Patient's Query
Hello doctor,
I am a 27-year-old male. My height is 5'7", and my weight is 165 lbs. My libido is reduced due to intense workouts. I do exercise for three to four hours a day for five days a week. This consisted of swimming, running about 1.5 miles in the morning, and two hours of weight training at night. I was sick often, never wanted to have sex, and was constantly bloated. I would only eat around 2000 calories a day and often fall asleep at my desk during work. I got my testosterone levels tested, and they are very healthy for my age. I now have problems focusing and was prescribed Adderall.
What should I do now?
Kindly help.
Hello,
Welcome to icliniq.com.
Your testosterone levels are normal (attachments removed to protect the patient’s identity). The low libido is more likely due to psychological reasons rather than organic. However, excessive exercising can cause fatigue and quickly bring down your energy, thereby reducing the urge to have sex. So, kindly limit your workout. I suggest you visit a psychologist for an opinion.
Take care.
Patient's Query
Hello doctor,
My free testosterone level is 19.64 ng/dL. Is this a normal level for my age? I struggle to grow facial hair, build muscle and maintain weight regardless of my strict diet and exercise routine. My sex drive is very low, and it dissipates quickly. There has been nothing to cause psychological issues. I do not have depression, and I am confident in myself as a person.
Thanks.
Hello,
Welcome back to icliniq.com.
Your free testosterone levels are really low at 19.64 ng/dL. Since your total testosterone is normal, it indicates that your bound form is more, and hence free testosterone is low. This free testosterone is important for your sexual wellness, muscle building, and metabolism.
The potential causes of low testosterone are as follows;
1) Injury or trauma that causes the interrupted blood supply to the testes.
2) Infection of the testes.
3) Chemotherapy for cancer.
4) Metabolic disorders such as hemochromatosis.
5) Dysfunction or tumors of the pituitary gland.
6) Medications, including opioids, hormones used to treat prostate cancer, and steroids.
7) Acute (short-term) or chronic (long-term) medical illness.
8) Alcohol abuse.
10) Chronic renal disease.
11) Obesity or extreme weight loss.
12) Uncontrolled type 2 diabetes mellitus.
13) Estrogen excess.
14) Previous anabolic steroid abuse.
15) Severe primary hypothyroidism.
So one needs to evaluate these factors before establishing a possible cause in your case. However, exogenous testosterone supplementation is the possible treatment option in your case. But without knowing the actual cause, the supplemented testosterone may also get bound.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
I have been struggling for years to find the cause for my low testosterone levels. What should I do now?
Thanks.
Hello,
Welcome back to icliniq.com.
You have to go through the causes that I have mentioned in my previous answer and need to evaluate the possible cause.
Kindly do the following investigations to help you better;
1) Hormonal profile including serum prolactin, serum estrogen, pituitary hormonal screen, and thyroid profile.
2) Doppler scan of the testis to check for testicular size and blood flow studies.
3) Ultrasound of testis.
4) Blood sugar.
5) SHBG levels (sex hormone-binding globulin). High levels of SHBG are associated with infertility, decreased sex drive, and erectile dysfunction.
6) Complete metabolic profile.
7) CT (computed tomography) scan of the brain with contrast for the pituitary gland.
I would suggest an exogenous testosterone supplementation therapy once after finding the cause. Unless the cause is found, the supplemented testosterone would get metabolized, depleted, or remain unused.
Regards.
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Answered byDr. Sameer Kumar
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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