Do these numbers warrant TRT? Low T but Dr says LH normal?

[mikzsan]

Hi

I have felt somewhat better when using gel in the past (appetite, erections etc) , but the last dr was just way too expensive.


I see a good, affordable Dr now, who is open to most ideas, but he thinks I don't actually need TRT for the sole reason that my LH is normal?

Just wondering if there is merit to this point?

Here are my recent results.

Age: 30


S LH: 3.8 IU/L (1.8-9.2)
S Oestradiol 54 pmol/L (<160)
S Testo 14.2 nmol/L (12-31.9)
S SHBG 33 nmol/L (17-56)
cfreetesto 308 pmol/L (260-740)
DHEAs 4.5 umol/L (4.3-15)


All other bloods (liver, thyroid, cell counts etc normal)

[hawk14dl]

If your dr won't do trt simply because lh is in range, he's not really open to most ideas is he?

If lh/ fsh are in range it means your body is signaling for production but your testes aren't producing. No amount of lh in the world is ever going to get your test levels back to normal

[mikzsan]

If your dr won't do trt simply because lh is in range, he's not really open to most ideas is he?

If lh/ fsh are in range it means your body is signaling for production but your testes aren't producing. No amount of lh in the world is ever going to get your test levels back to normal

True, I mean things he disagrees on he is still open to them if I present al ogical argument.

He said my LH would show abnormal readings (high I think) if my body was 'needing' more test, or something?

And also that he has levels lower than mine but feels 'fine' (he is muscular) - That last bit should be irrelevant though.

Its hard to find a Dr truly open to everything as you know.


Thanks for the quick response and affirmation!

[kelkel]

Your LH is at the lower end of the scale therefore your T is low. Who wants that at your age?
If you had a testicular issue your LH would be elevated while still having low T. Right now your problem appears secondary (pituitary) in nature.
Full BW to include a complete thyroid work up, cortisol and prolactin would be prudent. Need to find out if there's something suppressing your LH function and if so, correct it.

[mikzsan]

My cortisol is at the lower end of the spectrum (for the last 2 times) - years ago when this started it was at the top end.

The thing is, whether that's the result of the low LH/test, fixing that is another thing all together.

Ive been going through this since 2008. I get the impression (could be wrong) It's very hard to fix the 'cause' , unless its something obvious with clear generally accepted treatments (Eg prolactin inducing tumour).

DHEA worked at first, then downresponded - bloods showed most converted to E2
Pregnenolone is mild, and has some effect, nothing major.
Hydrocortisone helped a lot at first, then downresponded again and little effect.

Adreno-tone type supplements seem to help, but the effect is mild.

Would taking T + adrenal support supps be wise?

[kelkel]

How's your thyroid?
If you take DHEA and Preg they need to be micronized otherwise you are wasting money.
Of course taking testosterone would elevate your T. That said, if you rule out all possible causes then it could simple be idiopathic. Sometimes it just happens.
A thought would be to try clomid therapy and see how it goes. You can then come off at a later time if you so choose and see if your elevated LH levels down-regulate to the same low level or maintain a somewhat higher one.

[mikzsan]

Thanks! I did try the micronized dhea and preg from a compounding pharmacy. I also have depression and seems i lost my 'vitality' after a bout with accutane. That would be a good idea to try clomid first...the problem is the only guy who is willing to give it here is very expensive ... would it be counter productive at all to be on T gel first until I see that guy?

[kelkel]

Well the T gel would shut you down, so yes. Do what you can and find the problem if at all possible.

[mikzsan]

Thanks..

I've been on T gel from my old doc in the past, so wouldn't I be somewhat shut down now anyway ? At least to an extent...

That's why I was thinking to at least go on T in the mean time to feel better until I can see the Dr who can give clomid.

[kelkel]

Well when on any form of testosterone, as it's all the same just different delivery methods, your hpta will shut down. Once you stop, ultimately your own system will begin to restart, obviously with more difficulty due to the lack of stimulation via serms. It's all your call brother.