Low T, Lowish LH/FSH & Only 22

[LeBronGains]

Hey guys,

First post here, a friend from another forum encouraged me to post here regarding my situation as I look for more knowledge and help. I've read as much as I can but I obviously want to be more versed in what can happen so when my Dr. prescribes something I can have some knowledge on it or maybe suggest what could be a better route.

Well, for the past 12 months I've had lowish libido and energy levels. It actually wreaked havoc on my relationship with my ex girlfriend, as she was constantly paranoid and thought i was cheating on her. So that ended and i asked my Dr for a blood test. He originally refused to test for low T since I was only 21 at the time. Anyway, they found I had hypothyroidism, and since I've been on Synthroid (T4) and energy has been a bit better, although my levels aren't completely normal to this day and the Dr. Doesn't want to increase my dosage.

Still lacking libido I finally convinced him to test for Low T. Sure enough first test was 200 (I'll post full results down below). He wanted me to wait 4 months and take off of all supplements, including whey protein... because "whey protein contains androgens." I lol'd, but I digress. When I asked if the lower T could be at the end of dieting for a contest (which i pulled out of due to the health concerns) he said no, ietary fat and low body fat have nothing to do with hormone levels. Unfortunately, this is the only Dr. I can find in my area that can see me without having to wait 6+ months and this is something I'd rather get fixed.

I've never ran a steroid or prohormone cycle. So we waited four months, and my last blood test at the end of Dec 2014 my total T was 358. I tried my own restart with the guidance of a family friend with running Clomid at 50mg for 6 weeks, and still only got to 358 (Dr. does not know). Still concerned, the Dr. wants me to get another test in May, and if I'm not above 450 then "we'll do a low dose HcG to see if we can get things going again."

My questions for you guys, if you would be so kind, are:

1. Would low dose HcG be the right route to go here?
2. Can one fully recover and stave off the need for TRT with this protocol?
3. Is this the right protocol?
4.He's very adamant on NOT using an AI during this HcG protocol, is one necessary (I read conflicting info)?
5. Anyone know of a potentially better Dr in the Northeast NJ area?

Here's my results:

Sept 2014

FSH 2.8 (1.6 - 8.0)
LH 1.8 (1.5 - 9.3)
Prolactin 9.3 (2.0 - 18.0)
Estradiol 19 (< or 39)
Total Test 200 (250 - 1100)
Free T 40.4 (35 - 155)
SHBG 25 (10 - 50)

Thyroid:
T3 Free 2.2 (2.3 - 4.2)
T4 Free 1.2 (.8 - 1.8)
TSH 3.53 (.40 - 4.50)

December 2014:

TSH 1.19 (.4 - 4.50)
T4 Free 1.3 (.8-1.8)
T3 Free 2.6 (2.3 - 4.2)

LH 2.2 (1.5 - 9.3)
FSH 2.0 (1.6 - 8.0)
Prolactin 7.3 (2.0 - 18.0)
E2 32 (< or = 39)
Total T 358 (250 - 1100)
Free T 49.4 (35-155)
SHBG 33 (10-50)

Again I see the Dr. in May, so any advice would be appreciated. If I posted in the wrong place I apologize in advance.

 

[Gene Devine]

Hypothyroidism can and will cause Hypogonadism...fact.

I don't believe your Doctor has corrected your Thyroid condition correctly as you are still Hypogonadal both in labs and symptoms.

As a 22 year old otherwise healthy male should not be on TRT unless absolutely necessary.

Is your Physician an Endocrinologist who specialized in Thyroid disorders?

If not, I urge you to seek out an Endo who specializes in the Thyroid and get well.

I don't see in your labs RT3 nor Thyroid antibodies which are important as well.

 

[LeBronGains]

Hypothyroidism can and will cause Hypogonadism...fact.

I don't believe your Doctor has corrected your Thyroid condition correctly as you are still Hypogonadal both in labs and symptoms.

As a 22 year old otherwise healthy male should not be on TRT unless absolutely necessary.

