Low FSH & LH

[No. 7]

I have a teleconference scheduled next week to discuss this with my clinic but thought I would run it by you guys in the meantime to see what I can learn....

I don't drink, I don't smoke, no drugs other than blood pressure meds and am at the gym 5 or 6 days a week.

Protocol:
Shallow IM injections 2X weekly. 40ml T Cyp (200 mg/ml), .125 ml HCG and .25mg Anastrozole (each injection)

This week's blood work from Quest at my trough shows most everything in the normal range except the following:

Total T = 1249 (250-827 ng-dL)

(Honestly, I don't know what these next two are, how to stabilize them or what I may be missing or harm I may be doing running this low)

FSH = 0.7 (1.6 -8.0 mIU-mL) Low
LH = < 0.2 (1.6-15.2 mIU-mL) Wicked Low

I also have an appointment for a Double Red blood donation next week hoping to bring these numbers around.
I'm not as concerned here as I don't think they are that far out of whack but of course would feel better if it said "Normal" next to them on my next report ......

Hemoglobin = 17.8 (13.2-17.1 g/dL) High
Hematocrit = 51.7 (38.5-50.0%) High
RBC = 6.02 (4.20-5.80 million/uL) High


Estradiol = 24 (</= 39 pg-mL)

Comments, suggestions, insight and experience are all very much appreciated and knowledge will help put my mind at ease . Thanks in advance.

Ned

@Nelson Vergel

 

[Cataceous]

On TRT it is normal for LH and FSH to be suppressed to very low levels. Your body senses that there's more than enough testosterone and shuts down natural production.

Your testosterone dose is about double or more what it needs to be, probably contributing to the HGB/HCT/RBC problems. If serum testosterone is around 1,200 ng/dL at trough then the peak is more like 1,800. There's no need for most guys to maintain such high levels. If you cut your dose in half then you would likely still have serum levels well above average for young men in their prime. You might be able to go without the anastrzole as well.

 

[No. 7]

Thanks Cat, I appreciate the comeback.
Guess if nothing else, I now know my upper limits and the results thereof !

 

[Nelson Vergel]

I have a teleconference scheduled next week to discuss this with my clinic but thought I would run it by you guys in the meantime to see what I can learn....

I don't drink, I don't smoke, no drugs other than blood pressure meds and am at the gym 5 or 6 days a week.

Protocol:
Shallow IM injections 2X weekly. 40ml T Cyp (200 mg/ml), .125 ml HCG and .25mg Anastrozole (each injection)

This week's blood work from Quest at my trough shows most everything in the normal range except the following:

Total T = 1249 (250-827 ng-dL)

(Honestly, I don't know what these next two are, how to stabilize them or what I may be missing or harm I may be doing running this low)

FSH = 0.7 (1.6 -8.0 mIU-mL) Low
LH = < 0.2 (1.6-15.2 mIU-mL) Wicked Low

I also have an appointment for a Double Red blood donation next week hoping to bring these numbers around.
I'm not as concerned here as I don't think they are that far out of whack but of course would feel better if it said "Normal" next to them on my next report ......

Hemoglobin = 17.8 (13.2-17.1 g/dL) High
Hematocrit = 51.7 (38.5-50.0%) High
RBC = 6.02 (4.20-5.80 million/uL) High


Estradiol = 24 (</= 39 pg-mL)

Comments, suggestions, insight and experience are all very much appreciated and knowledge will help put my mind at ease . Thanks in advance.

Ned

@Nelson Vergel

how do you feel?

 

[No. 7]

how do you feel?

Ahah ! Now that's the real key here isn't it ?
Thanks for grounding me and focusing in on that.
I keep reading advise on not chasing numbers.... Here it is being played out maybe ?

There was a thread recently about what you feel after injection and I said I felt nothing. Analyzing it a little further I think I'm a little more sleepy the day after injection day but the days following that, I really feel strong.
I want to keep that feeling going and sometimes regret that my next injection day has arrived and I will "come down" a notch or two..

