Hypogonadism - Male - Hypogonadism in men under 40?
- 15 Mar 2014 by jblt83
- 25 Mar 2015
- hypogonadism, hypogonadism - male
I was diagnosed with hypogonadism about a year ago, I'm 30 now. My total T level baseline before I started therapy would range between 250-300. From what I understand that's about equivalent to the levels a man would have over age 60. Androgel didn't work raising my levels so now I take testopel which are pellets I get injected about every 3 months to keep my levels in a healthy range for my age which should be around 600.
I'm a root cause person so I've been to an endocrinologist and urologist. Had a pituitary MRI done to see if it might be a tumor or something causing secondary hypogonadism. Results came back negative. Urologist said nothing was apparent from a physical exam that my low t is anything testicular related but I'm thinking about trying to have an MRI done of my reproductive organs to check for any kind of growth or something.
Anyone else in a similar situation as me diagnosed with hypogonadism at a younger age than normal and how you are treated and whether you know if it is primary (testicular related) or secondary (pituitary related)
Obviously if your testicles are working they have to investigate the Pituitary as that is the 'master' gland that tells your testicles to produce androgens (male hormones).
I have to ask: do you take opiate/opiod pain medication? This is well known to produce hypogonadism by suppressing or even 'switching off' the Pituitaries primary functions. Heavy alcohol use and Liver failure are also a risk factors but you sound too lucid and well reasoned to be in that category.
Doctors will be reluctant to prescribe high strength hormone replacements as long term use (any strength) is believed to lead to hypogonadism (the irony) and sterility. The body eventually switches off natural Testosterone production it is believed.
Given that the Pituitary only communicates with organs other than the Hypothalamus by chemical signals alone, pursuing the issue with the Endocrinologist seems the best chance of finding a cause. Remember it may be just genetic chance that is causing the issue rather than some external source. It is also possible that at work or your local environment you are exposed to some kind of androgen antagonist.
The endocrinologist can also order blood tests for tumour markers (usually proteins) that are specific to certain tumour types. This will probably be ordered before an MRI due to the high cost of the latter.
I am a physician, and was diagnosed with secondary (or hypogonadotropic hypogonadism) a few years ago when I was 29. My total testosterone was even lower than yours, and I went through the work-up... MRI, physical exam, etc.
The endocrine system is VERY complicated, but basically (for the male reproductive system): the hypothalamus (in brain) releases a hormone (GnRH - gonadatropin releasing hormone) which tells cells in the anterior pituitary gland to release into the blood stream LH (luteinizing hormone) and FSH (follicle stimulating hormone). In the male, LH directs cells in the testes to produce testosterone, and FSH plays a major role in the production of sperm.
The way it is determined whether the problem is with the testes producing testosterone (primary), or the hypothalamus/pituitary (secondary or central), is by measuring LH levels. Circulating testosterone inhibits LH (and FSH) release by the pituitary, to "shut off" testosterone production. In the case of "low T", LH levels should be VERY high because there is nothing to tell the pituitary to stop releasing it. So... if the measured LH level is HIGH this means the problem is in the TESTES; if LH is LOW, the problem is in the PITUITARY (or hypothalamus).
That said, there are a number of reasons that could cause either. It sounds like in your case the problem is probably central (i.e. brain/pituitary). Although pituitary tumors can case hypogonadism, they are not the only (or even most common) cause - the only reason we always check is because, well, you DO NOT want a growing mass inside your skull. Many times no cause will be identified (termed idiopathic hypogonadotropic hypogonadism - my case). It can be due to a number of things - genetics, exposure to certain drugs/chemicals, autoimmume destruction (i.e. you body attacking itself), etc, etc... As frustrating as it my be, it is not unlikely that you WONT get a specific cause.
Hope that helps!
Hi I was diagnosed with hypogonadism when I was 26 and had started testosterone replaced soon after and still on it today now I'm 44. I started on Androgel patches which were very uncomfortable and gave me a rash. Then started on Androgel wipe on which raised my "T" then my insurance wouldn't pay for so switched to Axiron I get test every 2 year to check my levels and they are normal unless I'm slacking off on using it. I was born with an extra chromosome. I have not had any other health issues either.
Hope this helped.
Hi. How are you doing now? I am 32 years old with no Libido and no energy in my body. My T levels came to be 126, 220,190 in three tests. Pituitary MRI is fine. Dr. has prescribed 2 pumps of Axiron daily. Have been using it for 5 days but no improvement. Me and my wife, both are really depressed. Would really appreciate if you could update about you.
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