LH and FSH questions

[Jonsson]

Hello everyone!

Im 40 years old and liv in northern europe and need some advice from you.

Have som questions about my LH and FSH, why my fsh is high and one bw with low lh?

I did som bloodwork 2010 and its look like

Total Testosterone 14.7nmol/L 8-34 nmol/L

LH 4.5 IE/L 1.5-10 IE/L

FSH 16.1 IE/L 1.5-14 IE/L

SHBG 36.5 nmol/L 10-40 nmol/L

And i did some new bloodwork summer 2013 and its look like

Total Testosterone 6.0nmol/L 5.5-25.2 nmol/L

LH 1.8 IE/L 0.8-7.6 IE/L

FSH 11.6 IE/L 0.7-11.1 IE/L

SHBG 44 nmol/L 10-57 nmol/L

Now i met an endo and he did some bw, now my testosterone is 17nmol/l normal lh and fsh high
but he said my free testosterone is in the bottom. He prescibed me 1mg anastrozol ed and i said
its way to much but he said its not, so i eat that dose for a while and my T got up a little and
my estradiol is not measurable and shbg got up to 48nmol/L and now i take .25mg twice a week.
But i dont feel any different so i hope my dr put me on hcg treatment because i have no feeling in
my testicle when i press it betwen my fingers, feels dead.

I started to workout a year before my last bw to get more energy but that not work. My energy
went down and my musclecontact and musclepump disapperd after a month of workout. And i know
how to eat and sleep to progress in the gym. So could this workout lowered my testosterone?

My symptoms are fatigue, brainfog, no motivation for anything, low libido and ED

I have bw on tyroid,igf and prolactine also but do not have the result on paper but my dr told me its ok.

 

[Gene Devine]

I don't see an estrogen assay here? What was your estrogen levels before he started you on anastrozol?

Also, your SHBG is at the upper end of the reference range and it is this that is lowering you Free Testosterone.

Your Total Testosterone is at the bottom of the reference range. Where is Free Testosterone.

Sounds like you need Testosterone Replacement but by a Physician that knows what they are doing.

 

[Jonsson]

Hello Gene!

I do have an E2 assay but i dont have the results. I see the Dr in may again so he can print out the whole BW for me.

My Dr told me that E2 was little high so he prescribed anastrozole to see what happened with T.

So my last BW was mars 2014 an looks like

T 15.9 nmol/L 5.5-25.2 nmol/L

SHBG 48 nmol/L 10-57 nmol/L

E2 0nmol/L dont know range and not sensitive assay (too low to measure)

My Dr thinks my TT looks fine but i told him my free looks bad. He told me they look att TT first and he only calculate free T.

He thinks its strange that i dont feel better but i told him that E2 is not in range. Maybe anastrozole worked if i was owerweight?

Find a new Physician there i live isnt easy. Testosterone is tabu, but females can they fill with hormones.

Here i live the say T 8 nmol/L its lack of testosterone, T 8-12 nmol/L maybe lack of testosterone, T 12nmol/L and over

its not lack of testosteron.

I try to write more later because it takes such a time when I'll write in English and to make myself understood

 

[Gene Devine]

Prescribing you an AI was a wrong therapeutic strategy.

All it did was tank your E2, which is not healthy at all, and make you feel worse.

Your Total Testosterone is fine but Free is where you have an issue...and Free Testosterone is the important one.

Free is low because you have higher SHBG levels so you are getting excessive bonding which lowers Free Testosterone.

Here in the States a well trained Physician would prescribe once a week Testosterone shots. This would lower your SHBG and increase both Total and more importantly Free Testosterone...this is what you need.

 

[Jonsson]

Thanks for reply Gene!

When I meet my doctor in May and I'll point out that my free testosterone is low and see what he says about it.

Do you think I should stop with anastrozole, or should I continue with .25 mg twice a week?
Perhaps my total testosterone goes down a little bit if I stop with anastrozole, for he seems to only look at total testosterone.

My doctor said the next step is hcg so we'll see how I react to it. The Final step is treatment with testosterone, but I do not think he prescribes it when my total testosterone is in the right range

 

[Gene Devine]

Yes, in my opinion you don't need an AI at all!

It's tanked your estrogen levels to the point where you can't measure and that can be dangerous kid you not!!!

HCG as a mono therapy rarely raises Testosterone serum levels to any appreciable level so I wouldn't wast any more of your time.

