38M - Low-Normal Testosterone, Low LH/FSH, many symptoms - Looking for TRT Advice

[wha7]

I seriously need help as several doctors have not been able to help me so far.

I got diagnosed general anxiety disorder (ADHD and things like bipolar tested negative)

Could my hormones be the culprit for the symptoms below/should i follow this route?

Below the symptoms you find several blood works from the past years, always drawn at late morning (no food/drink).

As you can see always low-normal lh, fsh, testosteron

3 measurements late 2023/2024 because i am desperately looking for a solution.

the doctor only said “within the reference except for one time - that's fine”

Symptoms:

- Low energy (only in bursts, followed by shutdown) for 10+ years

- Motivational problems and mild depression for 10+ years

- low stress tolerance for 10+ years

- impulsive, easily irritable, quickly overwhelmed for 10+ years

now the following joined (1-2 years?)

- 0 - 1x morning wood (only light) per week

- Libido is gone. Never had a high one but: When i was 18 i had the urge every 3 days, with mid 20 every 4, starting 30 every 5 and now -> i force my self every 7-10 days but there is no desire and orgasm feels so much less intense.

 

[BigDadd7]

What has your therapist had to say about this?

 

[bananafeet]

Your higher prolactin levels could cause the reduced desire for sex and weakened orgasms.

No doctor is gonna give you testosterone with levels in the range.

It's up to you if you want to experiment with testosterone use/abuse. It will increase libido and agression/drive but might also exacerbate your other mental issues.

It's kinda a pain to manage and unless your into bodybuilding or physical activity then it might not be a good fit.

You might sort your issues but you might also keep looking for problems where none are...

 

[AlexDavis43]

I seriously need help as several doctors have not been able to help me so far.

I got diagnosed general anxiety disorder (ADHD and things like bipolar tested negative)

Could my hormones be the culprit for the symptoms below/should i follow this route?

Below the symptoms you find several blood works from the past years, always drawn at late morning (no food/drink).

As you can see always low-normal lh, fsh, testosteron

3 measurements late 2023/2024 because i am desperately looking for a solution.

the doctor only said “within the reference except for one time - that's fine”

Symptoms:

- Low energy (only in bursts, followed by shutdown) for 10+ years

- Motivational problems and mild depression for 10+ years

- low stress tolerance for 10+ years

- impulsive, easily irritable, quickly overwhelmed for 10+ years

now the following joined (1-2 years?)

- 0 - 1x morning wood (only light) per week

- Libido is gone. Never had a high one but: When i was 18 i had the urge every 3 days, with mid 20 every 4, starting 30 every 5 and now -> i force my self every 7-10 days but there is no desire and orgasm feels so much less intense.

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Ever follow-up on that vitamin D?

With regard to TRT, try to see an endocrinologist. They be more keen to correlating your blood tests with symptoms like no morning wood & low libido.

 

[wha7]

What has your therapist had to say about this?

I came to him because of the mental side of things - i thought its adhd (energy bursts and motivantional problems), got several tests, he said its general anxiety disorder and send me home with a ssri which just blunted everything and it took forever to orgasm. so i quit the ssri and i also lost my trust.
i think he is right with the general anxiety but what he did is just the 0815 guideline treatment without looking at my "system" and problems as a whole.

 

[wha7]

Your higher prolactin levels could cause the reduced desire for sex and weakened orgasms.

No doctor is gonna give you testosterone with levels in the range.

It's up to you if you want to experiment with testosterone use/abuse. It will increase libido and agression/drive but might also exacerbate your other mental issues.

It's kinda a pain to manage and unless your into bodybuilding or physical activity then it might not be a good fit.

You might sort your issues but you might also keep looking for problems where none are...

It was the first time that also prolactin had this high reading (and the symptoms including desire i had also before, where prolactin readings were normal), in the other blood works below it was in range, one time even total testosteron was out of range (below normal) and most of the times test, lh, fsh is in range but at the low side.

so my idea was as lh, fsh, test, bio available test, free test all of them always come back normal but on the low side that the doctor could say - maybe its just not optimal for me?

 

[wha7]

Ever follow-up on that vitamin D?