Overall I feel real good. Most importantly to me is that my well being and confidence is way up. I'm a whole lot less grumpy and I've smoothed out the bumpy road.
My body looks like it never has in my 67 years. Probably a lot has to do with my hard work and focus at the gym lately. What a great use of my time.
Youth is wasted on the young, I can attest....
Honestly though, I don't think these gains would have been possible without this boost at this stage of my life. It's not like I haven't spent my time in the gym over the years.

I wish I was hep to this remedy 20 years ago when I began to decline.

The Little Man wakes up with me every morning although I'm not always sure he's ready to go to work with me.... ; - ) but it's fun to wink at a pretty girl after her double take and a smile until she realizes I'm Grandpa material !

 

[Nelson Vergel]

I am glad you feel well.

I am 61 (almost 62), so I emphasize with you.

In my opinion (I hope you have read the many articles I have written on the importance of estradiol in men), I would cut down your anastrozole or let it go completely. Your joints, penile sensitivity, bones, your cholesterol may be affected by long term use of anastrozole (I know that you have not shared any lipid or other values).

Don't waste your money testing for LH and FSH since they both should be close to zero on TRT.

 

[gaz7718]

Sounds as though the protocol has done wonders for you.

I started TRT on E3D shallow IM of Sustanon before moving to cyp and Ethanate (not at the same time) EOD 0.11ml of 300mg/ml, which means my test per week is 115mg.

My T levels were running a bit high and the consequences appear similar to you in that RBC and hematocrit started to go out of range and blood pressure was also running high.
Suggest keeping a check on your blood pressure and reducing your T a bit and consider trying EOD to help smooth any peaks/troughs.

My hematocrit is back in the late forties and bp is a better place but need to ensure I keep within the right boundaries as both have a tendency on the high side. It’s a balancing act and strangely even when you think you’ve got it nailed the body can start to respond differently due to other factors.

the great news is that it’s probably just fine tuning in your case to get everything right.

 

[No. 7]

I am glad you feel well.

I am 61 (almost 62), so I emphasize with you.

In my opinion (I hope you have read the many articles I have written on the importance of estradiol in men), I would cut down your anastrozole or let it go completely. Your joints, penile sensitivity, bones, your cholesterol may be affected by long term use of anastrozole (I know that you have not shared any lipid or other values).

Don't waste your money testing for LH and FSH since they both should be close to zero on TRT.

Thanks Nelson.... I know you have put a LOT of work into education, I will buckle down and do some more homework !

 

[No. 7]

Sounds as though the protocol has done wonders for you.

I started TRT on E3D shallow IM of Sustanon before moving to cyp and Ethanate (not at the same time) EOD 0.11ml of 300mg/ml, which means my test per week is 115mg.

My T levels were running a bit high and the consequences appear similar to you in that RBC and hematocrit started to go out of range and blood pressure was also running high.
Suggest keeping a check on your blood pressure and reducing your T a bit and consider trying EOD to help smooth any peaks/troughs.

My hematocrit is back in the late forties and bp is a better place but need to ensure I keep within the right boundaries as both have a tendency on the high side. It’s a balancing act and strangely even when you think you’ve got it nailed the body can start to respond differently due to other factors.

the great news is that it’s probably just fine tuning in your case to get everything right.

I intend to keep chugging away at it Gaz, Thanks

 

[No. 7]

Not sure how they help, but here are a couple more pieces to the puzzle:
My Lipid Panel, CMP and CBC that Nelson asked for earlier, PSA was 1.2.

I also donated Double Red this afternoon.

@Nelson Vergel

 

[madman]

Not sure how they help, but here are a couple more pieces to the puzzle:
My Lipid Panel, CMP and CBC that Nelson asked for earlier, PSA was 1.2.

I also donated Double Red this afternoon.

@Nelson Vergel

No need for the double red and it is a surefire way to crash your iron/ferritin which can cause
many other issues.

 

[No. 7]

No need for the double red and it is a surefire way to crash your iron/ferritin which can cause
many other issues.

