Questions on Blood panels results for my nephew

[copacetic25]

Hello,

My Nephew after leaving the military has very low testosterone levels and we ran a recent blood panel that you see below, but aside from the Low Testosterone number, the only other number off was Triglycerides. I was expecting FSH or LH to be off, but not sure where to go from here. Panel attached. He's 25 years old and good shape. Any insight appreciated.

 

[Systemlord]

Your nephew has low testosterone. My LH was 3.6 and Total T 91 ng/dL and Free T abnormally low. My triglycerides we're also very high at 389.

TRT dropped my triglycerides substantially and are almost in the normal ranges.

Did your nephew suffer a head injury or fire off shoulder-mounted rockets?

 

[copacetic25]

He's has lost his hearing several times from loud, large caliber rifle fire and been concussed from breach charges/grenades. I'm just not sure what else to test for to determine what's wrong, I don't want him on TRT at 25 if he can avoid it.

 

[Systemlord]

He's has lost his hearing several times from loud, large caliber rifle fire and been concussed from breach charges/grenades.

TRT is inevitable at this point because there is no way to repair the damage from a traumatic brain injury (TBI) other than to replace the low hormones.

Your nephew's temporary loss of hearing and low-T may only be scratching the surface, growth hormone should be tested for people with head trauma/TBI.

 

[Cataceous]

It's rather important to know if he's having any symptoms that might be linked to the low T. If he's functioning ok then no need to rush into TRT at this point. If he is having symptoms then there are still options short of full blown TRT, such as testosterone nasal gel or enclomiphene.

 

[copacetic25]

Thanks, he has definitely noticed less drive, motivation and has lost 10 or more pounds in muscle. Yeah, I was leaning towards having him start something like Clomid, I hadn't heard of enclomiphene, but that looks like some similar?

 

[Cataceous]

Enclomiphene is actually part of Clomid—the part that does the useful stuff. The other part—isomer—is zuclomiphene. Zuclomiphene is rather like estrogen, and is usually counterproductive for guys to take. In other words, enclomiphene is strongly preferred over Clomid, though it's a little harder to get. However, as far as I know both Empower Pharmacy and Tailor Made Pharmacy are still providing it.

Although I use enclomiphene myself, I preferentially recommend testosterone nasal gel as a first-line treatment. Either option keeps your HPTA active, avoiding some potential problems with TRT. However, the subjective results with enclomiphene are less reliable, with some doing great and others having continued issues. It's also a little disconcerting that we don't know enough about what enclomiphene is doing, beyond that it's blocking some estrogen receptors and not others.