Low LH and FSH with low-normal Testosterone

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drew_k

New Member
I'm a 34 year old man and here's my recent bloodwork, with lab's normal values in parentheses:

Total-T LC/MS/MS: 496 ng/dL (250-1100) [LOW NORMAL]
Estradiol: 16 pg/mL (< 39)
LH: 2.1 mIU/mL (1.5 - 9.3) [BARELY NORMAL]
FSH: 1.6 mIU/mL (1.6 - 8.0) [BARELY NORMAL]
Prolactin: 7.5 ng/mL (2.0 - 18.0)
TSH: 2.47 mIU/L (0.40 - 4.50)

As you can see my LH and FSH are at the low end of the normal range, and total T isn't that high considering I'm 34.

I've been experiencing classic low-T symptoms for almost 3 years now. I have very poor erections, low libido, very rare morning erections, depression, lack of focus etc. I can't sleep properly, I wake up in the night with hot flushes and I've been lacking the usual zest for life so to speak. I've been prescribed Wellbutrin and Adderall recently to help with my symptoms but at a fundamental level I think I'm going down the wrong path. Up until around 31, I never had any issues focussing or sleeping...

Around 2 years ago I had visited a Urologist complaining of Erectile Dysfunction, so he got my hormones tested. The results then were:

Testosterone, total: 617 ng/dL (250 - 1100)
Testosterone, free: 113.5 pg/mL (35.0 - 155.0)
Estradiol: 20 pg/mL (< 39)
FSH: 1.8 mIU/mL (1.6 - 8.0) [BARELY NORMAL]
LH: 1.5 mIU/mL (1.5 - 9.3) [BARELY NORMAL]

Again my LH and FSH level were only borderline normal.

Although the urologist gave me some samples of Cialis to try out which certainly helped, it didn't really fix the root of the issue. I still had low libido, fogginess, etc.

I'm now at a point where I want to evaluate if TRT can be an option. Questions:

1. What conditions can cause low LH and FSH levels with a "normal" testosterone level? I read that this can be due to tumors in Pituitary...
2. Are low LH and FSH levels enough to diagnose secondary hypogonadism, even when Testosterone level is normal or low normal?
3. Does one need to have fairly low level of Testosterone to be considered for TRT?

Any advice is much appreciated.
Drew
 
Defy Medical TRT clinic doctor
HI and welcome to excel male. There are other factors that can lead to lower LH/FSH High prolactin can contribute to lowering your LH/FSH and your TSH seems a little borer line high to me there are probably some more tests that could be run to narrow root causes down. I would suggest posting your labs in the blood test section and you will probably get better advise from more knowledgeable members than myself. here is an example of some tests that should be run:https://www.excelmale.com/forum/sho...e-and-During-Testosterone-Replacement-Therapy
 
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