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I need opinions on what is causing this

Mikey851

Active member
Hi, new to the forum but not new to TRT. I'm 24 years old, 6' 4" and weigh 164 lbs. and slightly elevated body fat currently. I'll try to make this as short as possible. At around age 16 I noticed I just could not gain any muscle and my voice was not very deep etc. (symptoms of delayed puberty); so I went to an endo to see what was going on.

My total testosterone (I now know total T is not the most important but I didn't know at the time) was at a level of about 180. The doc gave me Androgel to use. I used it for about 1 1/2 years getting levels checked regularly. I fully developed and was 6' 4" about 175lbs with almost no body fat. He took me off the androgel and I was tested about 6 months after I stopped using it and my natural total testosterone level was at around 700 so I assumed everything picked up where it left off and I was good to go.

Recently as mentioned at the top of the thread I have noticed similar symptoms as when I had low T. Lack of muscle gain, tired, lack of libido to some degree. I got tested at a clinic and my level was back down to 270 total T. So I went to a Urologist here locally and he is testing all of my levels, most of which are mentioned by Dr. John Crisler; I have been reading in these forums and asked my Urologist many of the recommended questions. He gave me a shot of Testosterone and is going to analyze my bloodwork as well as reevaluate me when I go back in two weeks; he is also going to test me for fertility.

Anyways, that is my story and I am just wondering what you guys think it might be. I know you really need to see my labs, but I'm just worried and it seems like you guys can usually at least make things slightly better by discussion of the situation. Thanks for any help.
 
Sometimes it's just idiopathic with no detectable reason. In fact, it looks like a lot of otherwise unexplainable cases of hypogonadal hypogonadism these days, and prostate cancer is at record highs too. You are so tall that I doubt it's related to excessive E2 levels or environmental estros.

Life is not much fun with low test levels. Symptomatic relief is better than nothing in the meantime while you figure out what's wrong, and if it's even something you could fix. If you need permanent HRT/TRT, it's not the end of the world. Sometimes things can't be fixed and just need to be replaced.
 
Thanks for your input; I agree with everything you said. I will post my lab results in two weeks so you guys can check them out, maybe you will have some ideas.
 
Since you are working with Dr Crisler, you are probably in some of the best hands possible to work out at least how to not have it affect your day to day life, whether or not the condition is "curable"
 
No, he's working with another Doctor, not Crisler, in any event he claims to be being treated with injections of Test. Its hard for ectomorphs to really gain muscle to begin with, having low levels of test may just be genetic, Some people just mature later its not a physical illness for every guy that thinks he doesnt look like Mr. Olympia, sometimes its muscle dysmorphia.
 
Knowbull said:
No, he's working with another Doctor, not Crisler, in any event he claims to be being treated with injections of Test. Its hard for ectomorphs to really gain muscle to begin with, having low levels of test may just be genetic, Some people just mature later its not a physical illness for every guy that thinks he doesnt look like Mr. Olympia, sometimes its muscle dysmorphia.
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In my opinion that was a slightly offensive thing to say reguarding muscle dysmorphia. I constantly get told that I am overly skinny, it's not imagined. Are you saying I don't have low T levels? Compare my levels when I was 19 to now and that doesn't strike you as a problem? I am just trying to understand where you are coming from. Thanks for the input. I am not getting shots, the doctor gave me one shot to evaluate how I react to it so he can compare my labs before and after in a shorter amount of time. I understand what you're saying about some people just having a hard time gaining muscle but reguardless my level is low. I'm not trying to get huge I just want to be at my proper weight for my height which is around 175+ and I did weigh that at one point. My lab work will be the answer. Depending on what the labwork says the doctor said I may just be able to try HCG and see how I respond to it alone.
 
Mikey851 said:
In my opinion that was a slightly offensive thing to say reguarding muscle dysmorphia. I constantly get told that I am overly skinny, it's not imagined. Are you saying I don't have low T levels? Compare my levels when I was 19 to now and that doesn't strike you as a problem? I am just trying to understand where you are coming from. Thanks for the input. I am not getting shots, the doctor gave me one shot to evaluate how I react to it so he can compare my labs before and after in a shorter amount of time. I understand what you're saying about some people just having a hard time gaining muscle but reguardless my level is low. I'm not trying to get huge I just want to be at my proper weight for my height which is around 175+ and I did weigh that at one point. My lab work will be the answer. Depending on what the labwork says the doctor said I may just be able to try HCG and see how I respond to it alone.
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I like that you doc is planning HCG first.
Personally that would be my first move, I would have skipped that singular T-shot.
-------------------------------------------------------------------
If you have insurance, it would help to do good overall testing.
-------------------------------------------------------------------
================================================== ====================
Test and verify, I set up for my self list of tests.
My whole list, that I do once a year or less, is on post #44, between blue lines, here:
Jan's BloodTest April13/2007 - Page 2

I also have a set of goals, for those goals I need much shorter list of blood tests.
I test at Quest Diagnostics, 2-3x/year.

