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Author Topic: 19 year old - Needs Advice  (Read 155 times)

kevmtao

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19 year old - Needs Advice
« on: March 25, 2020, 06:40:10 pm »
I'm 19 years old and I have been suffering from low T symptoms for the last few years (fatigue, depression, low libido, weak erections). The other day I just realized that I can't even remember the last time I masturbated... it's been so long since I've had a libido.

Here are my labs from 2018 (https://imgur.com/mTs0NTZ). Here are my labs from 2019 (https://imgur.com/a/nxgsF2h).

And below are my most recent labs from 3/18/2020:

TESTOSTERONE, FREE

47 pg/mL

47 - 244 pg/mL


FOLLICLE STIMULATING HORMONE

8.28 mIU/mL

1.27 - 19.26 mIU/mL


LUTEINIZING HORMONE

6.60 mIU/mL

1.24 - 8.62 mIU/mL


These lab results are particularly disappointing because I have spent 2018 and 2019 trying to raise T naturally through diet, sleep, and lowering stress levels, but recently I've been feeling worse and worse.

I'm going to see an Endo in April, but in the past they have just told me that I'm "normal" and "in-range" and dismissed me. Should I instead go straight to a men's clinic or a tele clinic like Defy? What would you do if you were 19? I just can't handle feeling like shit all the time anymore. I'm wondering if I need to take matters in my own hands and get started on TRT without trying to go through an Endo that won't take me seriously.

Mr.L

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Re: 19 year old - Needs Advice
« Reply #1 on: March 25, 2020, 07:43:37 pm »
I'm 19 years old and I have been suffering from low T symptoms for the last few years (fatigue, depression, low libido, weak erections). The other day I just realized that I can't even remember the last time I masturbated... it's been so long since I've had a libido.

Here are my labs from 2018 (https://imgur.com/mTs0NTZ). Here are my labs from 2019 (https://imgur.com/a/nxgsF2h).

And below are my most recent labs from 3/18/2020:

TESTOSTERONE, FREE

47 pg/mL

47 - 244 pg/mL


FOLLICLE STIMULATING HORMONE

8.28 mIU/mL

1.27 - 19.26 mIU/mL


LUTEINIZING HORMONE

6.60 mIU/mL

1.24 - 8.62 mIU/mL


These lab results are particularly disappointing because I have spent 2018 and 2019 trying to raise T naturally through diet, sleep, and lowering stress levels, but recently I've been feeling worse and worse.

I'm going to see an Endo in April, but in the past they have just told me that I'm "normal" and "in-range" and dismissed me. Should I instead go straight to a men's clinic or a tele clinic like Defy? What would you do if you were 19? I just can't handle feeling like shit all the time anymore. I'm wondering if I need to take matters in my own hands and get started on TRT without trying to go through an Endo that won't take me seriously.

It wouldn't hurt to talk to Defy. I don't all endos are idiots but a lot of them aren't very knowledgeable about TRT. I am 100% certain that Dr. Saya wouldn't prescribe T if you didn't need it. I know that some on-line or tele-med clinics are sketchy but Defy is legit. I have been a patient for 4 years this month and I have never had a problem with their services or the pharmacies they use. My point is that they (specifically Dr. Saya) are/is trustworthy. If I had a 19 year old son with similar problems I wouldn't hesitate to send him to Dr. Saya. That doesn't necessarily mean he is going to tell you what you want to hear. He may very well tell you that he agrees with the endo and that your problem lies elsewhere. However, If he does I would trust his judgment and listen to what he has to say with an open mind. He seems to be pretty intuitive about men's health issues. Good luck!

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Re: 19 year old - Needs Advice
« Reply #1 on: March 25, 2020, 07:43:37 pm »


kevmtao

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Re: 19 year old - Needs Advice
« Reply #2 on: March 25, 2020, 07:51:50 pm »
Great advice... thank you. Only problem is that Defy is quite expensive for not taking insurance.

