T Nation

Lab Results: Very High FSH and LH, Very Low Testosterone


#1

Been on test. cyp. injections (100 mg per week) for 3 years, came off of it to get pregnant and followed recovery procedure via HCG followed by Clomid. I have been on Clomid for about 1.5 months starting with a dose of 25mg/day for 10 days and 25 mg EOD for about 30 days. Got my lab results back recently:

Total test: 259 (I have been significantly tired at the gym and hard time catch a breath)
Estradiol: 13.2 (I am taking 100 mg of DIM and 2 x 500 mg of D-Glucarate/day.)
FSH 14.1
LH: 19.4

What do you guys make of this? Should I up the Clomid dose to 25 mg / day instead of EOD? I’m just afraid that it may desensitize the LH and FSH. Is the problem in my testes? The weird thing is that my Testes have grown significantly since I stopped TRT injections and been on HCG followed by Clomid. And lastly, it will eventually get there, but takes longer for me to get it up during sex.

Lastly, I know some guys just stop TRT and takes them 6 months until they are fertile again. I have been off of Test cyp. just over 2 months. Is it just too early to tell?


#2

Your LH/FSH is high and T is low.
Your testes simply are not working very well and you should not increase LGH/FSH further. 3 years T without hCG-or-SERM can be expected to damage testes and your doctor should have discussed these issues with you 3 years ago.

Please get your semen examined.

Wait longer? If you want.

What has happened to size and firmness of your testes and did they get very small over three years?

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#3

My testes definitely shrank over the last three years, but have grown a little while stopping TRT and switching to HCG for a couple of a couple of weeks. However it has almost doubled its size while on clomid for the last 40 days. Doesn’t this point to proper testes function and should be seeing higher testosterone? I will be providing my semen sample in a few days.

Should I stop taking clomid cold turkey since it didn’t do anything with my testosterone levels? I do not want to desensitize the LH per your sticky I read. Would I be better off going natural for a month and check my FSH and LH levels again? Thoughts? Should I just stick with HCG Instead? My only concern is that HCG will desensitize the leydigs.


#4

hCG will not do anything that LH does, but hCG is not FSH. You are better off with a SERM so FSH improved sperm production. You need a semen analysis to see if you are even in the game. Some changes do take time as there are bulk tissue changes taking place. Going natural is not going to solve this.

You can stay on TRT and do SERM, then your libido may be up to the task.


#5

Thanks KSman. I like the idea of Test Cypionate + Clomid, but why do people just stick with Clomid and quit TRT when trying to get fertile again?


#6

KSman - Any thoughts on taking SERM + Test. Cypionate being counter intuitive to trying to be fertile again?

Man…I feel like death just on Clomid and very Low T and E2… Stopped taking DIM and D-Glucarate and reduced Clomid down to 12.5 mg EOD starting this past weekend… Throughout several years, I’ve also worked out int the gym 2 hours every day without much rest. Maybe my Cortisol level skyrocketed and messed up my T production from my testes due to no rest between workout days? I have stopped going to the gym as of this past weekend as well and will perhaps just do one hour light-moderate cardios for about a week?


#7

Why do guy stop T and do Clomid instead of T+Clomid?
Ask the brain dead doctors.

With T+Clomid, you still do these labs: TT, FT, LH/FSH and E2. LH/FSH tell you how well this is working. You will feel great with high T and E2 near E2=22pg/ml. If E2 and LH/FSH are high when using anastrozole, Clomid dose is way too high.

With T+SERM, if LH/FSH are good, fertility does not need anything else. You need the T to want to chase your wife around the house.

Always need to point out that some guys, not rare at all, feel horrible with clomid, but do great with Nolvadex that never does that. Clomid side effects: feel depressed and generally like shit, perhaps “feel like death”. That is in the stickies and you should have picked up on this on your own.

Have you read the things that damage your hormones sticky where over-training is discussed?

