T Nation

Bloodwork: Low T, High FSH


I got my bloodwork done in anticipation of my first cycle. I'm 26 5'10" 215 and have been powerlifting for about 9 years.

Made an appointment with a GP for a physical and to have blood drawn before I started my first cycle of AAS. First time going to this doctor and it was not a pleasant experience. I told them the reason I wanted my blood drawn was because I had taken propecia and stopped after it causes sexual dysfunction and wanted to make sure everything was working again.. They refused to test my estradiol, prolactin, progesterone because those were "female hormones only" and "had nothing to do with me".

Also wouldn't check my PSA because they said I was too young. Anyway they called with the results today and told me I need to stop taking whatever "supplements" I was on... when I said I wasn't taking anything they referred me to an endocrinologist.

Here were the results:

TSH, 3rd Generation 0.88 0.40-4.50 mIU/L
FSH 18.8 1.6-8.0 mIU/L
LH 9.2 1.5-9.3 mIU/mL
Testosterone Total 343 241-827 ng/dL

Tests were done early in the morning.

Any ideas on why this might be the case? Test seems quite low for a young healthy powerlifter. Never taken AAS, only thing is propecia for 6 months starting in 3/10 and stopped 9/10 after loss of libido. Came back shortly after I discontinued treatment.


hmmm... you should check out this topic on propecia at musclechatroom. this drug has severely messed with a large number of men and left some with permenant damage.


i was looking into that but it seems that most people with lasting propeica issues have low t, and low lh/fsh. And i don't feel like i have signs of any permanent damage. While I was taking it i couldn't get a good erection but after quitting that came back within weeks. I feel good now, lifting heavy weight... the only reason i had my levels checked was to get a baseline before i start taking AAS.

Does anyone know an explanation for this? Is it ok to have elevated lh,fsh?


but i will check out that forum, thanks


You should also be tested for prolactin and E2. Fin can raise prolactin levels and thus lower T levels. Good luck.


Uh, not really, because abnormally high FSH and LH MIGHT be an indication of primary hypogonadism.


@ PCdude thanks- I'm going to get E2 and prolactin levels checked tomorrow on my own.

If E2 and/or prolactin is high could this be the cause of relatively low T in relation to high FSH and LH? Wouldn't you think high E2 would result in low FSH/LH?

@Bricknyce- thats also what I've been reading... made an appointment with an Endo for the 28th. Anyone know what they would check for next? I would rather be proactive than wait...


or a sign of a hypothalamus or pituitary disorder, but that would normally be accompanied by very high levels of testosterone as your testicles jump into overdrive (until they burn out that is).


neither sound very desirable...

so to recap, i've either recently developed primary hypogonadism and am likely sterile or I have a pituitary disorder (ie: tumor) and my testicles are now burning out from running on overdrive for a while?

Any other possibilities? What are the chances of this being an incorrect result? Tests were done at Quest labs... could something have caused my FSH to be temporarily/incorrectly high?


LH/FSH is high and T is not. The problem is in the testes. hCG or SERMs will not be of any use.

Get tested for a FSH producing testicular tumor!

Estradiol may be anywhere, but we know that it is not inhibiting the release of gonadotrophins.

You do not have low LH caused by propeica.

How have you been feeling?
Are you a hairy beast or have lesser amounts of body/facial hair. This tells us something about what your past T levels were.

Put your cycle plans on hold.
You can do your own lab work if needed.


KSman & Purechace thank you for the response... i'm glad to receive advice from some of the experts on here and I've learned a lot reading through your previous posts.

I've been feeling alright, not great though. But I've always been prone to depression.

My body is fairly hairy (hairy chest, arms, legs, starting to come in thicker on back) and have moderate facial hair.

I don't feel any tumors on my testes...

Took first shot on Sunday, w/ another scheduled for tomorrow... needless to say I'll cancel that.

Thanks for the advice, im going to go to a place to get lab work tomorrow.

Recommendations on what to check?


Can get tests done today at:


Their Cancer Screen & Tumor Marker Panel (Male) test is $650.00... it looks like I'm going to have to wait until my appointment with the endo on the 28th.

I am however going to have DHT levels and E2, Progesterone and Prolactin testsed, any other recommendations?


Couldn't make an appointment with an endo any sooner but found a urologist that can see me tomorrow.


Does anyone think my TSH levels could be low? I sweat a lot an usually run a low temperature (96.8 now with a cold) whenever I take it (i only take it when I dont feel well however). I don't consider myself thin im about 215 at 5'10" however I compete at the 198 weight class and losing 20 lbs in a week for weigh-ins has never been an issue (the 2 times ive done it). I also think I am relatively strong for my weightclass, on Dec 18th I squatted 660, benched 460 and deadlifted 570 (in double-ply powerlifting gear).

My calcium levels were 10.0 with a range of 8.6-10.2 mg/dL

Could hyperthyroidism cause low T with high LH and FSH?


