Pre-TRT very low LH/FSH, moderately low testosterone

Observer · 2026-05-05T13:59:06-0500

I'm hoping to get your guys' opinion on these results. The total testosterone was performed via MS and free testosterone was dialysis. I'm confused as to why LH and FSH would be so low. Is there any significance or typical pattern that can be gleaned here? I'm open to any clarifying questions. Thanks in advance.

LH - 1.4 mIU/mL - 1.5-9.3 mIU/mL

FSH - 1.3 mIU/mL - 1.4-12.8 mIU/mL

T Total - 454 ng/dL - 250-1100 ng/dL

T Free - 70.3 pg/mL - 35.0-155.0 pg/mL

SHBG - 33 nmol/L - 10-50 nmol/L

madman · 2026-05-05T20:34:30-0500

Observer said:
I'm hoping to get your guys' opinion on these results. The total testosterone was performed via MS and free testosterone was dialysis. I'm confused as to why LH and FSH would be so low. Is there any significance or typical pattern that can be gleaned here? I'm open to any clarifying questions. Thanks in advance.

LH - 1.4 mIU/mL - 1.5-9.3 mIU/mL

FSH - 1.3 mIU/mL - 1.4-12.8 mIU/mL

T Total - 454 ng/dL - 250-1100 ng/dL

T Free - 70.3 pg/mL - 35.0-155.0 pg/mL

SHBG - 33 nmol/L - 10-50 nmol/L

What time was your blood drawn and were you fasted?

Last time round you were hitting a robust TT 650 ng/dL with SHBG 40 nmol/L and your FT 7 ng/dL was tested using the known to be inaccurate direct IA (CLIA/RIA).

You would have been hitting a cFTV 12.8 ng/dL which would be far from low.

Now you are hitting a much lower TT 454 ng/dL with normal SHBG 33 nmol/L and luckily your FT was tested using the most accurate assay the gold standard Equilibrium Dialysis which has you hitting a FT 7 ng/dL so close to the bottom end and definitely falls in what would be called the grey zone 5-9 ng/dL where some men may experience symptoms of low T.

The bottom end reference range for Quests ED is absurdly low and even then the top-end is well under where most ED assays sit which is 21-28 ng/dL.

Keep in mind men with low T and low or low normal LH/FSH have a pattern consistent with secondary hypogonadism but this may reflect either true hypothalamic–pituitary dysfunction or functional suppression of the axis.

Post in thread 'Ideal protocol for trialing TRT?'

Mar 13, 2026

Observer said:
That's good to know.

TT was 650 and SHBG was 40. No LH/FSH.

It was one of those cheap combo labs meant to give men an idea of where their levels are, but it sounds like it generally fails at that goal in terms of accuracy. Before I moved forward, I was already planning to get a higher quality full panel from Discounted Labs or somewhere similar.

MOON!

This changes the picture big time!

You are hitting a robust peak TT 650 ng/dL and although your SHBG 40 nmol/L is. highish it is not very high so your FT would be higher than 7 ng/dL.

If we take your robust TT 650 ng/dL, highish...

madman · 2026-05-05T20:38:05-0500

Observer said:
I'm hoping to get your guys' opinion on these results. The total testosterone was performed via MS and free testosterone was dialysis. I'm confused as to why LH and FSH would be so low. Is there any significance or typical pattern that can be gleaned here? I'm open to any clarifying questions. Thanks in advance.

LH - 1.4 mIU/mL - 1.5-9.3 mIU/mL

FSH - 1.3 mIU/mL - 1.4-12.8 mIU/mL

T Total - 454 ng/dL - 250-1100 ng/dL

T Free - 70.3 pg/mL - 35.0-155.0 pg/mL

SHBG - 33 nmol/L - 10-50 nmol/L

Again!

Most healthy young males would be hitting a cFTV 13-15 ng/dL or better yet tested using the most accurate assay the gold standard Equilibrium Dialysis 10-12 ng/dL and this is a daily short-lived peak to boot we are talking about here.

Trough would be 20-25% lower.

