My son is almost 18 and T is only 261

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Never seen any studies that indicate this. It's a good theory. Makes sense. Doesn't seem to play out that way. Sleep is the only thing known to cause low testosterone and be a root cause. Lifting weights sure didn't do a thing for my testosterone levels. Now I didn't have issues as a teenager. Seems quite a bit more complex than most of us have dealt with.



Here is a study for you to read:
"Regardless of the age or comorbid conditions, obesity is associated with hypogonadism. The Baltimore Longitudinal Study of Aging found that testosterone decreased by 10 ng/dL per 1-kg/m[SUP]2[/SUP] increase in body mass index.[6]" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255409/
 
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And you are even more of an ******* than I thought. BMI is a joke. The topic here is s kid with very low testosterone. I posted the angle I'd approach it from and you got butt hurt. I wouldn't spend a year of crucial development time on just diet and exercise. I'm sure in your world that solves the world's problems, but the kid needs medical help. That's an opinion btw. Tends to differ from person to person. Life must be tough if that bothers you.

Here is a study for you to read:
"Regardless of the age or comorbid conditions, obesity is associated with hypogonadism. The Baltimore Longitudinal Study of Aging found that testosterone decreased by 10 ng/dL per 1-kg/m[SUP]2[/SUP] increase in body mass index.[6]" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255409/
 
Here is a study for you to read:
"Regardless of the age or comorbid conditions, obesity is associated with hypogonadism. The Baltimore Longitudinal Study of Aging found that testosterone decreased by 10 ng/dL per 1-kg/m[SUP]2[/SUP] increase in body mass index.[6]" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255409/

I don't think anyone is denying that obesity can lower testosterone levels, and judging by this kid's T/E ratio (<10/1), I think it's pretty clear that his BMI isn't helping. That said, the kid is a teenager. We don't know if he really ever completed puberty. We'd have to know whether his testicles, penis, body hair, primary sex characteristics, etc have fully developed. If everything is in tact and "normal," then we could probably assume that at some point he had healthy testosterone levels, but doesn't anymore. If that's the case, his lifestyle may be to blame for low levels, but for them to be THAT low at his age it seems less than likely even if he's always been obese. We may also be reversing the causation here. I'm sure you and I both knew plenty of kids who were chubby or fat as pre-adolescents who leaned out tremendously once they hit puberty. This is in part due to the development of an adult hormone profile (more testosterone, more GH through puberty, etc). Is it possible that this kid is more prone to obesity because he never had healthy testosterone levels to begin with? It's hard to say.
 
So you'd rather him spend a crucial year of development time taking hormone drugs? What if the clomid doesn't work? What's the next step? Testosterone. Testosterone for a developing boy versus eating right and exercising?

What's so bad about taking the safest route and having him spend his development time learning new methods of how to live right. Exercise...diet, losing weight, etc. versus starting on drugs. Drugs that he might have to take for the rest of his life since it would shut down his normal production. I'm not saying that he should not be on it, but that shouldn't be the first choice.

I would be very wary about jumping on test at such a young age. This isn't like insulin. Docs don't consider this a lifesaving medication. What if he doesn't have good insurance when he gets older? What if his new doctor doesn't put him on? You already see the war on testosterone. Read a couple of threads down where they are now lowering the lab values. It's only going to get harder.
 
So you'd rather him spend a crucial year of development time taking hormone drugs? What if the clomid doesn't work? What's the next step? Testosterone. Testosterone for a developing boy versus eating right and exercising?

What's so bad about taking the safest route and having him spend his development time learning new methods of how to live right. Exercise...diet, losing weight, etc. versus starting on drugs. Drugs that he might have to take for the rest of his life since it would shut down his normal production. I'm not saying that he should not be on it, but that shouldn't be the first choice.

I would be very wary about jumping on test at such a young age. This isn't like insulin. Docs don't consider this a lifesaving medication. What if he doesn't have good insurance when he gets older? What if his new doctor doesn't put him on? You already see the war on testosterone. Read a couple of threads down where they are now lowering the lab values. It's only going to get harder.

