 and seem unable to tolerate even normal amounts TRT saved my life.

Then you must be taking an anti-estrogen? The biding capacity of SHBG is separately genetically determined and can differ by a factor of 5 from individual to individual. The question is... when you increased your T with TRT, did SHBG rise to match? If it didn't, was your FAI normal? In people with geneuine low SHBG, the FAI will remain double normal.
 
Then you must be taking an anti-estrogen? The biding capacity of SHBG is separately genetically determined and can differ by a factor of 5 from individual to individual. The question is... when you increased your T with TRT, did SHBG rise to match? If it didn't, was your FAI normal? In people with geneuine low SHBG, the FAI will remain double normal.

My tT started around 190 and my SHBG was middle range (18ish I think) and my E2 was 22. As tT went up to 500+ (700 peak) my SHBG went down to a few points below the low end of the range (around 11 I think). E2 has fluctuated from 0-30 during this time with little effect on SHBG. This caused my fT to shoot up just out of the top of the lab range (25.1).
 
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James, I have seen people on other forums with low SHBG on TRT who do great. Some people do poorly though. It doesnt seem to be a fact that low SHBG means TRT will be unsuccesful. You seem to emphasize that it is. How can this be explained?
 
James, I have seen people on other forums with low SHBG on TRT who do great. Some people do poorly though. It doesnt seem to be a fact that low SHBG means TRT will be unsuccesful. You seem to emphasize that it is. How can this be explained?

The binding capacity of SHBG varies from individual to individual. If someone has a low concentration of SHBG and feels fine, it may be that they have the more efficient version of SHBG. Low SHBG, by itself, is a marker of poor health.

"However, evidence suggests that SHBG independently affects glycemic control and predicts both T2D and metabolic syndrome." (Roberts, 2010.)"

In addition, binding capacity changes with age. Studies show that the liver is capable of expressing variations in the structure of SHBG. SHBG-BC increases by up to 40% in aging men, along with SHBG serum concentration. Binding capacity is low in prepubescent boys, while overall SHBG concentration is high at this time.

Also, what else are these men using? If they are forced to "control" estrogen havoc caused by their low SHBG, then the low SHBG is obviously a problem and we can't call the low SHBG "OK" any more than we can call the low T condition "OK." If the men do NOT have estrogen problems with normal TT and low SHBG, then they obviously produce SHBG with a much higher binding capacity.

Let's now address the biggest bro-myth of all. "SHBG eatz my T!! How can i kell it plz"

From, Andrology: Male Reproductive Health and Dysfunction, page 42:

"The main dissociation of testosterone from binding proteins takes places in capillaries. The interaction of binding proteins with the endothelial glycocalyx leads to a structural modification of the hormonal binding site and thereby to a change in affinity. As a result, testosterone is set free and can diffuse freely into the target cell or binds together with SHBG to megalin, a cell importer protein.(Hammes et al 2005)."

Three points:
1) SHBG is required for transport into certain cell tissues.
2) SHBG, as albumin, is required to keep testosteorne from early metabolization and early excretion. T has a SHORT half-life and is barely water soluble. The only way T can diffuse througout the blood is via binding protein transport.
3) SHBG is the primary regulator of the free/bound fractions of T, E2 and DHT. Without adequate SHBG, free estrogen (which is rarely ever tested) can be much HIGHER than you think, because you are looking only at total E2.
 
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Because I see a ton a dudes around the 15 to 20ish mark who proclaim success with TRT. Maybe they are lying, maybe they arent healthy. I dont even know.
 
Another set of bloods to be taken on tuesday morning at 09:20..

Any tips ? fasted ? Hopefuly we can start to progress after these bloods are taken, I really need to get my life on track.
 
Latest bloods came back

Test = 9.6nmol
SHBG = 11.6nmol
Estrogen = 222pmol
LH = 4.7U/L
FSH = 7.0U/L
 
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