I am a 24 year old male who was diagnosed with hypothyroidism in December 2020. I got out of a very toxic relationship in 2019 that has been used to cause stress and anxiety. 3 years ago, i noticed i had less firm erections and lasted shorter time in terms of sex (PE). I have had no issues with my sexual history for 4 years before that. I had my testosterone checked out 6 times and the average result was 550 ng/dL, the most recent blood test showed the most recent, highest T level of 669 ng/dl (November 2022). My TSH came back at 1.7 in the most recent blood test.

3 years later, i still have less firm erections, lower libido, and premature ejaculation. If i had to give my erection quality in terms of rigidity on a scale of 1-10 id say a 6-7. I am super stressed about this because my follow up isnt for another month and i still havent been getting morning erections as frequently like i used to when i was younger.

I also workout and do cardio 5x a week, drink tons of water, sleep 7-8 hours, supplement with vitamin D, fish oil, zinc,magnesium, Tongkat Ali. Someone please help me get some relief. I have also seen Pelvic floor physical therapists, urologists over 6 times, shockwave therapy, endocrinologists, and made significant lifestyle changes (lifting weights, cardio, no fap, no alc/drugs,etc.)

Some things i wrote down for my doctor:

• first noticed in march 2020
• 7-8x blood drawn to check hormone levels
• Diagnosed with hypothyroidism in nov 2021
• Total testosterone low of 360 in nov 2021 with high of 669 in Nov 2022
• Have not had blood drawn since
• Seen endocrinologist 3-4x, urologist 3-4x, Pelvic floor therapist > 12x
• Never fully went back to old sexual performance in last 3 years even with medication assistance (20 mg tadafil)
• Goal is to go back to performance pre 2020 without need for medication naturally and rule out physical causes

Symptoms history: - Main symptoms initially were weak erections (5/10), watery semen, premature ejaculation, urgent urinary frequency, significantly lower libido, very rare morning erection, lethargy and feeling of being tired all the time, increase in weight/fat, dry and brittle hair - Lifestyle changes made: consistently lift weights and do cardio (5x a week since October 21), eat under 2200 cals a day, consume more water, drink less (2-3x a month), gave up smoking vapes, sleep 6-8 hours daily, masturbation 3-4x a month maximum (no pornography), did pelvic floor PT and shockwave therapy - Symptoms improvement: body physique improvement, hair thinning/brittle, still tired, slightly higher libido(1-2x maximum in a day), erection quality now (7/10), premature ejaculation still struggle, still have urge to urinate a lot, infrequent morning erections

medications/supplements currently: - levothyroxine (50 mcg), Bupoprion XL (150 mg), tadafil (20mg as needed), l arginine and l cartinine, zinc, magnesium, d3, CBD (discontinued), Ashwagandha (disconctinued), melatonin (occasionally), and Omega 3 fish oils, Tongkat Ali, and DHEA (doc recommended)

Im pretty young so i doubt its anything heart failure related. Cholesterol came back a little bit on high side but blood pressure was great. No Diabetes either. I have mild breathing issues from asthma potentially causing sleep apnea so that can be a possible factor. I also have Low libido linked with the poor & infrequent morning erections so i believe its less likely to be solely from circulatory issues and mainly stemming from something hormonal as I have Hashimoto’s Disease.

I will be posting this in various different subreddits for maximum exposure. For those of you who have read this far and for those of you who are giving thoughtful insight, thank you so much, it means so much to me.