21yr old noob with ED, lethargy - test normal, SHBG high- ideas?

[madcapman]

Morning and greetings from South Africa,
I am a long time lurker who is coming out of the shadows for some hormone advice. I have the symptoms of low test, but my blood tests say I’m fine…

Background:
21 years old, 6’2, 73kg/160 lb
+-1 year gym experience, little weight gain and not very much progress (my fault; not eating well and not training consistently. This has greatly improved over the last 3 months.)
Maxes (all recent):
Squat: 95kgX5
Bench: 75kgX5
Dead: 120kgX5
Bodyweight: 63kg – 76kg in a year (give or take) but lost 3kg over the last two weeks due to not eating (moved out of home, has been a nightmare.)

I know I'm weak and scrawny, I'm working on that bit

Blood results (all done at my request, and my doc only wanted me to do these):
Original values are in nmol/L or pmol/L, converted using an online converter.
Total test: 23.93 nmol/L = 689.62 ng/dL
Free test: 421 pmol/L = 12.14 ng/dL (which is 1.76% of total test)
SHBG: 47.4 nmol/L
S-TSH: 2.30 mIU/L

Reason for tests:
Very low libido, no interest in sex-related matters, no morning wood for 8 weeks solid (now 11 weeks) and very few over the previous 3 months. I went from being able to have 4 rounds in an afternoon with my GF (+- 2 years ago) to being physically unable to get it up for days at a time.

We currently have sex around twice per month, which is no fun for me and driving her mad (we share a bed at night.)
I have very little body hair (average pubic hair, but very little on my arms and legs, none (at all) on my chest and back and I have a little moustache and chin hair but nowhere near a beard. It grows slowly (I shave about twice per week to keep neat) and to a max length of +-1cm (0.4 inches.) I come from a hairy family, and stand out in terms of hair (the other guys started shaving at 13.)

I remember times when I had plenty of energy with crappy eating, doing as I like and 4 hrs sleep. Now I wake up tired after 8 hours sleep, 4 solid meals and looking after myself. It's like I have constant fog in my head (read the term somewhere, perfect description.)

Essential question:
My total test is fine, my free test is lower than 2% but I don’t think it’s that low, and my SHGB is far too high (almost out of range, according to lab ranges; their upper flag is 48 nmol/L.) What are the chances that this is a hormone problem, and if it is, what is it likely to be?
I know I need to get an estradiol (E2) test done and most likely some others (prolactin for one.) Which should I?

My doc first said I was depressed (this is theoretically possible, as I’m bipolar, but I’m not that low. I also haven’t had this sort of libido/ED problem before, depressed or not. I am on Lamotrigine (brand name Lamictal) and have been on a list of others including lithium carbonate, if this rings any bells (all the research I have done says that this isn't the problem, but I’m asking anyway.) Now he says everything “must be fine, as your bloods were perfectly normal”.

Any and all advice would be much appreciated. I don’t know what my options are right now, but will get hold of an endocrinologist (I have looked at 3 online thus far) if you guys think this is worth taking up. I have read scary things about docs who say things like “you have test of 300, so it's not low and as such your ED is all in your head” kind of things. I frankly don’t know what to ask.

Much appreciated,
madcap

 

[madcapman]

I take it no answer means I did something I shouldn't. Would someone tell me what I did? Too much info? Missing something required?

I'm not trolling, in case anyone thought that...

Could I have a little advice as to what I should check next? If the answer is "stfu go bother someone else", if someone would say it it would help.

Regards,
madcap

 

[Idobehigh]

You kind of said it your self Ed is all in your head, it could be an estrogen problem to high can caz no libido see if you can get tested for it until then wait or you can maybe look into some OTC supps like hcgen or some other test booster to help out ur libido I'm not as experienced with bloods as some of these guys on here in the mean time relax stop over thinking it and just enjoy life at 21

 

[rustilldown]

You kind of said it your self Ed is all in your head, it could be an estrogen problem to high can caz no libido see if you can get tested for it until then wait or you can maybe look into some OTC supps like hcgen or some other test booster to help out ur libido I'm not as experienced with bloods as some of these guys on here in the mean time relax stop over thinking it and just enjoy life at 21

That's not really good advice man. In all honesty if I were seeking help the last thing I want to hear is relax stop over thinking it . 21 is when you should be happy horny and having a blast . Hormones raging. I would suggest you have your estrogen checked but having a high shbg could be part of the problem. I think lowering estrogen also lowers shbg to an extent. So maybe you have high estrogen. I am no product pimp but unleashed does a pretty good job at improving mood sex drive and lowering shbg. It's cheap too.