29 T3, Free
42 DHEA sulfate
46 Progesterone, LC/MS/MS - (17183X)
47 Pregnenolone, LC/MS/MS (31493X)
48 Estradiol, Ultrasensitive, LC/MS/MS (30289X)
49 Estrone, LC/MS/MS (23244X)
50 Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X
51 Dihydrotestosterone (204X)

============================================================
My own Goals
DHEAs(500-640)mcg/dL------------------major player, 95% time overlooked
Progesterone(0.9-1.2)ng/mL
Pregnenolone(> 100ng/dL)
Estradiol, Ultrasensitive(25-29)pg/mL
Estrone, LC/MS/MS (23244X)
BATest(342, 460-575)ng/dL------------stay around 342 if you need AI to control E2
DHT(60-90)ng/dL
FreeT3~400pg/dL
Body temperature (97.8° - 98.2°F) (36.56° - 36.78°C); (36.6-37C)(97.9-98.6F)

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Mikey851 said:
Depending on what the labwork says the doctor said I may just be able to try HCG and see how I respond to it alone.
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I was going to suggest asking your doc about hCG monotherapy, especially since you are young. Did you have FSH/LH tests before starting TRT?
 
Mikey851 said:
In my opinion that was a slightly offensive thing to say reguarding muscle dysmorphia. ...
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He's right though, it is a growing phenomenon right along with hypogonadism itself. Just last night I ran in the corner store for something and the girl behind the counter said 'bye muscle man' and gave me the wink and giggle thing as I was walking out. I told my wife as we drove home, and she concurred with her saying 'See, I told you you're still big! Everybody thinks your muscular.' Still, I have my doubts, lol.

Many of us are just extremely critical of ourselves apparently, so don't be offended because Knowbull is right about that. The majority of us might indeed have this issue to some degree. However, he must have overlooked your height/weight ratio. It sounds like you probably have a legitimate hindrance gaining weight my friend, and low test could certainly be a contributing factor.
 
Yeah, I guess I could have just went straight for the HCG but what's done is done. I am having a pretty thorough set of labs done as a baseline which will include LH and FSH of course. I will be interested to see what they come up with.

To DR D,

Oh I definately agree with Knowbull on the fact that muscle dysmorphia exists. I just don't think it applies to me. Plus, it's true that my body type is going to make it more difficult to gain weight, but it's not a genetics thing that I can't gain weight period because my dad is 6' 3" and weighs 215 and my grandpa is about the same and they've weighed this since they were my age; that's not to say that they have ever been muscled up but if my dad were to work out for a month or so you could see visible results in size increase at to were with me I just can't gain anything. I used to be happy that I could cut up really easy (low bodyfat, probably around 6% or so) but recently i've lost that ability and that's what made me go get tested.
 
Thanks, D. The single test inject is what sounded fishy to me. I just cant see any Doctor doing that. The OP needs to see an endo IMO HCG could very well help. Then again it could just be a case of personal genetics that resolves itself over a period of time. It could also be exposure to a toxin, soaps, paint, solvents, opiates, all these can affect hormones. Not trying to be offensive , dude
 
Not to get off track....I know this is about being healthy, not gaining but I am in the same boat.

I was skinny and could not gain weight to save my life until I was about 22, I am sure I had low T and begged Drs to test it, this was 20 years ago, but they would not

I am 6 ft 215 now and in decent shape but "perceive' my weight as about 175 when I see myself in a mirror.
 
Knowbull said:
Thanks, D. The single test inject is what sounded fishy to me. I just cant see any Doctor doing that. The OP needs to see an endo IMO HCG could very well help. Then again it could just be a case of personal genetics that resolves itself over a period of time. It could also be exposure to a toxin, soaps, paint, solvents, opiates, all these can affect hormones. Not trying to be offensive , dude
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Well, the reason why the doctor probably did that (give me the single shot) is because of my medical history that did come from an endo and included all testing and treatment data including an MRI to check out my pituitary. Maybe he just wants to evaluate if I feel any better until I go back to see him. I don't know though, that's why I'm on here is to get you guys advice and I appreciate it.

It is possible that it is the result of toxins. I just recently quit drinking and was a pretty heavy drinker (Did not drink when I was 18); so I might be sensitive to the high amounts of alcohol. I did share this information with the doctor though, so he will take it into consideration when he analyzes my labwork. I am pretty convinced, unless he finds something that stands out I will opt for the HCG treatment to see where it takes me. Maybe the HCG can just jumpstart my system back to where it was and then I can go natural again with a healthy lifestyle.
 
spinn said:
Not to get off track....I know this is about being healthy, not gaining but I am in the same boat.

I was skinny and could not gain weight to save my life until I was about 22, I am sure I had low T and begged Drs to test it, this was 20 years ago, but they would not

I am 6 ft 215 now and in decent shape but "perceive' my weight as about 175 when I see myself in a mirror.
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Well, I may end up at that size without treatment eventually, but consider this and give me your opinion: When I was 16 I was 5' 9" and weighed 130lbs. I was then given T supplementation and by the time I was 18 I was 6' 3" 175lbs and had a deep voice, facial hair etc.. Now I know this was not normal growth, more developmental, but it is still probably the reason why I felt the need to go back and get checked up again. It helped me out alot the first time around and I think it can do the same to a different degree this time.
 
