T Nation

Lengthy Post: Low LH and FSH


#1

First off, I want to thank the contributors to this site. I have learned more in the past few months than i ever could have imagined. I am still learning and to be honest, its alot to take in and absorb when you're frustrated, exhausted, and at both your emotional and mental limits. My story...

November 2009 I was a fat bastard. Marriage and its comforts and securities made me stop taking pride in myself and not be in the best physical shape since i was not "on the hunt" anymore. My best friend asked me to be in his wedding in August of 2010 and that become my motivation to better myself. I had roughly 9 months to loose my fatness and get in shape. About this time i had a friend who just went through and successfully completed Ranger school. When he went in, he weighed about 45lbs heavier than when he came out. So i asked him how he lost all his weight. His basic statement was move as much shit as long and hard as your body can go on minimal calories. That became my new workout plan which i guess upon reading on here, is probably why i am here to begin with. I lost 65lbs in roughly 8 months and honestly i looked damn good. But starving yourself and not getting the correct nutrients seemed to fry my joints(which were already shot to begin with) and screw up my metabolism. I honestly had no idea what i was doing to myself.

Fast forward to May 2012. I was able to keep my weight off and maintain with 5-6lbs of 2010. I had no symptoms of low t and was fucking life in the ass. Then my son was born. With all that associated with a new born, i gained back about 20lbs which brings me to May 2014. My son was now two years old and sleeping through the night. But why in the world was i so tired all the time. I basically woke up, went to work, came home, ate dinner, played with the kid, and was in bed by 830 completely exhausted. I felt something was not right so i went to the doctor and told her what was going on. She pulled blood and tested me for low t. Before i continue, i will admit right now that i had no clue what was going on. I had not studied up on what was being prescribed.

These are my numbers.
Test Total- 498 (292-1052)
Free T4- 1.13 (.5-4.7)
Free T3- 3.4 (2.3-4.2)
Free Test- 7.8 (4.8-25)
DHEA Sulfate- 398 (240-549)
TSH- 2.3 (.5-4.7)

Upon receiving those numbers, she prescribed 100mg Test-c every 10 days, 30mg armour thyroid ED, 50mg DHEA SR ED. Come back in 8 weeks. I asked no questions and walked out.

8 weeks came and went and i went back. I told her i noticed no difference in quality of life, sex drive, energy, ect. She told me to up to 200mg/1x per week and see how it was going in another month or so. I decided that if i was going to start injecting myself with drugs and basically need a dedicated calender and pill organizer for all the stuff i was now taking, i figured it was time to read up and get educated. About that time, i started to notice an uncomfortable feeling in my nuts. They started aching and becoming cold. I figured this was not good so i called her up and asked her what this could be. I was just getting into the data that testosterone can and will effect fertility and since me and the wife were about to try for a second kid, i wanted to make sure this is not a side effect. She told me it was not and not to worry. I also asked about using an AI and she said its not recommended for men and she will not prescribe one. Ok, so i continued to study and basically "made endocrinology a hobby." I found a walk in lab in Lubbock, Texas and asked if i could do my blood work plus a sperm test to verify nothing was wrong.

Early July numbers
Test Total- 1164 (208-1100)
Free Test- 242 (35-155)
T3 Free- 3.9 (2.3-4.2)
Estrodial- 50
Sperm Test- Sample was almost to small to test. 0 sperm found in sample provided.

At this point, i felt like a god. I was working out again, fucking the wife until she walked bowlegged, and was able to stay up voluntarily past 8:30 for the first time in several years. Then the sperm test came back and it confirmed my fears. I called the doctor and she was in disbelief of the test. She said the only thing i can do i refer you to a urologist. I made an appointment with the so called "best one in the area" but it was going to be late August before i can see him. I also called one of my friends who has dealt with AAS since high school and asked him what to do. I also asked another website for guidance and both replied with the clomid restart. 75mg ED for 2 weeks and then 50mg EOD. I did this protocol for 6 weeks and was retested. 1mg anastrozle split into 1/2mg doses per week.

Late August numbers
Test Total- 911 (200-1100)
Test Free- 138.3 (35-155)
Estrodial- 39
Sperm test- I handed the sample cup to the lab tech and she blushed. She said it was the largest sample she had ever seen. I maxed out all the categories on the test ran on the sample.

These numbers may look good but in reality, i felt like i was in living hell. I have suffered from depression all my life and i have been down pretty low but i was able to will myself out of it and i usually was able to. This was different. I was all ready to divorce the wife, was convinced she was having an affair, and was just short of wanting to blow my head off. Upon reading, clomid can cause depression like symptoms. I stopped this and started looking for other options. Also, the wife was still not pregnant. I took some time off from everything while i tried to reevaluate what i can do and was at my mental and emotional breaking point. Then the appointment came with the urologist. I waited over 2 hours in the lobby to see him. Waited over an hour in the room for a 7 minute conversation saying i should have never been on testosterone to being with, my numbers should have never gotten over 600 while on testosterone to be safe due to risk of heart attack and stroke. (insert doctors are idiots and have god complexes sticky here)

My only other options was hcg. After talking to my friend and the other members of the website i received advice from, 1000iu hcg 3x per week until the wife was pregnant. I started the hcg in mid September and took blood in October. I was long longer able to use the Lubbock walk in lab since i was back in East Texas. There is not a walk in lab within 100 miles so i used privatemblabs so i was unable to do a sperm test as they do not offer it. I had to do the woman's hormone panel. I feel that this may be the incorrect test as the test for the testosterone is the serum and not the free and total.