I'm 19 years old and I have been suffering from low T symptoms for the last few years (fatigue, depression, low libido, weak erections). The other day I just realized that I can't even remember the last time I masturbated... it's been so long since I've had a libido.

Here are my labs from 2018 (https://imgur.com/mTs0NTZ). Here are my labs from 2019 (https://imgur.com/a/nxgsF2h).

And below are my most recent labs from 3/18/2020:

TESTOSTERONE, FREE

47 pg/mL

47 - 244 pg/mL


FOLLICLE STIMULATING HORMONE

8.28 mIU/mL

1.27 - 19.26 mIU/mL


LUTEINIZING HORMONE

6.60 mIU/mL

1.24 - 8.62 mIU/mL


These lab results are particularly disappointing because I have spent 2018 and 2019 trying to raise T naturally through diet, sleep, and lowering stress levels, but recently I've been feeling worse and worse.

I'm going to see an Endo in April, but in the past they have just told me that I'm "normal" and "in-range" and dismissed me. Should I instead go straight to a men's clinic or a tele clinic like Defy? What would you do if you were 19? I just can't handle feeling like shit all the time anymore. I'm wondering if I need to take matters in my own hands and get started on TRT without trying to go through an Endo that won't take me seriously.

It wouldn't hurt to talk to Defy. I don't all endos are idiots but a lot of them aren't very knowledgeable about TRT. I am 100% certain that Dr. Saya wouldn't prescribe T if you didn't need it. I know that some on-line or tele-med clinics are sketchy but Defy is legit. I have been a patient for 4 years this month and I have never had a problem with their services or the pharmacies they use. My point is that they (specifically Dr. Saya) are/is trustworthy. If I had a 19 year old son with similar problems I wouldn't hesitate to send him to Dr. Saya. That doesn't necessarily mean he is going to tell you what you want to hear. He may very well tell you that he agrees with the endo and that your problem lies elsewhere. However, If he does I would trust his judgment and listen to what he has to say with an open mind. He seems to be pretty intuitive about men's health issues. Good luck!

ghce

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Re: 19 year old - Needs Advice
« Reply #3 on: March 25, 2020, 08:00:09 pm »
Yes I think you need to see a clinic such as defy that specialises in hormones. Your T is woeful for your age or indeed for any age and with a upper range LH like yours I would be very concerned, you need a real diagnosis.
Age:57, Height 6' 3" weight 92.5KG
2014 Androderm Patches
2014-2016 Oral Andriol 160mg Daily
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 
Reference Range Adult males  1000-6000 pmol/L

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Re: 19 year old - Needs Advice
« Reply #3 on: March 25, 2020, 08:00:09 pm »


Cataceous

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Re: 19 year old - Needs Advice
« Reply #4 on: March 26, 2020, 06:13:32 am »
I agree with the guys that Defy is a great option. Do you have health insurance? If so it's possible that some of Defy's treatment would be covered, but you have to submit the claims yourself.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 58, Ht: 5'10", Wt: 158 lbs
Protocol: 5.5 mg T propionate subQ qd, 4.5 mg T enanthate qod, 250 IU hCG subQ qod, 35 mcg anastrozole qd, 6.25 mg DHEA orally bid
Test results: TT: 800 ng/dL, E2: 30 pg/mL, DHEA-S: 264 ug/dL (49-344)—SHBG ~30 nMol/L

kevmtao

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Re: 19 year old - Needs Advice
« Reply #5 on: March 26, 2020, 06:32:41 am »
Im on a student health insurance plan. What do you think about starting TRT at my age?

I agree with the guys that Defy is a great option. Do you have health insurance? If so it's possible that some of Defy's treatment would be covered, but you have to submit the claims yourself.

Cataceous

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Re: 19 year old - Needs Advice
« Reply #6 on: March 26, 2020, 09:03:15 am »
Im on a student health insurance plan. What do you think about starting TRT at my age?
...

