Latest blood work, need advice

[endo518]

Latest blood work:

FSH: 6.5(1.6-8.0)
LH: 10.2 HIGH(1.5-9.3
Prolactin: 11.4(2.0-18.0)
Estradiol: 24 (under or equal to 36)
IGF-1: 248(83-456)
Testosterone Total: 404(250-1100)
Free T: 127.7(35.0-155.0)
SHGB: 6 LOW(10-50)

I am 20 years old. Symptoms: No libido, extremely weak erections, tiredness. I ran a nolvadex cycle a few months ago(above test taken after 6 weeks off) because my total testosterone came back at 119. Going by total testosterone alone, to me it looks like I am secondary but then looking at free testosterone, it is in the high range so I'm not sure. Any advice?

Also: pituitary MRI came back normal.

[jasondd1]

Let me get this straight. Before Nolva your total was 119 and 6 weeks after nolva cycle your test is 404? Did you feel any better while on nolva?

[endo518]

Yes, that is correct. And no, if anything I felt worse.

[bp2000]

you have any trama to your testicles or varicole?

[endo518]

No, none at all.

[kelkel]

Latest blood work:

FSH: 6.5(1.6-8.0) Fine
LH: 10.2 HIGH(1.5-9.3 Fine
Prolactin: 11.4(2.0-18.0) On high side and can be cause of your libido issues
Estradiol: 24 (under or equal to 36) Does not "appear" to be a sensitive assay...
IGF-1: 248(83-456)
Testosterone Total: 404(250-1100) Low for your age IMO
Free T: 127.7(35.0-155.0) Fine
SHGB: 6 LOW(10-50)high insulin levels will impact shbg. Adding T right now would reduce it even more.

I am 20 years old. Symptoms: No libido, extremely weak erections, tiredness. I ran a nolvadex cycle a few months ago(above test taken after 6 weeks off) because my total testosterone came back at 119. Going by total testosterone alone, to me it looks like I am secondary but then looking at free testosterone, it is in the high range so I'm not sure. Any advice?

Also: pituitary MRI came back normal.

I think you need more in depth blood work. Could be adrenal fatigue, thyroid issues, etc. Many things play into low shbg. Blood work examples are in the Finding a Doc sticky. If you have more BW post it up. Full thyroid including FT3, FT4, TSH, RT3 and Antibodies. CRP and cortisol would be good as well IMO.

You do not appear to be secondary. Secondary would show a low LH/FSH level as well as lot T levels.

[endo518]

We tested thyroid about a month or so ago and everything came back normal. Tsh was like 4.1 but it was still within range and Doc said there was nothing he could do about it until it goes over. FT3 was a bit over the range, flagged as high but my Doc said that was good. Antibodies came back normal. We didn't test RT-3 but RT-3 dominance could definitely be a factor so I will make sure to ask for that in my next blood work.

Okay, I meant to say "primary" in the original post. I understand I am definitely not secondary but what do you think about primary?

[kelkel]

Sorry for the lag time. I wanted to respond more but had to go grab a leg workout!

Primary, well people don't have to be totally one or the other. There are degrees. Not always completely one way or the other. I would not put you in either catagory right now. An HCG stim test would really tell you the responsiveness of your boys. But I feel your main issue is prolactin. Look, prolactin will directly suppress testosterone production. Point blank. Hell, cortisol can as well just like hypothyroid.

When it comes to your thyroid posting up the numbers would be good. Most docs don't really know thyroid or how to evaluate it. That's actually a high TSH level, even though TSH is a weak indicator. A more common and better range FYI is actually .3 - 3.0.

I also neglected to put in that your IGF-1 level could be better as well. Reduction there could be from you Nolva usage as it suppresses IGF-1 as well. I don't know how long it takes to return to normal or if it has.

Run the idea of low dose Cabergoline past your doc. Maybe .25 twice per week......just a thought. It will knock your prolactin way down, improve your libido and I bet your T as well. Worth a try as it will not hurt you. Personally I run caber all the time prescribed by my doc. Research it!