What's with the straw men fallacies? All we concluded was that further testing is in order to rule out any actual endocrine/testicular issues. If the doctors determine that a lifestyle change is the best solution based on the available evidence, then great. However, based on the information I have available to me and the knowledge I possess, I think it's unlikely that the fix will be so simple. As user-joe indicated, I've literally never seen one shred of medical or scientific evidence implying that simply getting "fit" corrects testosterone deficiency. I've never once said "just pump him up." That said, assuming he has an actual endocrine issue, something like clomid could SAVE him and give him the quality of life he deserves. When I was a teenager I knew people with hypothyroidism who had to take synthetic thyroid hormone. Sometimes you get dealt a shitty hand with a health issue and you have to take the steps to correct it, regardless of age. Being on something like clomid at age 17-18 if you NEED it is far from the worst thing in the world. Unlike testosterone, it doesn't cause total htpa shutdown. Coming off of it simply returns you to baseline. It is a quick and effective tool when NEEDED. All I'm saying is that I think it's more likely he will need it than not, and that it is more likely that his issue will not be resolved by lifestyle improvements.
 
The OP didn't come in asking for what additional tests he should ask his doctor. He asked for clomid. Then he said a small boost of T would help him lose the weight.

What would help him lose the weight is the proven methods to lose weight: eat better and increase activity levels. The OP is looking for the pharmaceutical way out of it instead of putting in some work and making the right changes. There should be more tests done, I agree, but, no matter what, he needs to lose 100 or so pounds. He young enough to learn the right way now versus 15-20 years from now, after his first cardiac event. When I got to my doc, I see a lot of fat people that are on TRT. TRT will not change bad habits.

Also, where are the full CBC's, the metabolic panel, Vit D, lipids, CRP, HBA1C, prolactin, etc.? I would turn every rock. I'd even get a sleep study and have a urologist check for varicoceles or any other testicular abnormalities before I jump on drugs. If he needs it, he needs it, but right now, nobody knows without further tests. The OP just wants to jump on it now.
 
The OP didn't come in asking for what additional tests he should ask his doctor. He asked for clomid. Then he said a small boost of T would help him lose the weight.

What would help him lose the weight is the proven methods to lose weight: eat better and increase activity levels. The OP is looking for the pharmaceutical way out of it instead of putting in some work and making the right changes. There should be more tests done, I agree, but, no matter what, he needs to lose 100 or so pounds. He young enough to learn the right way now versus 15-20 years from now, after his first cardiac event. When I got to my doc, I see a lot of fat people that are on TRT. TRT will not change bad habits.

Also, where are the full CBC's, the metabolic panel, Vit D, lipids, CRP, HBA1C, prolactin, etc.? I would turn every rock. I'd even get a sleep study and have a urologist check for varicoceles or any other testicular abnormalities before I jump on drugs. If he needs it, he needs it, but right now, nobody knows without further tests. The OP just wants to jump on it now.

I think OP is just concerned for his/her son and wants to do whatever they can to help him. Some parents are very apprehensive when it comes to allowing their kids take any drugs and others are willing to put them on whatever they think might help. I agree that no matter what, the kid needs healthier habits and far more comprehensive investigation.
 
The primary reason obesity causes lower testosterone levels is through the action of aromatase synthesis converting testosterone into estrogen.

The boy's estrogen levels are fine and therefore not likely the cause.
 
I had a suspicion something was wrong. No energy, heavy, no facial hair. I took him to his GP had a panel done. Then went to my Endo. She said his weight may be a factor. He's 6'2" and weighs 330lbs. She wants him to do a sleep study. She also tested him for cortisol but still waiting for results. I was really surprised how low his T was. I asked if he could do Clomid. She said no, he's too young. She said I can get a second opinion from a pediatric Endo. She said she is worried about affecting his pubertal process. I tried searching for other posts for younger low T. I had a hard time finding them. I know they are here. I've seen them, just never read them. I think a small boost of T would help him lose the weight. I have his panel info below:

[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]IgA[/TD]
[TD="class: valueCol"]210.0 mg/dL[/TD]
[TD="class: rangeCol"]70.0-400.0 mg/dL[/TD]


[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]Tissue Transglutaminase Ab, IgG, S[/TD]
[TD="class: valueCol"]1.9 U/mL[/TD]
[TD="class: rangeCol"]<6.0 (Negative) U/mL[/TD]


[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]Iron[/TD]
[TD="class: valueCol"]48 ug/dL[/TD]
[TD="class: rangeCol"]35-150 ug/dL[/TD]
[TD="class: flagCol"][/TD]

