Yes, appears to be primary. But at your age, not expecting age related decline, we should be looking for causes. That makes sense with secondary, but not much to look for for primary.
In the testes, DHEA–>T. It would be good to measure DHEA-S. Do not check DHEA as its levels change a lot.
We sometimes see problems with the veins that service the testes. So there is a physical exam that is needed. Any aches or pains?
If LH is high and constant, that would turn off the testes. The testes need the signal of pulses of LH. Get LH tested. There are many types of pituitary tumours [adinomas] that can shut off some hormones or produce lots of them. Luteinizing hormone-secreting pituitary tumor: biosynthetic characterization and clinical studies - PubMed There are adinomas that create TSH, LH, FSH, prolactin. There are some hormone secreting pineal tumours.
Your FSH high makes sense in terms of primary hypogonadism, but high-steady LH could cause the primary. The problem is that when you test LH, one cannot tell if the LH levels are steady.
In young men, pituitary disturbances can be suspected and confirmed or ruled out with a MRI. The optic nerves pass by the pituitary and if an adinoma is large it will press on the optic nerves. That causes visual field disturbances such as loss of width of peripheral vision. Other issues are possible.
TSH is a concern which leads to temperature and iodine issues. Also read the thyroid basics sticky for background. Subclinical, or worse, hypothyroid problems create symptoms that are similar to that of hypogonadism. And that could be contributing to many of the problems that you are experiencing.
Yes, excessive training and/or starvation diets can trash one’s hormones. But, that leads to secondary hypogonadism with low LH/FSH. Not seen a primary case before, but exceptions are the rule.
- body temperatures
- report iodine intake in supplements and iodized salt intake
- lab work for LH, but do not know how to eval if steady, which creates doubt
– if LH is low, that is also evidence for an adinoma [rare]
- report cholesterol levels
- test DHEA-S
- test E2 estradiol
- report when this started and any possible precipitating blows to the head or illnesses
Hopefully you do not have an adinoma, but at least now you will be able to consider some diagnostics to rule that in or out. The major concern is to detect these rare cases and take action to prevent further harm. This often comes up as an issue with young men; again because there is not age-related explanation.
Adenoma reference http://www.urmc.rochester.edu/neurosurgery/specialties/neuroendocrine/documents/PituitaryTumors.PDF