Fluctuating Testosterone Level

I’ve been having some issues over the past several months and have had my blood tested several times. The last few week my symptoms have gotten pretty bad (sleeping 10 hours a day, no sex drive or performance). So I found a new endocrinologist. Here are the partial results:

Testosterone, total (ng/dL):
11/15/2011: 164 (270-1070) 1pm
12/27/2011: 427 (270-1070) 9am
02/28/2012: 181 (250-1100) 12pm

LH (IU/L):
11/15/2011: 1.2 (2-12) 1pm
12/27/2011: 2.8 (2-12) 9am
02/28/2012: 6.7 (1.7-8.6) 12pm

Cortisol (ug/dL):
11/15/2011: 4.1 (5-15) 1pm
12/27/2011: 7.0 (5-25) 9am
02/28/2012: 10 (3.5-20) 12pm

Vitamin-D (25 OH):
12/27/2011: 45 (33-100) 9am
02/28/2012: 48 (30-100) 12pm

I guess I’m just perplexed by the drop in TT and spike in LH.

What times were your bloods taken?

Don’t read too much into the LH fluctuation. LH pulses between peak and valley every hour or so, so your readings will almost always vary dramatically depending on where in the pulse you happen to be when the blood is taken.

Testosterone can vary dramatically between morning and afternoon. Afternoon levels in young men are about half of morning levels. T can also vary from day to day depending on many factors, including how you slept.

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[quote]VTBalla34 wrote:
What times were your bloods taken?[/quote]
I edited my original post to include the time of day.

Anyone seen this sort of behavior from natural testosterone levels?

[quote]grox wrote:
Anyone seen this sort of behavior from natural testosterone levels?[/quote]

Yes, in healthy younger guys afternoon T levels are roughly half of their morning T levels, just like yours (the margin of error of the common lab tests for T is about 50 points). That kind of variation is normal. The T level that should be used for diagnosis should be the morning level, so only one of your three tests is actually valid.

Well, the last test was taken at noon, and I have a hard time believing that 181 isn’t low if taken at noon. Also, Quest has a margin of 20 ng/dL of accuracy for total testosterone.

While the fluctuation over the course of the day may be normal, your numbers are consistently low. It’s true LH function is pulsatile so you will see fluctuation there too, but the fact that you had one test come back below range and another come back at bottom may suggest there is some degree of dysfunction at the pituitary.

T level is also low. While the 420 result is within range and would prob not get you a diagnosis from many Docs, it is still sub-optimal and could be consistent w/ you feeling like shit - low T symptoms.

I can’t say for sure, but assuming no other contributing problems, it looks like you could have some degree of secondary hypogonadism. The pituitary for whatever reason is often not producing enough LH, even though it does sometimes. Your nuts are probably still responding sufficiently to whatever LH they’re given, and producing what T they can, but they need more LH.

Just my two cents. I cannot comment on cortisol or D3, other than saying you should probably start with D3 supplementation if you aren’t already

Thank you Robert. I have been supplementing 5000IU per day of D3, I’m going to up it to 9000.

My new endo just called and wants to put me on a monthly 200mg injection (at least initially). I don’t know how I feel about this.