Low normal test, super low E2, if TRT isn't the answer, what do I do?

I am young, 25, and from what I've read it sounds like TRT is a bad idea at my age and levels. I've tested several times at 400ish total test. Ref: 348 - 1148. The problem is that my E2 is not detectable on the regular or sensitive assay and I think that is where most of my symptoms come from.

The usual low t symptoms, no libido, low energy, drive and motivation. Joint pain and dry skin.

My LH is usually around 7-9 on a ref of 1.7 - 8.6.

Most people and doctors say that at my age testosterone isn't the answer, due to normal levels at 400, and free at 12 on a 9.6 - 25.6.

I also understand that low E2 is very bad for health, with mortality being significantly higher in low E2 men. Also for bone health, mental health, and skin health.

So how the hell do I get my E2 up if testosterone isn't the answer?

I am thin, 5'11 160.

If you raised your T levels, your E2 should also rise. Before I started TRT my E2 was unreadable, I was able to raise my E2 by supplementing with dhea, but then it also lowered my testosterone. How about a restart? Is Clomid (Clomiphene) Effective to Increase Testosterone, Fertility and Sperm Volume?

Read more at: https://www.excelmale.com/forum/sho...rease-Testosterone-Fertility-and-Sperm-Volume

I have done everything I can to naturally raise levels, good diet, exercise, no alcohol drugs or smoking. I am not overweight.

The only concern I have with clomid is that my LH is already at the top of the chart basically, and the goal with clomid is to get LH to the top right?

Since I am 400ish I'm told I'm normal, so testosterone isn't recommended for me. I don't know what else to do, because the joint pain is annoying and concerning.

How else can I raise my testosterone if no one will treat me, and I don't know if clomid will work. Also since E2 is low, an AI can't be used to raise testosterone.

400 isn't exactly normal for a 25 year old. You should be at your peak, around 800-900 right now, not 400. No wonder you don't feel good. Yes, you might be young for TRT, as there very well may be another fix to your problem. I would consult with a good TRT doc, and personally recommend Defy (which I'm sure you'll be told 100 other times on these forums...and for good reason).

Only a few members of EM are doctors, those of us who aren't can only offer you our advice guided by our reading, discussion, and experience. TRT for a guy your age is a bad idea - unless it isn't. I mean it would be a relief to find out why your levels are surprisingly low for a guy your age, but at the end of the day that question may not be answered.

All of of which means, though, that you need to have as complete a workup, a workup conducted by a skilled doctor. Do you have confidence in your physician?

You could have a consultation with one of the doctors at Defy Medical, maybe they could come up with something that could help you.

I understand and agree that 400 isn't good for a 25 year old, but technically it's normal in range. I just see a lot of people on here saying that when people post labs with 450 levels and are symptomatic, that their levels are good! Some of the more experienced members like nelson. They also state that TRT is serious, and at 450 it's not a good idea.

On some other forums I read people saying that a person with levels like mine won't really notice a difference from 400ish to upper levels of the normal range. So I'm confused, because it seems that when a young guy WANTS testosterone he's told not to, while someone like me who is a little wary of testosterone is pointed in the direction of testosterone.

I've had a lot of things checked: tons of labs(CBC, CMP, lipids, test, free test, LH FSH, prolactin, DHEA-S) multiple times since january last year.

Testicular ultrasound that was normal.

The only thing I haven't had answered here yet is what can I do if no doctor will prescribe testosterone because my levels are 400 ish. Which is the case with the local doctors, they say I'm slightly low, but not that bad and when I point out how low the E2 is they say it's because of the low testosterone. I mention how bad the low E2 is for health, and they say they can't give me testosterone, I am too young, it's malpractice, my fertility.

So how the hell can I raise my E2 without raising my testosterone by injections? I don't think clomid can help me, if the goal with clomid is to get LH to the high end of the range, and I am already at the high end of the range for LH!!!

I am so lost and confused, please.

Most important:
1. Can clomid help me?
2. Can testosterone actually help a person who's at 400 range?
3. How else can you raise E2 if I can't use testosterone or clomid? I would guess I'm not going to be able to be helped if no one will prescribe me clomid or testosterone.
4. I know defy exists, but I don't know if it's worth spending the money for a consult just to be told I'm not that low again. I've been to a bunch of doctors already and been told that.

Your question has been answered: call Defy Medical. They don't bow down at the altar of a mostly BS list of "normal" ranges.

lowtest said:

Most important:
1. Can clomid help me?
2. Can testosterone actually help a person who's at 400 range?
3. How else can you raise E2 if I can't use testosterone or clomid? I would guess I'm not going to be able to be helped if no one will prescribe me clomid or testosterone.
4. I know defy exists, but I don't know if it's worth spending the money for a consult just to be told I'm not that low again. I've been to a bunch of doctors already and been told that.

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1. Possibly, but I'm not well versed in that
2. Definitely!!!!! See my above responses about your age and 400...
3. Not sure, other than directly taking estrogen
4. Just call them...you won't be shunned because you're 25 and at 400.

