Need Advice! 23 Year old male

[Zach Hess]

Hey everyone. I am a 23 year old male 6'0 170 pounds. I recently had my test levels checked in January and the results are as follows:
Metric : my result ref range)
Total T: 168 ng/dl : (241-827 ng/dl)
Free T: 16.8 : (48.2-169.6 nl)
SHBG: 78.9 nl : (17.3-65.8)
Bio T: 50.8 nl : (113.1-397.7)
PRL: 4.03 ng/ml : n/a
TSH: 1.43 ulU/ml : (.4-4.0)
Free T3: 2.13 PG/ML: (2.3-4.2)
Free T4: 1.02 ng/dL : (.89-1.76)
Vitamin D: 42.3 ng/mL : (30-100)
FSH: 2.10 mIU/ml
LH: 1.07 mIU/ml


I have a variocele in my left teste but was told it was very common.
I have a follow up in 1 week so i have until then to make a decision. Im scared in terms of fertility, being reliant on a needle, etc. I've also been unable to gain hardly any muscle in my 5 years of training & store fat in the feminine areas despite hard lifting, good diet, etc. I gain fat very easily & exhibit all of the normal signs of low test, occasional morning wood, weak and lack of erections, low sex drive. I am not depressed or anything, but had a bit of a bout with some aspect of depression 3 years ago whilst at school(homesick, typical stuff.).
Also worth mentioning that prior to when I was 19 years old I was 255 lbs & obese most of my childhoold. Lost 75 pounds in the matter of 1 year & have been around 170-180 since that time. So this may have hindered puberty/etc?
I have had an MRI of my pituatory gland that showed no tumor/abrasions
Given my levels, should I hop on TRT?
What should I do for fertility?
Will it make me feel better?
Are the injections easy to do on my own?
Can I travel with the injections given that it would be prescribed?
Will it make my nipples puffy/ me gain fat?

 

[PAUL-E]

congratulations on the weight loss!
prolactin? PRL: 4.03 ng/ml : n/a do you know the range?
SHBG: 78.9 nl : (17.3-65.8) seems high hows your liver?

What should I do for fertility? HCG
Will it make me feel better? possibly it seems like you might have more going on
Are the injections easy to do on my own? yes
Can I travel with the injections given that it would be prescribed?yes
Will it make my nipples puffy/ me gain fat? If your properly monitored no
advice would be to go with a experienced clinic or DR like defy and get proper blood work before going on TRT.
Any ASS or pro-hormone use in the past, diabetic?
The research shows many causes for high SHBG , including liver dysfunction, certain dietary factors and alcohol
http://www.peaktestosterone.com/High_SHBG.aspx

 

[PAUL-E]

Your FSH and LH seem low a restart might be worth exploring given your age, perhaps others with more experience could chime in.

 

[Vince]

Zach, if you start TRT it will be for life. I don't know if you can do a restart? I sounds like your testosterone has always been low. You could call Defy Medical for a consultation and see if they are affordable for you. With testosterone and the right amount of HCG you may be able to stay fertile. http://www.defylowt.com/contact-us

 

[Zach Hess]

Dont have ref range for PRL. SHBG wise it is high but my liver is fine. I have none of the symptoms of SHBG and hardly ever drink. I have never used AAS or pro-hormones or any of that garbage. I am 6'0 170 and like 18-20% body fat so obviously im in a bad place w/ my body despite training hard and eating an extremely healthy diet. I have had some digestive issues over the past couple months.

Yeah a restart might be worth a try- would love to hear opinions.

The only "other issue" I think is the varicocele. THe low T is definitely getting to me a bit mentally w/ the symptoms. I have no desire to go out, no sex drive, morning wood and lack of strong erections. I also find it almost impossible to gain muscle or strength and seem to just get fat any time I try.

 

[Jackie Treehorn]

Zach,

You're really young to be going on TRT for the rest of your life. You didn't include ranges for LH and FSH, so we're not really positive what's going on there yet. I'm guessing a Clomid restart is going to be an option for you to consider. Get the straight info from Defy. Also, what's going on with your T3 level...it's off on the low side.

 

[Zach Hess]

I agree I do not want to go on TRT just yet. I dont have FSH & LH ranges but from standard research ive done it indicates that my levels are LOW. Thyroid might be an issue as well. Doc was concerned with the low T3 reading.

 

[socks]

Hey partner, you should definitely reach out to a TRT service provider like defy or primebody who can link you up with a Doc in your area that's competent. If you total T was higher, I'd say you look secondary, but as your numbers exist, you could certainly have some dysfunction at the testicular level.

