24 Yo Male - Advice Needed

futbolplayer

Have you had any injury like a blow to the testicles? Have you had any back trouble?

You feel that your genitals do not work and you have ruled out depression or anxiety due to the fact that you do not even feel like masturbating. Is that correct?
 
thanks for all the advice. I had previous bloodwork where my tsh came back at 1.4, I don't know why it would be so high this time. I have scheduled a sleep study and am hoping something can be found there. my biggest issues are a lack of sex drive, impotence, no morning erections, no nighttime erections, low libido, depressed mood, fatigue and low energy. I have started to supplement vitamin D at 3,000 ui a day. My urologist told me I had secondary hypogonadism and recommended clomid to raise the testosterone but said it would do nothing for my lack of erections or ed? He told me I needed to see a sex therapist because I was the issue? I never had any issues with my libido until over time it just stopped working. I do not think a sex therapist would be useful. Thoughts? Thanks everyone!

3000ius of vitamin D is not enough.

You need to investigate your thyroid and get your sleep study done first. See what those turn up and then go from there.

As for a sex therapist, if she is hot and you get to have sex with her, I say go for it. Otherwise I wouldn't bother unless you have problems with sexual relationships.

I'm not convinced your TT at 474 is the cause of your problems. I think you have some other things to look up first that could be the cause of your symptoms. If those don't play out, then you could try the clomid restart.
 
Agree with Megatron. You need a full thyroid panel. TSH alone is not a very accurate indicator of thyroid function and many experts think the reference range should be lower than 3.
Ask for a complete thyroid panel.
T
 
dude! how do you get all that women? lol :D i wish i could do that! well...as far as the concern of your testosterone levels go, i dont think they are very low, because i had two bloodworks and it was 384 the first time and 417 the second, and my dick works very good. jerked off 4 times this morning lol :D
but i have crappy gains in gym and most of the time feel depressed.
maybe you should try clomid, though your lh and fsh levels are also not THAT low...
 
Thanks for the great advice. I will go to an endocrinologist and have the thyroid looked into as well. I did play sports back in the day and took a soccer ball to the junk a few times, however this happened long after I finished playing sports. I agree that the sex therapist idea is complete bogus. I do not have performance anxiety, have had no issues in the past with women and being nervous about performing.

Here is the best way I can describe what has happened to my sexual response. It used to be if I was laying next to a girl and she would rub my inner thigh or do something sexual, I would feel a spark in a penis to to speak, I would become aroused, want to put my hands on her, get an erection, and become turned on. Now, if I am in a sexual situation with a girl, everything is dead down there, there is no spark, no arousal, and no erections. Furthermore, as I mentioned, I do not find myself seeking out the need to have sex or even masturbate like I used to. Really, I do not have any sexual thought or fantasies anymore. I obviously know when I am out with an attractive girl but there never feels to be much in term of excitement or lust with them anymore :( My doctor pretty much prescribed me Cialis to "help my confidence." There is no confidence issue other than the fact that my sexual response does not work with myself when I am alone and I have failed with about the last five girls I had seem. The Cialis doesn't get me in the mood, just mechanically allows me to get an erection and have successful sex but things aren't the same.

I agree that is 474 is on the low-normal side and may not be the issue of my problems but how about the free test? It seems significantly low to me especially given the reference range?

As for the sleep study, I have one scheduled within the next couple months. I do notice I never feel rested upon waking and am always fatigued. Don't really ever remember my dreams, if I do have them, I have noticed they are never about anything sexual, they are just bizarre dreams. No back troubles or pain by the way.

I was taking an SSRI for awhile that I found caused some ED but didn't necessarily impede fully nor did it affect my sex drive. Though I was still upset with the slight sexual dysfunction, I switched to Wellbutrin and any slight issues went away -- This was about three years ago. Today, I am simply on Wellbutrin and cannot have the sexual performance I did in the past. Honestly, something has just changed. I did talk to a psychiatrist and psychologist who both told me the SSRI was not the cause of my problems, especially as the problems persisted about one year off all psych meds -- I felt terrible the year while I did this but had read on PSSD [post ssri sexual dysfunction] and thought perhaps I was experiencing this, but after again one year off all meds and no improvement, I ruled this out. My doctors said this was not the cause.

I do not think depression or anxiety is the cause for lack of sex drive. Here is why: First, I do not have anxiety just depression. As for the depression, even when I was at my most depressed state in the past, I was still able to perform sexually. Though I might not have gone to seek it out, if a girl came onto me, I was able to become aroused no problem. I know for fact that even when I was in my deepest depression, I was still able to get strong erections, so I am confident this is not the cause.