Your TSH levels are fine - less than 1 is ideal. As stated, the issue seems to be in your testicles. LH and FSH are hormones that are manufactured by your pituitary gland in response to your body having a low amount of testosterone. Normally, your testicles respond to the increased amount of LH and FSH in your body by increasing their production of testosterone. Since they haven't, your pituitary is working overtime to produce LH/FSH, which is why you have far above normal values -- but it isn't working, because your testicles aren't able to ramp up production sufficiently.

This is called primary hypogonadism. If E2 were involved, then your TT would be high and your FT/BT would be low, but your TT isn't high.

It wouldn't hurt to request a second LH/FSH test, but don't expect the values to fluctuate by too much. If you have insurance, and you really want to check that you don't have a thyroid issue, you can request that Free T3, Free T4, and Reverse T3 are checked. As for hypogonadism tests, Free Testosterone, SHBG, and another Total Testosterone test would be good (do these at 8 AM) -- Total minus SHBG will give you Bioavailable Testosterone. See the labs sticky for more useful tests.


I don't necessarily think I would have hyperthyroidism, but I do have a lot of the same symptoms. I guess those same symptoms could be explained from the low T and heavy training?

I will request a second test however now I'm wondering if any decrease in LH/FSH wouldn't be directly related to the injection of 250mg test cypionate and 150mg of deca on sunday...

Would an individual with primary hypogonadism still expect to see a decrease in LH/FSH from administering exogenous hormones?

I would prefer not to tell the urologist (that I'm meeting tomorrow for the first time) that I had just began a cycle. I feel like he will automatically assume that the cause of primary hypogonadism would have been from prior AAS abuse, which is not the case.

At this point do you think I am required to tell him that?

On a side note- It does make sense to me now that I was so heavily interested in starting an AAS regimen... I was looking to correct a problem I wasn't aware that I had.


Yes. Your pituitary responds to the increase testosterone in your system by saying "oh, we have enough now, I can stop overmanufacturing LH/FSH". If you didn't see a decrease while your testosterone levels are reasonable (500+), then there's a serious possibility that there's a hormone-producing tumor involved. You're young, so this is unlikely, but it is a possibility.

I'm honestly uncertain. Your TSH levels do not indicate hyper; if they were less than 0.5, that would be something to look into, but 0.88 is a great level to have it at.

Were you using AAS before? For how long? A side effect of AAS use is testicular atrophy; while they will usually recover most of their effectiveness, it is possible for there to be permanent damage caused by AAS. By this, I mean that it is theoretically possible for AAS abuse to cause primary hypogonadism.

There is some concern that finasteride (propecia) can cause irreversible sexual dysfunction, including testicular functional atrophy. It is an unusual side effect, but it is possible - even with only 6 months' use.

You aren't REQUIRED to tell him anything. If he finds out (e.g. he's in the same clinic system as another doctor that you have, and therefore has access to your medical history including tests) then he may drop you as a client because it compromises his ability to trust you as a patient. In some extreme cases, the clinic may drop you as a patient altogether, and even contact your insurance about the incident. This is up to you - some people prefer to keep things from their physicians so that they can advocate for their own health in their own way, others prefer to have their physicians know everything and try to find a physician that will work with them regardless.

Addendum: if you lie to a physician in a manner that would allow you to do or obtain something illegally (e.g. obtaining a testosterone prescription by falsifying lab results), then you ARE responsible, and there may be legal penalties.


Regarding propecia: see http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/things_that_damage_your_hormones , specifically:


No I had never used AAS, prohormones, or drugs that would have effected my hormones other than the finasteride (propecia). I've been lifting weights for about 9 years and wanted to reach my max potential before using PED's. The shot I took on Sunday was going to be the start of my cycle and I had the bloodwork taken on Wednesday to use as a baseline for PCT and to know when I'd recovered. I wasn't expecting any abnormal results...

In regards to telling the doctor about the drugs I injected... I want him to have any applicable information. I'm fairly certain that shot will affect future bloodwork (especially since it wasn't just test, but also the notoriously suppressive Nandrolone Decantonate). Also since Nandrolone is easily detectible I assume he would quickly find out anyway. I just don't want the Urologist to jump to the conclusion that I have AAS induced primary hypogonadism (since I had the blood drawn before the shot). So I'm wondering if not telling him will cause him to not be able to adaquately diagnose my problem.

I haven't noticed any testicular atrophy... testicles seem to be the same size they always were.

And I certainly not trying to get prescribed anything, I already have my testosterone and anciliaries. I just want to figure out what is causing this apparent primary hypogonadism. If I do have primary hypogonadism is there a reason that I would NOT want to start a cycle of AAS? I'm thinking that if my testicles are already damnaged the concern is that once you shut them down it will be impossible to start them back up? If that is the case I really hope that 150mg of Nandrolone didn't shut me down for good...


Great write-up by KSman. Finasteride is truly a scary substance. You would have thought I had learned my lesson about "xeno-testosterones" before considering Nandrolone. I thought I had a healthy HPTA and that impotence was a common side effect of finasteride. Since it went away when I stopped the drug I assumed I wasn't someone who was vulnerable to that damage... Luckily I don't seem to be in the same boat as post-finasteride syndrome sufferers, since my LH/FSH are high. It seems I either just have damaged testicles or a tumor hah.