[TD="class: nameCol srchbl"]TIBC[/TD]
[TD="class: valueCol"]358 ug/dL[/TD]
[TD="class: rangeCol"]250-450 ug/dL[/TD]
[TD="class: flagCol"][/TD]

[TD="class: nameCol srchbl"]Iron % Saturation[/TD]
[TD="class: valueCol"]13 %[/TD]
[TD="class: rangeCol"]20-50 %[/TD]
[TD="class: flagCol"]L[/TD]


[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]FSH[/TD]
[TD="class: valueCol"]8.7 mIU/mL[/TD]
[TD="class: rangeCol"][/TD]


[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]LH[/TD]
[TD="class: valueCol"]4.63 mIU/mL[/TD]
[TD="class: rangeCol"]0.07-6.00 mIU/mL[/TD]


[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]Estradiol[/TD]
[TD="class: valueCol"]28.9 pg/mL[/TD]


[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]Testosterone, Free, S[/TD]
[TD="class: valueCol"]10.2 ng/dL[/TD]
[TD="class: rangeCol"]4.28-20.9 ng/d[/TD]


[TD="class: nameCol srchbl"]Testosterone[/TD]
[TD="class: valueCol"]261 ng/dL[/TD]
[TD="class: rangeCol"][/TD]
[TD="class: flagCol"]L[/TD]

[TD="class: srchbl, colspan: 4"]-------------------REFERENCE VALUE--------------------------
300-1200[/TD]


[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]Free T4[/TD]
[TD="class: valueCol"]0.99 ng/dL[/TD]
[TD="class: rangeCol"]0.75-2.00 ng/dL[/TD]


[TH="bgcolor: #F5F5F5, align: left"]Component[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Your Value[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5, align: left"]Flag[/TH]

[TD="class: nameCol srchbl"]TSH[/TD]
[TD="class: valueCol"]1.970 uIU/mL[/TD]
[TD="class: rangeCol"]0.450-5.500 uIU/mL[/TD]


Have you considered running the blood tests again? When I first got diagnosed, I drew blood three times before the doctor gave me the diagnosis. Mistakes happen sometimes, you really should test his T levels more than once.
 
I want to thank you all for the feedback and advice. Sorry I am first replying. This may be a bit long but I think it's really important I explain everything that has happened since I posted this. You may be quite surprised. Since my endo didn't want to consider clomid for my son I talked to my GP if he knew anyone that was a little more savy on the subject. He recommended a urologist he knew. I called the urologists office and when I mentioned who I wanted to see and why she said well if you want the best person here then you should see Dr xxxxxx. I thought that was interesting but I agreed. Now I took a different approach here. I made the appointment for myself. So I mentioned I wanted to try clomid and he wasn't keen on me doind that. Partly cause of my age and he saw that my results with Test Enan were quite good. So then I mentioned my son. That he really wasn't hitting puberty. He was quite heavy and that we recently tested him and his T was quite low. He said he was a potential candidate but also thought my son was a bit young. He said he would see him and we scheduled an appointment right after his 18th birthday. He had my son get another blood panel and his T was even lower. At the appointment he noticed my son had no facial hair and of course was concerned about his weight. He wanted to take the approach the endo did and get his weight down first and see if there was any change. I pushed him. He said I see you want your son to do this but let me ask him. My son said yes he would like to try it and see if it helped. BTW (side note), only my wife knew I did T so before this appointment I sat with my kids and explained what I did and why. So my son was prescribed 25mg per day. He was on it for 3 1/2 months. In one month he grew a full beard, grew 1.5 inches, was more energetic and more helpful around the house with chores. The uro ordered a second panel and his levels were quite high. So he asked him to stop. After one month his levels dropped in half. The uro was quite surprised by his results. So beginning of March we will test again. He said he has seen this before although not common where the clomid kick starts and then stays at a decent level. Another interesting result of him going on the clomid is his headaches/migraines have stopped. He recently had a couple so I'm not sure if his levels are dropping further.
SonsTlevels.jpgSon'sElevels.jpg


At my sons last appointment with the uro I asked if I can give this a shot. I developed quite late like my son and we have the same genetics so he agreed to start me on it. I'm not sure I agree on the protocol. He said for me to maintain my T injections for a month or more while taking the clomid. But I have learned to use my own judgement along with the advice on this site. BTW my LH was just about zero before I started. Now I know everyone here says you can't take both and expect to see any results. But I will wait like he said and test again in 1 month. He said I eventually should wean off the T and when I am fully off see what happens to my levels. Any advice on how to wean off or should I just stop?