RTFM :wink:


#8

So I read ALL the stickies and also switched from Clomid to Nolvadex about 4 days ago. I feel about 70% better. Clomid was horrible!

How long should I wait until I do another blood test to see if my testosterone is actually increasing with the elevated LH levels? Because I was on a relatively low dose of Clomid and my LH levels were still high & Testosterone LOW, the doctor put me on only 5mg Nolvadex ED and asked me to get my blood checked again in a few weeks and increase the dosage if all looks fine.


#9

That is the definition of primary hypogonadism. When one is primary, things will not work. Can testes recover from 3 years of HPTA shutdown? This is case by case. We do not know if you were primary before TRT. Original labs would help with that if LH/FSH were tested then.

I am glad that you got past this clomid problem, you can inform your doctor that this is not uncommon and that Nolvadex could be first line to avoid this.


#10

So did another lab a month later and the results are looking good. This is after tapering to only 2.5mg/ 5days of nolvadex during the last couple of weeks.

Total testosterone 516 (264 - 916)
Estradiol: 25 (7.6 - 42.6)
LH 15.9 (1.7 - 8.6)
FSH: 17 (1.5 - 12.4)

Should I up my nolvadex? My LH and FSH seems a bit high.

I will do another sperm count in the next couple of weeks.


#11

Your labs are meaningless without lab ranges, all labs have different lab ranges so these are important.


#12

No you do not need to up the Nolvadex, it is working per the high LH/FSH numbers. Give it some more time to work - your testicles are obviously trying to fire back up production and the LH/FSH is forcing them to start working for you again (which it appears it is from your lab work).

Have you noticed your testicles continuing to increase in size?

516 on total testosterone is not a bad number, your E2 looks pretty good.


#13

Yes it is continuing to get bigger and starting to feel better as well. I have not been on nolvadex for 11 days. I will probably check labs again in a few weeks without any meds.


#14

My test results came as

8.3 which is low i think 257.

Lh is 2.8 which is normal.
Fsh 5.5 which is normal.
Estrogen is 66 which is 17 and normal

Tsh is normal.at 1.58.

Do you think im primary?. I felt crap after taking a sarm ostarine for two days only.


#15

Are you attempting to convert E2 non-sensitive to E2 sensitive? Just because it’s normal doesn’t mean you’re in the clear, no labs ranges.


#16

Normal is from 40 to 155 in the uk and mine came at 66


#17

Testosterone conversion was a bit off
Looking at Low Test levels:
8.3 ng/dL = 288 nmol/L
FSH and LH are closer to the lower number range:
LH: Normal (~1-8) Preferred (4-7) : You (2.8)
FSH Normal (~1-11) : You (5.5)

I’m gonna lean towards - Secondary Hypogonadism - mostly due to the fact that your FSH and LH haven’t spiked into the upper level of ranges toward something like:
LH : (7+) & FSH : (8+)

Another thing to consider is the time of day your blood was drawn - due to LH and FSH surges throughout the day - along w/physical examination

  • Blood Drawn : 8:00 - 10:00 a.m.
  • Physical Exam : Evaluation of pubic hair development rate and most importantly the volume (largeness and fullness) of testicles

Your LH and FSH do not reflect numbers seen in patients experiencing PRIMARY Hypogonadism… With that said, your numbers certainly don’t reflect normal levels of sexual hormones. You mentioned normal Estrogen but depending on your doctor some may consider that elevated to a degree.
Normal Estrogen - (20-55) You : (67)
While TRT may be considered but with TRT comes a near shut down of LH and FSH levels so that must be taken into account…
As far as Ostarine goes, minimal suppression will occur w/Ostarine and to feel differently 2 days in is strange but everyone is different. One reason may be the slightly lowered levels of LH and FSH from Osta but 2 days still would be way too quick so last solution may be a problem w the source of Ostarine and the purity of your substance. I hope you’re able to, along with your physician, find a course of action for what seems to appear as Secondary Hypogonadism
Hope this helps you take your next step in treatment! Best of luck!