Healthy 22 year old with 298ng/dL total test.

[undercover]

Hi everyone. I decided to post here because I am at my witts end with the issues I've been having. For the past year I've had low testosterone. Testing at 348, 327, and now 298 ng/dL over 3 tests the past year. I live a healthy lifestyle, I go to the gym daily and love weightlifting. Diet is clean, I cook most of my foods and eat healthy foods, ground turkey, pasta, fruits, yogurt, granola, etc. I take multi vitamins, vitamin D3, etc. I've never touched any steroid or TRT in my life. I am able to put some muscle mass on, I'm not completely skinnyfat, however I do have bad ED. Some days I'll get one erection per day, almost never get morning wood. I'm really not that horny ever. I also am lethargic, need a nap typically halfway through the day, tired. I got tested for sleep apnea and it was not that, so we ruled that out.

My urologist prescribed me clomiphene which I have started and it seems to help a tiny bit with testosterone issues, like less groggy, able to wake up earlier in the day, however it did nothing for my libido and if anything made it worse.

I'm terrified because I'm only 22 and have issues having sex. I don't know what to do. I don't watch porn or masturbate. Hell I don't even have the desire to. I've tried testing it by watching porn and it doesn't turn me on super crazy. If I want to have sex with my girlfriend I'll take 20mg sildenafil and then I can have sex, but I can go one round and then I'm tired. Even on the sildenafil, shouldn't it help me go more than one round? I can't get hard again after I ejaculate that first time.

I am considering getting on TRT because I don't know which other way to go. I'm posting my blood work for you guys to take a look. Some info I've gathered: My thyroid levels are a bit wonky because my dad has hypothyroidism, but my levels are not treatable yet because they aren't super bad. My prolactin is high, test is obviously low af. This test was taken before I started the clomiphene. Here are the results:

 

[Systemlord]

My urologist prescribed me clomiphene which I have started and it seems to help a tiny bit with testosterone issues, like less groggy, able to wake up earlier in the day, however it did nothing for my libido and if anything made it worse.

This is common problem with clomiphene and clomid, often numbers are good and men don't feel much better.

My thyroid levels are a bit wonky because my dad has hypothyroidism, but my levels are not treatable yet because they aren't super bad. My prolactin is high

Prolactin can be elevated in people with hypothyroidism. I think you actually need thyroid treatment because your Free T3 is well below midrange which is where symptoms start to develop.

Those who have thyroid problems, TRT can't work very well because testosterone is metabolized in the liver for which thyroid hormones (Free T3) drives this process.

In range doesn't always mean normal, take testosterone as an example, normal ranges are 264-916 ng/dL, yet TRT is offered <300 ng/dL and some doctors even offer it up to 430 ng/dL.

The high RBC may make TRT a little challenging. I have to get phlebotomized monthly.

 

[undercover]

This is common problem with clomiphene and clomid, often numbers are good and men don't feel much better.

Prolactin can be elevated in people with hypothyroidism. I think you actually need thyroid treatment because your Free T3 is well below midrange which is where symptoms start to develop.

In range doesn't always mean normal, take testosterone as an example, normal ranges are 264-916 ng/dL, yet TRT is offered <300 ng/dL and some doctors even offer it up to 430 ng/dL.

Correct me if I'm wrong, but urologist don't specialize in thyroid treatment. You need to seek the opinion of an endocrinologist.

THANK YOU!
I just feel like none of the doctors I go to know what they are talking about. I've been telling the urologist the clomiphene does absolutely nothing for me and he keeps telling me to take it.

I have heard that about the clomid boosting numbers but not libido. My prolactin was a bit high. Some people mentioned it could be a pituitary tumor, but it's still within range for some labs so I doubt that. I also think I need hypothyroidism treatment. I got a prescription for NDT (naturally desiccated thyroid) from a compounding pharmacy but have yet to take it because Idk if self medicating is good. I'd rather just make an appt with an endo.