As mentioned, a restart should absolutely be tried first at your age and I believe any competent provider will be in agreement on this point.

 

[Zach Hess]

Doctors have determined its secondary. Saw both a urologist & endo. The only "physical" issue is the varicocele.

 

[socks]

Interesting, how'd they reach that conclusion? I've assumed from my reading that Docs usually rely on actual response to dosing(clomid/hcg challenge stuff) to genuinely determine primary vs secondary.

 

[Zach Hess]

They tested me for Klineffetters (an extra X chromosome), physical examination, other bloodwork, etc. That's what I think.

 

[Vince]

Klinefelter's Syndrome (extra X chromosome) which is a genetic abnormality

Read more at: https://www.excelmale.com/?s=63-TRT-Side-Effect-Management-High-Estradiol

 

[John O'Connor]

Request the "other bloodwork" results from those doctors. You should also bring copies with you for all future doctors visits related to these issues.

Yes, left sided varicocele is very common (present in 15% of teenage males, and that % increases with age groups.) but that doesn't mean its not part of the problem. Infertile men who had varicocele repaired had avererage of 98 point increase in testosterone in addition to increased sperm count.

At your age - I'd seriously consider having the varicocele repaired - especially if you think you might want kids some day. Seeing a fertility specialist might be a good place to start as your situation should really be fully investigated.

Some prior threads related to varicocele repair:
https://www.excelmale.com/forum/sho...and-erectile-dysfunction&highlight=varicocele

https://www.excelmale.com/forum/sho...lp-my-testosterone-level&highlight=varicocele

Keep us updated on your next steps, and post the more detailed blood work when you get it from your doctors.
Good luck!

 

[Vettester Chris]

Your FT3 is below the reference range, FT4 is super low (reserves), and TSH isn't elevated. If you just research some of Dr. Bruce Rind's material, you will find his experiences would lead to suspect that would be a signal to take a real close look at your adrenals. If you can, take your body temp. tomorrow at the time you wake up, take it again 2 hours later, then one more time 2 hours thereafter? We could get a little more deeper with this by doing it for the week, then taking daily averages, but for now let's see what it looks like during the early part of a day ...

The labs for the adrenals would consist of getting a ACTH assay, and a 4x Saliva Kit for Cortisol w/DHEA corrleation, providing a circadian profile. You also need to pull your antibodies (TPO and TgAb) and Reverse T3, as there is a chance you could also be dealing with autoimmune.

 

[Zach Hess]

Early morning temp yesterday AM was 95.6 and today was 96.0 -- took it 5 mins ago and it was 96.8. I've always been "easily cold" and have a hard time sweating ever since I initially lost weight down from 250 about 5 years ago.

 

[Vettester Chris]

Yeah, you need to get your adrenals addressed like pronto with a qualified physician. Refer to the labs I mentioned in the other post. They need to completely explore the primary and secondary related function of the adrenal cortex. I figured you might be low 97's, high 96's on temps. Mid 95's is even low for post menopausal females dealing with estrogen dominance, and that's several years into it! The tools are at your fingertips ... Get with a physician that can help.

 

[Zach Hess]

I'm just confused what this actually means? How does one fix their adrenals, etc? I've always had a lowish body temp since I lost weight initially and even when I was heavier my temp wouldnt be 98.6 in the morning.

 

[Vettester Chris]

There's a whole area on stop the thyroid madness, that is dedicated to the adrenals ...http://www.stopthethyroidmadness.com/adrenal-info/

If it is the adrenals, there's treatments and solutions, and obviously plenty of info on the Net to research, I don't need to spoon feed here. The thyroid WILL NOT function properly unless the adrenals are functioning, and/or some form of therapy administered (hydrocortisone, Anucort, etc.) Your thyroid markers demonstrate the need to get this checked out, as does the body temps you presented. You asked for advise, that's my .02, it doesn't mean I'm right, but I don't think it should be discounted ... Best

 

[Vettester Chris]

Additionally, regardless of what I say, labs always speak the truth. More labs and exams will remove any speculation.

 

[Zach Hess]

THANK YOU! A lot of this stuff makes sense & I will ABSOLUTELY bring it up to the doctor tomorrow. So basically my adrenals could be very comprimised which could bleed into T production. ANother question -- If a restart was deemed to be the best route, would this help with the adrenals or would the adrenals deem it useless. Furthermore, would the comprimised adrenals render any T therapy kind of "useless"