Blood work - what do these numbers suggest

[PolishHammer]

TL;DR: Test shows high LH, low-normal T. Ive got symptoms of low T. What could be causing the LH and T discrepancy? Does that ratio matter symptomatically?
_____

Stats: 34, 6'0, 195lbs, 20%BF

Problems: For the last 3-4 months, my sex drive has been in the pits. Can't get it up (with a partner or without). Haven't gotten off in 3 weeks - and I don't feel any of the pressure I normally would after having abstained for even 3 days. Don't seem to be losing weight despite exercise and diet. Strength gains are garbage.

Relevant drug use: I've never used exogenous hormones or pro hormones. I've been taking dutasteride (Avodart) for hair loss for four years without any obvious side effects.

Other history: I had been an especially easy gainer in my 20s - even for my age. (Total'd 1400 raw at ~11% BF at 24). Fat distribution has always been femaleish (hips and chest). Had a mild case of gyno during puberty.

Blood work (normal range in parentheses):
Test time: 8:00 AM
TSH: 3.55 mIU/L ( < 5)
T4: 14 pmol/L (12-22)
LH: 10 IU/L (2-9)
FSH: 4 IU/L (2-12)
Prolactin: 7 ug/L ( < 18)
HCrit: 0.44 L/L (0.31-0.51)
BA test: 4.0 nmol/L (1.6-13.2)

No other hormone tests were prescribed (He did get my sodium, potassium, LDL/HDL, glucose serum, etc. All were mid-normal.)

Doctor's response: Referred me to see an endocrinologist, but didn't seem too concerned by the numbers.
____

LH is high (above the normal range). However, bioavailable test (and FSH) is in the lower third of the normal range. I wonder whether the high LH is a consequence of the dutasteride blocking DHT conversion > decreasing inhibition of the hypothalamus > increasing LH production. I suspect (given my fat distribution) that I'm aromatizing a lot of the test that the LH has been producing. But I don't know shit.

What could be causing the problems that I've described?


Thank you

[Youthful55guy]

TL;DR: Test shows high LH, low-normal T. Ive got symptoms of low T. What could be causing the LH and T discrepancy? Does that ratio matter symptomatically?
_____

Stats: 34, 6'0, 195lbs, 20%BF

Problems: For the last 3-4 months, my sex drive has been in the pits. Can't get it up (with a partner or without). Haven't gotten off in 3 weeks - and I don't feel any of the pressure I normally would after having abstained for even 3 days. Don't seem to be losing weight despite exercise and diet. Strength gains are garbage.

Relevant drug use: I've never used exogenous hormones or pro hormones. I've been taking dutasteride (Avodart) for hair loss for four years without any obvious side effects.

Other history: I had been an especially easy gainer in my 20s - even for my age. (Total'd 1400 raw at ~11% BF at 24). Fat distribution has always been femaleish (hips and chest). Had a mild case of gyno during puberty.

Blood work:
Test time: 8:00 AM
TSH: 3.55 mIU/L
T4: 14 pmol/L
LH: 10 IU/L
FSH: 4 IU/L
Prolactin: 7 ug/L
HCrit: 0.44 L/L
Bioavailable test: 4.0 nmol/L
No other hormone tests were prescribed (He did get my sodium, potassium, LDL/HDL, glucose serum, etc. All were mid-normal.)

Doctor's response: Referred me to see an endocrinologist, but didn't seem too concerned by the numbers.
____

LH is high (above the normal range). However, bioavailable test (and FSH) is in the lower third of the normal range. I wonder whether the high LH is a consequence of the dutasteride blocking DHT conversion > decreasing inhibition of the hypothalamus > increasing LH production. I suspect (given my fat distribution) that I'm aromatizing a lot of the test that the LH has been producing. But I don't know shit.

What could be causing the problems that I've described?


Thank you

You need to post the normal ranges for all of the tests in order for us to give any meaningful feedback. High LH with low T is normally indicative of Primary hypogonadalism (problem with the testicles). I also don't see E2 posted, but then again it's probably not the issue if LH is high. Not sure if the finasteride treatment has anything to do with the high LH, but it certainly can account for Low T symptions, even with notmal T levels. Finasteride can cross the blood-brain barrier and lower DHT in the brain. DHT is the predominant androgen in the brain. T crossed the barrier, but is supposed to be converted to DHT for normal male brain activity.

My first recommendation is to stop the finasteride treatment before considering anything else and then have the labs redone in about 6 weeks.

[PolishHammer]

Normal ranges added

[Youthful55guy]

Given that FSH is in the normal range, I'm not overly concerned about the slightly out of range LH. They share a common releasing hormone (GnRH), so it appears not to be primary hypogonadism, as they both would be high. It also appears not to be secondary hypogonadism either, as you would expect both LH and FSH to be low and they are clearly not. Your TSH is a bit high and your T4 a bit low, though both are still in range. I wouls be interested in seeing reverse T3 levels, but it's difficult to get a doc to test for that.

You said your Total T was low-normal, but I don't see the results posted, or am I just not seeing them? I'd also ask for SHBG & Free or Bioavailable T. E2 would also be helpful as long as it's the sensitive male assay. However, if T is low-normal, I would not expect E2 to be high. Might be too low though. Low E2 is a major cause of ED. Are you taking any supplements to lower E2? If so, I'd stop immediately and see if that helps. If your doc won't order the extra tests, you might want to get them done yourself. I've had real good service with discountedlabs.com. They are very efficient, lab draw stations practically everywhere in the USA and good pricing.

[kelkel]

Agree with YG55 and I'll add that your TSH may be within range but it's an old range. A more modern one is .3 to 3.0. I would initially pursue further thyroid testing with an elevated TSH and low (er) T4 levels. Consider TSH, FT3, FT4, RT3 and maybe antibodies.

When it comes to Dutasteride / Finasteride it's quite unique stuff. Yes, it can lower LH output but at the same time T still usually rises due to less conversion via the 5 AR enzyme. You also commented you've been taking Duta for 4 years so it's doubtful to me that it's suddenly the cause.

[PolishHammer]

Spam filter restricts me from using any of the relevant words in my reply. So I'll just say thanks for the insights.