So aside from the prolactin any other hormone markers a little off? Estradiol? SHBG?

 

[undercover]

This is common problem with clomiphene and clomid, often numbers are good and men don't feel much better.

Prolactin can be elevated in people with hypothyroidism. I think you actually need thyroid treatment because your Free T3 is well below midrange which is where symptoms start to develop.

Those who have thyroid problems, TRT can't work very well because testosterone is metabolized in the liver for which thyroid hormones (Free T3) drives this process.

In range doesn't always mean normal, take testosterone as an example, normal ranges are 264-916 ng/dL, yet TRT is offered <300 ng/dL and some doctors even offer it up to 430 ng/dL.

Correct me if I'm wrong, but urologist don't specialize in thyroid treatment. You need to seek the opinion of an endocrinologist.

What is your Free T4, T4 and TSH level?

Free T4: 1.3
TSH: 3.43
T3: 2.6

Can you see the lab screenshots I posted?

 

[Systemlord]

I just feel like none of the doctors I go to know what they are talking about. I've been telling the urologist the clomiphene does absolutely nothing for me and he keeps telling me to take it.

The reason why your urologist keeps telling you to take clomiphene is because of your age, TRT may likely make you infertile while on it and shutdown your HPTA. Some doctors only care about the numbers and don't care if symptoms are resolved.

Stop wasting time with this urologist, find a compassionate doctor who cares about his patients.

Things are not going to get better on clomiphene, so it's time to move on.

I just feel like none of the doctors I go to know what they are talking about.

Male sex hormones are not taught in traditional medical schools, even some of the endos, the doctors who should be experts in this field of medicine are often clueless.

 

[Systemlord]

Can you see the lab screenshots I posted?

For some reason initially my screen wasn't rendering the top half of the lab report. I think the problem is on my end.

 

[undercover]

The reason why your urologist keeps telling you to take clomiphene is because of your age, TRT may likely make you infertile while on it and shutdown your HPTA. Some doctors only care about the numbers and don't care if symptoms are resolved.

Stop wasting time with this urologist, find a compassionate doctor who cares about his patients.

I know and I agree. I know that's the main concern with TRT. Couldn't I just hop on HCG when I'm older and plan to conceive? What's wrong with shutting down HPTA?

I have found a really good mens health doc, specializes in TRT. I told him I'd wait to go back to him and give the Clomiphene a few more weeks, but now that time has passed I'm considering making a follow up with him to start the TRT since this hasn't worked. But idk now you're saying to check the thyroid out. Can thyroid issues also lower testosterone?

 

[Systemlord]

Couldn't I just hop on HCG when I'm older and plan to conceive?

Yes and also FSH injections when HCG alone isn't enough.

What's wrong with shutting down HPTA?

Shutting down the HPTA can cause other hormones to decline, most don't register this decline, but for those that do notice a decline, this is where HCG comes into play because it backfills hormonal pathways that would otherwise be shut down due to TRT.

Natesto, a nasal spray doesn't shut you down or affect other hormones, it adds to your natural production. This might be better for you given your age, because your HPTA is still developing beyond 25 years of age.

Can thyroid issues also lower testosterone?

Usually not, but it can happen.

 

[Cataceous]

Elevated prolactin can suppress testosterone, but I'm not sure if your level is high enough to cause that particular problem. However, levels above 10 ng/dL can negatively affect libido and sexual function.

Find a provider who will use testosterone nasal gel as a first treatment for hypogonadism. Then you avoid the problems with HPTA shutdown, such as testicular atrophy and loss of fertility.

If issues persist and prolactin remains elevated then a trial with low doses of cabergoline may be useful.

 

[Roque]

The lowest my T has been was 64. I tested again in October and it was 173. Now I’ve got it leveled off. You’ll get there!

 

[JmarkH]

You can try the supplement P5P and see if it brings down your prolactin. If it works you may find the ED is better.

