Checking LH and FSH straight away ?

[milkshake89]

After pretty much a decade of losing time with antidepressants and antipsychotics, I am now approaching my new doctor with the concept of low T.

She is willing to test my total and free testosterone, but she says the rest isn't important for now. Is that true ? Is there not a possibility that, say, your LH or FSH is totally unbalanced even if you have a good total testosterone ?

Thanks

 

[Vince Carter]

LH and FSH should be a basic diagnostic tool to diagnosing Hypogonadism and even more so to knowing if there's a pituitary problem (secondary) or testes problem (primary), Total and Free T would be just a couple of pieces to the puzzle, an incomplete picture.

 

[milkshake89]

So I have 411 ng/dL of total T, and 31,95 of free T.
I am aware 411 is not necessarily an optimal level of total T, right ? I am also aware that free T should equal about 2% of total T. I am quite over that, is it possible to have too much free T ?
Would you guys suggest the whole LH, FSH tests over these ? I'm also thinking zinc, oestradiol, PSA, TSH, Lipids (LDL, HDL, triglyc), CMP, CBC, DHT, DHEA, Free T3, Free T4, Prolactin. Am I exagerating, or all these necessary before possibly prescribing TRT ?

 

[Vince Carter]

total T really isn't of much use when it's Free T that matters which is active in the body. I think TRT would be contraindicated with a Free T reading such as yours. Those other tests could be worthwhile though I see some left out of your Thyroid list which should include these 5:

TSH
Free T4
Free T3
Reverse T3
Antibodies

Running all of those would be good to see, you can have ancillary problems, like Thyroid, or Prolactin, that can be the part making you not feel good or like yourself.

 

[milkshake89]

TSH is all we checked for the thyroid, it's at 2,684 mU/L (0,350-4,940). Normally I should be under 2,5, no ?

 

[Systemlord]

Your numbers don't mean much without ranges, but if those are labcorps ranges I would say your problem is very low SHBG. Depression and anxiety is common among low SHBG men. Low thyroid hormones (Free T3) can lower SHBG.

If you are 21 years old, those testosterone numbers are terrible, if you are 80 years I would be somewhat impressed. We start losing 1% of our testosterone after 30 and start a slow decline as we age.

A person can have what looks like normal TSH, Free T4 but Free T3 is low, then depression and anxiety is almost guaranteed. Free T3 speeds up every cell in your body, it drives metabolic rates such as fat burning ability.

TSH closer to 0.5-1.0 is optimal, once you get to a TSH of 2.5 or above, problems are suspected. TSH by itself without Free T3 is all but useless, Free T3 is where the rubber meets the road.

I've seen normal TSH under 2.0 and Free T3 is below ranges, TSH by itself can be a false profit.

Optimal vs Normal Thyroid Levels for All Lab Tests & Ages