Hello everyone, I am new to this subreddit, and new to reddit in general. I have been lurking reddit for some years now, this subreddit in particular, and I have read various helpful posts, gathering a lot of info that set me in a good "place" of understanding hormones in general, especially Androgenous Hormones, and having an idea of my problems. Excuse me if I am posting in the wrong subreddit, but I think I actually am posting in the right place seeing how many people from other posts were directed here to ask for help.
First off, I need to clarify that English is not my main language, and thus I might have some incoherent mistakes (albeit rarely grammatical or vocabulary-wise) and might repeat myself. I apologize.
This is a relatively long post, and I don't have any more time to summarize it into TL;DR bullet points, so I am really sorry, but I beg you to please read this, have patience and bare with me, because I am desperate. However, I will summarize my questions and specify what advice I need at the end. As I write towards the end, I'll copy paste this here too: If you have little time, please read solely my stats, symptoms, hormonal test values and the doctor part.
Having got this out of the way, let me introduce myself, and explain why I finally decided to post my "story".
My name's John. I am a 19 and a half years old dude, and I am from Europe (I am sorry, but I will not specify the country I come from).
My stats are: Gender: Male (also straight, I am attracted to women - this is relevant to libido, mentioned below) Height: 188 cm (6'2") Weight: fluctuates depending on the day, ranging from 87.5 kg (or ~193 lbs) to 89 kg (or ~196 lbs) Bodyfat %: I haven't measured it in a doc since I was 16 years old or so (back then it was 15.5%), but having had an injury and High School exams to go into college, PLUS the whole coronavirus thing, I put on some weight, mainly fat, so I am guessing anywhere between 16.5 and 18%
I've been suffering from low T symptoms, or maybe also other hormone imbalances, for basically my whole life - and let me tell you, this has absolutely ruined my School years, a.k.a. wasted them, especially regarding relationships, but also meetings & "making new friends".
Thing is, when I was roughly 4-5 years old, I had cryptorchidism (basically one testicle, for me it was the right one, was undescended and not in the scrotum), for which I had successful surgery and it apparently was fixed, but since then the right testicle is hanging slightly lower than the left one. However, the surgeon and other docs had reassured my parents than all is well.
Having also got that out of the way, let me just add, that my testicles, having been examined numerous times, are of normal-to-big size and shape, thus I don't believe I am having all the problems I will describe below due to them.
One thing I think I also need to mention is the fact that I had "hit" puberty relatively early, roughly at around the age of maybe 10-11 or so. Maybe even earlier. I honestly don't remember. Keep in mind that by the time I was 12 years old, I was already the tallest kid at my school, being around 175 cm (or ~5'8").
Having said all of that, let's get to my symptoms, as I want to keep this as short as possible and not waste your time.
Symptoms include: 1) Zero libido, like when I say zero, I mean ZERO. I've never felt the need to have sex and this is problematic. I basically really like females, and find their feminine faces attractive, but when it comes to having the want or even the basic need to have sex, or just sexual thoughts about them... None. I know that looking at women walking in the street while I am walking is rude, but let's be real, every normal guy notices hot women, and despite not making moves, acknowledges the "hotness". I am like meh. This has been going on since I "hit" puberty, I've never had had sex, I've never felt the need, urge or want to have sex. Before you call ne asexual, that is NOT the case. I know I would want to have a relationship and a family with a woman.
2) Severe Erectile Dysfunction (like absolutely devastating). I cannot even feel my penis at all, I mean it's not numb (which would be indicating I could have a physiological problem there), but even if my life depended on it, I could not pop an erection, or at best, I would struggle to pop a jelly-like, 15% one. This includes absence of morning wood and wet dreams (although I admit, I used to have morning wood some years ago and onyroxis aka wet dreams ejaculation). This (the morning wood), was also jelly, not even 30%, like ever.
