Hey all, I haven’t posted here in quite some time. After finally getting some comprehensive lab work done, I have found my test and free test to be very low. I checked pituitary function, aromatization, and cortisol and have come up empty. Is this as simple as primary hypogonadism? I have attached my labs.
Symptoms include a hard time leaning out, easy fat storage with hip/thigh/chest as the primary sites. I also have a hard time maintaining strong erections throughout intercouse. Sex drive seems good but not great. I am very active and manage a demanding job with lots of energy. My food intake is usually pretty clean. My thyroid is underactive it seems as well but I figured the test is the main culprit.
Thanks for your help everyone
edit, I guess I can’t link PDF files.
Apparently I can’t post word documents. Sorry guys!
Lab 2 - done 6/18, approx 6 weeks after lab 1
3 - The rest of the thyroid values from lab 1
We work with numbers AND ranges here–so your bloodwork is only moderately helpful.
THat said, your Total T is not too bad, but your Free T is. This indicates a high amount of SHBG eating up your ciruclating testosterone and rendering it unavailable. There are many possibile reasons why, but I frequently have seen it correlated with high E2–this doesn’t seem to be the case with you though.
Thanks for the reply and sorry for the mess. The ranges got cut off.
Here is a better look…
5-7-12:
TT 427 (348-1197)
FT 8.1 (9.3-26.5)
FT4 .94 (.82-1.77)
TSH 1.620 (.450-4.5)
T3 76 (71-180)
FT3 2.5 (2.0-4.4)
After the first lab, I looked at better sleep quality, zinc 30mg/night, magnesium, and more rest days from training. I eat really clean 90% of the time and figured I probably had estrogen issues or secondary hypogonadism. I was sure to see high E2 or FSH/LH but nothing there!
6-18-12 - Just looking at Testosterone, pituitary output or aromatization
FSH 3.7 (1.5-12.4)
LH 6.0 (1.7-8.6)
TT 349 (348-1197)
FT Waiting on lab - assuming it’s flagged again
DHEA-S 290.5 (160-449)
Cortisol 11 (6.2-19.4)
Prolactin 4.2 (4-15.2)
E2 23.6 (7.6-42.6)
I was hoping to get away with a SERM or AI but don’t think that’s the case. Thanks again for any input.
I take back what I said about your Total T, it is pretty low as well.
Your LH/FSH look decent (FSH is a bit low) but your nuts do not seem to be producing. This points towards primary hypogonadism, but is not conclusive. HCG or SERM challenge could be appropriate to rule out primary.
Have you ever experienced blows to the testicles? Any undescended testicle as a boy? Varioccles? Any pain in the balls?
Testicular torsion at age 9, but even prior I’ve always been a chubby, stocky kid. Can easily put on muscle and fat. Shedding fat is very difficult. No other pain or blows to the testes. Experiencing low sex drive and hard to maintain erections. Wouldn’t the SERM challenge just restart the pituitary hormones? They look fine, no? Thanks again!
I think what was going through my mind when I wrote that was that your FSH is actually on the lower side, even though LH looks good. The thing about these is that LH has a much shorter half life than FSH, so it is harder to nail down what your actual value is. I think this is why I suggested the challenge just to rule it out.
I would probably opt for HCG for the challenge in this case.
What time of the day were your labs drawn?
They were drawn at 8am both times. I will try to find a endo to work with. I have been bouncing these ideas off a internist I work with and she is relaying my labs to her endo friend. It doesn’t sound that promising between the two, I will research my own as well. Also, should it be expected that my FSH/LH be through the roof trying to get my testes to increase Test considering it’s so low? I tracked down some old thyroid and test labs from an old thread: This is from December 2010
Testosterone, Serum 507ng/dL (280-800)
Free Test, Direct 12.2 pg/mL (9.3-26.5)
TSH - 2.49 uIU/mL (0.450-4.50)
Free T3 - 2.8pg/mL (2.0-4.4)
Free T4 - 1.08ng/dL (0.82-1.77)
Also got my free test back, flagged again at 5.0 with 8.3 being the bottom range of the lab norms. Long road ahead!
Yeah defnitely low–I would certainly ask to do a HCG challenge to see if you can regain testituclar output.
BTW, your cortisol is fairly low for an 8 am blood draw as well.
Any recommendations or comments on clomid only for a trial to see if it helps my test?
Thanks
The clomid challenge is also an option…
Any efficacy in 25mg each day or 50 every 2 days? The endo I am “kind of” working with (through a co-worker, an internist) suggests getting my SHBG and bio-available T checked out…I going to hold off and see what he thinks. However, he did mention to her that he doesn’t think my symptoms are related to low free T…so I’m somewhat skeptical. Hopefully he has some answers! VT, thanks for all your help and replies!
I’ve suspected either Adrenal fatigue and/or hypothyroidism in the past, but with the drop in T from Dec 10 (5xx) to now (239) I decided to pursue this…
Sx include:
Ups and downs with fatigue
Foggy brain and vision in the morning
No morning wood and hard to maintain erections
Easy weight gain and terrible weight loss
Low sex drive
Female fat storage patterns (hips, butt, chest, and stomach)
