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Old 11-08-2007, 10:45 AM   #1
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low LH-Hypopituitaryism?

My most recent labs show a low LH (1.3 mIU/mL with normal range being 1.5-9.3) from *******. In August 2006, it was 3.2.

My first low t was in July 06 (total=153 with normal being 241-827). In Aug. 06, I retested and total went to 395 and free t tested at 14.2 (ref. range 8.7-25.1). Now, my november shows free of 8.8. They had to resubmit my total so I don't know that number yet. My FHS=2.7 (ref. range of 1.4-18.1), estradiol 291 (range of 95-530). I am age 40 so I consider these numbers too low.

My question is with low LH and low t (or even low normal t), would the diagnostic code be hypopituitaryism? This is important because my insurance company tells me that whether t replacement is covered depends on the correct treatment and diagnostic code being submitted by my physician. DOES ANYONE HAVE EXPERIENCE WITH THIS ISSUE? I know a couple of you have appealed (insurance denial). If you can help, I will appreciate.

Once my complete numbers are back, I will post them in summary form.

 
Old 11-08-2007, 11:04 AM   #2
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Re: low LH-Hypopituitaryism?

dont know much about insurance companies. I've never even called mine. The doctor submits the bill and they pay it. Now if I was tying to get

but, if your LH is low. I would make sure hte doctor tried to find out why. in other words I would request an MRI to make sure nothing is growing on the pit gland.

(pit gland is very sensitive damage can be caused by a blow to the head)

 
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Old 11-08-2007, 02:01 PM   #3
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Re: low LH-Hypopituitaryism?

I think you need to ask your insurance company under what condition it is not covered. With low LH many things could be the cause. High estrogen (and yours is slightly high consdiering T is so low), hypothalmus problems, pituitary problems, thyroid problems, pituitary adenoma, etc...

Most doctors are going to use "257.2 Hypogonadism, male". There are many forms of hypogonadism but basically it breaks down to primary (the testicles don't work) or secondary (the pituitary/hypothalmus don't work). This diagnosis code covers both I believe. Most insurance companies should cover this. Good luck. All of them do their best to not pay for anything. I hope you don't have United Healthscare. From the many ones I have had they are by far the worst. They will not pay for my HCG. Have not tried them on T replacement yet but am about to. I can't imagine any insurance refusing to cover hypogonadism, the long term health effects of not treating it are far more serious than sexual disorders.

 
Old 11-08-2007, 02:20 PM   #4
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Re: low LH-Hypopituitaryism?

thanks. mine would have to be secondary, I would think. I'm very concerned about why my LH is low. I have a good appetite, no sudden weight loss, etc. but I do have the symptoms of low t. My prolactin is only 3.2 and think this is usually high with tumors, etc.??? Also, I have puffy eyes and feels like I have sinus often. I don't know. I've got to stop worrying and get it all squared away.

hayfarmer, thanks especially for the very specific diagnostic coding. Mine is Humana which always seems to be in a state of denial.

Last edited by jkhh; 11-08-2007 at 02:23 PM. Reason: omission

 
Old 11-08-2007, 03:42 PM   #5
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Re: low LH-Hypopituitaryism?

You can have non-prolactin secreting adenomas. Still from all the boards I read it seems most men fall in to the category of no known cause. I had the same thing happen to me around the age of 40. I felt that was awfully young to have this happen but I read about many men having this problem in their 20's so that makes me feel lucky. In ecourage you to get your doctor to explore what the cause is even if it turns out it can not be found. Also, at 40 I would encourage you to consider HCG as a treatment or a combination of HCG and T replacement. A clomid test would also be a good idea to see what happens.

 
Old 11-08-2007, 03:50 PM   #6
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Re: low LH-Hypopituitaryism?

hayfarmer,

that's encouraging. do you recall your symptoms (at 40)? Also, I've heard you refer to a Clomid test. What does this mean?

 
Old 11-08-2007, 03:58 PM   #7
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Re: low LH-Hypopituitaryism?

Clomid will bind to the receptors on the hypothalmus that T is supposed to bind to. This prevents T (or estrogen which is similar to T and can also bind there) from binding and essentially tricks the hypothalmus into thinking your T is too low. The T and estrogen would energize the receptor but I think the clomid does not. It just binds and blocks anything else from binding. If your problem is at the hypothalmus this may show up with this test. The test is to take 25mg - 50 mg of clomid per day for a week or two. Then re-test LH and total T. If the problem is at the hypothalmus receptors LH should jump up. Often you can then take clomid as a treatment but many have bad side effects from it so can't take it. It may also reveal the problem is with high estrogen in which case you can take measures to reduce estrogen as a treatment.

If the clomid test shows nothing then it means the problem is probably with your pituitary or that your hypothalmus is just uable to send GnRH to the pituitary no matter what it is sensing. Hope this helps.

Did you ever take anabolic steroids? If so you may have caused your HPTA to shut down and often clomid is part of the protocol to restart it.

Last edited by hayfarmer; 11-08-2007 at 04:00 PM.

 
Old 11-09-2007, 07:47 AM   #8
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Re: low LH-Hypopituitaryism?

Quote:
Originally Posted by judgejkh View Post
thanks. mine would have to be secondary, I would think. I'm very concerned about why my LH is low. I have a good appetite, no sudden weight loss, etc. but I do have the symptoms of low t. My prolactin is only 3.2 and think this is usually high with tumors, etc.??? Also, I have puffy eyes and feels like I have sinus often. I don't know. I've got to stop worrying and get it all squared away.

hayfarmer, thanks especially for the very specific diagnostic coding. Mine is Humana which always seems to be in a state of denial.
I had a increasingly frequent sinus headache for 2 years. It was a pit tumor. Get the MRI.

 
Old 11-09-2007, 07:52 AM   #9
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Re: low LH-Hypopituitaryism?

Quote:
Originally Posted by hayfarmer View Post
I
Most insurance companies should cover this. Good luck. All of them do their best to not pay for anything. I hope you don't have United Healthscare. From the many ones I have had they are by far the worst. They will not pay for my HCG. Have not tried them on T replacement yet but am about to. I can't imagine any insurance refusing to cover hypogonadism, the long term health effects of not treating it are far more serious than sexual disorders.
I have United and they pay for my testim and they didn't even argue over HGH. but, I think mine has a clause about no approval needed on drugs.

 
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