Is your Physician an Endocrinologist who specialized in Thyroid disorders?

If not, I urge you to seek out an Endo who specializes in the Thyroid and get well.

I don't see in your labs RT3 nor Thyroid antibodies which are important as well.

1. I completely agree, and when I asked if i should have a higher dose of synthroid (only 50mcg) he said no, thyroids fine...

2. I'm not sure his specialization, but from what i was told he was "the best in the area" which I'm starting to doubt.

3. Looked for other endos, 6 months waiting time to get an appointment is the issue . do you suggest i still switch even if i have to wait that long?

4. about the RT3 i asked for him to test that.. was told it's not necessary which is what extremely pisses me off because after doing my research he tells me i'm reading too much on the internet.

i agree about TRT, it's the last thing i want at this age

 

[Vettester Chris]

Like Gene mentioned, hypothyroidism + hypogonadism can and many times are correlated.

LH & FSH are definitely sub-optimal .. You are about where I was at age 40! At age 21, I think you need an MRI to be honest. More than likely there are other factors contributing to all of this, including thyroidal complications, but I'd rule it out just to be sure.

OK, the easy observation ... Real low thyroid values with free serum T3, and T4. Although, both are low, your FT4 sits higher in its respective range value than your FT3. Presuming you were off of meds for these labs? How much Synthroid are you taking?

Notice how your TSH has dropped into a great area on your 2nd labs, but your free serum values are still sub-optimal. My "suspicion" is that you also have some adrenal issues taking place, and/or you might be seeing some form of autoimmune disorder like Hashis!

Like Gene mentioned, we need the Reverse T3 lab, plus antibodies, being the TPO & TgAb. If your T3 isn't able to effectively get to the cells of your body, throwing a little Synthroid at it is just going to be like throwing gas in the fire!! This will just promote higher than desired amounts of Reverse T3, and it will be a mess if you have an autoimmune disorder. If it were Hashis, you can treat it with thyroid meds (preferably NDT is what I would do), but you need to titrate it properly and know how to monitor it.

Again, at the moment, there's just a ton of speculation. I'm glad you're considering another doctor, because this one IMO is not providing you with the adequate care that you need and deserve! (there, I worded it with a friendly touch) ... Also, like I said early, I get a funny feeling about the adrenals here. It's a lot to digest with one serving, but also take a look at a diurnal 4x saliva cortisol/DHEA-s saliva kit, where we can review the circadian profile report of your adrenals, and get a cortisol/DHEA correlation analysis. If the results don't provide these reports for you, I can ...

You can learn a healthy amount of this stuff at STTM .. http://www.stopthethyroidmadness.com/

In your statement with #4, you mention that your doctor says you're reading too much on the Internet. I'm not into knocking doctors on the forum, even the not so good ones! However, that statement, made by a doctor, engineer, or truck driver, doesn't matter, that's about the most ignorant thing anyone could ever tell you. Noooo, please, read, read, and read some more!!! Learn from all zillions of resources that are now available, which we didn't have 20 years ago!

So, so sorry this guy is threatened with your desire to gain knowledge! What he is really saying to you is that he doesn't know shiat about RT3 and the other variables related to it, and he's afraid that you're going to exploit his ineptness by building your own knowledge. Just spend a few hours perusing through the STTM site .. They make mention many times about those types of docs http://www.stopthethyroidmadness.com/give-me-a-break/ and they have resources for finding good physicians http://www.stopthethyroidmadness.com/how-to-find-a-good-doc/

 

[LeBronGains]

Like Gene mentioned, hypothyroidism + hypogonadism can and many times are correlated.

LH & FSH are definitely sub-optimal .. You are about where I was at age 40! At age 21, I think you need an MRI to be honest. More than likely there are other factors contributing to all of this, including thyroidal complications, but I'd rule it out just to be sure.

