T Nation

Any Thoughts on My Bloodwork?

T Replacement
#1

How does Lexapro affect sex drive/testosterone? Any ideas? (crosspost)

35M

Ireland

5.11

94 kg

About 2 years ago I went to the doctor and requested blood tests. I had been feeling very tired and quite cold. Sure enough the blood tests showed that I had low testosterone. My Test came back at 3.3 nmol/L. I have been on Lexapro/escitalopram for anxiety, at various strengths, since 2012. I am currently on 10 mg.

I attended an endo last Jan and they prescribed Testogel and another old fashioned anti-depressant. I have not purchased either at the pharmacy as I don’t want another pill and am reluctant to use any gels.

I had my bloods tested last week and today I received the results

Range

Hormones

Testosterone 7.9 nmol/L 8.6-29.0

SHBG 14.1 nmol/L 18-54

Free Test 226 pmol/L 198-619 pmol/L

PSA 0.4 ug/L 0-2.0

Prolactin 205 Mu/L 45-375

FSH 1.4

LH 1.4

Oestradiol 69 pmol/L

Thyroid

TSH 2.49 Mu/L 0.50-4.40

T4 free 15.9 pmol/L 11.5-22.7

Some other scores

Ferritin 288.0 ng/ml 20-300

Albumin 45 g/l 34-45

ALT 142 IU/L 10-55

I don’t know where to go at this point as I am very tired due to the low test and/or the Lexapro. A psychiatric nurse recommended my doctor to prescribe 15 mg of Lexapro for me ‘as the tiredness I am experiencing is the result of my anxiety and depression’

I’d appreciate any help from anyone that has experienced similar circumstances or know anything about why my TEST could be so low.

Thanks folks

#2

Low T with low FSH/LH is an issue. Your numbers should qualify you for TRT if that’s what you’re asking. Diagnosing exactly why is tougher.

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#3

Thanks

#4

I read a study some time ago about the effect of SSRI’s on testosterone. I don’t recall if Lexapro was in that study, but they did find a strong correlation between some SSRI’s and low blood level testosterone. They had suspected the drugs were increasing production of prolactin, thereby interfering with gonadotropin releasing hormone, or were lowering levels of dopamine and effecting testosterone production.

I suppose the only way to be sure would be to go off the SSRI’s for a time and recheck the blood at exactly the same time of day.

Anyhoo, TRT is being more commonly prescribed to people that suffer from SSRI induced sexual sides.

#5

Youre welcome. If you want to try and actually diagnose the cause you would probably need a couple repeats ont he bloodwork. If you’re low T with consistent low FSH/LH then you have an HPTA problem. You’re not signaling for more T production despite low levels meaning secondary hypogonadism. The opposite would be if you had FSH/LH in adequate range meaning you are signaling fine but your tesitcles are failing to produce… ie primary hypogonadism. The thing is that FSH and moreso LH change very frequently. So a couple tests are needed for a true diagnoses.

#6

The Lexapro is more than likely going to decrease your natural testosterone.

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