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Old 12-28-2010, 10:04 AM   #1
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Low Testosterone level, LH and FSH: Help

Hi,

After i discussed with my primary doctor that i started having low libido (I'm 39 y old) he did a testosterone test and it come back low. He sent me to an endo that i saw and did some tests. Here are the results and their normal ranges:

total testosterone: 265 ng/dl (280-800)
free testosterone: 9.2 pg/ml (8.7-25.1)
FSH: 3.9 mIU/ml (1.5-12.4)
LH: 2.9 mIU/ml (1.7-8.6)
Prolactine: 6.7 ng/ml (4.0-15.2)
GH: 4.0 ng/ml (0.0-6.0)
FT4: 1.19 ng/dl (0.65-1.4)
Cort: 13.70 ug/dl (5.0-25)
TSH: 2.31 uiu/ml (0.4-4)

I did a pituitary MRI and waiting for the results to come back.

My testosterone is low but I don't know what to make of other numbers ?

Does those numbers like LH and FSH look low ?

Do i need to do more tests to try to find the underlying cause of low testosterone ? Any advise is really appreciated !

Thanks

 
Old 12-28-2010, 02:41 PM   #2
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Re: Low Testosterone level, LH and FSH: Help

there are a lot of experts on this board that can give exact numbers....but I can say mine are/were similar and biggest issue was libido/ED LH and FSH are what trigger body to make T....they are low though mine were even/are lower....as such unless you can find an issue causing the low simulation you may be looking at TRT to help raise your levels and get your libido back....that's where I am heading now.

I would however suggest getting a more comprehensive panel done...ideally with a 24hr urine test....they are more accurate and typically get you more specific info. I am awaiting results of mine right now.

Good luck as low T sucks....

 
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Old 12-28-2010, 02:53 PM   #3
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Re: Low Testosterone level, LH and FSH: Help

Thank you 'boscot' for your response !

The endo want me to try Androgel and from reading this board its seems like a too quick response from an endo as I want first to understand the underlying cause and do any additional tests to try to find why T is low instead of just replacing T. Plus I don't want to be infertile by using Androgel. This is a major concern to me. The endo I saw is a physician assistant (PA) and he recommended Androgel saying he is using it himself !!!

I wanted an expert advice from an Endo. Should i ask for more tests. Or change the PA endo ? I'm in lost right now as this is a serious issue and throwing Androgel on it seems too quick for a solution. The PA endo said that my LH and FSH are fine. They seemed to me on the low range but I'm not sure.

Any advices ! Thank you very much every one who can suggest or provide some help.

 
Old 12-28-2010, 06:28 PM   #4
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Re: Low Testosterone level, LH and FSH: Help

More investigation isn't necessary. Low T combined with low normal LH and FSH and with the symptoms you describe point to a pituitary origin for the low T. Normally if T is low, then LH and FSH will be high attempting to compensate - which would indicate a testicle problem, but this isn't your case.

I would first try clomid to see if you can stimulate the LH production and restore normal T levels. If clomid doesn't work, then you need to keep an eye on your pituitary for further hormone loss, which may come over the next few years (GH would normally be next after LH and FSH loss, followed by thyroid and coritsol). Meanwhile, its time to start testosterone replacement because low T has a lot of bad long term side effects, either with androgel or shots.

Personally I find androgel annoying to put on every day. The shots are not as easy but once weekly is a lot easier to live with over time.

You can also add some HCG in order to prevent testicle shrinkage which will follow from T replacement.

Last edited by orion; 12-28-2010 at 06:32 PM.

 
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Old 12-28-2010, 06:30 PM   #5
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Re: Low Testosterone level, LH and FSH: Help

Quote:
Originally Posted by nnnfff View Post
Thank you 'boscot' for your response !

The endo want me to try Androgel and from reading this board its seems like a too quick response from an endo as I want first to understand the underlying cause and do any additional tests to try to find why T is low instead of just replacing T. Plus I don't want to be infertile by using Androgel. This is a major concern to me. The endo I saw is a physician assistant (PA) and he recommended Androgel saying he is using it himself !!!

I wanted an expert advice from an Endo. Should i ask for more tests. Or change the PA endo ? I'm in lost right now as this is a serious issue and throwing Androgel on it seems too quick for a solution. The PA endo said that my LH and FSH are fine. They seemed to me on the low range but I'm not sure.

Any advices ! Thank you very much every one who can suggest or provide some help.
NNfff

first don't let them just stick you on gel....it will mess up any further testing for underlying cause and yes it will cause testicular artophy....

First find a really good Doc there aren't that many....any who would just stick you on TRT without any other thoughts first is doing you no favors.

TRT and HCG would be correct protocol to keep boys healthy and still add to your system. That said I wouldn't do either until you had more exhaustive testing to determine underlying cause (if possible) then and only then look at other options....
Clomid restart, HCG alone, etc.

Most Doc's even a lot of endo's are not schooled enough in this area....I started with one....got no results (had to drive 300 miles to get to him too)....so after a year found a really great one.....but had to fly 1000 miles to see him.....like his approach we will see his prognosis once new labs come back.

Best of luck....its not easy....but finding right Doc is the answer.

Lou

 
Old 12-29-2010, 03:54 AM   #6
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Re: Low Testosterone level, LH and FSH: Help

Thanks Orion,

I'm puzzled no extra tests are needed !? and just ask for Clomid or TRT. Is't positive that the underlying cause is the pituitary. I'm still waiting on results of the MRI.
I really want to find out more as the end just recommend trying the gel and come back in 2 months. I don't want to go that route as in 2 months my T will probably be high but its artificial as the gel may just hide the real problem (that I still need to figure out). I want to treat the origin of the problem.

