20 Y/O, Secondary Hypogonadism?

[nickdavid712]

Age- 20 year old male
height-65 inches
weight- 130 pounds


Symptoms- had delayed puberty...didn't start to develop until around 16... everything went normal from there developmental wise (except for my inability to grow facial hair/ look young for my age) up until age 18 when i started to notice low libido. Been about 2 years with lowered libido and just recently found out about 2 months ago my hormone levels were out of whack. My endo does not think it is genetic because I have a "muscular build"....he seems to think this is a case of anabolic steroid-induced hypogonadism, however, I have not taken steroids (knowingly).


The only type of anabolic I can think of that I have taken that potentially had anabolic in it without me knowing was a supplement called "super cardarine" from primeval labs. Could have been laced with a pro-hormone that I was unaware of? I only took 1 bottle supply worth which was 30 days if I remember correctly. I took this supplement about a month after I started noticing a lowered libido. Could this be the cause of my problem? I did not notice any anabolic effects from it or a dramatic shutdown/difference after coming off of it which leads me to believe it wasn't an anabolic substance. Only other cause i can think of is overtraining. Could overtraining cause my levels to drop this low? Any suggestions as to what my lab values suggest would be helpful, Thanks.




SEX HORM. BIND. GLOB. 72 (H) 17 - 56 nmol/L
FREE TESTOSTERONE 0.78 (L) 5.25 - 20.7 ng/dL
TESTOSTERONE, TOTAL 49 (L) 240 - 950 ng/dL
LH 1.3 (L) 1.7 - 8.6 IU/L
FSH 0.6 (L) 1.5 - 12.4 IU/L
CHOLESTEROL 186 <200 mg/dL
TRIGLYCERIDES 35 35 - 150 mg/dL
HDL 105 (H) 40 - 80 mg/dL
PROLACTIN 8.8 4.0 - 15.2 ng/mL
IGF-1 (Somatomedin C) 114 91 - 442 ng/mL
FREE T4 1.0 0.9 - 1.7 ng/dL
TSH 3.09 0.50 - 5.70 uIU/mL
CORTISOL 19.6 ug/dl
WBC 4.40 4.00 - 10.00 K/uL
RBC 4.09 (L) 4.50 - 6.40 M/uL
HGB 12.7 (L) 13.5 - 18.0 g/dL
HCT 39.0 (L) 40.0 - 54.0 %
PLT 150 150 - 450 K/uL
MCV 95.4 (H) 80.0 - 95.0 fL
MCH 31.1 27.0 - 32.0 pg
MCHC 32.6 32.0 - 36.0 g/dL
RDW 14.3 11.5 - 14.5 %
MPV 9.4 8.4 - 12.0 fl
SODIUM 143 136 - 145 mmol/L
POTASSIUM 4.5 3.4 - 5.0 mmol/L
CHLORIDE 101 98 - 107 mmol/L
CO2 31 22 - 31 mmol/L
BUN 26 (H) 6 - 23 mg/dL
CREATININE 0.96 0.50 - 1.20 mg/dL
GLUCOSE 82 70 - 100 mg/dL
ALBUMIN 4.7 3.5 - 5.2 g/dL
TOTAL PROTEIN 6.7 6.4 - 8.3 g/dL
CALCIUM 9.4 8.8 - 10.7 mg/dL
ALKALINE PHOSPHATASE 51 35 - 130 U/L
TOTAL BILIRUBIN 0.3 0.0 - 1.0 mg/dL
AST 56 (H) 10 - 50 U/L
ALT 54 (H) 10 - 50 U/L
GLOBULIN 2.0 (L) 2.2 - 4.2 g/dL
EGFR 113
IRON, TOTAL 83 50-195 mcg/dL
IRON BINDING CAPACITY 295 250-425 mcg/dL (calc)
% SATURATION 28 15-60 % (calc)
FERRITIN 95 20-345 ng/mL
DHEA SULFATE 366 24-537 mcg/dL
GROWTH HORMONE (GH) 2.0 < OR = 7.1 ng/mL
PROGESTERONE 0.7 <1.4 ng/mL
ESTRADIOL <15 < OR = 39 pg/mL


MRI- showed normal pituitary gland...nothing abnormal

 

[Systemlord]

I looks as if you have several concurrent problems, secondary hypogonadism, hypothyroidism and elevated SHBG, the latter could be the result of a liver insult from something ingested, once liver is damaged there's no going back. Your SHBG is binding up what little testosterone your producing and you will need high normal testosterone or possibly supraphysiological doses of testosterone to hammer down the high SHBG, then increasing free testosterone.

Hemoglobin is low, low bioavailable testosterone is the cause. Fertility is a concern, you will likely become completely infertile after you begin TRT. You can forget about Clomid as it raises SHBG significantly and yours is already too high for a 20 year old. Overtraining can cause testosterone to decrease, but you have other problems preventing you from seeing any of testosterone gained, high SHBG. Thyroid labs are inadequate, you need a full thyroid panel checking free T3, reverse T3, free T4 and antibodies.