IMO alchohol really does a number on test, and if youre hypo to begin with it definately wont help. If youve already seen an endo why didnt he treat you?
 
Mikey851 said:
Well, I may end up at that size without treatment eventually, but consider this and give me your opinion: When I was 16 I was 5' 9" and weighed 130lbs. I was then given T supplementation and by the time I was 18 I was 6' 3" 175lbs and had a deep voice, facial hair etc.. Now I know this was not normal growth, more developmental, but it is still probably the reason why I felt the need to go back and get checked up again. It helped me out alot the first time around and I think it can do the same to a different degree this time.
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I was 6 ft and maybe 140 when I got out of High School. I first complained of these issues when I was 15 but nobody believed me. Certainly not my parents, and DRs just laughed it off. When I finally got fed up, 15 years later, my Test was about 200.

You are luckier to have this board, and support, than you realize.

I have been called lazy thousands of times, in reality nobody would do the things I have done, in the condition I was in.
 
Knowbull said:
IMO alchohol really does a number on test, and if youre hypo to begin with it definately wont help. If youve already seen an endo why didnt he treat you?
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you have a much higher opinion of endos than most................
 
Knowbull said:
IMO alchohol really does a number on test, and if youre hypo to begin with it definately wont help. If youve already seen an endo why didnt he treat you?
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The endo did treat me. He said that because I had low testosterone from the get go my testicles didn't develop properly to produce natural T levels. He gave me supplemental testosterone which helped me to develope and then after the testosterone he gave me some kind of medicine which he said would help ensure that I am fertile later in life (I'm guessing this was something like HCG but I hadn't done any research at the time). Six months later I tested at a level of 700 total T. Now approx. 4 years later I'm back down to 270 total T.
 
Assuming that my low levels of testosterone are because I'm really sensitive to the effects alcohol; do you guys think it to be possible that a temporary usage of HCG could get me back up to normal levels and then maintain them with healthy lifestyle? Or is HCG usually used for long periods?
 
could work, too many variables there. you'd really have to try it for a few months, then go off a few months and do blood tests frequently to see
 
I just found an old medical file from when I went to the Endo that has Idiopathic Hypogonadotropic Hypogonadism. Like I said, I wasn't involved with what was going on at the time. I looked it up on the internet and it appears that it is reversible in a high percentage of patients. I thought I was cured from it but apparently not. A few things though:

1. Even though that was written as the diagnosis; there was also a statement saying LH and FSH seem normal which is contradictory. I believe I would need to be tested throughout the day to see if my LH pulses are what they should be rather than just one single test.

2. IHH is supposed to be treated with HCG, but my endo gave me Testosterone and then HCG. I guess it did the same thing but knowing what I know now I would have rathered straight HCG.
 
Mikey851 said:
I just found an old medical file from when I went to the Endo that has Idiopathic Hypogonadotropic Hypogonadism. Like I said, I wasn't involved with what was going on at the time. I looked it up on the internet and it appears that it is reversible in a high percentage of patients. I thought I was cured from it but apparently not. A few things though:

1. Even though that was written as the diagnosis; there was also a statement saying LH and FSH seem normal which is contradictory. I believe I would need to be tested throughout the day to see if my LH pulses are what they should be rather than just one single test.

2. IHH is supposed to be treated with HCG, but my endo gave me Testosterone and then HCG. I guess it did the same thing but knowing what I know now I would have rathered straight HCG.
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GEt with a dr that speciailzes in this area. if caught early TRT can probably be avoided if you are under 25 but examining other areas that have not been explored thoroughly. We see alot Dr's jumping on androgel band wagon for low T, but they never explored why it was low or what was causing it. When you find a dr that will take time to look for the source of the issue then you truely have found the best. Alot of dr's use the fill up method and only end up causing more problems. OH if T is low less give androgel, but we never checked his adrenals properly and if they are low then guess what you took one step forward 3 steps back wards. I see this all the time in people and now since I am starting to work with soldiers with PSTD i guarrantee you will find severe hormonal imbalance at the cause of their depression or reason why it never gets resolved on antidepressants.
 
Well I didn't have time to get a copy of my labs but I remember some results as far as what was good and what was out of range. My total T and free T were low, but my shbg was normal. My FSH was low-normal (This was confirmed by my spermanalysis which shows that I am fertile) and my LH was low, I believe it was 1.2 (sorry I don't remember the unit it was measured in, probably miu/ml).

So the doctor is starting me on HCG mono at 2000 units twice a week for two weeks and then reevaluate. He says he may want to run an MRI again just to be safe since it's been 6 years since my last one.

Do you guys think I should take some over the counter AIs just to help with estradiol levels, or should I just use the HCG by itself until we see how I react to it (as far as E2 levels are concerned)?
 
After taking HCG for a while if my testosterone level rises, although it will be a good thing, this will tell me that my testicles are not the problem from what I've read. So at that point would I want to try something like Clomid to stimulate production of natural LH?
 
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