 

[Idobehigh]

I was just saying there is no point stressing over it and relax and sort it out not ur fine relax lol

Sent from my SGH-T999 using EliteFitness

 

[madcapman]

Much appreciated, I guess the next thing to do is check my estrogen.

As for it being all mental, I'm assuming there is a mental aspect (and not being confident doesn't exactly help) but that wouldn't explain why it started in the first place. I'm also assuming there is something biologically wrong (no bad sexual experiences or anything like that) and that the mental side is making it worse.

I'm not losing much sleep over it, and life carries on as usual so it's more an irritation than the end of the world (not that it's nice, but I can live with it.)

I will get the bloods done when I can and will post them if they're interesting. Who would be good to PM about the bloods specifically?

Thanks for replying

madcap

 

[Hen0152]

Bone other chicks maybe you sick of the one you got now lol

 

[madcapman]

Bone other chicks maybe you sick of the one you got now lol

It's more a matter of "wish I could get some of that" except it's not that shes taken, it's that I can't take...

 

[Labtec70]

Hi madcapman

Did you get Luetinising Hormone and/or Follicle Stimulating Hormone tested by any chance?

From what I can deduce form your results...

1. Your symptoms are clearly indicative of hypogonadism, but it doesn't necessarily mean you have got low testosterone.
2. Total testosterone is well within normal range, however, for your age of 21 it's more "lowish normal" rather than ideal or a median figure.
3. Free testosterone is again just within normal range, but for your age is pretty low. A 21 year old should be 14 and upwards with no symptoms of low testosterone.
4. SHBG is clearly too high, and this would - if we had an E2 reading - usually be in lign with an elevated oestrogen level.

Basically, guidelines from the Endochrine Society state that men who experience low testosterone level symptoms with a free or bioavailable level of less than 13 nmols/dl, may be candidates for replacement therapy.
It does look like your symptoms and the high SHBG combined with low Free T, could point toward high oestrogen. Maybe something as simple as Aromasin, or Arimidex would help. You could also try Forma Stanzol to control E2, it works wonders for me. I do recommend getting a retest that includes E2, prolactin, LH, and FSH, since these would shed more light on your symptoms.

I certainly think your presentation deserves more investigation by your doctor.

Let us know how you intend to proceed please.

Craig

 

[Zyglamail]

Did they check your thyroid levels as well?

 

[madcapman]

Hi madcapman

Did you get Luetinising Hormone and/or Follicle Stimulating Hormone tested by any chance?

From what I can deduce form your results...

1. Your symptoms are clearly indicative of hypogonadism, but it doesn't necessarily mean you have got low testosterone.
2. Total testosterone is well within normal range, however, for your age of 21 it's more "lowish normal" rather than ideal or a median figure.
3. Free testosterone is again just within normal range, but for your age is pretty low. A 21 year old should be 14 and upwards with no symptoms of low testosterone.
4. SHBG is clearly too high, and this would - if we had an E2 reading - usually be in lign with an elevated oestrogen level.

Basically, guidelines from the Endochrine Society state that men who experience low testosterone level symptoms with a free or bioavailable level of less than 13 nmols/dl, may be candidates for replacement therapy.
It does look like your symptoms and the high SHBG combined with low Free T, could point toward high oestrogen. Maybe something as simple as Aromasin, or Arimidex would help. You could also try Forma Stanzol to control E2, it works wonders for me. I do recommend getting a retest that includes E2, prolactin, LH, and FSH, since these would shed more light on your symptoms.

I certainly think your presentation deserves more investigation by your doctor.

Let us know how you intend to proceed please.

Craig

First of all, much appreciated. Wonderful reply

Secondly, I am rather short of money at the moment (so I'm not sure when tests will be done - asap, when possible.)

