Need Help- Low Testosterone

[Chow4321]

Hi Everyone,

I hope all doing well. I am 31 years old Male living in Canada. I always had many symptoms all my life and after many trips to doctor i was able to do blood test, Mri of pituitary & adrenal gland. Following are my results

**SYPMTOMS:**
•Headches, Pain behind eyes, Neck & Shoulder
•Anxiety espcially going out.
•Hot Flashes, Swollen Face
•Frequent Urination
•Restlessness in legs
•Weakness & lack of energy
•No motivation for anything
•Hard to see purpose in things
•Extreme anger because of the symptoms how much it affects my life
•Less Body & Facial Hair
•Fat Around Abdomen, Skinny arms and hard to put muscle
•Sexually Ok but sometimes do have erectile dysfuction

**BLOOD TEST RESULTS**:
Result Unit Range
Total Testosterone 12.4 nmol/L (7.6-31.4)
Free Testosterone 329 pmol/L (159-510)
LH 6 IUS/Liter (2.5-16.3)
FSH 5 IU/L (1-16)
Estradiol 58 pmol/L (0-158)
DHEA 12.4 mmol/L (4.3-12.2) **HIGH**
Prolactin 5 µg/L (4-18)
Progesterone 1 nmol/L (0-0.6) **HIGH**

TSH 1.70 mIU/L (0.35-5)
Free T4 17.8 pmol/L (12-22)
Free T3 5.1 pmol/L (3.4-5.9)


Cholestrelol, Total 6.27 mmol/L (0 - 5.19) **HIGH**
Triglycerides 1.40 mmol/L (0 - 1.69)
HDL Cholesterol 1.08 mmol/L (1 - 2.3)
LDL Cholesterol 4.55 mmol/L
NON-HDL-Cholesterol 5.19 mmol/L

Vitamin B12 425 pmol/L (> 221)
Sodium 137 mmol/L (136-146)
Potassium 4.0 mmol/L (3.7-5.4)
HB A1C 5.4 % (0-5.9)

PSA 1.59 µg/L (0-2.5)
Free PSA 0.48 µg/L
Free PSA/Total PSA 0.30 Ratio

Creatinine, Urine 31.8 mmol/L (3.5-24.6) **HIGH**
Creatinine 68 µmol/L (60 - 110)

**Urine Culture NEGATIVE <10e7 CFU/L**

ALT 27 U/L (0 - 45)
Ferritin 73 µg/L (24 - 453)
C-Reactive Protein 1 mg/L (0 - 5)
GFR Your results are >=120 This is considered NORMAL.

Red Blood Cells 4.8 10e12/L (4.7 - 6.0 )
Hemoglobin 131 g/L (135 - 180) **LOW**
Hematocrit 0.403 F of T (0.420 - 0.520) **LOW**
MCV 84 fL (78 - 100)
MCH 27 pg (27 - 34)
MCHC 325 g/L (320 - 360)
RDW-CV 12.7 % (11.5 - 14.0)
White Blood Cells 8.1 10e9/L (4.0 - 10.5)
Neutrophils # 3.3 10e9/L (1.5 - 6.6)
Neutrophils 0.41 % F of T (0.37 - 0.75)
Lymphocytes # 4.1 10e9/L (1.5 - 3.5) **HIGH**
Lymphocytes 0.51 % F of T (0.20 - 0.75)
Lymphoc/Neutrophils **1.24** (0.25 - 0.99)
Monocytes # 0.5 10e9/L (0 - 1.0) **HIGH**
Monocytes 0.07 % F of T (0.02 - 0.10)
Eosinophils # 0.1 10e9/L (0 - 0.7)
Eosinophils 0.02 % F of T (0.01 - 0.11)
Basophils # 0.03 10e9/L (0 - 0.1)
Basophils 0.00 % F of T (0.00 - 0.02)
Immature granulocyt 0.01 10e9/L (0 - 0.03)
Immature granulocytes 0.001 % F of T (0 - 0.005)
Platelets 225 10e9/L (150 - 450)
MPV 14.1 fL (7.4 - 12.8) **HIGH**


**PITUITARY GLAND MRI:**
The pituitary gland is of small volume measuring 4 mm thick, it is however homogeneous and raises in a uniform way without sign of pituitary adenoma. The pituitary stem is in a central position, it is of normal volume.There is no sign of hypothalamic lesion. The brainstem and basal ganglia appear normal. There is no hydrocephalus, No supratentorial lesion.
Conclusion: Brain study within normal limits. Homogeneous small volume pituitary without sign of pituitary adenoma

**ADRENAL GLAND MRI:**
7mm left adrenal nodule at the crux of the adrenal gland with features suggestive of a millimeter adrenal adenoma.


My doctor is saying everything is normal and don't need any treatment for time being. I am staying most of the time home and don`t feel any energy to go outside. I am really lost & don't know what route to take from here on. Any advice or help would be greatly appreciated.

