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:
-
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.
-
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.
-
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.
-
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.
-
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.
Related Questions
Managing Abdominal Pain in a 52-Year-Old MS Patient
My mother, aged 52, received a diagnosis of Multiple Sclerosis (MS) back in 2008. Since 2018, she has not undergone any treatments for the condition. Within the confines of our home, she can manage short walks with the aid of walls and furniture; however, she relies on a wheelchair for mobility outdoors. Much of her day is spent either resting in bed or watching television. Her current medications include baclofen, vitamin D, and previously bromazepam. In the past year, she has started experiencing persistent discomfort in her lower left abdomen. Typically, this manifests as a steady dull pain, although there are instances of sharp, fleeting sensations. We have sought medical advice from a range of specialists, including a gynecologist, a gastroenterologist, an emergency room physician, a neurologist, and an internal medicine doctor. She has undergone an extensive series of tests, including a comprehensive blood panel, urinalyses, ultrasounds, X-rays, and MRIs of both her abdomen and brain. An attempt to perform a colonoscopy was made but was unsuccessful due to concerns regarding the safety of anesthesia in light of her MS, which left her unable to tolerate the procedure without it. All test results thus far have yielded normal findings. Despite trying various laxatives, she has not found relief. The gastroenterologist suggested pancreatin, while the neurologist substituted bromazepam with diazepam and introduced pregabalin into her regimen. Unfortunately, the abdominal pain remains, though she notes it feels slightly less severe than at the onset of her symptoms; still, it continues to disrupt her daily life since we began seeking medical assistance in November 2024. The neurologist indicated that the pain might be associated with her MS, suggesting that pain management could be the primary approach moving forward. I would love to hear any suggestions for further actions we might consider or additional specialists we could consult. We are open to any further tests or screenings that might clarify her diagnosis. As a 25-year-old in my final year of pharmacy school, any insights would be incredibly helpful.
Understanding Low Testosterone: Should I Consider TRT?
Over the course of a year, I underwent two fasting blood tests for testosterone levels, both conducted in the early morning. The results from these tests showed my testosterone to be in the low 200s, which is considered below normal for a man in his early thirties. Interestingly, my LH (Luteinizing Hormone) levels were significantly elevated, sitting at 11.9, while my FSH (Follicle Stimulating Hormone) and Prolactin levels were also on the higher end of the normal scale, measuring 10.8 and 17.8 respectively. During a consultation with a urologist regarding an unrelated issue, I was informed that my testicular size falls below the average range. This has led me to suspect that I may be experiencing primary hypogonadism. The idea of beginning testosterone replacement therapy (TRT) feels daunting to me. The thought of having to self-administer hormone injections for the rest of my life is discouraging. Moreover, I was taken aback by how promptly my primary care physician suggested TRT. Could there be other avenues to explore for ascertaining the underlying issues? Is it truly apparent that diminished testicle size directly correlates to inadequate testosterone production? Are there no significant lifestyle modifications I might consider at this juncture? I maintain a consistent workout regime, exercising four times a week with a focus on both cardio and weightlifting, and I have generally sustained a healthy weight throughout my life. However, I often face challenges in muscle development and frequently hit a plateau early on, compounded by persistent abdominal fat. My diet is decent, although I recognize that I indulge in drinking and socializing a bit more than is wise. I have experienced episodes of erectile dysfunction in the past, which I've attributed to anxiety in certain situations. Once I grow accustomed to a partner over time, I typically have no issues. Additionally, I still experience morning erections every few days, albeit with some instances of absence lasting longer periods. In general, I consider myself to be in good health. I am quite energetic and do not contend with persistent fatigue, cognitive muddiness, or depressive feelings. If I choose to forego TRT, what potential risks might I encounter? Can I focus solely on addressing specific symptoms, such as the occasional erectile dysfunction? Are there effective strategies to manage that? Thank you for your insights.
Seeking Clarity: Is This Ringworm?
I desperately need some feedback: could this be ringworm? I really hope not, as I am not equipped to handle this situation once more. A week ago, while spending time with a friend, we encountered an outdoor cat. We decided to pet it, but I noticed the cat had some patches of missing fur and dry skin, prompting me to stop. Upon returning home, I took precautions by washing my hands and changing clothes. However, I’ve recently discovered these marks on my own skin, and it’s sending me into a spiral of anxiety. I honestly cannot manage another episode like this. Previously, I suffered through extensive treatment as it took months for the condition to resolve, not only for me but also for my three cats. Their recovery was equally prolonged and exhausting, both mentally and physically. Given my existing health challenges, I am feeling overwhelmed and at my wits' end. The prospect of dealing with this again is frightening, and I am genuinely distressed. It’s simply not feasible for me to apply cream on my cats multiple times throughout the day, maintain a rigorous cleaning schedule, or shower daily—all of which have become significant struggles due to my ongoing health issues. I desperately wish to avoid constantly applying creams or sprays on myself as well. The thought of reliving this ordeal is immensely daunting, and I am wrestling with troubling thoughts at this moment. I am a 20-year-old female, 165 cm in height, weighing 65 kg. I take medication for hay fever, don't smoke, and am navigating various health concerns, including ongoing efforts to receive a diagnosis for abdominal issues.
Odd Growths in Children’s Hair at Mountain Home
Hello everyone, I wanted to share an unusual observation concerning the daughters of my partner, aged 7 and 9. Whenever they visit their family's mountain residence, they develop a peculiar bump in their hair after spending just one day there. This growth starts to appear, continues to enlarge, and eventually disappears on its own when they return home. Interestingly, we have ruled out changes in laundry detergent, bedding, and hair products, as their stays are brief and they don't wash their hair during these visits. Despite consulting with pharmacists, no one seems to have a clear explanation for this phenomenon. They have been experiencing this for some time now, with the younger sibling beginning to show symptoms last year. This occurrence aligns with their annual family gathering, yet none of the adults or older relatives report similar issues. While the bumps are itchy, they do not seem to cause any pain. The children often play beneath a linden tree, but beyond that, we are at a loss regarding the cause. Any thoughts or insights would be greatly appreciated! Thank you!
Concerns Regarding Sexual Health
As a 15-year-old male, I am facing an issue with my sexual health that I have been unable to resolve. I consider myself to be in good health—standing at 5'7" and weighing 130 pounds—and I do not partake in any drugs or medications. However, whenever I become involved in sexual activities, I experience a significant decrease in my libido and find it difficult to maintain an erection after pre-ejaculation. It feels as though I've had an orgasm, yet without any pleasurable sensations accompanying it. This predicament has persisted since my early years, leaving me perplexed about its origins and uncertain about how to address it.