Your body is compensating well for thyroid problems.
TSH should be closer to 1.0 and this indicates that your thyroid is needing to be whipped with more TSH to get the job done.
fT4 is below mid-range
T3 is below mid-range
fT3 is the active hormone and was not tested
Thyroid looks large?
fasting cholesterol? - can be too low
fasting glucose?
RBC?
Hematocrit [HTC]?
Cannot say that FT is low|OK|high based on any single lab.
You have secondary hypogonadism, E2 and prolactin are not causing this. Low E2 is from low FT, limiting FT–>E2. FT may be less than lab indicated as FT released in pulses with a short half-life, could have picked up a higher level. Same for LH lab results and often FSH with its longer half-life is a better indicator of LH status than LH itself.
Starvation diets can mess with LH/FSH and so can blows to the head. Some doctors will want an MRI to see if something is wrong with the pituitary even in cases when elevated prolactin is not pointing in that direction.
DHEA-S is very low for your age. This means that your adrenals are not doing enough pregnenolone–>DHEA. The conversion can be defective or there is not enough pregnenolone. Pregnenolone is made in the mitochondria inside of almost every cell type in your body and the testes produce a significant amount, which gets reduced with low LH/FSH. But in any case, your DHEA-S is exceptionally low. In USA you can find 25mg DHEA tablets in with the vitamins. Try 25mg/day. This will not solve your main problem.
Cortisol=16.9 is strong which suggests that adrenals are good in that regard. ACTH changes, do not know how to read that. As AM cortisol is normal, not worried. Blood work needle anxiety can be a factor.
Do you get selenium in your supplements? [thyroid]
Stress can have major effects on hormones and thyroid function via rT3. If you had a rT3 problem, you seem to be over that now as that would affect oral body temperatures. Your fT3 rT3 balance is delivering good body temperatures. Would be interesting to see what fT3 is. With weak fT4, less fT4–>T3 is expected as seen.
You can attempt a HPTA restart, there is a sticky for that. If that fails, get TRT. Please note that that sticky has intermediate labs as part of a decision tree.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys
- things that damage your hormones
- protocol for injections
- finding a TRT doc
- HPTA restart
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.