Okay will do! Thank you, I am just absolutely angry with local doctors and the state of medicine at present time.

I just have wasted so much money on consults with doctors who just tell me that im in range! I just dont want to waste more money on being told im normal when E2 being low is a serious health concern from what I've read.

I get that my testosterone level is low for my age, but even steroid forums are saying that going from 400 to like 800 or 900 won't do much for a guy, because he was already normal. I just thought that if a steroid forum is saying it, and they are absolutely not anti testosterone, then it must have some validity.

I am not asking for an exact diagnosis here of course, more just asking for peoples experiences and things they've learned along the way. That's all!

lowtest said:

I get that my testosterone level is low for my age, but even steroid forums are saying that going from 400 to like 800 or 900 won't do much for a guy, because he was already normal. I just thought that if a steroid forum is saying it, and they are absolutely not anti testosterone, then it must have some validity.

Click to expand...

That is so untrue. Some men would feel wonderful at 400 (though I've yet to meet one) and others, like myself, didn't truly start feeling great until the 1000+ mark. Do some research on the "standard range" and you'll soon learn that it's mostly useless...for one, they included older men who were low in T already (naturally at that age) in the "normal" range. How is that normal and why should young men be held to that standard?

I was at 440 and had no problem getting a prescription. True I am 48 but one can argue, testosterone levels at 400s are more problematic when your are 25. The important thing is to articulate your symptoms and how they have screw up your life. Most doctors with TRT experience would prescribe in my opinion.

It would be interesting to see if pregnenolone plus DHEA can help you increase your estradiol.

Nelson: my dhea s is at the top of the range already, so i don't think i can supplement that.

I can't stand when doctors tell me i might mess up my fertility, because im pretty sure you have to want sex, and then be able to have it in order to have a child.

The standard range really annoys me because it's based on an average of who they test, but how many healthy people are getting their testosterone checked because they feel good? It's going to be skewed to people who want theirs checked, because they have symptoms. I'm not getting my troponin checked because I'm not having heart problems!

lowtest said:

Most important:
1. Can clomid help me?
2. Can testosterone actually help a person who's at 400 range?
3. How else can you raise E2 if I can't use testosterone or clomid? I would guess I'm not going to be able to be helped if no one will prescribe me clomid or testosterone.
4. I know defy exists, but I don't know if it's worth spending the money for a consult just to be told I'm not that low again. I've been to a bunch of doctors already and been told that.

Click to expand...

1. Clomid raises LH/FSH, so this is not indicated for you.
2. Testosterone endo/or exogenous can help your symptoms. Median total-t for your age is around 650ng/dl..
3. I suggest you calmly and copiously research the matter as you're in a unique situation and the root cause for your issue will take some digging. (as I'm currently doing, young guy w/symptoms but not "low" t according to most folks)
4. First step with defy is a relatively inexpensive blood work panel, it's worth the consult.

Since you're LH is high and you're not aromatizing testosterone (low e2) then your total-t should be higher. However, it's not, therefore something is messing up the HPTA flow chart.

Keeping in mind, estrogen and testosterone both negatively feedback on the hypothalamus/pituitary. The latter less than the former. We're left knowing your testes work and the primary negative feedback loops aren't in action since LH is still high (too much test/e2/or stress hormones ACTH/Cortisol are suppressive of GnRH & LH).

I wouldn't rush into any treatment at this point. I know you feel miserable, but given all your bits 'n pieces work, a root cause solution would be best. It may take a lot of work on your part, but eventually you'll find a Doc who understands your symptoms and can appropriately diagnose you.

Potential lines of inquiry:
a) Comprehensive Estrogen Panel (estradiol, estrone, estriol)
b) Thyroid/cortisol Panels
c) Other more comprehensive tests to determine potential cause

Couldn't it just be the beginning of primary hypogonadism? Basically my body wants more testosterone, and my testes aren't able to produce that much. While I am not in the 200 or 300s, I am considered here, to be low for my age. Maybe I am wrong, or I just need to wait for more failure.

There could be, and probably is more to it than that idea. So until you get more comprehensive testing, you should be consciously avoiding anxiety/obsession with the issue (says the guy posting on excelmale...Lol), get more sunlight exposure, and make all the right lifestyle choices to support your HPTA. Add more healthy fat or cholesterol to your diet(provide upstream ingredients for steroid hormones) if it's lacking etc...this article elaborates on what I'm saying about with lifestyle.

Well my vitamin D is good, around 70 30-100, my cholesterol intake is really good I just ran my usual diet into an app. 40% carbs 40% fat 20%protein. 300 mg of cholesterol a day.

I don't think there is any more I can do, stress is not an issue, sleep is not an issue. Exercise is good, no smoking drinking or drugs. No medications. I am not deficient in any vitamins that I have checked, and with the way I looked at my diet there's nothing I am missing macro or micro nutrient wise.