Low LH/FSH and low/normal Test

[senorman]

New to the board and thought I’d seek your advice/expertise. I hope I’m not offending anybody here by asking for advice without having contributed anything to this forum. Thanks for your help in advance!

Stats:
Age: 37
Height 6’2”
Weight 175
Body Fat – 12.3% (measured via BIA)
Never used AAS
Athletic background: Regular exercise for 25 years. Started as a distance runner, moved into adrenalin sports…snowboarding, climbing, surfing, kiteboarding. Started lifting about 5 years ago, put on 15lbs of lean mass. Goals are to continue such sports and to continue performing at a high level (by my standards anyways!)
Bench 1RM – 230
Shoulder Press 1RM -130
Squat 1RM – 235
Deadlift 1RM – 300

Thought it was time to get some blood work done as well as hormone levels tested. Recovery time from lifting/exercise has increased over the past few years.

Total Test 593 ng/dl (250-1100)
Free Test 116.7 pg/ml (35-155)
Estradiol, Serum 18 pg/ml
FSH 2.9 mIU/ML (1.6-8.0)
LH 1.8 mIU (1.5-9.3)
SHBG 41 nmol/L (10-50)
IGF-1 212 ng/ml (53-331)
CBC and Metabolic Panel results were all well within range. I can post any specifics if necessary/requested.

Observation/Question: My Test levels are low/normal. However, LH/FSH seen quite low, which leads me to believe that I’m having problems with my Hypothalamic-Pituitary-Testicular Axis system.
How do you guys think I should proceed in getting my Test up to the optimal range? Perhaps an MRI/CT to make sure my pituitary is OK? Other thoughts?

Thanks again!

[kelkel]

Hi senorman.

Yes, your LH is on the low side at the moment. That said, your numbers are not bad at all for your age. You're getting older and it's normal for recovery periods to be longer, etc. You're human. Restructure your workouts, get more rest, nail down your nutrition. It will all help. I'd definitely keep an eye on things but I don't know that an MRI is needed to check for a pituitary abnormality just yet. I'd see how things look in 6 months on more BW first.

Speaking of BW, be sure to get a full thyroid panel, cortisol and prolactin as well. All those items can suppress endogenous testosterone production. It's also good to know your Vit D level. D is a hormone and optimum levels will help to decrease SHBG levels a bit which can improve free Test levels. Free is what's important, total test means nothing.

[carbo]

To me, it looks like a case of hypochondria. And that's good news.

[senorman]

Kelkel,

Thanks for your input. I'll get a complete thyroid/vitamin D in the next few months. Good to establish a baseline I suppose. Perhaps I can boost my Test a bit!

[Docd187123]

Hi senorman.

Yes, your LH is on the low side at the moment. That said, your numbers are not bad at all for your age. You're getting older and it's normal for recovery periods to be longer, etc. You're human. Restructure your workouts, get more rest, nail down your nutrition. It will all help. I'd definitely keep an eye on things but I don't know that an MRI is needed to check for a pituitary abnormality just yet. I'd see how things look in 6 months on more BW first.

Speaking of BW, be sure to get a full thyroid panel, cortisol and prolactin as well. All those items can suppress endogenous testosterone production. It's also good to know your Vit D level. D is a hormone and optimum levels will help to decrease SHBG levels a bit which can improve free Test levels. Free is what's important, total test means nothing.

Not much more to add..... Nicely done Kel

[Bonaparte]

You're fine. Your gonadotropins are only low because your testes respond well to them. If they were high and your T were lower, then you'd have problems.

[Lee_1978]

Hi senorman.

Yes, your LH is on the low side at the moment. That said, your numbers are not bad at all for your age. You're getting older and it's normal for recovery periods to be longer, etc. You're human. Restructure your workouts, get more rest, nail down your nutrition. It will all help. I'd definitely keep an eye on things but I don't know that an MRI is needed to check for a pituitary abnormality just yet. I'd see how things look in 6 months on more BW first.

Speaking of BW, be sure to get a full thyroid panel, cortisol and prolactin as well. All those items can suppress endogenous testosterone production. It's also good to know your Vit D level. D is a hormone and optimum levels will help to decrease SHBG levels a bit which can improve free Test levels. Free is what's important, total test means nothing.

Is total T really unimportant?

My GP reckons if all other hormones are within range and at a healthy level then this is usually indicative of good free T?

Similarly, l had an appointment with an Endo and he's wanting to carry out thyroid/cortisol tests but sees no need to check my free test as it's in the higher end of the range (26.9 ng/dl). Crazy, right?

But the OP has good total T levels.

[kelkel]

Pretty much yes. Weak indicator. I say that as total t really doesn't do anything for you. Free T is what works. You can have a ton of TT but if it's all bound by SHBG then it's useless. That said, there's no reason not to know your free T level. Testing thyroid/cortisol/prolactin is a great idea as all impact your test level. Remember, most doc's simply don't know hormones. They aren't trained in them in med school other than very briefly.

[senorman]

Update:

Doc ordered more blood-work with a few more tests.

Results:
Total Test 428 ng/dl (250-1100)
Free Test 57.1 pg/ml (35-155)
FSH 3.1 mIU/ML (1.6-8.0)
LH 2.2 mIU (1.5-9.3)
Prolactin 6.3 ng/ml (2-18)

Vitamin B12 979 pg/ml (200-1100)
Vitamin D, 25-OH, Total 56 ng/ml (30-100)

TSH 1.01 mIU/L (.40-4.5)
T4 Total 5.9 mcg/dl (4.5-12.0)
T4 Free 1.5 ng/dl (.8-1.8)
T3 Total 75 ng/dl (76-181)
T3 Free 3.6 pg/ml (2.3-4.2)
Iron, Total 195 (40-175)
Iron Binding Capacity 291 mcg/dl (250-450)
Ferritin 167 ng/ml (20-354)
Iron Saturation 67% (15-50%)

Observations: Total test dropped a fair amount, and free test plummeted. Iron levels are too high as well. All else looks good.

Doc has me scheduled for an MRI for the pituitary and hemochromatosis screening due to high iron.

Opinions??? Predictions for the MRI???

Thanks again guys!