Thirdly, these are the tests I am thinking of having done:
Test - total and free
SHBG
E2
FSH
LH
Prolactin

Last time I had tests, I had my S-TSH tested (thyroid, as far as I know) and it was "normal", whatever that means. Should I have anything thyroid or otherwise related tested? I have seen a few people talking about testing for an iodine deficiency...

Lastly, I have looked at an aromatase inhibitor (anti-e, if I have the names of these things right) but thought they would only really help on a cycle - i.e. when the levels are so far above ordinary that they need active management. Would an anti-e alone be able to deal with my current state of affairs, or will it definitely need to be extra test?

This is all very new to me (although I am reading as much as possible) and yet very interesting. What are the chances this is permanent (i.e. I'm not just going to "go back" to how I was)? If that's impossible to know yet, such is life.

Out of interest, where do you get your figures? I'd be interested in seeing exactly what they "should" be.

Again, thanks for the advice.

madcap

 

[madcapman]

Did they check your thyroid levels as well?

Thanks for the question, I also thought it might be that (although I wasn't gaining weight on a minimalist diet, to no-one's surprise but my own.)

I had my S-TSH levels checked, which were at 2.30 mIU/L if this is what you're asking about (srs, slightly unsure.) If not, what should I have tested?

Apparently there is quite a strong link between the two, but apparently my levels are "normal" and if I was on thyroid replacement, the dose should be fine.

Thanks,
madcap

 

[pdelta]

I've battled lethergy for years. I finally found that my DHEA levels were slightly below normal. I take DHEA daily and it works for me. I personally like Diesel Test Pro. It has DHEA and a number of other goodies that increase test and control estrogen. I usually take 4-6 tabs daily depending on how I feel that day. I've tried 7-keto DHEA and topical DHEA and neither work for lethergy. Oral DHEA is best for combating lethergy and it's cheap.

 

[Zyglamail]

Ive been in this game for for about 25 years now and am continually trying to improve my performance. Hormone levels and how you feel is tied incredibly tightly to the nutrients you consume. Before you spend money on any more blood work I would seriously consider spending that money on supplements and your diet. Over the years I have hit many plateaus, suffered nagging injuries that wouldnt go away and have encountered lethargy, sleeplessness and a myriad of other "problems" and in basically every case the problem was solved by altering my diet to address a deficiency.

Blood tests for mineral deficiencies are next to worthless because in most cases your body will try and maintain a certain level in the blood even though the actual tissue where the mineral is stored may be severely deficient so lab work shows "normal".

Deficiencies develop over time and in order to restore mineral levels in the body you need to not just take in an adequate amount but you need to take extra so your stores can be replenished. "Loading" can take from weeks to months to get chronically low mineral levels back up to where they should be. Here is what I would recommend to you.

Log everything you eat for the next week. Goto Foods List and record the the calories, protien, fat and carbs for each item. In addition record the amount of the following vitamins and minerals and make sure your getting at least the numbers below from food.

zinc (11mg)
magnesium (400mg)
potassium (4700mg)
vit D (>5000)

My guess is you will find your chronically lacking in at least 1 of the above and likely have been for many years. The RDA numbers are typically poorly calculated and generally are no where near what an athlete needs but I like to use them as just a starting point to determine deficiency. Athletes and those with jobs that require extended physical labor often need significantly more.

I recommend you google the above nutrients and you can see just how important they are to bodily function. Even if your just say 10% below what you your body needs on a daily basis, over weeks, months and even years that starts to take its toll and side effects manifest in a variety of ways.

For example, potassium is CRITICAL to electrical signalling in the body. When its running low in the cell's lethargy and poor performance is common as well as chronic injuries. I have had many people report chronic injuries will be gone in just a couple weeks when potassium levels are restored. Muscle output and endurance output increase as well. It can actually be pretty tricky to get enough potassium (ie 4700mg) daily. A lot of potassium rich food people simply dont eat for one reason or another. Unlike magnesium and zinc, potassium is also a bit tricky to supplement because it easily upsets the stomach so needs to be taken with food and only comes in 99mg tablets (without a script).