Got an MRI already, came back negative. I did fracture my skull when I was younger, but the MRI and a Ultrasound on my Thyroid both came back perfectly normal/clear

OK, the easy observation ... Real low thyroid values with free serum T3, and T4. Although, both are low, your FT4 sits higher in its respective range value than your FT3. Presuming you were off of meds for these labs? How much Synthroid are you taking?

50 mcg

Notice how your TSH has dropped into a great area on your 2nd labs, but your free serum values are still sub-optimal. My "suspicion" is that you also have some adrenal issues taking place, and/or you might be seeing some form of autoimmune disorder like Hashis

Negative on the adrenals and Hashis apparently, he ruled that out via the rest of my bloods (don't have them on me, but can if you'd like to see them)

Like Gene mentioned, we need the Reverse T3 lab, plus antibodies, being the TPO & TgAb. If your T3 isn't able to effectively get to the cells of your body, throwing a little Synthroid at it is just going to be like throwing gas in the fire!! This will just promote higher than desired amounts of Reverse T3, and it will be a mess if you have an autoimmune disorder. If it were Hashis, you can treat it with thyroid meds (preferably NDT is what I would do), but you need to titrate it properly and know how to monitor it.

What's NDT? I did ask bout Amrout Thyroid but of course it was immediately dismissed

Again, at the moment, there's just a ton of speculation. I'm glad you're considering another doctor, because this one IMO is not providing you with the adequate care that you need and deserve! (there, I worded it with a friendly touch) ... Also, like I said early, I get a funny feeling about the adrenals here. It's a lot to digest with one serving, but also take a look at a diurnal 4x saliva cortisol/DHEA-s saliva kit, where we can review the circadian profile report of your adrenals, and get a cortisol/DHEA correlation analysis. If the results don't provide these reports for you, I can ...

lol at friendly touch. he lost my faith the second he said hormones have nothing to do with dietary fat or cholesterol...

You can learn a healthy amount of this stuff at STTM .. http://www.stopthethyroidmadness.com/

In your statement with #4, you mention that your doctor says you're reading too much on the Internet. I'm not into knocking doctors on the forum, even the not so good ones! However, that statement, made by a doctor, engineer, or truck driver, doesn't matter, that's about the most ignorant thing anyone could ever tell you. Noooo, please, read, read, and read some more!!! Learn from all zillions of resources that are now available, which we didn't have 20 years ago!

So, so sorry this guy is threatened with your desire to gain knowledge! What he is really saying to you is that he doesn't know shiat about RT3 and the other variables related to it, and he's afraid that you're going to exploit his ineptness by building your own knowledge. Just spend a few hours perusing through the STTM site .. They make mention many times about those types of docs http://www.stopthethyroidmadness.com/give-me-a-break/ and they have resources for finding good physicians http://www.stopthethyroidmadness.com/how-to-find-a-good-doc/

i'll be reading up tonight, thank you so much for the detailed response! i posted answers to some of your questions, they're in bold!

thank you again guys, already happy i signed up

 

[Vettester Chris]

OK, thanks, I'll post kind of quick ...

Good on the MRI, glad it's negative! That rules that out, we don't have to talk about it any further.

Yes, if you have any previous tests on the adrenals then see what you can find. If it was just a 1 time cortisol blood serum test that fell within the reference range, then my suspicion still stands. A 24 hour circadian profile via saliva is the gold standard.

You hit it, Armour is an NDT .. NDT = Natural Dessicated Thyroid .. It's T4, T3, T2, T1 made from pigs, and mimics much like our own natural thyroid. The ratios are a little different, but we can touch on that later. STTM will have all sorts of info on it ..

50mcg of Synthroid, LOL!! That will play out like about 1/2 grain of NDT when all the dust settles. Sorry, he's shooting from the hip! His program is safe as long as guys like you don't do some reading and get edgemucated!

Catch up soon ...

 

[LeBronGains]

OK, thanks, I'll post kind of quick ...

Good on the MRI, glad it's negative! That rules that out, we don't have to talk about it any further.

Yes, if you have any previous tests on the adrenals then see what you can find. If it was just a 1 time cortisol blood serum test that fell within the reference range, then my suspicion still stands. A 24 hour circadian profile via saliva is the gold standard.