Thanks in Advance

 

[Systemlord]

Headches, Pain behind eyes, Neck & Shoulder
•Anxiety espcially going out.
•Hot Flashes, Swollen Face
•Frequent Urination
•Restlessness in legs
•Weakness & lack of energy
•No motivation for anything
•Hard to see purpose in things
•Extreme anger because of the symptoms how much it affects my life
•Less Body & Facial Hair
•Fat Around Abdomen, Skinny arms and hard to put muscle
•Sexually Ok but sometimes do have erectile dysfuction

Hello and welcome,

As someone that has had very low estrogen, I can’t tell you with certainty all of these symptoms are from low estrogen. Normal estrogen for an adult male is 20 pg/mL or 85> pmol/L.

You may actually have an aromatase deficiency, which is an enzyme that coverts T to E2.

I would get checked for osteoporosis because of that low estrogen value.

Being in the climate near the poles, low vitamin D can lower estrogen.

I got all of your symptoms right after taking an aromatase inhibitor, which blocks estrogen from being converted from testosterone. The pain behind the eyes was the very first symptom, which happens when estrogen declines quickly.

The vast majority of Canadian doctors are brain dead when it comes to sex hormones!

I can recommend some knowledgeable doctors depending upon your location.

Where are you in Canada?

 

[Chow4321]

As someone that has very low estrogen, I can’t tell you with certainty all of these symptoms are from low estrogen. Normal estrogen for an adult male is 20 pg/mL or 85> pmol/L.

You may actually have an aromatase deficiency, which is an enzyme that coverts T to E2.

I would get checked for osteoporosis because of that low estrogen value.

Being in the climate near the poles, low vitamin D can lower estrogen.

I got all of your symptoms right after taking an aromatase inhibitor, which blocks estrogen from being converted from testosterone. The pain behind the eyes was the very first symptom, which happens when estrogen declines quickly.

The vast majority of Canadian doctors are brain dead when it comes to sex hormones!

I can recommend some knowledgeable doctors depending upon your location.

Where are you in Canada?

Thank you for your response. I am in Montreal, Quebec. What do you think about adrenal adenoma i have, may that cause all the problems.

What do you think could be causing Low testosterone. Or any other comment on my blood test would be appreciated

 

[Systemlord]

I am in Montreal, Quebec.

I’m sorry, I don’t know any doctors in that area, maybe @madman, a super moderator will be able to recommend a doctor in that area.

If i take aromatase inhibitor that will lower my estrogen more or it will high my testoterone

I couldn’t think of a worse course of action! Please don’t do this.

 

[Systemlord]

What do you think about adrenal adenoma i have, may that cause all the problems.

Most are benign and do not cause problems.

 

[Systemlord]

I think you have iron deficiency anemia, which is usually diagnosed with low hemoglobin. Low hemoglobin means there’s less oxygen available to your tissue. No wonder you’re fatigued.

What did your doctors say about the low hemoglobin and hematocrit?

I think you need to see a hematologist.

 

[Cataceous]

...
As someone that has had very low estrogen, I can’t tell you with certainty all of these symptoms are from low estrogen. Normal estrogen for an adult male is 20 pg/mL or 85> pmol/L.

You may actually have an aromatase deficiency, which is an enzyme that coverts T to E2.
...

You might consider the strong possibility that he has low SHBG. This renders moot your idea that a particular threshold is applicable to total estradiol. Free estradiol is probably more reasonable.

Your speculation about low aromatization is contradicted by the ratio of estradiol to testosterone. It is 0.47%, around the middle of a rough normal range of 0.3-0.6%.

@Chow4321: What are your diet and exercise like? These should be sound before you consider any pharmaceutical interventions.

 

[Chow4321]

You might consider the strong possibility that he has low SHBG. This renders moot your idea that a particular threshold is applicable to total estradiol. Free estradiol is probably more reasonable.

Your speculation about low aromatization is contradicted by the ratio of estradiol to testosterone. It is 0.47%, around the middle of a rough normal range of 0.3-0.6%.

@Chow4321: What are your diet and exercise like? These should be sound before you consider any pharmaceutical interventions.

Hi there,

I am 5’11 and 78kg weight. Waist around 34. Diet is pretty normal except it is spicy sometimes. I am not very active with excercise, stay mostly at home, The moment i go outside anxiety just hit me very hard that i am not able to do things. I don’t have any fat except abdomen and little bit gynecomastia.

Also My SHBG is really low 15.5nmol/L (13.5-88.5). I don`t know if that has any link with that

 

[Systemlord]

My SHBG is really low 15.5nmol/L (13.5-88.5).

Low SHBG is strongly associated with metabolic syndrome.

