27 yo male with severe symptoms and low LH/FSH

[Above-and-beyond77]

Hello everyone!

I've been dealing with extreme symptoms since I was 19yo.

My symptoms :

- Loss of libido
- Complete impotence
- Extreme fatigue (to the point of being bedridden at times)
- Severe anhedonia
- Body aches
- Non-restorative sleep


Here are my latest results :

Total testosterone : 450 ng/dl [249-836]

Bioavailable testosterone : 2.8 nmol/L [2.9-12]

Cortisol : 224 nmol/L [102-535]

Prolactin : 9 ng/ml [2-17]

FSH : 0.9 mUI/mL [1.4-18.1]

LH : 1.6 mUI/mL[1.5-9.3]

IGF-1 : 305 ng/ml [94-246]

TSH : 2.7 mUI/L [0.5-4.5]

FT3 : 3.2 pg/ml [2.3-4.2]

FT4 : 1.08 ng/dl [0.89-1.76]

ACTH : 12 ng/L [10-48]

Here are the results of my DUTCH :

Screenshot-92

Screenshot-91

Screenshot-90

Screenshot-89

Screenshot-88

Screenshot-87

I've been trying to improve my lifestyle (weight training 4 times a week, balanced diet, 8 hours of sleep), to no avail.

Any help would be greatly appreciated.

 

[Mountain Man]

Hello everyone!

I've been dealing with extreme symptoms since I was 19yo.

My symptoms :

- Loss of libido
- Complete impotence
- Extreme fatigue (to the point of being bedridden at times)
- Severe anhedonia
- Body aches
- Non-restorative sleep


Here are my latest results :

Total testosterone : 450 ng/dl [249-836]

Bioavailable testosterone : 2.8 nmol/L [2.9-12]

Cortisol : 224 nmol/L [102-535]

Prolactin : 9 ng/ml [2-17]

FSH : 0.9 mUI/mL [1.4-18.1]

LH : 1.6 mUI/mL[1.5-9.3]

IGF-1 : 305 ng/ml [94-246]

TSH : 2.7 mUI/L [0.5-4.5]

FT3 : 3.2 pg/ml [2.3-4.2]

FT4 : 1.08 ng/dl [0.89-1.76]

ACTH : 12 ng/L [10-48]

Here are the results of my DUTCH :

Screenshot-92

Screenshot-91

Screenshot-90

Screenshot-89

Screenshot-88

Screenshot-87

I've been trying to improve my lifestyle (weight training 4 times a week, balanced diet, 8 hours of sleep), to no avail.

Any help would be greatly appreciated.

You need to devote six months to a year of weight training and the physical regimen here. A year or more would be better. Get body fat down to 15% or less. I don’t know what you consider weight training, but it can’t be machines. Barbells, dumbbells, a bit of cardio and focus on squats, deadlifts, and bench as your staples.

This is a good plan to follow:

Westside for Skinny Bastards Program Templates (WS4SB) - WS4SB (2024) - Lift Vault

Westside for skinny bastards (WS4SB) was developed by Joe DeFranco in 2008 as an effective strength training program for beginner athletes. Below you’ll find two different spreadsheets / templates for the program. A few things to clear up up front: Westside for skinny bastards is not a...

liftvault.com

There are no shortcuts. I don’t care what your numbers and bloodwork are. Don’t even think about TRT until you devote years-15 anyway- to this lifestyle. It is a rare case that TRT. Is needed before age 40.

 

[Systemlord]

testosterone : 450 ng/dl [249-836]

Bioavailable testosterone : 2.8 nmol/L [2.9-12]

FSH : 0.9 mUI/mL [1.4-18.1]

LH : 1.6 mUI/mL[1.5-9.3]

This is classic secondary hypogonadism. If you’ve been like this for 8 years, I don’t think you’re going to fix this naturally.

How anyone can go 8 years like this is beyond me, I would have sought treatment long ago.

 

[sammmy]

Were you taking any anabolic steroids, testosterone, or similiar supplements like SARMS when this blood tests were done? Your FSH and LH are suppressed and this either due to secondary hypogonadism or to such supplements.

The intense fatigue is strange. Are the body aches intense too and do they happen occasionally at particular muscle groups or are continuous all over body all the time?

 

[Above-and-beyond77]

This is classic secondary hypogonadism. If you’ve been like this for 8 years, I don’t think you’re going to fix this naturally.

How anyone can go 8 years like this is beyond me, I would have sought treatment long ago.

I've been denied treatmend by so many doctors. They all told me that my labs are perfectly normal (which is ludicrous). And I live in Europe, so any kind of treatment with borderline low labs is frowned upon. I'm at a loss.

