Lower Test levels and High LH and FSH

[PersuAsian]

Hey guys. I hope to get a little insight on my blood work that I will post below. I have been dealing with low libido for about two years now. It is basically non-existent. I had have had BW pulled multiple times over the past couple of years and they all seem to come up with a lower testosterone level. Not as low as many people that I have seen post up here. I don't really care at all about the numbers. I just want to feel good again. The newest test results seemed odd to me because of what I have read on this board. My LH and FSH were on the high end, but my test was still low. I have a follow up appointment with my endo next Friday, but I just want to prepare any questions that I should have for him. Thanks in advance for any guidance.

Bloodwork---6/6/2014----I have some other numbers, but LH,FSH,prolactin were not taken at this time.

Total Test---- 361 range of 280 - 800
Estradiol ---- 16.7 range of 12 - 42.6
Free Test---- 7.3 range of 4.7 - 24.4
SHBG---------32 range of 10 - 80
Cortisol AM---18 range of 6.9 - 19.4

The next set of blood work was from my first appointment with a new endo. He did a physical exam of my testicles too and said that one was larger than the other and might need to be checked out. Other than that he said from my original bw (from above) that I my test was low, but he couldn't tell why from that bw alone. So that being said here is what I got back from this pull.



Bloodwork---2/23/2015----

FSH-------5.1 range 1.6--8.0
LH--------6.0 range 1.5-9.3
Total Test----426 range 290-1200
free test-----83.6 range 45-220

Hopefully this is enough for some input.

[NACH3]

Your Pituitary is up and functioning great... However your TT/& FT does suck... I'm in the same boat(this means it could be testicular - primary Hypogonadism)...

But, have you checked your cortisol and Thyroid(hypothyroidism causes hypogonadism)

I would suggest a full male hormone panel... With:
CBC
CMP
LIPID Panel
THYROID w/TSH, T4 & T3 serum
Free/&Total test again(as its included)
PSA
E2
Add Ptolactin and cortisal as they aren't in that hormone panel... But if your going thru your Doc then ask about these tests...

Have you experienced any head trauma etc... As this can directly impact T levels as well! Just make sure you rule everything else out b4 looking into TRT... Just my .02...

Also if you do have some of this other BW it may be cheaper to do the whole hormone panel than picking each test!

GL OP!

[PersuAsian]

Thanks for the time and advice NACH! I was going to tell my endo to add some of those tests and even debated checking them on the lab order before I went in for the draw. I just am not pushy enough I guess. I will request that when I go back in the endo next week. Thanks again for the input, I appreciate it.

[FakeLove]

Well lowish test but not horrible so symptoms count. Normal-high LH indicates your HPTA axis is working, but testes won't for some reason produce enough. It's called a primary hypogonadism, while LH being low it's secondary. Any trauma history in your testicles? How old are you?

All in all a bit like my case. I went to see a urologist and she noticed my testicles were on the smallish side and the composition indicated atrophy. That's how it began with me. LH was maxed out and my testes produced in between 370 to 400. All other values were spot on. I had lots of low T symptoms.

I'd suggest you would read the finding a trt physician sticky. It should give you an idea what BW could still be done and what to consider. At least a full thyroid panel, prolactin etc. Also, make also sure your doc truly understands TRT. Reading the sticky will take you already further about what to ask from him. If you would end up on TRT it's important that all necessary baseline values are known, that the protocol is rational and that you will have a proper monitoring.

Good luck.

[PersuAsian]

Thanks FL. I'm 36 years old 6' tall and about 210. Lifted quite a bit except for the last 6 months or so. Just don't have the motivation right now. I did have a time when I was about 10 or 11 where one of my testicles did swell up to the size of a dang lemon. I think it was a UTI from what I can remember. Other than that I have had no issues or injury. Which reminds me about Nach's questions with head trauma. I have had no head injuries either.

I really don't want to do TRT for the rest of my life, but I can't see feeling like this forever either. I wish there were more Doc's that had the knowledge that this board does. If anyone knows a good one near St. Louis let me know.