Concerns Over Testosterone Levels
Hello everyone, I’m reaching out to share my story and seek some advice. I’m 25 years old, with a height of 160cm, and I've recently undergone a significant weight transformation, dropping from 100kg to 55kg. After enjoying a wonderful vacation in Italy (which included my wedding!), my weight has now settled around 59kg. My weight loss journey involved following an extremely low-calorie diet, consuming only 700 to 800 kcal per day, with the aid of a medication called Mounjaro. Since January, I've started to notice several unsettling symptoms: diminished libido, difficulties with erections, severe fatigue, persistent body aches, fluctuations in my mood, and an overwhelming sense of emotional numbness, among others. In February, I underwent blood tests that revealed low levels of testosterone, estradiol, and prolactin, while LH and FSH levels were within the low-normal range. I initially attributed these issues to my diet and made efforts to gradually increase my daily caloric intake. Currently, I’ve been consuming about 1750 to 1800 kcal each day, but it’s been several months and I haven’t seen any improvement in my condition. I also stopped taking Mounjaro abruptly last month. Last week, I had another round of blood tests, and the results were alarming—indicatively worse than those from February. Today, I consulted with an endocrinologist who attributed my issues to my previous weight loss and was dismissive of the need for more extensive testing. He reassured me that my low prolactin levels excluded the possibility of a pituitary tumor and suggested that I aim to regain weight, ideally reaching 65kg, which would classify me as overweight by BMI standards. However, he offered no further lab tests or an MRI. I can't help but feel that my concerns are being overlooked. If this issue were merely due to functional suppression, shouldn’t I have noticed some positive change by now? Additionally, as someone who is trying to conceive, the timing and hormone balance are crucial for me. I have a few questions for anyone who may have experienced something similar: - Could my condition still be classified as functional hypogonadism, or would it be prudent to advocate for an MRI and a comprehensive pituitary evaluation? - Is it truly necessary for me to gain weight to reach the overweight BMI category, or is that an excessive measure? - Have any of you recovered from issues stemming from a drastic calorie restriction? If so, how long did the recovery take? I would greatly appreciate any advice or insights from those who have faced challenges with low hormone levels, male infertility, or pituitary problems, especially while using Mounjaro. Thank you for your help!
Answers (1)
8/6/2025, 7:40:58 PM
OpenHealth AI
Thank you for sharing your journey and concerns. It sounds like you’ve been through a lot, especially with your significant weight changes and the symptoms you’re experiencing. It’s understandable that you feel anxious about your hormone levels and overall health, particularly with your goal of conceiving.
Summary of Main Points:
- You may still be experiencing functional hypogonadism related to your previous extreme calorie restriction.
- Gaining weight to a more sustainable level may help your hormone levels improve but doesn’t necessarily mean reaching an "overweight" category.
- Recovery from drastic calorie restriction can vary, but several factors play a role in how quickly improvement occurs.
Explanation:
Your symptoms, including low libido, fatigue, and emotional changes, can indeed be associated with low testosterone levels, which may stem from your extreme weight loss and low-calorie diet. Functional hypogonadism is a potential diagnosis alongside low hormone levels, especially since your body may still be adapting after such significant changes.
While the endocrinologist's advice to gain weight is based on general guidelines, it’s essential to consider your body's needs and how you feel during this process. Aiming for a healthy weight that supports your overall well-being—not just the BMI category—is important. Furthermore, your symptoms do warrant comprehensive evaluation to rule out other potential causes, such as pituitary issues.
Next Steps:
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Gradually Increase Your Caloric Intake: Continue focusing on a balanced diet with adequate calories (aiming for at least 2000 kcal might be reasonable) and ensure your diet includes necessary macronutrients (protein, healthy fats, carbohydrates) and vitamins. This is vital for hormone health and overall recovery.
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Track Your Symptoms: Keep a journal of your symptoms, dietary intake, and any lifestyle changes. This information can be valuable if you seek further evaluation with another specialist.
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Consider a Second Opinion: If your concerns continue to be dismissed, it might be worthwhile to seek another opinion from a different endocrinologist or a reproductive specialist who can conduct more thorough testing and evaluate your hormone levels. Mention specifically your desire to understand more about the pituitary function.
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Stay Informed About Your Health: Research functional hypogonadism and the impacts of significant weight loss on hormonal balance. Knowledge will empower you to advocate for your health.
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Reflect on Mental Health: Emotional numbness and mood fluctuations can also arise from hormonal imbalances and significant lifestyle changes. Consider reaching out to a mental health professional who can support you during this transition.
Remember that recovery can take time and it’s critical to prioritize your well-being. Please don’t hesitate to continue seeking support and insights from others who have experienced similar challenges. You deserve to have your concerns fully addressed.
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