 

[Above-and-beyond77]

Were you taking any anabolic steroids, testosterone, or similiar supplements like SARMS when this blood tests were done? Your FSH and LH are suppressed and this either due to secondary hypogonadism or to such supplements.

The intense fatigue is strange. Are the body aches intense too and do they happen occasionally at particular muscle groups or are continuous all over body all the time?

I've never used testosterone/testosterone/SARMS. Doctors are clueless as to why my FSH and my LH are so low.

The intense fatigue and the body aches seem to be caused by my bordeline low cortisol levels. They are not intense, unless I exert myself too much (walking/standing up for too long).

 

[sammmy]

Is it possible that your body aches are post weight training sessions, not from walking or standing up? Are they all over body or just specific muscle focal points?

Fatigue and aches all over body without training might be a sign of persistent infection. If that is the case, this must be treated first - you can't cure an infection with TRT.

Your creatinine tests are strangely high, although in "normal range". Are you supplementing creatine?

Regarding TRT, you do seem to have a secondary hypogonadism. I would repeat the tests for total T, free T (dialysis or ultrafiltration method if possible), SHBG, Albumin (to be able to use free T calculator), FSH, and LH just to make sure.

I would also do a Complete Blood Count with Differential (to check immune system status) and a Comprehensive Metabolic Panel (to see any abnormality in metabolism). These are relatively inexpensive tests.

 

[Belekas]

All the above. Also more context is needed. What is your weight? Body composition? Diet? Stress? Drug use? Bad habits? Numbers don't look good and coupled with your symptoms you def need to get all the tests mentioned above to be sure. But in all fairness if your symptoms are so severe from 19yo till now with all the improvements you did/try to do and still nothing then i'd go ahead and say that you are a legitimate candidate for TRT. I have a mate from India who suffered just like you till I forced him to do all the required hormone tests and once he seen the results his doc put him on treatment without much problem. He had a serious accident before thus when most of his problems started. His life changed completely. Hes now happy, able to build more muscle, feels way less anxious and his ED improved greatly. Before even with crashed levels and feeling like shit he was working out for years trying to grow with little to no progress as well. Was painful to see him struggling like that. So yeah I'd def do all those tests just to be sure and then push to get TRT. If that is not possible to get from a doc then self administered protocol if you can get good pharma grade testosterone. Hang in there! Always here to help where/if I can. All the best.

 

[Systemlord]

I've been denied treatmend by so many doctors. They all told me that my labs are perfectly normal (which is ludicrous). And I live in Europe, so any kind of treatment with borderline low labs is frowned upon. I'm at a loss.

Yeah, the doctors in Europe are heavy on the numbers and light on the knowledge, what a shame!

 

[Above-and-beyond77]

All the above. Also more context is needed. What is your weight? Body composition? Diet? Stress? Drug use? Bad habits? Numbers don't look good and coupled with your symptoms you def need to get all the tests mentioned above to be sure. But in all fairness if your symptoms are so severe from 19yo till now with all the improvements you did/try to do and still nothing then i'd go ahead and say that you are a legitimate candidate for TRT. I have a mate from India who suffered just like you till I forced him to do all the required hormone tests and once he seen the results his doc put him on treatment without much problem. He had a serious accident before thus when most of his problems started. His life changed completely. Hes now happy, able to build more muscle, feels way less anxious and his ED improved greatly. Before even with crashed levels and feeling like shit he was working out for years trying to grow with little to no progress as well. Was painful to see him struggling like that. So yeah I'd def do all those tests just to be sure and then push to get TRT. If that is not possible to get from a doc then self administered protocol if you can get good pharma grade testosterone. Hang in there! Always here to help where/if I can. All the best.

1m75 69kg
Body composition : below 15% bodyfat
Diet : fruits, vegetables, eggs, nuts, meat fish. I barely eat processed foods.
Stress : no, but my DUTCH test is indicative of a HPA dysfunction.
I've never done drugs
Training routine : 4 day split with compound exercises
I've been into training and dieting since I was like 17.
Thank you very much for your help. There is no way I'll get any kind of treatment from a doc over here.

 

[Above-and-beyond77]

Is it possible that your body aches are post weight training sessions, not from walking or standing up? Are they all over body or just specific muscle focal points?

Fatigue and aches all over body without training might be a sign of persistent infection. If that is the case, this must be treated first - you can't cure an infection with TRT.

Your creatinine tests are strangely high, although in "normal range". Are you supplementing creatine?