Got one from the 12.30 test:
Cortisol: 15.3 (4 - 22.0)
Thyroglobulin Antibodies: <1 (<=1)
ACTH Plasma: 9 (6-50)
Growth Hormone: 1.3

You hit it, Armour is an NDT .. NDT = Natural Dessicated Thyroid .. It's T4, T3, T2, T1 made from pigs, and mimics much like our own natural thyroid. The ratios are a little different, but we can touch on that later. STTM will have all sorts of info on it ..

50mcg of Synthroid, LOL!! That will play out like about 1/2 grain of NDT when all the dust settles. Sorry, he's shooting from the hip! His program is safe as long as guys like you don't do some reading and get edgemucated!

Awful man, and annoying since i still occasionally get the easily fatigued symptoms.

Catch up soon ...

answers bolded, thanks again so much i appreciate you taking the time

 

[tmckenzie]

I agree with the above statements. I was in your exact shoes at your age. I suffered until 32. You said MRI. But did you get an MRI focused on the pituitary gland? Reason I asked is I had one or two brain MRIs that totally missed me having empty sella and not any pit gland to speak of. And I cannot stress any higher than Chris did the cortisol test, that will tell a lot. And good luck on an endo, I had one that was OK, but he retired and I have yet to find one, thank God defy handles my trt, but rule everything out before treatment.

 

[LeBronGains]

I agree with the above statements. I was in your exact shoes at your age. I suffered until 32. You said MRI. But did you get an MRI focused on the pituitary gland? Reason I asked is I had one or two brain MRIs that totally missed me having empty sella and not any pit gland to speak of. And I cannot stress any higher than Chris did the cortisol test, that will tell a lot. And good luck on an endo, I had one that was OK, but he retired and I have yet to find one, thank God defy handles my trt, but rule everything out before treatment.

I'm sorry to hear that man At least I'm not the only one who experienced this at such a young age. It sucks for sure

Who's "Defy"?

Yes particularly for the pituitary. I had gotten hit by a car when I was younger and fractured my skull, so we did many tests on the brain to figure it out. Never had issues with libido until i was 21 unfortunately, and the accident occurred when i was 12.

Just makes me upset i'll be 23 in March, and i have ZERO desire to do anything for it really. idk just hoping it all gets resolved soon. i don't know if i should press him to take care of me earlier or what or do his low dose of HcG idea.

 

[tmckenzie]

When did you have the last pit gland MRI? Defy medical. I would reach out to them as they will certainly make sure everything is right before starting anything. Oh my twenties and early 30 sucked. And I am better, but the other issues caused by empty sella still try and keep me down.

 

[LeBronGains]

MRI was done in October of 2014

 

[LeBronGains]

i see Defy is in FL. Do they do anything in other states? Im going to research more later but any quick info would be appreciated

 

[CoastWatcher]

Defy's model of patient care allows them to work with patients across the country. Call them.

 

[LeBronGains]

got it, i will! thank you so much!

 

[Vince]

I live in wisconsin and also use Defy Medical, thursday will be my 11th week and I will have labs on my 12th week.

 

[LeBronGains]

Hey Vince,

how does it ork if you dont mind giving me aquick rundown?

 

[Vince]

you have to have a physical once a year through your primary or clinic (paperwok for your doctor to fill out). there's paperwork to fill out so give yourself some time. you can watch videos to self inject and mix HCG. most everything else is done through emails and phone. my insurance Aetna only paids 60% out of network and I fax all the paperwork to Aetna. that's all I can think of right now

 

[LeBronGains]

intersting, so essentially my regular GP can order blood work, correct? and then defy determines via phone calls what the best course of action?

i have two insurances luckily, cigna and horizon blue cross blue shield.

 

[Vince]

Your doctor only gives you a physical and Defy sends you to a local labcorp for blood work

 

[LeBronGains]

ok cool, thank you so much for taking the time Vince!