Low T at 18? Please help.

[ashechtman]

Ok bloods just came back, I'm so confused. On 2 tubes of testim, it said my testosterone was 1073 and my estradiol was 27...Sounds perfect right? I got bloods done about 1-2 hours after application. I've been on the 2 tubes of testim for a few weeks now and I don't notice anything. My libido is still low, my energy is pretty bad, my skin isn't very oily, no random boners, morning wood once in a while. In fact, at times I seem to be lethargic. I don't know whether or not to stay on the testim or switch to test cyp injections. Any help fellas?

 

[Midnight80]

If your T level is that high and you don't feel better then maybe yout symptoms are not completely due to low T?

 

[ashechtman]

I had read that putting the gel on the same arm used during the blood draw can alter the results. Anyone know if this is true? I know the day of I made sure to not put it on near the blood draw site but the preceeding days I may have.

 

[jester72]

I'm going to say it doesn't matter. It's a hormone that's systemic in the blood, and it's not going to miraculously all collect in one spot.

That number is WAY higher than a TRT dose should be (over all), so I'm guessing that was probably close to, if not a peak level. Am I correct that that's a Total Testosterone Serum figure? What was your Free Testosterone figure? If that was low, that could very well be your problem.

 

[ashechtman]

Yes that was my total testosterone, my free testosterone I don't have the number but my doctor said it was also high above the reference range I believe. Also that was definitely a peak value considering it was about 2 hours after application.

 

[ashechtman]

My shbg is on the low end of normal, I think that's the problem. I'm well aware that low shbg makes gels pretty useless but how about injections?

 

[ashechtman]

Shbg was 13, ref range is 10-50. Could that be the problem?

 

[traumaj1]

Shbg was 13, ref range is 10-50. Could that be the problem?

There's something missing from your story. Not flaming... just need more info!

Firstly... why did you have your test level drawn at 16? This isn't standard practice for that age group. This leads me to believe that you had symptoms of hypogonadism or a similar affliction. If this test was done by a doctor, then why wasn't it investigated further back then? Did you have any other labs drawn then?

Secondly... Your recent stim test alluded to a possible hypothalamus deficiency. Did you have labs for the rest of the pituitary, or just the 2 stim tests? Are you getting more labs or a MRI of the pituitary/hypothalamus?

Lastly... your TT is at or near the upper limit. Not horrible, but not really TRT values either. Elevated FT... how high though? Low/lower SHBG will equate to higher FT levels. With TRT, it's a big game of trial and error to get things dialed in.

Ok... this is last... I'm still bothered by the fact you had values drawn at 16. You have no answers as to why you were low. You are now on TRT with limited improvement. I would be highly suspect of other pituitary insufficiencies. If you are cool with this doc, have him put you through the ringer! Get B12, iron, vitamin D, etc drawn also.

Good luck!

 

[Zyglamail]

Shbg was 13, ref range is 10-50. Could that be the problem?

I do8bt thats the whole problem but its not helping.

The reason I asked my earlier questions is because at your age low T is very unlikely unless there were other underlying problems. mineral deficiency, intestinal pathogens etc which lead to systemic inflammation and poor functioning of adrenals, thyroid etc etc.

I would ditch the general doc and look for a doc who practices function medicine.

 

[ashechtman]

Sorry for the delay, I'll answer all your questions now.
1) I was having symptoms, no energy, low motivation, hard time building muscle, put on fat way too easily, no hair anywhere, no morning wood, low libido, decreased bone density as verified by a bone density scan. It wasn't further investigated because I was 16 and my endo said I'm probably just a late bloomer (my dad was).

2) At 16 I got an MRI of my pituitary/brain and everything was fine, except for the fact that my pituitary itself was much smaller than normal.
3) In terms of labs and other body systems... My morning cortisol was tested to be normal, but in the high end of the normal range (blood sample, not salivary). My TSH has always hovered a little high, around 3.1-3.9. Now before you say "you're hypothyroid", my free T4, free T3, reverse T3, antithyroid antibodies, have always been normal, and I have no symptoms of low thyroid. In fact, I have HEAT intolerance, lol.
4) My mom is into functional medicine and has always attacked me in that approach. I take plenty of vitamin D, fish oils, a good bioactive multi, etc... Oh and my DHEA levels has always been very good.

By the way, I ditched my original doctor (the endo that has been following everything), because when he decided to put me on testosterone, his only protocol was for him to do a 400mg injection once a month. I walked out the door when he said that. I'm now seeing a VERY good urologist who is treating me.

Follow up: He currently has me on 60mg test cyp e3d. He had me put sperm in a cryobank just in case a clomid/hcg restart doesn't work in the future. At the moment, no AI or HCG, he says he'll add those in if needed. I feel great since switching from the testim to the test cyp. I don't know why but I have loads of energy, morning wood, finally horny, and oily skin. I think my skin was absorbing the testim too fast, causing a spike a few hours after application and a very low trough for most of the day.

Hope that answers all your questions.