 

[bennettjc]

The focus of the discussion has been on treatment, which is indicated.
But I am also concerned with the cause of your hypogonadism. Your low FSH and LH indicate secondary hypogonadism. Medications do not seem to be a factor. Prolactin is a bit high. Has an MRI of the pituitary been considered?

 

[undercover]

The focus of the discussion has been on treatment, which is indicated.
But I am also concerned with the cause of your hypogonadism. Your low FSH and LH indicate secondary hypogonadism. Medications do not seem to be a factor. Prolactin is a bit high. Has an MRI of the pituitary been considered?

Pituitary tumor wouldnt be it... my prolactin is high but not that high. Testosterone is also not incredibly low.

 

[sammmy]

Reasoning that this or that hormone is not "optimal" and you starting messing with them has a potential to get you in a bigger mess if you are not addressing first the parameters that are obviously out of range.

1. Your prolactin is high, get a prescription for cabergoline and see how that affects sex life and energy levels.

2. Your diet is allegedly clean, yet your LDL is high, RBC high, Hematocrit high, SHBG low which may be due to eating too much carbs.

3. Your Monocytes are 12%, Lymphocytes slightly depressed, Neutrophils elevated, C reactive protein a bit high. These point to some kind of inflammation or infection.

High Monocyte Count: Causes, Symptoms, and More

Monocytes, along with other types of white blood cells, are a vital part of your immune system. Learn what it means if your monocyte level is high.

www.healthline.com

 

[Abonicex]

Hi everyone. I decided to post here because I am at my witts end with the issues I've been having. For the past year I've had low testosterone. Testing at 348, 327, and now 298 ng/dL over 3 tests the past year. I live a healthy lifestyle, I go to the gym daily and love weightlifting. Diet is clean, I cook most of my foods and eat healthy foods, ground turkey, pasta, fruits, yogurt, granola, etc. I take multi vitamins, vitamin D3, etc. I've never touched any steroid or TRT in my life. I am able to put some muscle mass on, I'm not completely skinnyfat, however I do have bad ED. Some days I'll get one erection per day, almost never get morning wood. I'm really not that horny ever. I also am lethargic, need a nap typically halfway through the day, tired. I got tested for sleep apnea and it was not that, so we ruled that out.

My urologist prescribed me clomiphene which I have started and it seems to help a tiny bit with testosterone issues, like less groggy, able to wake up earlier in the day, however it did nothing for my libido and if anything made it worse.

I'm terrified because I'm only 22 and have issues having sex. I don't know what to do. I don't watch porn or masturbate. Hell I don't even have the desire to. I've tried testing it by watching porn and it doesn't turn me on super crazy. If I want to have sex with my girlfriend I'll take 20mg sildenafil and then I can have sex, but I can go one round and then I'm tired. Even on the sildenafil, shouldn't it help me go more than one round? I can't get hard again after I ejaculate that first time.

I am considering getting on TRT because I don't know which other way to go. I'm posting my blood work for you guys to take a look. Some info I've gathered: My thyroid levels are a bit wonky because my dad has hypothyroidism, but my levels are not treatable yet because they aren't super bad. My prolactin is high, test is obviously low af. This test was taken before I started the clomiphene. Here are the results:
View attachment 23280View attachment 23281View attachment 23282View attachment 23283View attachment 23284

hello ser.

i just saw your op.

i would like to ask you about toxins.

i used to be perfectly healthy but most likely scented toilet paper (i chewed it out of bad anxiety), mold in water, chemically castrted myself.

check your exposures to toxins like phtalates and bpa.

also please id like to talk to you.

please send me a pm. for some reason my browser doesnt let me write you.

 

[aneuman]

You can try the supplement P5P and see if it brings down your prolactin. If it works you may find the ED is better.

@JmarkH
This is intriguing. I checked it out and it seems to be high dose of vitamin B6. At least according to one product on Amazon, "...P-5-P contains a potent 25 mg of vitamin B6 (1,471% Daily Value) in the active form of P-5-P (pyridoxal 5’-phosphate)"

Do you have any experience with it? Didn't it cause any sort of nerve problems (high doses of B6 can cause nerve damage)

Thanks in advance.