 

[madman]

Hi Everyone,

I hope all doing well. I am 31 years old Male living in Canada. I always had many symptoms all my life and after many trips to doctor i was able to do blood test, Mri of pituitary & adrenal gland. Following are my results

**SYPMTOMS:**
•Headches, Pain behind eyes, Neck & Shoulder
•Anxiety espcially going out.
•Hot Flashes, Swollen Face
•Frequent Urination
•Restlessness in legs
•Weakness & lack of energy
•No motivation for anything
•Hard to see purpose in things
•Extreme anger because of the symptoms how much it affects my life
•Less Body & Facial Hair
•Fat Around Abdomen, Skinny arms and hard to put muscle
•Sexually Ok but sometimes do have erectile dysfuction

**BLOOD TEST RESULTS**:
Result Unit Range
Total Testosterone 12.4 nmol/L (7.6-31.4)
Free Testosterone 329 pmol/L (159-510)
LH 6 IUS/Liter (2.5-16.3)
FSH 5 IU/L (1-16)
Estradiol 58 pmol/L (0-158)
DHEA 12.4 mmol/L (4.3-12.2) **HIGH**
Prolactin 5 µg/L (4-18)
Progesterone 1 nmol/L (0-0.6) **HIGH**

TSH 1.70 mIU/L (0.35-5)
Free T4 17.8 pmol/L (12-22)
Free T3 5.1 pmol/L (3.4-5.9)


Cholestrelol, Total 6.27 mmol/L (0 - 5.19) **HIGH**
Triglycerides 1.40 mmol/L (0 - 1.69)
HDL Cholesterol 1.08 mmol/L (1 - 2.3)
LDL Cholesterol 4.55 mmol/L
NON-HDL-Cholesterol 5.19 mmol/L

Vitamin B12 425 pmol/L (> 221)
Sodium 137 mmol/L (136-146)
Potassium 4.0 mmol/L (3.7-5.4)
HB A1C 5.4 % (0-5.9)

PSA 1.59 µg/L (0-2.5)
Free PSA 0.48 µg/L
Free PSA/Total PSA 0.30 Ratio

Creatinine, Urine 31.8 mmol/L (3.5-24.6) **HIGH**
Creatinine 68 µmol/L (60 - 110)

**Urine Culture NEGATIVE <10e7 CFU/L**

ALT 27 U/L (0 - 45)
Ferritin 73 µg/L (24 - 453)
C-Reactive Protein 1 mg/L (0 - 5)
GFR Your results are >=120 This is considered NORMAL.

Red Blood Cells 4.8 10e12/L (4.7 - 6.0 )
Hemoglobin 131 g/L (135 - 180) **LOW**
Hematocrit 0.403 F of T (0.420 - 0.520) **LOW**
MCV 84 fL (78 - 100)
MCH 27 pg (27 - 34)
MCHC 325 g/L (320 - 360)
RDW-CV 12.7 % (11.5 - 14.0)
White Blood Cells 8.1 10e9/L (4.0 - 10.5)
Neutrophils # 3.3 10e9/L (1.5 - 6.6)
Neutrophils 0.41 % F of T (0.37 - 0.75)
Lymphocytes # 4.1 10e9/L (1.5 - 3.5) **HIGH**
Lymphocytes 0.51 % F of T (0.20 - 0.75)
Lymphoc/Neutrophils **1.24** (0.25 - 0.99)
Monocytes # 0.5 10e9/L (0 - 1.0) **HIGH**
Monocytes 0.07 % F of T (0.02 - 0.10)
Eosinophils # 0.1 10e9/L (0 - 0.7)
Eosinophils 0.02 % F of T (0.01 - 0.11)
Basophils # 0.03 10e9/L (0 - 0.1)
Basophils 0.00 % F of T (0.00 - 0.02)
Immature granulocyt 0.01 10e9/L (0 - 0.03)
Immature granulocytes 0.001 % F of T (0 - 0.005)
Platelets 225 10e9/L (150 - 450)
MPV 14.1 fL (7.4 - 12.8) **HIGH**


**PITUITARY GLAND MRI:**
The pituitary gland is of small volume measuring 4 mm thick, it is however homogeneous and raises in a uniform way without sign of pituitary adenoma. The pituitary stem is in a central position, it is of normal volume.There is no sign of hypothalamic lesion. The brainstem and basal ganglia appear normal. There is no hydrocephalus, No supratentorial lesion.
Conclusion: Brain study within normal limits. Homogeneous small volume pituitary without sign of pituitary adenoma

**ADRENAL GLAND MRI:**
7mm left adrenal nodule at the crux of the adrenal gland with features suggestive of a millimeter adrenal adenoma.


My doctor is saying everything is normal and don't need any treatment for time being. I am staying most of the time home and don`t feel any energy to go outside. I am really lost & don't know what route to take from here on. Any advice or help would be greatly appreciated.

Thanks in Advance

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Dr. Andrew Steinberg, MD, CM, CCFP | Steinberg Urology Private Clinic

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Low Testosterone | Steinberg Urology

Low Testosterone | Steinberg Urology Private Clinic

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