22 with low test - Possible pituitary issues?

AnonEagle

New member
Question: Based on my bloods, does it look like this is an issue that can be resolved without testosterone replacement therapy (TRT)? My estradiol is pretty high, with low LSH and FH, and low test. What can be done if the issue lies in your pituitary system? I'm not opposed to testosterone replacement therapy (TRT) but if I can see reasonable T levels without spending huge $ and without starting life-long injections that is obviously preferable. Plus the sperm/fertility issue.

I believe I have had low T for a long, long time (ie high school, before ever touching a prohormone or AAS) and I've had pretty frustrating ED for pretty much FOREVER. I did use some AAS in college starting shortly after turning 19, roughly 3 cycles total. First cycle just test E, forgot exactly what the middle cycle would have been, and a final cycle of test E and tren A. I always followed the PCTs recommended on this site. AIs on cycle (aromasin), and SERMs clomid and nolva after following standard PCT dosage schedules. Never used Human Chorionic Gonadotropin (HCG), seemed to be more up to debate at the time but oh well that ship has sailed.

And again, I honestly don't think the AAS brought me to a lower level of Testosterone than I had before cycling! The way I feel now is pretty much equally as shitty as I have felt ever since being 16 or some shit, just grew sick of the sexual frustrations I've had since I was 15 and finally decided to go see some doctors.

Finally got the results from my Urologist today, he referred me to an endo. Endo was booked up for a long time, so I'm going to try a different endo but at the same practice. I'm seeing the endo tomorrow to talk about the results. Looking for anything I should be aware of going into the endo meeting. Urologist said my low FSH wasn't the cause of my low T, is this right? Will see what the endo says...

-age - 22

-height - 6' 3"

-waist - not exactly sure how to measure it, but around my belly and lovehandles is 37.6" fully relaxed, upper abs is 36"

-weight - 217 lb.

-describe body and facial hair
Used to be huge (309 lb) when I played college football, been cutting since then. Facial hair (as well as hair all over body) has been pretty much non-existent. I get some stubble on the very bottom of chin, and a little mustache, but both thin and scraggly

-describe where you carry fat and how changed
Almost 100% on torso, belly/chest. My legs are freakin lean, pretty lean arms, still have a gut after losing almost 100 pounds. Photos are here: imgur.com/a/45qrW/all

-health conditions, symptoms [history]
None, other than some major head trauma, 8 years of football, broke jaw, knocked out a couple times (not during football),

-Rx and OTC drugs, any hair loss drugs or prostate drugs *ever*
-- real dangers! see this http://propeciahelp.com/overvi...
None

-lab results with ranges (bolded low and/or worrisome to me results)
Protein, Total 7.8 g/dL (6.1-8.1)
Albumin 5.2 g/dL (3.6-5.1)
Globulin 2.6 g/dL (1.9-3.7)
Albumin/Globulin Ratio 2.0 (1.0-2.5)
Bilirubin, Total 1.3 mg/dL (0.2-1.2)
Bilirubin, Direct 0.3 mg/dL (<=0.2)
Bilirubin, Indirect 1.0 mg/dL (0.2-1.2)
Alkaline Phosphatase 89 U/L (40-115)
AST 22 U/L (10-40)
ALT 29 U/L (9-46)
Dihydrotestosterone, LC/MS/MS 19 ng/DL (16-79)
FSH 1.0 mIU/mL (1.6-8.0)
LH 1.7 mIU/mL (1.5-9.3)
Prolactin 8.2 ng/mL (2.0-18.0)
Estradiol 33 pg/mL (<=39) Not out of range, but this seems high given how low my T is...
Testosterone, Total, LC/MS/MS 294 ng/dL (250-1100)
Free Testosterone 55.6 pg/mL (35.0-155.0)


-describe diet [some create substantial damage with starvation diets]
I did definitely do a starvation diet around like 15, but bulked heavy from jr. year of high school trough my senior season of CFB. Been doing a keto cut for a couple months now.