3) EDIT#1: I also struggle to take the lead and make decisions in my life. Complete beta personality (around women or new people I meet), even though it should be otherwise. I also cannot express myself properly, as I struggle to know how to respond (especially in romantic context), act, or even find the right words to say. This, along with such social awkwardness & feelings of insecurity, that I have refused to go to parties, gatherings, etc., most of my life, cowering in fear, having social anxiety and agoraphobia which is something I absolutely hate. No, I am not an introvert, I was much more socially active before puberty, without shyness. Now I am a complete shy, introverted, socially anxious and awkward mess. I hate that I am missing out on so much in life, and I want to get my life ON TRACK, be and feel normal, and actually alive.
Having said this, I need to add about relationships, I guess am (without bragging) at least a 9/10 guy which is basically verified from various females and some gay dudes, and even other straight dudes I know (whom are baffled I am still single and socially awkward & insecure). This is also backed up by the amounts of women checking me out and giving me sexual looks when I walk, my female former classmates, and all the girls I've ever asked out, who said yes, but were hugely disappointed in the date itself due to my lack of social skills and betaness. This is not something I wrote to brag, because I am miserable, but it's something I am writing to explain that I can carry myself when walking alone, or with a group of friends, with an alpha aura, however when talking to people I feel like my balls go in my stomach. It sucks so much that I can get any female I want, but as soon as I take her on a date (which even by itself is a huge feat for me due to betaness & anxiety) and I talk (or not and listen), she always loses interests.
It is mainly #1, #2 & #3 in combination and coordination that puts on me the label of the "virgin", as it is impossible to ever have sexual intercourse or progressing so far as to try.
4) Complete fatigue, demotivation and "laziness", apathy, lethargy & depression. I even struggle to get out of bed, and I have lost all the objectives & meaning of my life, this includes postponing tasks infinitely. I even sleep 12 hours on some days, and still feel like shit. I am constantly yawning and tired. Low energy, altogether. I am also OVERLY emotional and moody, and often cry (alone).
5) Related to #4, I have a severe loss of memory & focus, my brain simply does not work like it used to, and that is the reason my academic path is declining. Not only do I find myself struggling to learn something by heart, but I also seem to lose my focus fairly quickly and think of other, general and irrelevant to the moment, things. I am desperate to fix this also.
6) I am shedding way more (head) hair than I used to, every day. I also am shedding my pubes fairly quickly and constantly, even with a little touch, which has resulted in them being sparse and thinning. My armpit, arm and leg hair are normal. I have like zero chest or back hair (which could be genetics), but the main problem here is I barely have any beard-mustache growth, which resemble those of a 15 year old or even younger boy. I also noticed they're thinning and my mustache is even worse than when I was 16. And genetics here cannot be the case, as both my grandarents and also my father had glorious beards and facial hair.
7) My bodyfat is weirdly placed around my body, given my upper body is relatively lean, yet my glutes, waist (& the so called "lovehandles"), lower stomach and legs are the main fat stores, giving me a weird reversed body shape, which despite my muscle mass seems like shit. Trust me on this one, I hate it.
8) I have slight gynaecomastia, puffy nipples and hard lumps underneath them. But this does not really concern me at the moment, even though I absolutely hate it when my nipples can look funky underneath thin summer t-shirts.
I need to note at this point, that despite all those problems-symptoms that seem to be hormone-related, my musculature system is excellent, for which I have perfect genetics, and thus very responsive to even low Testosterone (I gain muscle mass fairly quickly, but now I started training again, I've plateaued).
A prolonged (basically since 10-11 years old) experience of all of these is driving me insane, and spiralling me further into depression. I had been nagging my parents to get me to a lab or microbiologist to perform hormonal bloodwork on me since I was 15, but they ignored me. I was too shy and ashamed to tell them about my zero libido, severe ED and failed-absent sex life, due to obvious reasons. So I used the excuse that "my muscle mass & gains are shit thus I have low Testosterone", to which they joked even more against me, and basically never took me seriously. I actually nagged them for so much and so long, that they eventually gave in without me ever having to tell them about my such severe symptoms, and went to a doc, when I was 17+, last year September, 2019, to prescribe me bloodwork (however the doc was an idiot, and my parents were clueless), so he only prescribed Total Testosterone & TSH alone! Nothing else.
