Compensated hypogonadism

milosz

New Member
Being treated for hyper compensated hypogonadism. Am I alone?

I've just been prescribed - ten days ago - testosterone gel on the basis of compensated hypogonadism, having total testosterone higher than laboratory reference range, free testosterone near the lower end of the range, FSH and LH both above upper reference range, SHBG twice upper reference range value, and a calculated bioavailable testosterone higher than reference range - and all consistent with repeated testing. Endocrine specialist investigation finds no primary hypothalamic or pituitary pathology. It was said that although my testosterone values are actually high they are nevertheless insufficient for my needs, hence the gonadotrophin response. All the cases of compensated hypogonadism that I've seen described have values of testosterone within laboratory reference ranges but I've not been able thusfar to find any similar examples where the testosterone is actually high but insufficient. Presumably successful treatment would thus reduce my total testosterone level into the laboratory range.

I suppose it might theoretically be compatible with testosterone insensitivity but I'm 71 and have had no signs or symptoms of androgen insufficiency until eight years ago, and I'm unaware that such insensitivity can develop thus late in life.

I'm puzzled and should greatly appreciate any views that can throw some light on this.
 
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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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