It's doubtful a student plan would cover hormonal treatments, but you can inquire. TRT is a last resort, but necessary in some cases. A good doctor will discuss less drastic options, including enclomiphene. However, as ghce alluded, LH should be retested. If it is consistently high then it could be pointing to testicular insufficiency, in which case TRT in some form might be necessary. If so I would learn about Natesto. Its short-acting nature means that it does not disable natural HPTA function, which is highly preferred in someone so young.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 58, Ht: 5'10", Wt: 158 lbs
Protocol: 5.5 mg T propionate subQ qd, 4.5 mg T enanthate qod, 250 IU hCG subQ qod, 35 mcg anastrozole qd, 6.25 mg DHEA orally bid
Test results: TT: 800 ng/dL, E2: 30 pg/mL, DHEA-S: 264 ug/dL (49-344)—SHBG ~30 nMol/L

Anthony01234567

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Re: 19 year old - Needs Advice
« Reply #7 on: March 26, 2020, 09:16:56 am »
It's doubtful a student plan would cover hormonal treatments, but you can inquire. TRT is a last resort, but necessary in some cases. A good doctor will discuss less drastic options, including enclomiphene. However, as ghce alluded, LH should be retested. If it is consistently high then it could be pointing to testicular insufficiency, in which case TRT in some form might be necessary. If so I would learn about Natesto. Its short-acting nature means that it does not disable natural HPTA function, which is highly preferred in someone so young.

Interesting that you mention Natesto.  That is the one that you stick up your nose ... correct?

A while back -- maybe a good year ago? -- I was all set to try / start Natesto ... and, at the very last minute, my doctor said that they don't make it anymore.  Or they stopped making it.  Or it is no longer available.  Etc.  No ... ?

We had a big discussion about this.  He said he would talk to his "pharmaceutical rep", who regularly visited him from the Natesto Company.  And, the company "closed down" and she no longer visited his office anymore as a Natesto rep.

Anyone know more?

kevmtao

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Re: 19 year old - Needs Advice
« Reply #8 on: March 26, 2020, 09:41:46 am »
I see... im having a call with Defy today to schedule my first consultation.

Also- it’s interesting that my LH was low in 2018 and 2019 (1.3 and 2.5, respectively) but recently it was 6.60. FSH has stayed constantly pretty high though (~8)

Im on a student health insurance plan. What do you think about starting TRT at my age?
...

It's doubtful a student plan would cover hormonal treatments, but you can inquire. TRT is a last resort, but necessary in some cases. A good doctor will discuss less drastic options, including enclomiphene. However, as ghce alluded, LH should be retested. If it is consistently high then it could be pointing to testicular insufficiency, in which case TRT in some form might be necessary. If so I would learn about Natesto. Its short-acting nature means that it does not disable natural HPTA function, which is highly preferred in someone so young.

Cataceous

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Re: 19 year old - Needs Advice
« Reply #9 on: March 26, 2020, 03:29:09 pm »
...
Interesting that you mention Natesto.  That is the one that you stick up your nose ... correct?

A while back -- maybe a good year ago? -- I was all set to try / start Natesto ... and, at the very last minute, my doctor said that they don't make it anymore.  Or they stopped making it.  Or it is no longer available.  Etc.  No ... ?

We had a big discussion about this.  He said he would talk to his "pharmaceutical rep", who regularly visited him from the Natesto Company.  And, the company "closed down" and she no longer visited his office anymore as a Natesto rep.

Anyone know more?

Natesto is a nasal gel. A coupon is available for it on GoodRx (11 g for $212), so I would infer that it can be purchased and has not left the market. The main Natesto website also seems normal.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 58, Ht: 5'10", Wt: 158 lbs
Protocol: 5.5 mg T propionate subQ qd, 4.5 mg T enanthate qod, 250 IU hCG subQ qod, 35 mcg anastrozole qd, 6.25 mg DHEA orally bid
Test results: TT: 800 ng/dL, E2: 30 pg/mL, DHEA-S: 264 ug/dL (49-344)—SHBG ~30 nMol/L

Cataceous

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Re: 19 year old - Needs Advice
« Reply #10 on: March 26, 2020, 03:33:17 pm »
I see... im having a call with Defy today to schedule my first consultation.