Thread 'Largest dataset of mFT levels to date: male reference ranges spanning a wide age range, using a gold standard Equilibrium Dialysis LC-MS/MS method'

Mar 14, 2026

Sit and dwell on that!

Think of all those overmedicated men on T-therapy gassed up on FT well beyond their natty genetic set-point and unfortunately many off them off the hop!

You can blame all those run of the mill T clinics, kiddie forums loaded with all those numbskulls, throw those blast n cruisers in there too and put the icing on the cake the cesspool of so called gurus polluting gootube!

Gotta love all those kiddie forums loaded with the brainwashed sheep still pushing that more T is better mentality dishing out piss poor advice!

So much misinformation littered on the net its...

Observer · 2026-05-05T20:58:39-0500

madman said:
What time was your blood drawn and were you fasted?

Last time round you were hitting a robust TT 650 ng/dL with SHBG 40 nmol/L and your FT 7 ng/dL was tested using the known to be inaccurate direct IA (CLIA/RIA).

You would have been hitting a cFTV 12.8 ng/dL which would be far from low.

Now you are hitting a much lower TT 454 ng/dL with normal SHBG 33 nmol/L and luckily your FT was tested using the most accurate assay the gold standard Equilibrium Dialysis which has you hitting a FT 7 ng/dL so close to the bottom end and definitely falls in what would be called the grey zone 5-9 ng/dL where some men may experience symptoms of low T.

The bottom end reference range for Quests ED is absurdly low and even then the top-end is well under where most ED assays sit which is 21-28 ng/dL.

Keep in mind men with low T and low or low normal LH/FSH have a pattern consistent with secondary hypogonadism but this may reflect either true hypothalamic–pituitary dysfunction or functional suppression of the axis.

Post in thread 'Ideal protocol for trialing TRT?'

Mar 13, 2026

Observer said:

That's good to know.

TT was 650 and SHBG was 40. No LH/FSH.

It was one of those cheap combo labs meant to give men an idea of where their levels are, but it sounds like it generally fails at that goal in terms of accuracy. Before I moved forward, I was already planning to get a higher quality full panel from Discounted Labs or somewhere similar.

Click to expand...

MOON!

This changes the picture big time!

You are hitting a robust peak TT 650 ng/dL and although your SHBG 40 nmol/L is. highish it is not very high so your FT would be higher than 7 ng/dL.

If we take your robust TT 650 ng/dL, highish...

madman

The blood was drawn about an hour and a half after waking in the morning, and I was fasted at the time.

I'm sorry, I really should have been more forthcoming in our previous conversation regarding my labs. That test was from five years ago when I was 36. I was thinking the results probably wouldn't change too much in that amount of time, but that's obviously not the case. The numbers I've posted here are reflective of my current condition. As your FT criteria describes, I seem to be in a grey zone, and I would say I'm experiencing some obvious symptoms.

What's throwing me off is the super low LH/FSH. Does that indicate there's significant room for improvement naturally if I optimize lifestyle factors such as sleep? It seems like an LH/FSH as low as mine should be producing a much lower TT and FT than what we're seeing here. But I also don't have a lot of experience looking at labs, so maybe this is normal.

madman · 2026-05-05T21:31:31-0500

Observer said:
The blood was drawn about an hour and a half after waking in the morning, and I was fasted at the time.

I'm sorry, I really should have been more forthcoming in our previous conversation regarding my labs. That test was from five years ago when I was 36. I was thinking the results probably wouldn't change too much in that amount of time, but that's obviously not the case. The numbers I've posted here are reflective of my current condition. As your FT criteria describes, I seem to be in a grey zone, and I would say I'm experiencing some obvious symptoms.

What's throwing me off is the super low LH/FSH. Does that indicate there's room for improvement naturally if I optimize lifestyle factors such as sleep? It seems like an LH/FSH as low as mine should be producing a much lower TT and FT than what we're seeing here. But I also don't have a lot of experience looking at labs, so maybe this is normal.

Lack of quality sleep, excess stress (mental/physical) following a poor diet, lack of exercise, carrying too much adipose especially visceral fat can hammer down natty T.

Improving those will help but even then losing a lot of adipose would be key here if you are overweight.