You need TRT, TRT is your only option going forward.

 

[Sean Mosher]

With that TSH definitely need to see a full thyroid panel like Systemlord said.

 

[CoastWatcher]

Don't waste your time, your money, and (potentially) your health with "supplements" purporting to boost testosterone levels. If they worked, why are the rest of us on exogenous testosterone supplementation? Did you run these labs on your own, or did a doctor order them? I ask because, given your age and so many red flags flying with your lab results, the choice of who you work with, the doctor who will assist you in this process, is a critical one.

 

[nickdavid712]

doctor ordered them

 

[CoastWatcher]

doctor ordered them

Has this doctor adequate expertise, as best you can tell, to help you sort out these issues?

 

[DragonBits]

Age- 20 year old male
height-65 inches
weight- 130 pounds


Symptoms- had delayed puberty...didn't start to develop until around 16... everything went normal from there developmental wise (except for my inability to grow facial hair/ look young for my age) up until age 18 when i started to notice low libido. Been about 2 years with lowered libido and just recently found out about 2 months ago my hormone levels were out of whack. My endo does not think it is genetic because I have a "muscular build"....he seems to think this is a case of anabolic steroid-induced hypogonadism, however, I have not taken steroids (knowingly).


The only type of anabolic I can think of that I have taken that potentially had anabolic in it without me knowing was a supplement called "super cardarine" from primeval labs. Could have been laced with a pro-hormone that I was unaware of? I only took 1 bottle supply worth which was 30 days if I remember correctly. I took this supplement about a month after I started noticing a lowered libido. Could this be the cause of my problem? I did not notice any anabolic effects from it or a dramatic shutdown/difference after coming off of it which leads me to believe it wasn't an anabolic substance. Only other cause i can think of is overtraining. Could overtraining cause my levels to drop this low? Any suggestions as to what my lab values suggest would be helpful, Thanks.




SEX HORM. BIND. GLOB. 72 (H) 17 - 56 nmol/L
FREE TESTOSTERONE 0.78 (L) 5.25 - 20.7 ng/dL
TESTOSTERONE, TOTAL 49 (L) 240 - 950 ng/dL
LH 1.3 (L) 1.7 - 8.6 IU/L
FSH 0.6 (L) 1.5 - 12.4 IU/L
CHOLESTEROL 186 <200 mg/dL
TRIGLYCERIDES 35 35 - 150 mg/dL
HDL 105 (H) 40 - 80 mg/dL
PROLACTIN 8.8 4.0 - 15.2 ng/mL
IGF-1 (Somatomedin C) 114 91 - 442 ng/mL
FREE T4 1.0 0.9 - 1.7 ng/dL
TSH 3.09 0.50 - 5.70 uIU/mL
CORTISOL 19.6 ug/dl
WBC 4.40 4.00 - 10.00 K/uL
RBC 4.09 (L) 4.50 - 6.40 M/uL
HGB 12.7 (L) 13.5 - 18.0 g/dL
HCT 39.0 (L) 40.0 - 54.0 %
PLT 150 150 - 450 K/uL
MCV 95.4 (H) 80.0 - 95.0 fL
MCH 31.1 27.0 - 32.0 pg
MCHC 32.6 32.0 - 36.0 g/dL
RDW 14.3 11.5 - 14.5 %
MPV 9.4 8.4 - 12.0 fl
SODIUM 143 136 - 145 mmol/L
POTASSIUM 4.5 3.4 - 5.0 mmol/L
CHLORIDE 101 98 - 107 mmol/L
CO2 31 22 - 31 mmol/L
BUN 26 (H) 6 - 23 mg/dL
CREATININE 0.96 0.50 - 1.20 mg/dL
GLUCOSE 82 70 - 100 mg/dL
ALBUMIN 4.7 3.5 - 5.2 g/dL
TOTAL PROTEIN 6.7 6.4 - 8.3 g/dL
CALCIUM 9.4 8.8 - 10.7 mg/dL
ALKALINE PHOSPHATASE 51 35 - 130 U/L
TOTAL BILIRUBIN 0.3 0.0 - 1.0 mg/dL
AST 56 (H) 10 - 50 U/L
ALT 54 (H) 10 - 50 U/L
GLOBULIN 2.0 (L) 2.2 - 4.2 g/dL
EGFR 113
IRON, TOTAL 83 50-195 mcg/dL
IRON BINDING CAPACITY 295 250-425 mcg/dL (calc)
% SATURATION 28 15-60 % (calc)
FERRITIN 95 20-345 ng/mL
DHEA SULFATE 366 24-537 mcg/dL
GROWTH HORMONE (GH) 2.0 < OR = 7.1 ng/mL
PROGESTERONE 0.7 <1.4 ng/mL
ESTRADIOL <15 < OR = 39 pg/mL


MRI- showed normal pituitary gland...nothing abnormal

I assume you don't have any blood tests at all before taking super cardarine which appears to be GW501516. If so, you don't have a baseline to know how GW501516 maybe have affected your blood tests.