Sorry this is all over the place. Lets see what else.. I can also describe myself as feeling dead inside. I really dont have much enthusiasm for anything and force myself to do things because its better than the alternative of sittings around doing nothing. When I think back to around three years ago, so much had just changed in terms of how I feel. My urologist told me my LH and FSH were low, I had secondary hypogonadism, he would prescribe clomid but said it would not help with the depression, poor concentration, poor feelings of well being, ED, and lack of libido. He told me it would simply help with energy and he didn't feel I needed it, so I declined the prescription.

I did talk to one doctor who believe my free T and total T were way too low for my age. He said he wanted to see total T around 800 ng/Dl and free T at least 15 ng/Dl? He was going to run more blood work and figure out the best way to treat me.
An odd thing to mention is that I am in great shape, I have been more lazy when it comes to the gym due to a lack of energy, feel I get fatigued more quickly in the gym, don't enjoy my workouts anymore, but I am still able to add some muscle mass. Albeit, though I have low bf, my muscles have always had a "soft" tone or appearance to them.

As for getting the girls, I am by no means an expert. I am lucky enough to have good genetics in terms of appearance, keep them laughing with a good humorous personality, and project confidence which always seems to do the trick [even though its incredibly difficult to feel good about yourself with depression]. I should add my depression is 100% chronic in that it never goes away. It is pretty intense if not medicated and is not like I am sad about anything. I just literally feel down, awful, suicidal thoughts, guilty about everything, its pretty weird. That also makes me thing it is something hormonal as it simply never improves or goes away completely. I saw a psychologist for 10 sessions because I heard this cause take care of depression. After meeting with him, he told me he was sure this was related to something biological, he said likely at least low t or something hormonal causing it, and that there was no way he could help me with therapy. We never got anywhere because he would ask why do you feel down? Is there anything that made you feel better or worse? You just got a great job, are you happy? You own your own company, isnt that great? Me: objectively these things sound great doctor, but I just feel bad for no reason all the time. So, we both agreed it wasn't worth my time or money to meet anymore.

Bought vit D as local nutrition store. Wish I could get back to the days of getting off four times a day. For a while, I had a theory that I had simply just used up all my libido when I was younger..

Thanks again everyone
 
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I should add that I likely had depression when I was younger but now it has gotten much more intense. Never growing up did I ever need to consider medication. If I felt down, get to the gym and workout or get around some people. Now, its so intense, if it is not medicated with something, I am not functional..
 
None.. While I wanted to be a pilot, I was unable to due to vision issues. I went the engineering route instead and have no problems with it. I had a serious girlfriend that took a while to get over but don't think about here anymore and hope she didnt steal my libido for life..
 
Updated Lab Results

C-Reactive Protein, Cardiac 0.45 [0.00 - 3.00 mg/L]
Homocyst(e)ine, Plasma 7.0 [0.00 - 15.0 umol/L]
Vitamin D, 25-Hydroxy 26.4 [30.0 - 100.0ng/mL]

TSH 2.33 [.450 - 4.5 uIU/mL]
Triiodothyronine, Free, Serum 3.5 [2.0 - 4.4 pg/mL]
T4, Free (Direct) 1.30 [0.82 - 1.77 ng/dL]

Cholesterol, Total 123 [100 - 189 mg/dL]
Triglycerides 118 [0 - 114 mg/dL]
HDL Cholesterol 39 [> 39 mg/dL]

VLDL Cholesterol Cal 24 [5 - 40 mg/dL]
LDL Cholesterol Calc 60 [0 - 119 mg/dL]
LDL/HDL Ratio 1.5 [0.0 - 3.6 ratio units]

Hemoglobin Alc 5.0 [4.8 - 5.6]
Estim. Avg Glu (eAG) 97 mg/dL

Testosterone Serum 464 [348 - 1197 ng/dL]
Free Testosterone (Direct) 12.7 [9.3 - 26.5 pg/mL]

DHEA-Sulfate 368.3 [164.3 - 530.5 ug/dL]
Cortisol 18.8 [2.3 - 19.4 ug/dL]
Luteinizing Hormone (LH) 5.4 [1.7 - 8.6 mIU/mL]
Prolactin 14.3 [4.0 - 15.2 ng/mL]
Estradiol 18.2 [7.6 - 42.6 pg/mL]
Prostate Specific Ag, Serum 0.4 [0.00 - 4.0 ng/mL]

IGF-1 271 [83 - 344 ng/mL]
Glucose, Serum 85 [65 - 99 mg/dL]
Uric Acid Serum 5.4 [3.7 - 8.6 mg/dL]

