Primary or Secondary Hypogonadism

[meanbreen]

I was wondering if it is possible for LH and FSH to be adequate and for the testicles to also be working fine, and yet testosterone be low due to low Progesterone and DHEA, which is where testosterone is derived from. This could be due to low conversion from cholesterol -> pregnenolone and/or adrenal insufficiency.

I ask because way back in 2013 my LH was 7.5 (1.5-9.3) and FSH was 8.6 (1.4-18.1). Testosterone was 209 (at age 22!). Conventional wisdom would say that I was clearly primary. However, with the help of clomid treatment my testosterone was able to get as high as 772!

I am wondering if there is more to Clomid than meets the eye; could Clomid increase other pituitary hormones, such as ACTH?

I apologize if that was all over the place, I just started researching the endocrine system earlier this year. I was on clomid from 2013 through early 2017 and was blissfully ignorant to what secondary vs primary really meant, I just knew that Clomid was working and trusted my endocrinologist to lead the way. I am now on TRT and have low progesterone, DHEA and likely low cortisol (need to get the 4x test). I am feeling better now, especially after recently adding NDT for my sluggish thyroid.

 

[Vince Carter]

Testes make Testosterone, the Adrenals when healthy or in the best environment only produce a small amount. That's what I think I know about it. So some upstream disfunction I don't think would make an appreciable change in your baseline T.

 

[meanbreen]

I keep seeing a hormone map that people are posting showing that testosterone directly comes from progesterone and dhea. Maybe the testicles need those as ingredients so to speak? But yeah, my understanding is very limited when it comes to that. I am just trying to understand why LH indicated I was primary and yet Clomid worked great for me.

 

[hva]

Did Clomid actually raise your testosterone numbers or is this just based on how you feel.

EDIT: Sorry, I didn't see in your OP that it actually did. I need to read better lol

 

[meanbreen]

haha no problem. Yep...actual number improvement. Very odd.

 

[lowe2sucks]

one question for you not related to thread did you experience any side effects on clomid?

 

[meanbreen]

None whatsoever.

EDIT: Around summer of 2015, about two years after being on Clomid, my IGF-1 dropped dramatically. We tested my GH in a stimulation test and it was low. I supplemented HGH for about a year. Now on TRT, haven't used HGH in over a year, and my IGF-1 is on the high side by itself. I have read some things about Clomid having that effect.

 

[Vince Carter]

I keep seeing a hormone map that people are posting showing that testosterone directly comes from progesterone and dhea. Maybe the testicles need those as ingredients so to speak? But yeah, my understanding is very limited when it comes to that. I am just trying to understand why LH indicated I was primary and yet Clomid worked great for me.

Doing well on Clomid is what we typically label as a "Unicorn"...glad it worked for you! But yeah, that whole hormonal cascade probably works really well when were; young and healthy, the stuff shows LH as the catalyst for the cascade and how HCG use replaces the LH that should spur that downstream conversion but then so many guys present as being on a sufficient HCG (and T) protocol that still exhibit deficiencies in Prog/Preg/DHEA/Cortisol. Its the kind of stuff that looks good on paper but doesn't seem to work in a lot guys that are Hypo (primary or secondary). I mean if things were working properly and HCG was replacing the LH, you wouldn't be low or needing to supplement those things, yet just about everyone dabbles in Preg/DHEA supplementation so HCG obviously isn't stimulating the downstream due to some other disfunction we haven't figured out yet. But there's very little endo T being produced in the adrenals even in ideal health situations.

 

[meanbreen]

Thanks for the comment! Yeah I have messed with DHEA and flat out hated it. Gave it three chances. One time in mornings for a week, then a couple trials at night for a few weeks. I have considered pregnenolone but it's impossible to find anyone that actually says they felt better with it lol.

Re: clomid - no lie, it gave me my life back. Took it for 3.5 years. As I approached the end of my Clomid run, I started feeling more and more like my burned out pre-clomid self, despite my numbers looking good. We only tested total T, free T, and TSH during those years so maybe something else was going on.