Therapy? Or something else?

[drarcher]

I have been looking everywhere for info and it seems hard to find the right combination for my particular case. I recently had tests done and the results were as follows:

Luteinizing Hormone 2.9 (1.5-9.3) mIU/mL
Prolactin 14.8 (2.1-17.7) ng/mL
Testosterone, Total 178 (332-896) ng/dL
Testosterone, Free 7.1 (5.0-40.0) pg/mL

I am 35 years old with a clean history (no drgs/alcohol/smoking etc.). Before the recent results the Dr. hinted that replacement therapy was a choice I would have to think about (I had been tested and found to have low T by my primary before going to the specialist). I know the therapy is a lifetime thing and with my results as they are is it something I should consider? I am sure the specialist will give me more direction but with only two urologist in the area I am 4 weeks out from seeing him again and hate having lab info with no explaination for that long.

Do my labs warrent therapy? Is there somethign else I should be asking the doctor for, like another test of some sort? Most things I have read talk about low T and high LH, i haven't found much that talk about my combo.

Thanks for any help you can provide.

[drarcher]

I should have added my reason for even going was a general loss of energy and inability to lose substantial weight despite regular exercise and helthy diet. Also reduced libido.

[jamotech]

Looks like your a candidate, I'm sure someone who knows the number better than I will chime in, however they are gonna tell you to get Estrogen checked... that could be an issue also.

[zaggahamma]

like jamo said

yes bloodwork AND symptoms warrant

dont know what u mean by high LH though

as jamo also stated more bloods are good

e2(estrogen(estradiol)
psa
dhea
thyroid values
prolactin

just to name a few

[drarcher]

like jamo said

yes bloodwork AND symptoms warrant

dont know what u mean by high LH though

as jamo also stated more bloods are good

e2(estrogen(estradiol)
psa
dhea
thyroid values
prolactin

just to name a few

Some of the info I have read other places and here (I believe it was something from Tulane) talked about what the combo of low T and High LH mean. I don't have that combo and have been unable to locate research that talks about what the combo I have, low T and realitively low LH. I was wondering if anyone know what that combo tells me?

[GotNoBlueMilk]

Some of the info I have read other places and here (I believe it was something from Tulane) talked about what the combo of low T and High LH mean. I don't have that combo and have been unable to locate research that talks about what the combo I have, low T and realitively low LH. I was wondering if anyone know what that combo tells me?

If LH is low then you are going to have low T. This is because LH tells the leydig cells to produce T. There are a couple ways to boost LH; however, even with high LH values there is no gaurntee you will produce enough T.

You have very limited bloodwork posted here, as pointed out above. Your prolactin is on the upper end. That will add to your bad overall feeling and libido issues.

[Vettester]

LH (Luteinizing Hormone), along with FSH is produced in the pituitary gland, and works in feedback loop process with the testes to produce testosterone and sperm. When everything functions properly, LH levels will increase when the testosterone level decreases, and it will decrease when the testosterone level increases. Essentially, it is a regulator that is conducting when and how much testosterone gets made.

When the body ceases to produce normal amounts of testosterone, it is known medically as hypogonadism. There are two (2) variations of this diagnosis: Primary and Secondary.

You asked about the combination of LH and Testosterone. When your LH is high, but you have low testosterone, it's usually diagnosed as 'Primary Hypogonadism'. What this usually means is that there is failure with the testicles to produce testosterone. This could be a result of leydig cell damage, tumors, or other conditions. Again, LH is the regulator in the matter, so the brain is increasing this hormone because it is not getting any response back with an increase of testosterone.

In the scenario of low LH and low testosterone, that would usually result a diagnosis of 'Secondary Hypogonadism'. In this case, the testicles are usually quite capable of producing endogenous testosterone, but the problem sits in the pituitary, and it is not producing the LH. Unfortunately, the testicles tend to work only when they're signaled to do so. When the LH starts decreasing, the testes are basically being told that it's time to take a break. IMO, it's always good to run an MRI if it is determined that you have Low LH/FSH. It's rare, but sometimes a tumor or cyst can cause these deviations. Once ruled out, various medications and treatments can be discussed with the doctor.

Hope this helps. Also, keep in mind, HCG mimics LH. This is why guys include it in their therapy when they are confirmed with secondary hypo. If the testicles are still functional, then it's a good idea to include HCG, which will help keep the testicles working, and from shrinking.

[Vettester]

As GNBM mentioned, your prolactin is up there. I somehow get this strange feeling that your E2 is also going to be on the high side. At this stage, I totally agree that a lot more information is needed on labs, and it would be helpful to know the rest of your stats (height, weight, BF% if you know).

[drarcher]

My height is 5'7" and I weigh about 225-230. I don't know what my BF% is but I carry belly fat and muscle (10 years ago I was in pretty good shape at 175lbs).

What tests should I request from the Dr?

[kelkel]

Below labs are right from Crislers protocols: See www.allthingsmale.com and read up.


• Total Testosterone
• Bioavailable Testosterone (AKA “Free and Loosely Bound”)
• Free Testosterone (if Bioavailable T is unavailable)
• SHBG
• DHT (perhaps)
• Estradiol (specify “sensitive” assay for males)
• LH
• FSH
• Prolactin
• Cortisol
• Thyroid Panel
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA (age dependent)
• IGF-1, IGFBP-3 (if HGH therapy is being considered)


FOLLOW-UP LABS

Four weeks after initiating or changing dose for transdermal, six weeks for IM injection TRT. The time delay provides for stabilization via HPTA suppression and pharmacokinetics of medication:

• Total Testosterone
• Bioavailable Testosterone
• Free Testosterone (if Bioavailable T is still unavailable)
• Estradiol (specify “sensitive” assay for males)
• LH
• FSH
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA (for those over 40 with Family Hx of prostate CA, >45 yo. all others)
• IGF-1, IGFBP-3 (if GH Therapy has been initiated already)

Agree with Vettemann. An MRI may be a great first step to hopefully rule out a benign pituitary tumor. Many people (myself included) have these tumors and can be unaware of it due to poor/lack of medical care. Although very small, they can cause a variety of effects due to the pressure they exert.

Good luck and keep us posted please....

[drarcher]

Thanks for the info. I feel better equipped to go talk to the doctor again.

I was reading the HRT Info stickied in this forum and it suggested "chorionic gonadotropin (***) hormone for injection" as a possible treatment? It also said something about cancer concerns, has anyone done this?

[zaggahamma]

Thanks for the info. I feel better equipped to go talk to the doctor again.

I was reading the HRT Info stickied in this forum and it suggested "chorionic gonadotropin (***) hormone for injection" as a possible treatment? It also said something about cancer concerns, has anyone done this?

thats hcg

and yes... a lot of trt patients use hcg as part of their protocol and it is highly recommended

[kelkel]

BTW, great post above Vetteman. Perfectly explained.

[Vettester]

BTW, great post above Vetteman. Perfectly explained.

Thanks for the kind words. I was actually half asleep when I was typing that, so it was one of those I had to read the next morning to make sure it wasn't botched up or anything. Hopefully it helped the OP get a better feel on how the hormones work with each other through the feedback loop process, and what to look for if one part is working, but one isn't.

[kelkel]

It gives everyone a better feel for how that loop works. Type while your half asleep more often!