<s>[INST] Hello, Dr Shehzad Topiwala! My name is Daniel, and I am seeking your professional advice and expertice. I am 21 years old, male, good health, fit, no smoking or excessive alcohol. I am experiencing low testosterone symptoms such as: no sex drive, ED, depressed mood, etc. My sex life is almost non-existent. I am 21 years old, and should not be dealing with problems like these. The blood work done with my doctor, all came back within the normal range, and my doctor tells me everything is like it should be, yet I don’t feel like it is. I have gotten a copy of my results and did some research online. Aberrantly my T-levels at 14,5 nmol/L (around 350-400 converted to ng/dl), are in the same range as an average 80 year old… My testosterone levels are not god for a guy my age, and far from optimal. So I went back to my doctor, but now she tells me my symptoms are caused by depression. I admit feeling depressed, but that is a result of my problems, depression is not causing them. And then she continued to prescribe me some Viagra… I am confident in saying that the symptoms I am experiencing are hormone/testosterone related, not psychological. My testosterone levels are low, but not low enough to get treatment, and thereby no chance to get sent of to an expert on the subject. So I am glad I found your internet service. What am I supposed to do? I cannot live like this, life feels so empty at the moment, and I don’t feel youthful at all… Some of my friends tells me that they can masturbate/have sex 3-4 times a day. Me, I need a two-day recharge time after just one “session”. Below are my results, please take a look at them, what do you think? Free T4      18.9 pmol/L 11.0 - 22.0 FSH 3.9 IE/L 1.0 – 12.0 Cortisol 577 nmol/L LH      9.7 IE/L      1.0 – 10.0 Prolactin 156 mIE/L      100 – 400 SHBG      18 nmol/L      15 – 85 Testosterone 14.5 nmol/L 9.0 – 35.0 TSH      0.66 mIE/L      0.30 – 4.2 Estradiol 0.09 nmol/L 00 – 0.16 Free Testosterone 7.1      3.0 – 14.7 I was hoping your profession on this subject could cast some light on my situation. Do you see anything out of the ordinary when looking at my blood test results? I am noticing elevated LH levels, along with the low testosterone, does this mean there could be something wrong with my testicles/leydig cells ? One guy told me that my pituary maby needed a kickstart. And that my T-levels would increase with the use of a drug like arimidex or clomid. To my understanding, these drugs work by increasing the LH levels, thus increasing testosterone. If my leydig cells where not responding well, trying this would be pointless? If possible, I would ask for a detailed response. Thank you in advance. Best regards Daniel [/INST] Hi, Low testosterone can be treated by hormone replacement therapy and assisted reproduction. Also, hormone affects body processes by regulating the activity of the organs. Estrogen modulator mimics the effect of oestrogen on various tissues, including the breast, bones and reproductive organs. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Monish De, Oncologist </s>