I went to the doctor a week or two ago because I was depressed, always tired, and generally hated my life. He decided to run some blood labs to see if anything was going on and called when the labs came back to let me know that my testosterone was low. My total testosterone level was 114.5 ng/dl and free testosterone was 3.2 pg/ml. He prescribed Androgel. After doing some reading I had questions about fertility and what might be causing me to have low testosterone at age 25. The doctor essentially said that I would have no fertility problems and that the cause could be anything. I asked if we should run more blood tests and he said it wouldn't be necessary. He gave me a referral to a urologist, but recommended I go ahead and start using Androgel immediately. So I guess my question is where should I go from here? It is certainly not normal for a 25 year old to have low testosterone. I'd like to know what is wrong with me, especially if I am going to have to take hormones for the larger part of my life. SO should I wait to start Androgel until after seeing the urologist? I asked for a referral to an endo, but the doctor said it could be 6 months+ before I could get in to see one. Is there anyone else who has had low t at my age with any advice?
Sorry to hear that. I'm 26 and was diagnosed with low t when I was 24. I felt miserable physically and mentally. My advice is to have the doctor to run a full hormone panel test. Thyroid, cortisol, estrogen, etc. I went doctor to doctor over two years and the most recent doctor just ran the panel and I was low in all of them. The endocrine system works together, so if one is low the others could be low as well.
As for androgel, I didn't like it. My estrogen ended up being 3x's its max, having to put it on daily, cross contamination (can't be around your gf without a t shirt on), and it made my bp go through the roof. To the point of needing blood pressure meds. I done the shots before androgel. I hate needles and it to was a hassle. I found a doctor who does testosterone implants. It gives you level t levels without the rollercoaster. Implants are every 3-4 month's and you barely feel them.
You really need to determine with some certainty why you have Low T. Go look up primary and secondary hypogonadism to see what the difference is. Testosterone treatment will pretty much demolish your fertility so it pays to know WHY you are low before just treating it. There are other ways to get your T up but read read read and get more informed. Your doc hopefully figured some of this out before just knee jerk giving you Androgel.
Androgel is a fine product but WHY are you low. Start there.
Thanks for the advice guys. I have read about primary vs. secondary hypogonadism and really have no idea which it could be. I've never had any kind of injury that could have damaged either area of my body. My doctors initial blood test ran thyroid and it tested normal. Cortisol and estrogen were not tested and neither were the pituitary hormones that control the boys. My gp didn't want to run any further blood tests, so I'm hoping the urologist I've been referred to will run some more tests.
I saw the urologist today. He told me he would never prescribe testosterone to someone my age. Instead he told me he would start me on clomid. He also did another blood lab and checked total t, lh, fsh, and prolactin. He called me about an hour later and said he was confused, because I had symptoms of low t and my initial test indicated I was pretty low, but the most recent blood work showed normal numbers. He said that he had never seen a swing in numbers like this before. He also said he had never seen someone with free t levels as low as the first test not have low t. He didn't check free t on the new labs, so he wasn't able to tell me if it was still low. I haven't seen my numbers yet, but he is mailing me a copy. My question is this: How much can total t vary? Is it possible that my stress level at the time of the first test was enough to drive down my testosterone? I would essentially have had to triple the numbers of my first test to be in the normal range. I wonder what the likelihood is of my first lab work being mixed up with someone else's or something. The weird thing is that I do have several low t symptoms. Pretty much the only one I haven't experienced in some form is ED. He is going to do another round of blood labs in two weeks and said we'd go from there.
Stress can affect it but not by that much, I wouldn't think. So was your LH level in the normal range? Also keep in mind, that even if the total testosterone is now "in range" but at the low end, that is still way too low for someone your age.
At your age the T should be in the upper 1/4 of the range.
If you are not much over weight & you have boobs then you may have Klinefelters Mosaic Syndrome. It you are obese then you probably have Esdtradiol E2 that is over the MAX. It can be reduced with 1/2 Armidrex tablet 3 time a week & that may increase you testosterone
Ater you start on T injections your testicles will shut down & produce little or no sperm. They will shrink.
If the Clomid does not work try HcG injections. It sends signals to the Testicles to produce more testosterone & sperm.
You need a different doctor. He should have tested your thyroid, LH, FSH, & E2
Well I'm not overweight (5'7 145lbs) and I don't have boobs. I had my total t checked again on Monday and it came back 334. I had to call and harass them to get my results and when they finally got back to me the nurse was pretty short with me. She said "your testosterone is 334. That's normal." And hung up. I'm about to just give up and learn to cope.
The following user gives a hug of support to wtfmate:
I'm 25 and was diagnosed last summer with low-T. My levels were 328, 140, and 250-ish.
I've been doing IM injections of testosterone, and I feel ALIVE! I no longer hate my life, and I know what you're talking about. Lethargy, lack of energy, loss of mental sharpness, feeling weak... I dealt with all of that.
I'm worried about my fertility after 6 months of shots, and I'm still trying to find a Dr. who will actually use clomid or HCG for me.
First off, DO NOT start any hormones until you've been thoroughly tested to find out what the cause is. Hormone therapy will screw up every last lab you do. The ones we care about anyway.
As for the big swing - blood draws for testosterone testing MUST be done before 9am. As close to 7am as possible is ideal. A healthy man's testosterone will swing from its peak (say 900 for fun) to half of that in the afternoon (down to around 400-500).
Regardless of what anyone says, your testosterone should be above 500. The "normal" range is not based on age, and the data for the range is including men from 15 to 95. A level of 334 ng/dl is found in the lowest 5% of men between 35-40 years old. You should be closer to 650, which is double that.
Anyway, the important thing to find out is - do you have primary or secondary hypogonadism? What's to blame?
If you have primary hypogonadism, your testicles don't produce sufficient testosterone because they can't.
If you have secondary hypogonadism, your testicles don't produce sufficient testosteorne because they're not being told to with proper hormones.
This is important because it dictates what treatment you should get. If you have Primary Hypogonadism, you have no alternative to TRT besides refusing treatment.
If you have secondary, it can be from a few different causes. You can differentiate these causes via hormone testing. Pituitary damage (or malfunction) can cause a lack of other hormones too, so low-T can be the tip of the iceberg and you can be deficient in 5 or 6 important hormones.
Get the urologist to run an anterior pituitary hormone panel to make sure your pituitary functions normally. Your LH level is the most important in relation to your testosterone production.
So, you need to:
-Find out why your testosterone is low ( <500-600 is low for your age)
-*This includes finding a doctor who will run tests - an endocrinologist might be the best bet
-*This also includes waiting a few weeks to have things checked
-*You might also want a sperm analysis done to make sure your fertility is not already compromised
-Find a Dr. who will treat you with something beyond testosterone, be it HCG or clomid
-Get back to life - it's possible!!
Last edited by moderator2; 01-07-2013 at 08:02 PM.
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Great post. I'm dealing with hormonal issues after having my right adrenal gland removed. I get hot flashes and fatigued very easily. We're on track with treating it, but I know what you mean when you say you feel alive again. Thanks for sharing!