BUN 21 [6 - 20 mg/dL]

Creatinine, Serum 1.31 [0.76 - 1.27 mg/dL]
eGFR 76 mL/min/1.73 [> 59]
eGFR African 87 mL/min/1.73 [>59]

Sodium, Serum 139 [134 - 144 mmol/L]
Potassium, Serum 3.2 [3.5 - 5.2 mmol/L]
Chloride, Serum 102 [97 - 108 mmol/L]
Calcium, Serum 9.3 [8.7 - 10.2 mg/dL]
Phosphorus, Serum 4.2 [2.5 - 4.5 mg/dL]
Protein, Total, Serum 6.8 [6.0 - 8.5 g/dL]

Albumin, Serum 4.4 [3.5 - 5.5 g/dL]
Globulin, Total 2.4 [1.5 - 4.5 g/dL]
A/G Ratio 1.8 [1.1 - 2.5]

Bilirubin, Total 0.3 [0.0 - 1.2 mg/dL]

Alkaline Phosphatase, S 98 [39 - 117 mg/dL]

LDH 157 [0 - 225 IU/L]

AST (SGOT) 22 [0 - 40 IU/L]

ALT (SGPT) 22 [0 - 44 IU/L]

GGT 15 [0 - 65 IU/L]

Iron, Serum 52 [40 - 155 ug/dL]

Bilirubin, Direct 0.12 [0.00 - 0.40 mg/dL]

Magnesium, Serum 2.3 [1.6 - 2.6 mg/dL]

Insulin 6.0 [2.6 - 24.9 uIU/mL]

Ferritin, Serum 73 [30 - 400 ng/mL]

Sex Horm Binding Glob, Serum 32.3 [16.5 - 55.9 nmol/L]

Male, 24, Symptoms:
-Low Libido
-Erectile Dysfunction
-Fatigue
-Mental Fog
-Depression
-Hypersomnia
-Overall feeling of sickness
-Poor memory
-Difficulty Concentrating
 
Just two quick observations. It might help to increase your cholesterol as that is a building block for testosterone.

Supplement Vitamin D. Try 10,000 iu's per day.
 
Yes, vitamin D3.

I am not a nutritionist. You should talk to 3J and hire him to help you out. You should look at your whole diet. Maybe you are consuming butt loads of fiber. You could eat eggs and avocados and some red meat. Basically, look on the list of foods they recommend you avoid when you have high cholesterol. I'm not saying you should go crazy and eat at Chinese buffets every day or anything. Moderation.
 
Is that safe?

10,000 iu per day puts my vitamin D levels at 88 (30-100). When I took 30,000 iu per day I was at 122. I believe you get diminishing returns from vitamin D so it can sometimes take quite a bit to increase your levels. Everyone is different though so see how you respond to a dose by getting blood work done.
 
Hcg shot

My Doctor gave me a shot of 150 IU of HCG about five days ago. At around day three, I noticed I have stronger erections, more intense orgasms, and raised libido.. I have not felt a huge effect in the mood department, however perhaps this will come with time. I know T is at least part of the equation!
 
I am following up on this thread. I am finally getting a sleep study done but my doc and I do not believe I have apnea nor if I did, would it be causing all my issues entirely. I should also add, my test levels are always done at 8am. I recently gave a reading at 390 (350 - 1200) and the HCG lost its effect. My total test is low normal but me free t is very low. This is due to my high SHBG. I tried stinging nettle to bring this down which didn't work. When my testosterone came back at 470, I also had low DHT, which is a result of low testosterone. I tried one t injection and almost all my symptoms abated, this was told to be okay by my new doctor. I have lyme disease test that was negative. I have two brains MRIs that ruled out any pituitary growth. I have started to supplement with vit d3 10,000iu sublingual daily and it did help me depression. Can any one comment on the low free T and low DHT. I am not sure there is a way to increase low DHT without TRT, and hear gels is best for this. Sleep test is my last resort before commiting to TRT. Megatron, sorry, I have read multiple sources online guy my age should have total t of 600 - 750. Regardless of total t, my free t is dht is incredibly low. I also tried an elimintation diet to no avail -- new this was a long shot. I tried hcg at varying dosages from 500iu weekly to 3000iu weekly to no avail. The hcg worked for about 2 weeks, made me feel a ton better, then quit working. I don't get much of a response to it anymore. I can confidently say I am comfortable committing to TRT based off my labs and experience. Again, I will wait until the sleep study and try anything they recommend before comiting. Does any have a comment on my delayed puberty in high school, lack of hair growth and need to shave? I mean, I went through puberty between ages of 17 - 20. THanks everyone
 
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