20 years old random Low T don't know where to turn

[mclendonc]

A little background info.

No AAS, no propecia, diets fine.
Normal Puberty, Penis testicle size all good, pubertal gyno I've had for a while, anxiety my whole life, have always been able to put on mass quicker than the next guy, great athlete. Abnormally high libido until now, hairline receded noticeably at 18.

At 19 I moved states and started working a graveyard shift job, going to the gym, and then staying in my house and playing music. That was my routine the past 2 years and as you can imagine, not much sunlight or socializing. A few months ago, I started feeling like lifting, and my other hobbies just weren't worth it, and I stopped doing everything that I used to enjoy. My testicles started hurting a few weeks afterwards and I went to the ER and they found nothing but a hydrocele. I went straight to the Urologist and had a few different opinions to scope out my testicles and they all said structurally I was fine and it could just be a random bout of inflammation. I had a pregnancy scare with a girl during this time and started to feel like ****. Told the doc to test my T levels. TOT 237 RANGE 350-890.

While I was constantly stressed about having a kid I found out it was all a hoax and this girl said she had HIV( a cheap shot after dumping her I assume) and that sent my stress levels through the roof, it was all I could think about. Went to the doc and came up negative for all STDS, but with new test results
TOT 189 ng/dl Range 350-890
SHBG 12 nmol/L Range 11-80
Free Test 5.7 Range 4.7-24.4
Prolactin 5.3 ng/ml Range 3-20
LH 2.7 Range 2-12 MIU/ML
FSH 2.5 Range 1-12 ML/MIU

My libido is non existent, losing muscle mass quickly, and my testicles have begun shrinking. I have an appointment with an endo next week so I'm anxiously awaiting that. I need some direction as to what could be the cause and what I can do to avoid being on TRT for life at this time. Am I a good candidate for a HPTA restart? I'm grateful for any help I can get so thank you ahead of time.

 

[Ad Fortitudo]

I can't speak too much about a restart protocol.

That said, two things immediately stood out to me:
I) High stress
II) Graveyard shift.

I) Stress causes shifts in our neuroendocrine function [1]. It causes changes not only in the adrenal glands, but also changes in the brain that is part of the feedback loop that regulates cortisol and the adrenals. This is what people mean when they talk about HPA dysfunction. You probably already know this, but the stress you experienced may have caused changes in how your adrenal glands are functioning.

This can be tested with a diurnal cortisol test: zrtlabs.com

You can certainly order this test on your own (without a doctor's requisition) but with some of your lab numbers, it'd probably be really helpful to get a good doctor. Your best bet to to look for an MD with a focus on "Integrative Medicine" or a naturopathic doctor. Anti-aging docs can be good too, but sometimes they just want to push hormone sups. That may or may not be your thing, but there is plenty you can do to get your HPA back online (not to mention, your nuts) without pharmaceuticals. That's not to say that you don't need them: if there's something functionally wrong with your pituitary or your endocrine glands, you may need pharmacuiticals; but, that's something to be determined through testing that you can run (hopefully with a good doc).

II) Shift work: Shift work can definitely disrupt your normal neuroendocrine function. Here's a quick and dirty explanation of how: The "H" in HPA stands for "hypothalamus." The hypothalamus acts as a sort of control center: it integrates signals from all over the body and makes adjustments accordingly. In particular, it regulates the things we need to do to survive, also known as the "4 F's": Fighting, Fleeing, Feeding, and Reproduction. It does this by monitoring a variety of hormonal signals and signals from the external world: For example, it monitors our immediate energy availability (via insulin), energy storage (via leptin), food intake (via grehlin and PYY from the stomach and intestines), stressors (via cortisol), threats (from the amygdala, a part of your brain that looks for things you should be afraid of), and external conditions.

Specific to this last one, the hypothalamus is highly sensitive to light levels. There's a part of your hypothalamus called the Suprachiasmic Nuclius (the SCN). The SCN has a direct neural pathway from your eyes. It is literally sensing light levels in the external world and setting your circadian rhythms accordingly. Moreover, many of our hormones are circadian by nature, and are entrained by these light signals.

The problem with shift work is that light levels from artificial light are 100 to 1000 times dimmer than natural light outside (even on an overcast day) [2]. And guess what happens? Your SCN no longer has the light signal it needs to set your circadian rhythm. This can disrupt your HPA, and has implications for your endocrine system and behavior [3] including disruption in cortisol levels, melatonin, prolactin, and testosterone [4].

My point? Stress and shift work probably aren't helping your cause. If you need to up your T levels and get your HPA back online, doing some relaxing and moving away from shift work might do you some good.


[1] Ulrich-Lai, Y. M., & Herman, J. P. (2009). Neural regulation of endocrine and autonomic stress responses. Nature reviews neuroscience, 10(6), 397–409.
[2] Wikipedia: Lux
[3] Karatsoreos, I. N., Bhagat, S., Bloss, E. B., Morrison, J. H., & McEwen, B. S. (2011). Disruption of circadian clocks has ramifications for metabolism, brain, and behavior. Proceedings of the national Academy of Sciences, 108(4), 1657–1662.
[4] Touitou, Y., Motohashi, Y., Reinberg, A., Touitou, C., Bourdeleau, P., Bogdan, A., & Auz by, A. (1990). Effect of shift work on the night-time secretory patterns of melatonin, prolactin, cortisol and testosterone. European Journal of Applied Physiology and Occupational Physiology, 60(4), 288–292.

 

[CaptnCaveman]

It also may be worth having your vitamin D levels checked as many people are already deficient mainly due to lack of exposure to sunlight. It's more likely that the stressors in your life and the shift work are effecting your sleep quality and your natural circadian rhythm as Ad suggested, but Vitamin D levels jumped out at me when I read your OP since you work graveyard shift and likely sleep during the day. Just a thought.

 

[The Matrix]

How about examining the pathologies why this occurred instead of jumping right to TRT as many drs have you do..Check out my thread 4 weeks getting to the root cause has all the necessary information in there. I also work with a team of Drs world wide who may be able to assist you.

 

[mclendonc]

Quick update, started supplementing with 5-10000iu of vitamin d, along with zinc and iodine to try to catch some sort of activity the past few days. A couple days of morning wood and dreaming of sex.(possible the zinc) but now I'm back to baseline.

Matrix I'd be curious to know if you have any suggestions close to Memphis, TN. I figure I'll need a backup in case this endo is not used to actually finding the problem, and just wants to put me on trt.

 

[The Matrix]

Quick update, started supplementing with 5-10000iu of vitamin d, along with zinc and iodine to try to catch some sort of activity the past few days. A couple days of morning wood and dreaming of sex.(possible the zinc) but now I'm back to baseline.Matrix I'd be curious to know if you have any suggestions close to Memphis, TN. I figure I'll need a backup in case this endo is not used to actually finding the problem, and just wants to put me on trt.

Pm me.