You are saying, "yes" blood donation is in order but "double red" is over the top ?

 

[madman]

You are saying, "yes" blood donation is in order but "double red" is over the top ?

Many will tend to donate when hematocrit starts creeping up over the high end but some leave it be unless it hits 52-54.

Donating too frequently let alone double red to try and manage elevated RBCs/hemoglobin/hematocrit is a catch 22 as although it will bring levels down it can lead to crashing your iron/ferritin stores which can lead to many other issues.

Too many get caught up on where their TT levels sit at the true trough on such protocol (dose T/injection frequency) without paying attention to peak let alone FT level which is more important when managing your T levels.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.

The key point being is that running too high of FT levels can result in elevated RBCs/hemoglobin/hematocrit let alone cause some other minor side-effects in sensitive individuals (genetically prone).

As you can see your protocol of 90mg/week split into twice-weekly injections (every 3.5 days) has your TT levels on the higher end but unfortunately, we have absolutely no idea where your FT level sits let alone what your SHBG is.

The goal of trt is to replace physiological levels with the use of exogenous testosterone which will allow one to achieve a healthy TT and more importantly FT level which would result in relief/improvement of low-t symptoms and increase overall well-being while at the same time minimizing/avoiding any potential side-effects and keeping blood markers health long-term.

You need to know where your FT level sits at the true trough on such protocol as for all we know it may very well be much higher than you think and you may be able to drop your overall weekly dose slightly while at the same time still feeling great overall and improving your blood markers.

Of course, treating symptoms is what truly matters but it is still critical to know where your FT levels sit as yes there is such a thing as not only too low but too high.

Too many men on trt get caught up in the more T is better mentality and some are running absurdly high levels at the true trough and although they may think they feel better overall they are the same individuals struggling with issues on such protocol.

Top it off with the fact that many are relying on inaccurate testing methods for FT and have no idea where their FT level truly sits which may be much higher than they think yet they are struggling with such protocol chasing their tales.

You need to have your FT tested using the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where your FT level truly sits.

 

[No. 7]

Many will tend to donate when hematocrit starts creeping up over the high end but some leave it be unless it hits 52-54.

Donating too frequently let alone double red to try and manage elevated RBCs/hemoglobin/hematocrit is a catch 22 as although it will bring levels down it can lead to crashing your iron/ferritin stores which can lead to many other issues.

Too many get caught up on where their TT levels sit at the true trough on such protocol (dose T/injection frequency) without paying attention to peak let alone FT level which is more important when managing your T levels.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.

The key point being is that running too high of FT levels can result in elevated RBCs/hemoglobin/hematocrit let alone cause some other minor side-effects in sensitive individuals (genetically prone).

As you can see your protocol of 90mg/week split into twice-weekly injections (every 3.5 days) has your TT levels on the higher end but unfortunately, we have absolutely no idea where your FT level sits let alone what your SHBG is.

The goal of trt is to replace physiological levels with the use of exogenous testosterone which will allow one to achieve a healthy TT and more importantly FT level which would result in relief/improvement of low-t symptoms and increase overall well-being while at the same time minimizing/avoiding any potential side-effects and keeping blood markers health long-term.

You need to know where your FT level sits at the true trough on such protocol as for all we know it may very well be much higher than you think and you may be able to drop your overall weekly dose slightly while at the same time still feeling great overall and improving your blood markers.

Of course, treating symptoms is what truly matters but it is still critical to know where your FT levels sit as yes there is such a thing as not only too low but too high.

Too many men on trt get caught up in the more T is better mentality and some are running absurdly high levels at the true trough and although they may think they feel better overall they are the same individuals struggling with issues on such protocol.

Top it off with the fact that many are relying on inaccurate testing methods for FT and have no idea where their FT level truly sits which may be much higher than they think yet they are struggling with such protocol chasing their tales.

You need to have your FT tested using the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where your FT level truly sits.

Thank you very much for this detailed response. I have learned a lot here today !