I will update everyone on with my sons labs and my labs in March. Oh and to answer some of your questions. My son never had bad acne so no accutane. Yes he is a classic millennial and he is obese. BTW his Iron was a little low because he rarely eats red meat or veggies. So I had him on medium level iron pills and his levels are good now. I really hope this helps anyone else who is younger and wonders if this is a possible choice.
 
my son is 16 1/2, and i worry about the same thing. please update

I had a hard time finding anyone because he is 18. I think you'll have an even more difficult time at 16 1/2. I recommend you start by having his levels tested. Bare minimum his T, E, CBC and LH.
 
His voice is cracking a bit, but I have never seen a zit on the him. He is 5'6 and overweight, with a fatty heavy chest. I cannot motivate him to work out with me. The worst part is he is a gift to my wife and I after we lost our first two biological kids, so I have no idea what to expect of his genetics. I will be following your thread closely. Thank you for asking about this, it has been heavy on my heart.
 
I want to thank you all for the feedback and advice. Sorry I am first replying. This may be a bit long but I think it's really important I explain everything that has happened since I posted this. You may be quite surprised. Since my endo didn't want to consider clomid for my son I talked to my GP if he knew anyone that was a little more savy on the subject. He recommended a urologist he knew. I called the urologists office and when I mentioned who I wanted to see and why she said well if you want the best person here then you should see Dr xxxxxx. I thought that was interesting but I agreed. Now I took a different approach here. I made the appointment for myself. So I mentioned I wanted to try clomid and he wasn't keen on me doind that. Partly cause of my age and he saw that my results with Test Enan were quite good. So then I mentioned my son. That he really wasn't hitting puberty. He was quite heavy and that we recently tested him and his T was quite low. He said he was a potential candidate but also thought my son was a bit young. He said he would see him and we scheduled an appointment right after his 18th birthday. He had my son get another blood panel and his T was even lower. At the appointment he noticed my son had no facial hair and of course was concerned about his weight. He wanted to take the approach the endo did and get his weight down first and see if there was any change. I pushed him. He said I see you want your son to do this but let me ask him. My son said yes he would like to try it and see if it helped. BTW (side note), only my wife knew I did T so before this appointment I sat with my kids and explained what I did and why. So my son was prescribed 25mg per day. He was on it for 3 1/2 months. In one month he grew a full beard, grew 1.5 inches, was more energetic and more helpful around the house with chores. The uro ordered a second panel and his levels were quite high. So he asked him to stop. After one month his levels dropped in half. The uro was quite surprised by his results. So beginning of March we will test again. He said he has seen this before although not common where the clomid kick starts and then stays at a decent level. Another interesting result of him going on the clomid is his headaches/migraines have stopped. He recently had a couple so I'm not sure if his levels are dropping further.
View attachment 4595View attachment 4596


At my sons last appointment with the uro I asked if I can give this a shot. I developed quite late like my son and we have the same genetics so he agreed to start me on it. I'm not sure I agree on the protocol. He said for me to maintain my T injections for a month or more while taking the clomid. But I have learned to use my own judgement along with the advice on this site. BTW my LH was just about zero before I started. Now I know everyone here says you can't take both and expect to see any results. But I will wait like he said and test again in 1 month. He said I eventually should wean off the T and when I am fully off see what happens to my levels. Any advice on how to wean off or should I just stop?

I will update everyone on with my sons labs and my labs in March. Oh and to answer some of your questions. My son never had bad acne so no accutane. Yes he is a classic millennial and he is obese. BTW his Iron was a little low because he rarely eats red meat or veggies. So I had him on medium level iron pills and his levels are good now. I really hope this helps anyone else who is younger and wonders if this is a possible choice.

Glad to hear that your son was forced into puberty with the use of modern medicine.

You never mentioned anything about what your son eats. What does your son's diet look like?
 
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Another update: My son was off Clomid for 2 months and his levels dropped under 400. He called the doc and they agreed to starting Clomid again at 25 mg EOD. He was losing some of that energy he got from his T being higher and his headaches came back. Doc wants to test in 3 months.
 
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