To further worsen my misery & situation of despair (please do NOT judge yet, as I have had newer bloodwork in which more hormones were tested, earlier this month in 2021), my Total T came back at 8.15 ng/mL (or 815 ng/dL) with a normal range being from 2.5 ng/mL to 10.7 ng/mL (or 250 ng/dL to 1070 ng/dL), which is pretty high, so everyone stopped taking me seriously, because obviously this was relatively high. TSH came back at 3.50 μIU/mL (normal range being 0.25 to 4.10 μIU/mL), so no problem there. However, we all know that a Total T alone, plus super early in the morning (like 7 am), means absolutely NOTHING.
Anyway, going back to today, 2021, I actually continued nagging my parents (because they are super strict and I also don't know how to go on alone about this whole ordeal, plus I don't have money to pay the doc) for most of the year since November 2020 to now, and since they refused to believe me and thought I was bullshitting them, I found the courage to sit them both down and tell them everything I experience, which is a living hell (they are good parents, yet so busy that they didn't pay much attention to my everyday life - thus never noticed abnormalities), and that includes basically about the zero libido and ED, and to my surprise they actually believed me and felt bad about ignoring me, and were sympathetic with me. So they researched a bit online (finally! as they think only BS is written online), and decided to get me to an endocrinologist.
Surprisingly enough, and completely opposite to the "horror" stories I've read online about idiotic endocrinologists, he is actually a good doc and very sympathetic (listened to everything I said and took notes) and reassured me that whatever it is, that is causing me all this, he will find it and fix it. So I was relieved a bit. He then went on to examine me physically, also checked my thyroid with an ultrasound. It was, as expected, in perfect health. He also found, and listed, my physical symptoms, such as slight gynaecomastia, thinning & sparse pubes, little chest & back hair, and absolutely shit facial hair. He also found out on about my right testicle, which had undergone surgery for cryptorchidism as mentioned above, hanging lower than the normal left one which was something that worried him, but since he told me about it, I told him about the surgery, and he agreed it was normal then.
Long story short about the endo, he prescribed me a hormonal bloodwork, consisting of the hormones: TSH, FT4 and Anti-TPO (all 3 are about the Thyroid), and SHBG, LH, E2, Total Testosterone, and finally Prolactin. I was negatively surprised that he didn't prescribe me a test for Free Testosterone, DHEA and DHT, but I didn't dare to say a thing or play "doctor" myself right to his face, seeing how respectful he was.
The hormonal test results came back and are as follows (the measurements are 100% accurate, because he sent me to the best lab for them, yet the normal ranges on the Testosterone suck, they are most likely about older men):
Thyroid: TSH: 3.11 uIU/mL, normal range: 0.25 - 4.10 uIU/mL
FT4: 15.60 pmol/L, normal range 9.90 - 24.20 pmol/L
Anti-TPO: 18.0 IU/mL, normal range 0.0-50.0 IU/mL
Testosterone & others:
SHBG: 24 nmol/L, normal range: 14 - 69 nmol/L
LH: 5.4 mIU/mL, normal range: 1.7 - 8.6 mIU/mL
Estradiol (E2): 25.57 pg/mL, normal range: 7.63 - 42.60 pg/mL
Total Testosterone: 5.05 ng/mL or 505 ng/dL, normal range: 1.65 - 7.53 ng/mL or 165 - 753 ng/dL (something is definitely wrong with those limits, based on androgenhacker.com, the lowest should be 3 - 12 ng/mL or 300 - 1200 ng/dL)
Prolactin: 10.2 ng/mL, normal range: 2.1 - 18.0 ng/mL
From a quick look, I can see that my Total Testosterone has dropped a staggering significant amount of basically ~3 ng/mL or ~300 ng/dL in a bit over a year. From common sense, this id definitely not normal, but I reassure you that even when my Test was "high", I still had all of those problems. It's just that now they've worsened even more. One scenario could be that the microbiologist I had conducted my first test for a standalone Total Test was a complete moron and didn't get the proper result.
On the other hormones, I cannot really speak, because I don't know what's wrong, they really do seem like in the normal range, albeit kind of in the low end. I, of course, spoke of the Total Test, because that's the hormone I am more familiar with.
