" Primary hypothyroidism (Gonad problem) is usually diagnosed based on an elevated TSH level. In this situation, the failure of the thyroid gland to secrete sufficient thyroid hormone results in decreased levels of T3 and T4. In turn, there is less negative feedback inhibition at the hypothalamus and pituitary, causing TSH levels to increase (Figure 1). Increased TSH levels are therefore indicative of the diagnosis, and normalization is seen during adequate treatment."
In contrast, owing to hypothalamic or pituitary failure, TSH levels might not increase in response to low T3 and T4 levels.6 Thyroid-stimulating hormone levels can, in fact, be in the low, normal, or elevated range.3This is because TSH pulse frequency and amplitude might be maintained, and additionally, its biologic activity might be reduced with its immunoactivity still retained.2 Furthermore, other hormone deficiencies can affect its measure.7 Therefore, for the diagnosis of central hypothyroidism, one needs findings of low free T3 and T4 levels together with low or “inappropriately” normal TSH concentration in the context of hypothalamic-pituitary disease.3les/PMC3114669/figure/f1-0570677/)). Increased TSH levels are therefore indicative of the diagnosis, and normalization is seen during adequate treatment.
(test= low-normal TSH LH and T3 and T4)
for It to be a gonad problem their must be elevated levels of TSH LH and elevated as in much beyond the normal range. Usually around double.