With regard to TRT, try to see an endocrinologist. They be more keen to correlating your blood tests with symptoms like no morning wood & low libido.

Yes. In the past i also adressed it and took high doses (20k IU a day) were i had normal levels in blood work, but still had some of the symptoms. this time is different tho - i got an vitamin d injection before 1 week and my mood is definitely better right now. But i think its just 1 puzzle, i have the hard feeling it wont fix the low test, lh, fsh readings and i might feel better with also adressing them together with vitamin d.

 

[Ateam2023]

i'm going to state the obvious and possibly the answer your actually looking for,, Get on a low dose of testosterone and evaluate bloodwork in 4 weeks after starting say, 120 mg testosterone cypionate per week,, The low FSH could be a problem with your "pituitary gland" or "hypothalamus" the parts that control your hormone production, And the loss of libido could absolutely be the high prolactin levels, Have you ever had any brain injuries ? or it could be a genetic condition ??

 

[BigDadd7]

I came to him because of the mental side of things - i thought its adhd (energy bursts and motivantional problems), got several tests, he said its general anxiety disorder and send me home with a ssri which just blunted everything and it took forever to orgasm. so i quit the ssri and i also lost my trust.
i think he is right with the general anxiety but what he did is just the 0815 guideline treatment without looking at my "system" and problems as a whole.

SSRIs suck. If it's that or kill yourself, they're great. The sides can be worse than the original problem. I'd rather have anxiety and lots of sex, as opposed to be all no-worries-man while having no desire or ability to bang my woman. Ask about a low dose of trintellix. It's not an SSRI and works on a different pathway. Testosterone isn't a magic pill and it won't cure what ails you.

Also, lifting weights is f'n awesome. It sucks a little while you're trying to make it a habit. After that, watching your body change and get stronger, seeing the numbers go up, adding five more pounds to the bar, and feeling the fullness in your muscles is pretty bad ass. That's what Arnold was talking about when he said working out was like cumming. I would never give this up.

 

[AlexDavis43]

i'm going to state the obvious and possibly the answer your actually looking for,, Get on a low dose of testosterone and evaluate bloodwork in 4 weeks after starting say, 120 mg testosterone cypionate per week,, The low FSH could be a problem with your "pituitary gland" or "hypothalamus" the parts that control your hormone production, And the loss of libido could absolutely be the high prolactin levels, Have you ever had any brain injuries ? or it could be a genetic condition ??

From catching up this morning on OPs replies, I think he came here wanting [perhaps unwittingly] a green light to start DIY TRT and get some gtg sources

I still think it's best to get the ball rolling through a specialist; ie, endocrinologist or urologist not TRT clinic

I'm very happy for places like Meso to bounce ideas off people and get advice & tips but as much as everyone thinks all doctors suck and don't know shit about TRT, it's still good to have a professional on your side

 

[bananafeet]

It was the first time that also prolactin had this high reading (and the symptoms including desire i had also before, where prolactin readings were normal), in the other blood works below it was in range, one time even total testosteron was out of range (below normal) and most of the times test, lh, fsh is in range but at the low side.

so my idea was as lh, fsh, test, bio available test, free test all of them always come back normal but on the low side that the doctor could say - maybe its just not optimal for me?

If you have a private TRT clinic in your country you may have more luck than seeing an endocrinologist. A private clinic may treat you on symptoms.

I got treated very poorly by an endocrinologist and her treatment plan was terrible anyway.

Buying a bottle of testosterone and a packet of aromasin won't be that expensive and you can titrate up the dose until you "feel" better. I don't think it's anymore dangerous than taking an SSRI.

Testosterone isn't perfect and you will still have to do frequent blood tests to keep on top of any potential side effects. As the other poster suggested starting at 120mg and testing after 4 weeks is a good starting point.