-describe training [some ruin there hormones by over training]
High school football/other sports, average training and crossfit
In college, trained with the football team, and in off-season trained at world class PL gym

-testes ache, ever, with a fever?
Had ache/pain very rarely, never with a fever

-how have morning wood and nocturnal erections changed
Basically non-existent in the morning, and at night difficult to keep and maintain even with hot girls!
 
When was your last cycle and consequent post cycle therapy (pct)? Albumin is indicative of poor kidney processing of protein, so you either need to lower the protein intake or drastically increase the water intake. I'd revisit that once you've made the appropriate changes there.

Honestly, your panel looks like someone who has been shutdown by AAS which I'm sure you're aware of. Is it possible that you could try another restart instead of testosterone replacement therapy (TRT)? Sure, but if your PCT was long ago - it might become a tricky proposition even with aggressive doses of clomid. Honestly, this is definitely a case for a good endo/urologist that can hopefully be thorough with an MRI of your pituitary gland and start off with clomid/HCG and see how it goes from there.

Best of luck!

My .02c :)
 
When was your last cycle and consequent post cycle therapy (pct)? Albumin is indicative of poor kidney processing of protein, so you either need to lower the protein intake or drastically increase the water intake. I'd revisit that once you've made the appropriate changes there.

Honestly, your panel looks like someone who has been shutdown by AAS which I'm sure you're aware of. Is it possible that you could try another restart instead of testosterone replacement therapy (TRT)? Sure, but if your PCT was long ago - it might become a tricky proposition even with aggressive doses of clomid. Honestly, this is definitely a case for a good endo/urologist that can hopefully be thorough with an MRI of your pituitary gland and start off with clomid/HCG and see how it goes from there.

Best of luck!

My .02c :)

Thanks for the input. It has been roughly a year now since my cycle. I would think that I would be pretty restored to baseline by now (even if my baseline is fucked)... Seeing the endo tomorrow. Pretty much just a random one that could see me so I'm kinda doubtful they'll be on top of their shit... I guess we'll see.

Do you have info or know a source for a the protocol on a clomid/hcg restart after this long after PCTing?

and I have been doing a keto cut for a few months now, weighed 309 about a year ago and down to about 215-220. This could explain the albumin deal maybe?
 
Yeah man talk to your endo and see what he says. I'm 22 too, and I'm about to start my 3rd cycle next week. Shits scary to think about haha. I'd run an HCG blast and run clomid again. That should get you kickstarted.
 
I'm not so sure you can kickstart above a baseline that you may or may not have been at for a year or more (if ever)... I seriously had old man libido and issues messin with the girls in high school, not much different than now. Can get it done but it's frustrating to say the least!

Yea I'll report back after the endo tomorrow morning though
 
Thanks for the input. It has been roughly a year now since my cycle. I would think that I would be pretty restored to baseline by now (even if my baseline is fucked)... Seeing the endo tomorrow. Pretty much just a random one that could see me so I'm kinda doubtful they'll be on top of their shit... I guess we'll see.

Do you have info or know a source for a the protocol on a clomid/hcg restart after this long after PCTing?

and I have been doing a keto cut for a few months now, weighed 309 about a year ago and down to about 215-220. This could explain the albumin deal maybe?
It doesn't fully apply to you, but some have had great success with this. Even if you've been baseline like that for some time, it's really little different than being shut down the entire time by exogenous testosterone (at least in theory).
http://www.steroidology.com/forum/anabolic-steroid-forum/612215-hrt-exit-strategy.html

Food for thought. :)
 
Good luck getting restarted. I take it you didn't run labs prior to your first cycle to know what your baseline was. Or did you? Finding a doc to put you sounds testosterone replacement therapy (TRT) at age 22 is often difficult.

Just some advice: you may be tempted to be honest tomorrow with your doc. DO NOT BE HONEST! Do not say, mention or hint anything about past steroid use.