You need once a week Testosterone injections as soon as you can.

Your Doctor needs to look at both Total and Free Testosterone levels including estrogen among others...

 

[Jonsson]

Ok Gene i drop that AI for now.

I do another bw before i met my doctor in May, but only TT, LH, FSH and SHBG.

I'll update when I met and discussed with the doctor.

 

[GettingAnswers]

Just from experience, HCG had my t levels over 900. I was only on it for about two months solo so I don't know if that would have maintained, but it gave me a boost. I couldn't tell because it didn't have the same feel as trt but my numbers liked it

 

[Gene Devine]

Just from experience, HCG had my t levels over 900. I was only on it for about two months solo so I don't know if that would have maintained, but it gave me a boost. I couldn't tell because it didn't have the same feel as trt but my numbers liked it

HCG may work for some guys but for most it doesn't work; if it did we all be on it instead of Testosterone LOL

 

[Jonsson]

Now i got my last bw and talked to my Dr.

My bw looks like this

TT 5.9 nmol/L 5.5-25.2 nmol/L

LH 3.8 IE/L 0.8-7.6 IE/L

FSH 13.1 IE/L 0.7-11.1 IE/L

SHBG 57 nmol/L 10-57 nmol/L

So my Dr prescribed me pregnyl 1500 iu once a week for the first two weeks and then 1500 iu twice a week.
But when I get to self-administer I think to split the dose to 500 ui eod for more steady levels.

I got the first injection on Wednesday and already know that I feel better. Like less brainfog, begin to feel the muscles again,
dont get slepy after dinner and increased appetite.

Hope this trend continues.

 

[Jonsson]

Got my second injection last Wednesday, but it has not produced the same effect as the last injection. Next week I get two injections hcg, Monday and Thursday.

I suspect that estradiol has increased substantially, so then I wonder if I should start
with anastrozole again? And what dose and how often I should take the tablets?

Or should i wait and see what next BW says?

It feels like I've gone past the sweet spot for E2 because i was real low on E2 before
the HCG monotherapy. After the first shot my libido and erection went through the roof
and now after the second shot its gone again.
It may be estradiol causes this?

 

[Jonsson]

Anyone have any idea about this?

 

[HarryCat]

Probably best to wait until your next BW. I know what you are going through and it is difficult for a psychological point of view. Although I have never done HCG mono-therapy I've had a similar reaction whenever restarting TRT, a few days of amazing libido boost, no hint of ED, and then it all evaporates and you wonder what happened. I've been on TRT for 2 years and I'm still trying to figure it out.

Once you verify that your T numbers are where you want them and get you estradiol checked, then you can start adding in other stuff, but until then will be counterproductive adding in another variable.

 

[Gene Devine]

Got my second injection last Wednesday, but it has not produced the same effect as the last injection. Next week I get two injections hcg, Monday and Thursday.

I suspect that estradiol has increased substantially, so then I wonder if I should start
with anastrozole again? And what dose and how often I should take the tablets?

Or should i wait and see what next BW says?

It feels like I've gone past the sweet spot for E2 because i was real low on E2 before
the HCG monotherapy. After the first shot my libido and erection went through the roof
and now after the second shot its gone again.
It may be estradiol causes this?

I highly doubt that E2 was elevated due to one injection; not at all likely.

Consider it takes at least 6 weeks before Testosterone serum levels stabilize when starting TRT and it takes time after that for any aromatase synthesis to happen to the level that E2 is elevated to cause side effects.

Don't do anything till your next blood work and don't over think it for now.

 

[Jonsson]

Thanks HarryCat and Gene for the advice!

Maybe i have read to much about HRT, TRT and the trouble with E2 hehe.

 

[Jonsson]

Hello!
Now I have received a reply to the latest blood samples after four weeks hcg monotherapy, and they look like this.

TT 23.9 nmol/L (5.5-25.2)
E2 140 (0-250) not sensitive
SHBG 50 nmol/L (10-57)

TT looks good but FT seems low, I got 1.7% when i use onlinecalculator. Do i calculate right?
I still get 1500 iu twice a week and the day after the shoot my libido feels better but still poor erection.
My brain fog has gotten a lot better but I still need a lot of sleep and remains listless.
And my testicles have not grown up as much as I thought they would do, I have used hcg for two months now but it might take longer than two months to feel the difference in the testicles?

One more question, can i be primary when my FSH is so high? Would be strange since my TT raised on hcg.