You have a degree of primary hypogonadism with low T and high LH/FSH. Docs may want to put you on clomid but that may be a bad idea as too much LH could desensitize the LH receptors.
Docs examined your testes and found ?
If you go on TRT without hCG to support your testes your fertility at major risk. With TRT, the standard hCG 250iu subq EOD may not work as your testes are not working very well with high LH.
High prolactin should be treated with 1/4mg Dostinex/cabergoline twice a week. MRI often used to judge size of adinoma. If allowed to grow it can press on optic nerves and that outcome must be avoided.
Injuries and other stress can lead to elevated rT3, reverse T3 that interferes with fT3 at T3 receptors. There is no receptor for T4.
Your fT3 should be able to support good oral body temps. You will find how to check that below. When fT3 is adequate and temperatures are low, we are quite certain that rT3 is the problem.
In the thyroid basics sticky find references to: stress, surgery/injury, over training, fT3, rT3 adrenal fatigue and Wilson’s book ← read it!
Prolactin lowers dopamine and that is depressing. That is another stress factor. Could show up as apathy or lack of joy.
Training with low T and low thyroid function is a very high contributor to adrenal fatigue as natural energy is eroded and replaced by adrenalin to get the work done.
Prolactin has no direct effect on FT. SHBG does.
SHBG is made in the liver to scavenge sex hormones. That is increased by low T and elevated E2.
AM cortisol appears OK. In later stages of adrenal fatigue cortisol can go low then that would be a major problem.
How to reduce rT3?
Address stress issues and life style. Workouts need to be tamer.
Need T3 only thyroid med to depress TSH so T4 drops. Then there will be less fT4 for fT4–>rT3. T3 time release is available in USA as a compounded med only. Do not know options there.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.