For magnesium and zinc if you find your diet lacking after logging for a week I would triple the RDA via supplements for a good 60 days or so. For vit D if you dont get a lot of sun and arent getting enough in diet, then suppliment that as well, take 35,000IU 2x a week. Studies have shown 2 large weekly bolus's are more effective than daily steady doses.

For potassium start eating food rich in potassium. Simply google potassium rich foods for some ideas. Be careful of fruit juices since they lack the natural fiber of the whole fruit and are heavy in sugars. My guess is you will find you are severely lacking in potassium. Use supplements if needed but add them cautiously until you understand how much they upset your stomach. Potassium supps are pretty cheap.

Lastly if you are having problems sleeping, try adding some melatonin, inositol and trytophan about an hour before bedtime.

Post back in a few days after logging your diet and share with us what you found. As I mentioned I suspect you will find you are likely deficient in one or more of the above and if so start eating and supplementing as outlined above, then pots back a couple weeks after that and let us know how you feel.

Blood work is fine and dandy but is only going to (at best) confirm what you already know based on how you feel, something isnt right. Give your body the building blocks it needs to thrive and then once your sure thats happening if problems persist dig deeper into the medical cause.

 

[Labtec70]

Hi madcapman

Zygla is absolutely right in everything he's telling you. As a nutritionist I can't criticise a single word he's said about the importance of food on mood and productivity etc.

To be honest, you aren't in the best of places regards a doctor's perspective of your blood results. Testosterone is something that's still a complex and stgmatised area of medical science. Unless there's a critical or blatently evident reason for futher testing or treatment to that effect (from your last bloods) you aren't going to get much joy from the medical community.

Your SHBG is quite high, but not as high as to require any treatment or further retests. They'll see that your total and free test are within range and SHBG hasn't influenced them to any siginificant degree. That aside, if your problems are hormonal then I reckon it's probably safe to conclude that the SHBG is a possible cause. The only thing that might significantly reduce the SHBG, and thereby increasing availabilty of testosterone, is either anti-oestrogen medication - which I don't think you'll get prescribed - or making changes to your diet. Oestrogen can be hugely influenced by diet, and it's effects on hormone pathways and feedback loop systems.

Making some changes to your diet and adding some testosterone boosting/oestrogen busting supplements will do the job of anti-E's much more safely and effectively without the need of expensive drugs and the side effects that go with them. And believe me, anti-E and anti-prolactin drugs can have some very unpleasant side effects, hence the reasom I never use cabergoline anymore. While that stuff is expounded by some, it makes me bordering on suicidal. any, I digress...

The cheap and basic supplements Zygla recommends can be purchased from your local pharmacy or Walmart type store. In English money you're looking at less than 10 pounds stirling, or $16.00 American money.
Avoiding the fatty, processed foods, and hydrogenised fats/transfats that MacDonald's cook chips in for example will help with oestrogen control in itself. Adding foods rich in the above Zygla mentions will elevate mood enhancing and productivity nutrients and should get your pecker firing again, not to mention extra seminal fluid.

At the end of the day, blood results may just show a cause, much like a bathroom scale will show you if you're overweight. The bathroom scale won't help you lose the weight though, and that's the aim.

It's likely your problem is transient, or rather acute and hormones are up-and-down all the time. The good thing about hormones though is the fact that they are influenced greatly by what we eat and do. Physical activity and testosterone increasing diet and supplements will, I'm sure fix the problem without resorting to expensive retest of blood values and drugs. I really do believe your doctor will refuse to treat a problem like high SHBG, becasue they know little about the subject or hormone, and there's not a lot they can do about it in any case. As I said, there are drugs but these are by far only prescribed to women mostly. If you want to try something more focused than general diet then there is Forma Stanzol, that's available on Mr Supplements. It contains Formestane which is an anti-aromatase drug (anti-E2). I've used Arimidex and Aromasin, and now I only use Forma, becasue it's cheap, legal, lasts about 6-7 weeks, and you can rub it in, as it is a topical. If it is oestrogen via SHBG that is your problem, then this will definately sort it.

All the best.

Craig
PS. I have no affiliation with the supplement and aren't a representative of any kind. I just recommend a product when I know it works.