You might say that 505 ng/dL test is in normal range, BUT: based on my symptoms, my significant drop, AND other online sources mentioning Test for my age (19-20 years old), it is ABSOLUTELY NOT. These are the levels of a 70 year old man, for crying out loud. From some sources, I've read the low end for my age is 500 ng/dL and the high end is 1200 ng/dL, so I am definitely on the low end.
One other thought of mine I need to add is that I crossed out the fact that I could have secondary hypogonadism from my mind, seeing as my LH value is normal (see above), and assuming (despite not having tested for it) that my FSH. Problem is, it can't be primary either, seeing as my testicles are of normal size. So if it's not the damn hypophysis (a.k.a. pituitary gland), nor my testicles, then what is causing the living hell I am currently experiencing?
I've read somewhere that there's also a form of hypogonadism other than primary and secondary, called hypogonadotropic hypogonadism or normo-gonadotropic hypogonadism or something along those lines, but I don't exactly remember.
Going back to the doc with the results, he said that the hormonal test he ordered was in relative normal range, but seeing all of my symptoms, he said the test alone doesn't tell him much, and that he will have me take another blood test roughly in 20 days from now, focusing solely on Androgenic Hormones (as my Thyroid is normal) to verify that the results are more or less the same, and do not fluctuate, so I am assuming he's also going to prescribe Free Testosterone, DHT, DHEA, and others. He then said that even if my second test comes back in "normal range", he will definitely resolve my problem, and thus he's planning to send me to a big city to have "dynamic tests" (without ever telling me what those were or included), check my pituitary gland, etc. He is basically doing a good job from what I can tell, and he's going step by step. He didn't tell me neither to "fuck off because your Testosterone is in normal range" nor "here, grab this TRT without me even finding your problem first", so he's definitely competent, or so I hope.
After I go to have all those "dynamic" tests, and other tests, he told me to come back again to him, give him the results and he will see then how he will proceed with my case.
Now, on to specify the main concerns & worries I have, on which stuff I need advice on how to proceed & summarize my questions:
If you have little time, please read solely my stats, symptoms, hormonal test values and the doctor part.
TL;DR (questions):
1) What do you think, based on your experience & knowledge (or even expertise if you are a doctor), is the root cause of all my problems? Could it be hypogonadotropic hypogonadism? Normogonodotropic hypogonadism or whatever? Something else, altogether? Also, please explain to me shortly what those 2 (or maybe it is 1 with different names) types of hypogonadism are and how they differ from primary & secondary. Could it be my pituitary gland? My testicles? Something else, something "in between"? Both?
I am asking these so I know what to expect from my case.
2) Do you, or someone you know, have or have you/they ever had such a similar case? If so, how did you/they treat it, or what did it take exactly to treat it? I am sure it's a terrible experience, so are the treatment options easy or difficult? TRT? HCG? Clomid? All 3? Something else? Surgery?
3) How should I proceed with my doctor? Do you also think he seems competent? I believe in him, and I am not making this post to discredit him in any way, but I am actually making this post because: a) I see it as a way to relax a bit through chatting and sharing info with you guys, b) it will definitely make me less anxious in this 20+ day wait and answer some of my questions, thus I'll also know what to expect and how to proceed (if I ever need to add something or note to the doc).
I think that is all for now, and I hope I didn't forget to add any more important information, but if I did, I'll be sure to put edits in here.
I'll definitely be active on this post, as I am desperate and totally waiting for your inputs, which I'll definitely appreciate a lot. I'll read everything, and reply to everyone if I have time.
If you made it to the end, I kindly thank you with all my heart. -John
P.S.: No, I am not actually longing to go on TRT for "gains". As I said, my musculature is genetically excellent and I make gains even with such shitty symptoms. However, I am definitely willing to go on TRT and other medications if that means my life does a 180° turn around and changes for the best.
Edit #1: added an Edit to the beginning of Symptom #3
Edit #2: I basically feel like a little, emotional and immature child, I do not feel like a man, like at all.
Edit #3: Question 4) Which hormones and other bloodwork should I persuade my doctor to prescribe me so I can have them also tested (in case he "forgets" or deems unnecessary)?
Yes, I am overthinking this. Lol.
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