 

[chriskchris]

THANK YOU!
I just feel like none of the doctors I go to know what they are talking about. I've been telling the urologist the clomiphene does absolutely nothing for me and he keeps telling me to take it.

I have heard that about the clomid boosting numbers but not libido. My prolactin was a bit high. Some people mentioned it could be a pituitary tumor, but it's still within range for some labs so I doubt that. I also think I need hypothyroidism treatment. I got a prescription for NDT (naturally desiccated thyroid) from a compounding pharmacy but have yet to take it because Idk if self medicating is good. I'd rather just make an appt with an endo.

So aside from the prolactin any other hormone markers a little off? Estradiol? SHBG?

Your age and results looked nearly identical to mine when I started HRT, although I suspect my problems started around 15-years old. Never got on HRT until 28.

Like you, started with Clomid. Initially I felt absolutely amazing and testosterone skyrocketed which proved my hypogonadism was secondary and not primary (testicular failure.) Clomid is given also as a test to distinguish whether your pituitary is functioning.

If your testosterone levels are up on Clomid it's a good sign your problem is secondary. The biggest issue I've seen people have on Clomid is high E2 as LSH/FSH go bonkers.

Shortly after Clomid I swung to 200 mg/2-weeks of enanthate plus 1500 iu/week of HCG to preserve fertility. Successfully fathered a child a couple years later. Again, one of the issues with this regiment was estrogen, which seems to cancel all positive impacts of higher testosterone levels.

 

[jayt]

Hi everyone. I decided to post here because I am at my witts end with the issues I've been having. For the past year I've had low testosterone. Testing at 348, 327, and now 298 ng/dL over 3 tests the past year. I live a healthy lifestyle, I go to the gym daily and love weightlifting. Diet is clean, I cook most of my foods and eat healthy foods, ground turkey, pasta, fruits, yogurt, granola, etc. I take multi vitamins, vitamin D3, etc. I've never touched any steroid or TRT in my life. I am able to put some muscle mass on, I'm not completely skinnyfat, however I do have bad ED. Some days I'll get one erection per day, almost never get morning wood. I'm really not that horny ever. I also am lethargic, need a nap typically halfway through the day, tired. I got tested for sleep apnea and it was not that, so we ruled that out.

My urologist prescribed me clomiphene which I have started and it seems to help a tiny bit with testosterone issues, like less groggy, able to wake up earlier in the day, however it did nothing for my libido and if anything made it worse.

I'm terrified because I'm only 22 and have issues having sex. I don't know what to do. I don't watch porn or masturbate. Hell I don't even have the desire to. I've tried testing it by watching porn and it doesn't turn me on super crazy. If I want to have sex with my girlfriend I'll take 20mg sildenafil and then I can have sex, but I can go one round and then I'm tired. Even on the sildenafil, shouldn't it help me go more than one round? I can't get hard again after I ejaculate that first time.

I am considering getting on TRT because I don't know which other way to go. I'm posting my blood work for you guys to take a look. Some info I've gathered: My thyroid levels are a bit wonky because my dad has hypothyroidism, but my levels are not treatable yet because they aren't super bad. My prolactin is high, test is obviously low af. This test was taken before I started the clomiphene. Here are the results:
View attachment 23280View attachment 23281View attachment 23282View attachment 23283View attachment 23284

my suggestion would be to continue to work with your Urologist... but at your age injecting T might become an issue as you will shut down natural production.... and you are very young to be totally dependent on T injections. as for sex....ask your Urologist to prescribe Trimix.... you inject it directly into your penis, and don't panic after the first one it does not hurt..... Trimix will give you a rock hard dick for more than an hour and allow the greatest sex you have ever had... it does not soften after cuming so you can rock thru orgasms with your partner as many as you want ... Good luck man.