Brief Answer:
Aging processes as most plausible cause;however,consider following too...

Detailed Answer:
Hi,

I have gone through your medical history carefully and understood your concern.

There are various causes to low testosterone as borderline as in your case.
Hormonal changes at your age should be taken into account first.
Next, I was going through the lab reports you provided and everything seemed perfectly normal except for:
- high total cholesterol/LDL and non-HDL cholesterol. This makes me think you might be overweight, which can negatively affect testosterone levels.

I have noted that you already measured estradiol which was within normal range. However, I did not see any other hormone measured like TSH, FT3, or FT4, LH, Prolactin, Ferritin

Please take note that use of steroids? and iron? supplements? alcohol use? can also alter testosterone levels. What have you been using so far?

Please follow up with endocrinologist to run the advised hormonal panel to see if any change.

Do you recall any trauma/injury in your genital area? Any chronic disease you might be suffering or taking meds on daily basis?

However, to my opinion, overweight and normal aging process at your age are the most plausible factors to cause low testosterone.

Hope this helps.
Dr.Albana

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Brief Answer:
Low testosterone a side effect of Roaccutane used for acne...

Detailed Answer:
Hi back,

I am so sorry for the late reply.

Thank you very much for your additional data you sent in.

Roaccutane is the brand name for isotretionin which is a form of vitamin A used to treat severe acne.

Unfortunately, there are cases where the use of roaccutane is associated with low total testosterone as in your case.
To me, this might explain why you are having low levels of testosterone, while other hormones are fine.

That's temporary and will get back to normal range unless you keep taking roaccutane. If so, report this as side effect of roaccutane to the doctor who prescribed to you to stop taking it.

Hope this answered your primary query.
All the best.
Dr.Albana

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Brief Answer:
Still thinking of aging processes as following...

Detailed Answer:
Hi back,

Ok, it was 8 years back. But for how long?
When was the last time you took it?

If you are 23 now, 8 years back (around 15), too young to undergo to this treatment so you might suffer the side effects.
However, I'm still thinking of aging processes too so, regular check ups of total/free and bioavailable testosterone is recommended as further follow up steps.

All the best.
Dr.Albana

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