Halfwit: just curious. Why are you recommending an MRI? I was thinking that given the normal prolactin and past cycles that a pituitary tumor seems unlikely to be the cause of his Low T. Or are you going off his "feeling" that he has always had low T?
 
Good luck getting restarted. I take it you didn't run labs prior to your first cycle to know what your baseline was. Or did you? Finding a doc to put you sounds testosterone replacement therapy (TRT) at age 22 is often difficult.

Just some advice: you may be tempted to be honest tomorrow with your doc. DO NOT BE HONEST! Do not say, mention or hint anything about past steroid use.

Halfwit: just curious. Why are you recommending an MRI? I was thinking that given the normal prolactin and past cycles that a pituitary tumor seems unlikely to be the cause of his Low T. Or are you going off his "feeling" that he has always had low T?

Wish I had taken a baseline but I didn't.

Why do you say do not be honest like it is such a big deal? I was planning on maybe implying it but not explicitly saying it... wouldn't giving them some idea help make an accurate diagnosis? Before I told my urologist I have used some "supplements" he was going to prescribe me nothing but mental therapy ... "Most kids your age are just nervous, it's normal..." ugh lol
 
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Your labs clearly show you are hypogonadal. They are going to run all the same tests and do the same things regardless of what caused it. Just talk about how you have always felt like you have had Low T, etc.

But, if you tell them you took illegal AAS several times in the past, 9 out of 10 docs will not even consider prescribing testosterone. Not at 22 years old. Actually, probably much higher than 9 out of 10. It is just how they think. They want to protect their license to practice medicine.

If you really feel compelled to tell them something, talk about a prohormone that your buddy convinced you to take a year ago or something like that. And you have felt even worse ever since then.

Do yourself a favor though and don't mention AAS. Don't talk about "not getting serious pumps in the gym anymore and your bench press has been stuck at 275 for the last 5 month.". Don't come across as a meathead. :)
 
We have nothing to go off of prior to your AAS usage. It's all just speculation at this point. Err on the side of caution and try a restart before jumping into TRT. You already cheated your body once - do things the right way and try as little drugs as possible. You're 22 - we may find out after 30 years of usage, that these drugs cause cancer at alarming rates. Is that fact at this point? Absolutely not, but just like I wouldn't be taking chances by popping aspirin every day or smoking cigarettes everyday, I wouldn't want to be the guinea pig and test dummy.

You may be pleasantly surprised by what a restart accomplishes. You also may not be surprised or happy with the results. At least you'll know and looking back 30 years from now, you won't question if you made the appropriate choice - you'll have made the only choice that was available.
 
Just got back from the endo, actually seemed like they knew wtf they were talking about!! (at least so far) Maybe it pays to live in the big city with half a dozen big med schools here. Long, frustrating process with each set of labs taking 4 weeks to get back ughh, but at least these people seem to be making progress. They ordered an MRI looking for a pituitary tumor, thyroid labs. Ferramin and SHBG labs, as well another set of T labs, another Albumin (liver), and LH FSH again. Hopefully they get to the bottom of this, will try to update when I see the doc again in 4 weeks.


We have nothing to go off of prior to your AAS usage. It's all just speculation at this point. Err on the side of caution and try a restart before jumping into TRT. You already cheated your body once - do things the right way and try as little drugs as possible. You're 22 - we may find out after 30 years of usage, that these drugs cause cancer at alarming rates. Is that fact at this point? Absolutely not, but just like I wouldn't be taking chances by popping aspirin every day or smoking cigarettes everyday, I wouldn't want to be the guinea pig and test dummy.

You may be pleasantly surprised by what a restart accomplishes. You also may not be surprised or happy with the results. At least you'll know and looking back 30 years from now, you won't question if you made the appropriate choice - you'll have made the only choice that was available.

Thank you and others for all the input so far. I definitely agree with you too. It's definitely possible that I am now paying the consequences of cycling at 19, maybe maybe not but such is life..
 
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