 

[wha7]

i'm going to state the obvious and possibly the answer your actually looking for,, Get on a low dose of testosterone and evaluate bloodwork in 4 weeks after starting say, 120 mg testosterone cypionate per week,, The low FSH could be a problem with your "pituitary gland" or "hypothalamus" the parts that control your hormone production, And the loss of libido could absolutely be the high prolactin levels, Have you ever had any brain injuries ? or it could be a genetic condition ??'

no brain injuries, first time high prolactin reading ever. i guess i will redo bloods and if still high get an mri from the head.

to be honest, i don´t know for which answer iam looking for. i just want to feel good and an external objective view.

i thought my symptoms could be because of those values but it seems the answer isn´t that easy.

if the answer is: there is a high chance that it might me because of your values, then i know what to do.
if the answer is: your values look okayish and probably are not the reason for those symptoms, then iam also fine and wont touch it.

 

[Ateam2023]

no brain injuries, first time high prolactin reading ever. i guess i will redo bloods and if still high get an mri from the head.

to be honest, i don´t know for which answer iam looking for. i just want to feel good and an external objective view.

i thought my symptoms could be because of those values but it seems the answer isn´t that easy.

if the answer is: there is a high chance that it might me because of your values, then i know what to do.
if the answer is: your values look okayish and probably are not the reason for those symptoms, then iam also fine and wont touch it.

ok heres what your after it seems, "do trt, feel better",, There you go now feel free to do whatever you decide, make sure to keep up on bloodwork, theres a thread on which blood panels you should pull while on trt and on blast , "if" that is also another option you want to explore,, Good luck on your journey,,,,

 

[wha7]

SSRIs suck. If it's that or kill yourself, they're great. The sides can be worse than the original problem. I'd rather have anxiety and lots of sex, as opposed to be all no-worries-man while having no desire or ability to bang my woman. Ask about a low dose of trintellix. It's not an SSRI and works on a different pathway. Testosterone isn't a magic pill and it won't cure what ails you.

Also, lifting weights is f'n awesome. It sucks a little while you're trying to make it a habit. After that, watching your body change and get stronger, seeing the numbers go up, adding five more pounds to the bar, and feeling the fullness in your muscles is pretty bad ass. That's what Arnold was talking about when he said working out was like cumming. I would never give this up.

and the stupid thing is, i already had the opinion already but i trusted the doc because he was one of the more expensive private ones.

just had a quick look up - trintellix sounds interesting at first glance. but iam really afraid to fuck my brain up. i already tried escitaloprame (SSRI), wellbutrin and Ritalin (by my self but stopped it, yes i felt motivated but everyone does on it probably but the effect got less and i think its also not a healthy solution for me as 2 tests canceled out ADHD - so its just some oil into fire, sure the fire gets more but the whole system burns quicker till i crash again).

so you think i should consider this route instead of trt?

i was into powerlifting for over 10 years and decently strong. after i quit PL i didnt find motivation to lift as iam used to heavy lifting. but i think i should start with a new mindset on training - not strength, just feeling good.

 

[wha7]

From catching up this morning on OPs replies, I think he came here wanting [perhaps unwittingly] a green light to start DIY TRT and get some gtg sources

I still think it's best to get the ball rolling through a specialist; ie, endocrinologist or urologist not TRT clinic

I'm very happy for places like Meso to bounce ideas off people and get advice & tips but as much as everyone thinks all doctors suck and don't know shit about TRT, it's still good to have a professional on your side

to be completely honest:

i had 3 cycles a few years ago (last 2 years ago) when i was into powerlifting, the 2016 values are my baseline before i ever touched anything.

so i know where and how to get it and i can assure you:
iam not looking for sources or a go for steroids because iam afraid or something like that.

just want to feel good and looking for honest opinions if iam on the wrong path.

i can't judge how bad my values are, i don't know any experience reports on cases with values similar to mine. also my 3 cycles are not representative as they were with 250-500mg far above a trt dose and i think too much can also turn negative psychologically.

thats the reason iam here.

 

[wha7]

ok heres what your after it seems, "do trt, feel better",, There you go now feel free to do whatever you decide, make sure to keep up on bloodwork, theres a thread on which blood panels you should pull while on trt and on blast , "if" that is also another option you want to explore,, Good luck on your journey,,,,

look at my recent answer. i'm not trying to make it easy for myself and make a decision lightly.

it's more about an objective opinion on my blood values in combination with my symptoms. because i no longer trust doctors and like to get several opinions. and i would only do the trt route under a doctor's go + supervision anyway. but my last doctor just send me away with your values are fine.
if now many people say the same, no one comes with a different real expierence (same issues with similar values than me) - then i definetely know trt is not the solution for my problems.