A detail I forgot to mention: my libido started to go down I think about same time when I started taking a static for my high cholestrol and i stopped taking 2 months ago. I felt a sudden libido surge just after it then it went down. my primary did a test 1 month after stopping the static --> Total T: 180. After 2 months my current endo did a test --> Total T: 265.

I just start taking another statin: lower dose 10 mg. (on recommendation of my primary). my second T tests was before i start taking the new statin (i was 2 months statin free).

Could the statin drove my T to be low since I can time the libido decline to the period when I was on statin (for 2 years) ? or just coincidence ?

A question about Clomid. From the web I found out that "This medication is not approved by the FDA for use by men".

Last edited by nnnfff; 12-29-2010 at 03:59 AM.

 
Old 12-29-2010, 03:55 AM   #7
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Re: Low Testosterone level, LH and FSH: Help

Thanks Lou,

I appreciate your encouragements. I'm in same line of thinking. I need to find out the root cause if its possible. How to find a good Endo ? I'm in up state NY. I'll not mind driving or flying if I can find a good Endo.

Thanks

 
Old 12-29-2010, 07:38 AM   #8
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Re: Low Testosterone level, LH and FSH: Help

no sure about the statin....

I took clomid for almost a year with my first Endo....trying to get my T production going. It did help but as soon as I tapered off the dosage my T levels fell. My level isn't as low as your but remember its the percentage it dropped not just the number. My LH and FSH were much lower and did rise some with the clomid but never enough to sufficiently sustain me.

Clomid HCG etc are not specifically approved for our needs but a competent doc can prescribe them with good results.

I am now a month off of any level of clomid etc. My labs should be back next week....then I will see where I am heading. I would suggest waiting on MRI and getting a comprehensive 24 hr urine panel before starting any treatment plan.

Good luck

 
Old 12-29-2010, 09:50 AM   #9
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Re: Low Testosterone level, LH and FSH: Help

Hi,

Thanks for your response. My MRI came back today and the pituitary is normal. So its does not appear to be the pituitary but the LH and FSH still look a bit low ! No sure what to make of this.

Regarding the 24 h urine panel, is't different from blood as I was thinking, from reading on this forum, to ask for the following tests to try to isolate the underlying cause(s) of low T:

estradiol
total estrogen
progesterone
T3
T4
SHBG
DHEA sulfate
vit D 25 OH

Anemia Panel:
iron
ferritin
TIBC
saturation %

Does the 24 h urine panel looks for some thing else ?

'Boscot': I wish you good luck too with your upcoming results and the way ahead.

 
Old 12-29-2010, 08:07 PM   #10
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Re: Low Testosterone level, LH and FSH: Help

I have had several blood panels done at 3 different hospital labs....in each case they had some variation in both tests run and results....in the main two I had done...home hospital lab and boston lab....back to back...the results were off by almost 100 pts in total T other areas varied some also.

New Doc didn't trust blood results we were getting and suggested a urine test....said he a had better results as it measures your levels over a 24hr avg period...not just one time during day. I can get you the list of results given but it is quite lengthy and I don't remember as I write this but I would say about 20 in total.

I will post results and doc's opinion when I get it....in about 10 days.

Lou

 
Old 12-30-2010, 08:15 AM   #11
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Re: Low Testosterone level, LH and FSH: Help

Thanks Lou ! Looking forward to your posted results.

Any other advices from other readers: orion, hayfarmer, anyman and others.

Orion: my MRI of the pituitary came back with normal results.

Beside the tests I listed that I would like to do, any thing else ?

I'm currently looking for a good endo, so he can help me isolate the root issue if its possible.

I'm not planning to ignore low T for any reason. I want expert advice before undertaking any protocol. I want for sure not to loose fertility.

Any good end in upstate NY or should I seek the 2 experts doctors that are most listed here: Dr John in Michigan or Dr Shippen ? No other endo experts beside these 2 !!!??

Thanks

 
Old 12-30-2010, 02:48 PM   #12
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Re: Low Testosterone level, LH and FSH: Help

I ending up heading to Dr. John....tired of expirementing with others...wanted a sure thing.

Lou

 
Old 01-01-2011, 07:17 PM   #13
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Smile Re: Low Testosterone level, LH and FSH: Help

I have a similar situation. I have low normal total t 279 in a range of 250-800 ng/dl. My free t is 7.5 in a range of 7.2-18. My psa is .69 in a range of 0-4. My concern is that my day is low normal of 3 in a range of 1-15 miu/ul and my lh is high normal 8.9 in a range of 1-9 miu/ul. Is my issue with my testes or pituatary glands? Am I primary or secondary hypogonadism. Thxs

 
Old 01-02-2011, 10:42 PM   #14
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Re: Low Testosterone level, LH and FSH: Help

Quote:
Originally Posted by chesty View Post
I have a similar situation. I have low normal total t 279 in a range of 250-800 ng/dl. My free t is 7.5 in a range of 7.2-18. My psa is .69 in a range of 0-4. My concern is that my day is low normal of 3 in a range of 1-15 miu/ul and my lh is high normal 8.9 in a range of 1-9 miu/ul. Is my issue with my testes or pituatary glands? Am I primary or secondary hypogonadism. Thxs
Low T, high LH = testicle problem with making T. You can not fix that problem. Your only choice is to supply extra T via gel, or shots.

 
Old 02-20-2011, 03:49 PM   #15
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Re: Low Testosterone level, LH and FSH: Help

Hey-
I'm in Albany and am also looking for a good HRT Dr. I have a lead on one but in PA near Philly. Have you found anyone in NY?

Last edited by Mod-S4; 02-21-2011 at 05:28 PM.

 
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