Average T, High LH and High E2. Some Erection Problems

Hi guys, my blood work came back today, I’d appreciate if you could help me with some input.

Note that I’m “natural”, not on TRT or on cycle, never was. I’m a 21yo male.

TT: 600 ng/dl (285 - 800)
FT: 2.3 ng/dl (0.1 - 2.9)
SHBG: 24 nmol/l (18 - 54)
Prolactin: 361 µUI/mL (98 - 456)
FSH: 3.2 mUI/mL (1.5 - 12.4)
LH: 10.4 mUI/mL (1.7 - 8.6) - HIGH
E2: 168 pmol/L (41 - 159) - HIGH

As you can see, my TT and FT are pretty average, nothing wrong there. Although, my LH and E2 are way high considering my T levels. There are people on cycles of 500mg of test per week that don’t get my E2 levels.

Things that might be relevant: lately I’ve been experiencing puffy nipples (not gyno or sensitive, just puffy), random mood changes, some weird type of social anxiety out of nowhere, and some erection problems… I can get an erection when I’m having sex, just not that easy and I kinda struggle to maintain it during sex. This might be related to the high E2 levels.

Could this be the beginning of some sort of primary hypogonadism, considering my high LH level and average T level? Thanks a lot!

An autoimmune disease can lead to the LH surge while having normal testosterone levels. You erections problems are most likely related to the deregulation of the hypothalamic-pituitary-gonadal axis.

Your estrogen is over the top of the ranges for men with natural testosterone.

Dysregulation of the hypothalamic-pituitary-gonadal axis in experimental autoimmune encephalomyelitis and multiple sclerosis.

Elevated luteinizing hormone despite normal testosterone levels in older men-natural history, risk factors and clinical features.

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Thanks a lot for the reply, I appreciate it.

Will definitely continue to look into it, do more research and obviously go to an endocrinologist to look over my results.

Would there be any solution to this type of hormonal unbalance? Usually, people have low T, they get on TRT and that’s it. What do you think would be an option for me if it were to be the case?

You need to find the cause and it may not be easy, if they doctor doesn’t know what to do, I expect doctors not to be concerned. They typically won’t care about erection problems are will prescribe ED drugs to treat the symptoms.

This will be an exhaustive diagnostic process.

Thanks! I’ll figure it out and will update here in case it may help someone.

You’re not on finasteride are you?