 

[Ateam2023]

to be completely honest:

i had 3 cycles a few years ago (last 2 years ago) when i was into powerlifting, the 2016 values are my baseline before i ever touched anything.

so i know where and how to get it and i can assure you:
iam not looking for sources or a go for steroids because iam afraid or something like that.

just want to feel good and looking for honest opinions if iam on the wrong path.

i can't judge how bad my values are, i don't know any experience reports on cases with values similar to mine. also my 3 cycles are not representative as they were with 250-500mg far above a trt dose and i think too much can also turn negative psychologically.

thats the reason iam here.

look at my recent answer. i'm not trying to make it easy for myself and make a decision lightly.

it's more about an objective opinion on my blood values in combination with my symptoms. because i no longer trust doctors and like to get several opinions. and i would only do the trt route under a doctor's go + supervision anyway. but my last doctor just send me away with your values are fine.
if now many people say the same, no one comes with a different real expierence (same issues with similar values than me) - then i definetely know trt is not the solution for my problems.

just because one dr said this, doesn't mean you have to follow his advice , your free to find another dr that might be more in tune with cuttent trt protocols etc, Sometimes you have an old "outdated" dr that is not up on "current" trt protocols etc, simple as that,,

 

[archive]

no brain injuries, first time high prolactin reading ever. i guess i will redo bloods and if still high get an mri from the head.

to be honest, i don´t know for which answer iam looking for. i just want to feel good and an external objective view.

i thought my symptoms could be because of those values but it seems the answer isn´t that easy.

if the answer is: there is a high chance that it might me because of your values, then i know what to do.
if the answer is: your values look okayish and probably are not the reason for those symptoms, then iam also fine and wont touch it.

Repeating the blood test is probably a good idea.

Elevated prolactin combined with low test and LH could be caused by a prolactinoma. If memory serves, prolactin is usually much higher in the case of a prolactinoma though. It might be worth doing some research and retesting.

See "Evaluation and Management of Testosterone Deficiency":

https://www.auanet.org/documents/Guidelines/PDF/Testosterone-Deficiency-JU.pdf

 

[bananafeet]

Repeating the blood test is probably a good idea.

Elevated prolactin combined with low test and LH could be caused by a prolactinoma. If memory serves, prolactin is usually much higher in the case of a prolactinoma though. It might be worth doing some research and retesting.

See "Evaluation and Management of Testosterone Deficiency":

https://www.auanet.org/documents/Guidelines/PDF/Testosterone-Deficiency-JU.pdf

I went through the prolactinoma scare. His levels aren't that high. I think the tumors pump out prolactin in relation to their size.

When I went through this ordeal I had:
Brain scan (MRI)
Testicular scan (ultrasound)
Abdomen scan (ultrasound)
Sleep study
Tumor market blood tests (HCG and one other)
Full blood panels including thyroid

I think these are a pretty good starting point. It's better to be safe than sorry...

Also masturbating or sex before a test can increase prolactin levels as well as some drugs.

But yeah I'm not an expert

 

[BigDadd7]

and the stupid thing is, i already had the opinion already but i trusted the doc because he was one of the more expensive private ones.

just had a quick look up - trintellix sounds interesting at first glance. but iam really afraid to fuck my brain up. i already tried escitaloprame (SSRI), wellbutrin and Ritalin (by my self but stopped it, yes i felt motivated but everyone does on it probably but the effect got less and i think its also not a healthy solution for me as 2 tests canceled out ADHD - so its just some oil into fire, sure the fire gets more but the whole system burns quicker till i crash again).

so you think i should consider this route instead of trt?

i was into powerlifting for over 10 years and decently strong. after i quit PL i didnt find motivation to lift as iam used to heavy lifting. but i think i should start with a new mindset on training - not strength, just feeling good.

It doesn't sound like you have a low t issue, so t won't change anything.