How soon after stopping super cardarine did you take this blood test?

Reason I ask, I think any TRT doctor will want to see all the flags in the blood test go away before starting TRT. Like BUN, RBC, elevated liver enzymes, etc. This might take a few months.

The liver can usually regenerate from damage, as long as the damage isn't too great. When I took DHEA, my liver enzymes ALT went to 57, with hepatitis liver enzymes will go above 2000 IU/L, when you recover your liver enzymes recover also. Elevated is only a concern, I would take it as a warning to stop doing whatever is causing it. Something as simple as aspirin can cause such a mild elevation.

I also think a full thyroid panel is indicated.

What does your endo suggest you should do now? Depending on that answer, maybe you should get a consult with those more expert in this field like Defy.

The flags on your blood test aren't "critical" but with so many, I think a doctor should be consulted to determine how you proceed from here. Even if your testos will return to what was normal before cardarine, you don't know what is normal for you.

 

[nickdavid712]

From best I can tell he does seem to have decent knowledge. I was however a little shaky due to the large dose he prescribed me of HCG. We discussed the options of clomid, HCG, and testosterone. He seemed to think the clomid would most likely not work and that he had better hope with HCG. I was prescribed 2,000IU 2x per week and retest levels in 4 weeks. I took my first dose last night of 2,000IU, however, I am most likely going to switch to 1,000 IU 2x per week instead so my e2 doesn't go too crazy.

 

[Systemlord]

From best I can tell he does seem to have decent knowledge. I was however a little shaky due to the large dose he prescribed me of HCG. We discussed the options of clomid, HCG, and testosterone. He seemed to think the clomid would most likely not work and that he had better hope with HCG. I was prescribed 2,000IU 2x per week and retest levels in 4 weeks. I took my first dose last night of 2,000IU, however, I am most likely going to switch to 1,000 IU 2x per week instead so my e2 doesn't go too crazy.

That's far from standard procedure, this dosage of HCG isn't sustainable.

 

[Vettester Chris]

From best I can tell he does seem to have decent knowledge. I was however a little shaky due to the large dose he prescribed me of HCG. We discussed the options of clomid, HCG, and testosterone. He seemed to think the clomid would most likely not work and that he had better hope with HCG. I was prescribed 2,000IU 2x per week and retest levels in 4 weeks. I took my first dose last night of 2,000IU, however, I am most likely going to switch to 1,000 IU 2x per week instead so my e2 doesn't go too crazy.

Are you saying that the physician is aiming to restart your natural testosterone by implementing this solo HCG protocol?

 

[nickdavid712]

Are you saying that the physician is aiming to restart your natural testosterone by implementing this solo HCG protocol?

No, I believe his goal is to see if my testosterone and sperm parameters improve and if they do it could potentially be a long term treatment option? He was not hesitant to testosterone replacement, however, seemed this would be a better first option to try out and then go from there after seeing levels 4-weeks after starting. I am currently doing 1,000IU 2X per week.

 

[nickdavid712]

I looks as if you have several concurrent problems, secondary hypogonadism, hypothyroidism and elevated SHBG, the latter could be the result of a liver insult from something ingested, once liver is damaged there's no going back. Your SHBG is binding up what little testosterone your producing and you will need high normal testosterone or possibly supraphysiological doses of testosterone to hammer down the high SHBG, then increasing free testosterone.

Hemoglobin is low, low bioavailable testosterone is the cause. Fertility is a concern, you will likely become completely infertile after you begin TRT. You can forget about Clomid as it raises SHBG significantly and yours is already too high for a 20 year old. Overtraining can cause testosterone to decrease, but you have other problems preventing you from seeing any of testosterone gained, high SHBG. Thyroid labs are inadequate, you need a full thyroid panel checking free T3, reverse T3, free T4 and antibodies.

You need TRT, TRT is your only option going forward.

Just got updated thyroid labs:
T4, FREE, DIRECT DIALYSIS = 1.3 (0.9-2.2 ng/dL AMD)

THYROID PEROXIDASE ANTIBODIES = 11 (<9 IU/mL)

THYROGLOBULIN PANEL
THYROGLOBULIN ANTIBODIES = <1 (< or = 1 IU/mL)

THYROGLOBULIN = 10.9 ng/mL
Reference Range
Intact Thyroid 2.8-40.9
Athyrotic <0.1

T3, FREE = 1.9 (3.0-4.7 pg/mL)