Also- it’s interesting that my LH was low in 2018 and 2019 (1.3 and 2.5, respectively) but recently it was 6.60. FSH has stayed constantly pretty high though (~8)
...

LH is pulsatile, so the single high value could have simply caught a peak while the other values are more typical. This would be good if it implies ok testicular function, which is also more common. Enclomiphene may be a good option.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 58, Ht: 5'10", Wt: 158 lbs
Protocol: 5.5 mg T propionate subQ qd, 4.5 mg T enanthate qod, 250 IU hCG subQ qod, 35 mcg anastrozole qd, 6.25 mg DHEA orally bid
Test results: TT: 800 ng/dL, E2: 30 pg/mL, DHEA-S: 264 ug/dL (49-344)—SHBG ~30 nMol/L

Anthony01234567

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Re: 19 year old - Needs Advice
« Reply #11 on: March 27, 2020, 12:22:16 pm »
Natesto is a nasal gel. A coupon is available for it on GoodRx (11 g for $212), so I would infer that it can be purchased and has not left the market. The main Natesto website also seems normal.

Thanks.  That's very strange. 

I wonder what exactly happened at my doctor's office? 

I remember this being a big deal. 

I was all set to start Natesto and then -- poof -- it was gone. 

The pharmaceutical rep was gone; her district manager was gone; etc. 

My doctor said that the company closed down ... ?

Very strange.

A

Flyingfool

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Re: 19 year old - Needs Advice
« Reply #12 on: March 27, 2020, 05:40:52 pm »
Seems extremely expensive to me.
53 year old, 5’-7” and 166 lbs.
exercise: walk 1/wk 3.2 miles, swim 3x/wk over 1 mile each session.

Blood tested 8/7/19 prev 9/19/18

Total = 520 ng/dL (250-827) 59.9% down from 580
Free T= 5.82 (4.6- 22.4) 6.9% (9.07calc) down from 10.8 calc & 6.9 serum

SHBG= 40 up from 39 (10.0-50.0) 75% of range

Bio-avail= 132.4 (110-575) 4.80%, down from 147. Calculated =246

Estradiol = 23 up from 22 (<39)
Estrone 29 (<=68)

DHES =231 mcg/dL (38-313) =45.5% tested 2/14/18
DHEA = 838 ng/dL(147-1760) = 45.6% tested 8/7/19

Currently on 50mcg Synthroid (T4)
TSH = 1.0
Free T4 = 1.15 (0.70 - 1.48)=57.7% of range
Free T3 = 3.4 (2.3-4.2) = 57.9%  of range
Current protocol: 100mg DIM once per day.  Has lowered E2 from upper 30’s to low 40’s to current low 20’s. However freeT decreased with DIM. Seems SHBG increased with DIM to offset reduction in E2 and net result lowering of free T.  No real change in how I feel. I think I will stop DIM and see what happens. Until next test.

Cataceous

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Re: 19 year old - Needs Advice
« Reply #13 on: March 27, 2020, 06:34:33 pm »
Seems extremely expensive to me.

Yes, even the GoodRx price is going to be hard for most to justify. If I'm figuring this right it's over $600 a month. I wonder what rate the insurance companies are paying?
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 58, Ht: 5'10", Wt: 158 lbs
Protocol: 5.5 mg T propionate subQ qd, 4.5 mg T enanthate qod, 250 IU hCG subQ qod, 35 mcg anastrozole qd, 6.25 mg DHEA orally bid
Test results: TT: 800 ng/dL, E2: 30 pg/mL, DHEA-S: 264 ug/dL (49-344)—SHBG ~30 nMol/L

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Re: 19 year old - Needs Advice
« Reply #13 on: March 27, 2020, 06:34:33 pm »