Regarding TRT, you do seem to have a secondary hypogonadism. I would repeat the tests for total T, free T (dialysis or ultrafiltration method if possible), SHBG, Albumin (to be able to use free T calculator), FSH, and LH just to make sure.

I would also do a Complete Blood Count with Differential (to check immune system status) and a Comprehensive Metabolic Panel (to see any abnormality in metabolism). These are relatively inexpensive tests.

Lower back and legs.
From what I've gathered, it might be related to my bordeline cortisol levels.
I've never taken creatine.

Here is my most recent Complete Blood Count :

WBC : 3.7 [4.1-11]

RBC : 5.1 [4.5-5.9]

HGB : 14.7 g/dL [13.4-16.7]

HCT : 44.9% [39.2-48.6]

MCV : 82 fL [79.6-94]

MCH : 26.9 pg [27.3-32.8]

MCHC : 31.5 g/dL [32.4-36.3]

Neutrophils : 1.76 [2-7]

Eosinophils : 0.13 [0.05-0.59]

Basophils : 0.02 [0.00-0.10]

Blood sugar : 87 mg/dl [77-107]

Total cholesterol : 165 mg/dL [150-240]

Triglycerides : 35 mg/dl [50-150]

Sodium : 140 mmol/L [132-146]

Potassium : 4 mmol/L [3.5-5.5]

 

[sammmy]

Lymphocytes?

 

[sammmy]

Just realized your creatinine was measured in urine so it is fine. Have you done a Comprehensive Metabolic Panel blood test? It has Creatinine in blood.

 

[sammmy]

What Does It Mean to Have Low MCHC?

MCHC is the average concentration of hemoglobin in your red blood cells. Find out how a low MCHC level is diagnosed and what conditions it may point to.

www.healthline.com

 

[Belekas]

1m75 69kg
Body composition : below 15% bodyfat
Diet : fruits, vegetables, eggs, nuts, meat fish. I barely eat processed foods.
Stress : no, but my DUTCH test is indicative of a HPA dysfunction.
I've never done drugs
Training routine : 4 day split with compound exercises
I've been into training and dieting since I was like 17.
Thank you very much for your help. There is no way I'll get any kind of treatment from a doc over here.

You're def underfed and the last thing you should do is diet. So your diet is without basic carbs like grains? Don't fear to have a cheatmeal every once in a while it will actually help you. Also you should incorporate carbs into your nutrition regiment and try to gain weight without stressing at the bf % too much. But like I said if you have been exhausting most of the options to get healthier and stronger over the years and nothing works, coupled with your symptoms and labs, then you should def seek TRT and try to administer yourself. No point wasting time as time waits for no man.

 

[Above-and-beyond77]

You're def underfed and the last thing you should do is diet. So your diet is without basic carbs like grains? Don't fear to have a cheatmeal every once in a while it will actually help you. Also you should incorporate carbs into your nutrition regiment and try to gain weight without stressing at the bf % too much. But like I said if you have been exhausting most of the options to get healthier and stronger over the years and nothing works, coupled with your symptoms and labs, then you should def seek TRT and try to administer yourself. No point wasting time as time waits for no man.

I do eat carbs at each meal (100g) and grains, I forgot to mention it.

 

[Above-and-beyond77]

Just realized your creatinine was measured in urine so it is fine. Have you done a Comprehensive Metabolic Panel blood test? It has Creatinine in blood.

My creatinine (blood) is at 11 mg/l [6.6-12.5]

 

[Above-and-beyond77]

Lymphocytes?

1668/mm3 [2000-4000]

 

[sammmy]

So far, your tests show:

1. Anemia (low MCH, MCHC, fatigue). It could be due to no iron in your diet - eat home cooked beef and chicken, see the page that I gave for low MCHC above for suggestions. Should be checked with Iron Panel blood test

2. Somewhat suppressed immune system (low neutrophils, low lymphocytes). This could be some kind of a persistent infection and MUST be checked by doctor. It could be causing the pains in legs and lower back. Also check if your Platelets count is normal.

These MUST be addressed by an actual doctor - go with these concerns and don't tell them to put you on TRT, it may not be related to hormones and forcing them is not going to achieve anything.

After these are addressed and corrected, repeat the tests for Testosterone (in Europe it is better to calculate the free T yourself from SHBG, they don't have precise tests free T tests). If it's still very low, you can start TRT yourself - you don't need a doctor for that.

 

[sammmy]

3. Your pituitary is low in several critical hormones (LH, FSH, ACTH). I would go to an endocrinologist and request a brain scan to look for brain infections (you mentioned non restorative sleep), lesions, and tumors:

Hypopituitarism - Symptoms and causes

www.mayoclinic.org