Late October numbers
Test Serum- 204 (348-1197)
LH- 7 (1.7- 8.6)
FSH 4.6 (1.5-12.4)
Estrodial- 16.2

I was back to feeling like crap again but without the depression. The wife became pregnant early November so i found it was time to start my testosterone again so i could improve my quality of life again. I started at 100mg test-c 1x per week along with 500iu hcg 2x per week to help ward of testicle atrophy. I continued the 1mg anstrozle divided into 1/2mg doses per week.

December 30 numbers
Test Serum- 601 (348-1197)
LH- <.2 (1.7-8.6)
FSH- 0.7 (1.5-12.4)
Estradial- 16.4

While i do not feel god like, i feel "ok" Its still hard to stay up past 9ish and find the energy to do much around the house. What is confusing me is why the LH and FSH are low since i have been taking the hcg. So any advice is welcome.

I do apologize that this is so long. I hoped to get as much information stated so there was no delay in conversation trying to obtain the basic information needed.


#2

LH and FSH are still low because you're on exogenous testosterone, and is a perfectly normal finding. Although hCG is an LH mimic, it does not show up as LH on bloodwork.

The reason you don't feel that great is because your E2 is far too low. This was not a sensitive test, so your actual E2 value is going to be much lower than 16.4, possibly at undetectable levels.

Back off the Anastrozole. You definitely need to lower the dose, or you may not even need it at all.


#3

Thanks Alwaysup. I noticed that as well. In your opinion, would upping the test-c to maybe 150mg be a good move?


#4

How many days after your last T injection were those labs drawn?


#5

You need to inject 50mg twice per week. With weekly injections, your levels change a lot and not knowing when labs were done re injection timing, its hard to know what TT=601 means. Your E2 levels are also sort of meaningless with 1/2mg acting on falling T levels.


#6

I inject on Saturday and those numbers are from Friday the day before.


#7

Free T4- 1.13 (.5-4.7)
Free T3- 3.4 (2.3-4.2)
TSH- 2.3 (.5-4.7)

TSH is too high, SB near 1.0
fT3 is good
fT4 should be near mid range. Do you have the range numbers correct?

Are you using iodized salt?
Are your body temperatures low?
- thyroid basics sticky

Clomid can make some males feel horrible. Nolvadex does not do that and does the same thing. And dose may have been too high. Result was E2=39 that would make you feel bad too.


#8

I do apologize. I was looking at alot of numbers and read off the wrong line for t4.(.73-1.95

I read the thyroid stick and I do not believe I have a thyroid issue. My temps are normal and not low in the mornings. I honestly despise salt. Only salt I get is in the form of whatever the food already has in it or whatever a restaurant prepares with. Only thing I do add salt to is chips when I eat chips and salsa. Hahaa.


#9

Ideally you don't want to make too many changes at once, but your protocol needs some work. I'd agree with KSman that you should split your T dose into 50mg twice weekly. On top of that, drop the Anastrozole. You probably don't need it, and you're less likely to need it once you've split your T injections. Retest in ~6 weeks and see where your values are.

Depending on how your bloodwork looks you could consider raising your dose of testosterone. I'd hold off on upping your dose until after follow up labs, it would be helpful to see how much aromatization occurs with you on 50mg twice weekly before raising the dose by 50%.


#10

And continue the 500iu hcg 2x per week?


#11

Yes.


#12

Thanks!

OK based on my t3 and t4 numbers, do I need to continue with the 30mg armour? Seems to me that the difference was very minimal in my numbers. My prescription is about to run out and it will not be until March until I can get it refilled. If I do need to keep taking it, can I substitute with research t3 from a reputable source?


#13

No problem.

I'll let KSman chime in on the thyroid stuff, as I'm far from an expert on the matter and don't want to give you bad advice.


#14

Thanks for the help thus far. It's much appreciated.


#15

If you don't take iodized salt, you are deficient and TSH is pushing your thyroid harder to maintain good T3, T4 levels; but that probably will break in time. You need IR and vitamins that have selenium and iodine. Then try tapering off of Armour.

If you do nothing: Hypo can progress to hyper with nodules that can become cancerous for some.

Your good fT3, fT4 numbers and good body temperatures indicate that rT3 is not elevated and so you can probably take adrenal and stress considerations off of the table.

If others in your home do not use salt, they might not be doing as well as you. Take temperatures.


#16

You're absolutely right. Someone else in my house is not doing so hot. My wife is on 90mg daily armour. I forwarded her the thyroid sticky and she is reading it and trying to figure things out.
She is currently pregnant and is getting up every few hours to pee during the night. When is the best time to do temps?


#17

The point is to try to see how cold you get during sleep. With thyroid drugs, body temps are controlled by dose and half-life and normal temperature cycles might not apply. In any case, body temps provide good feedback on thyroid dosing. Low body temps can indicate that T4-->T3 is not very effective in some individuals. fT3 and fT4 labs are important. If fT3 is good and body temps are low, rT3 is suspected and with adrenal fatigue, more T4 leads to more T4-->rT3 and things can get worse in that situation.

Iodine and thyroid issues can be important during pregnancy.

Iodine is stored primarily in the thyroid gland, as a reservoir. However, women also store iodine in breast tissue to provide some iodine during breast feeding. I assume that the thyroid gland is storing available iodine during pregnancy. Perhaps a major IR during pregnancy might not be wise. There is some iodine in thyroid drugs that will be of some benefit.

Please explore these links: https://www.google.com/search?q=iodine+during+pregnancy


#18

Can anyone comment on the increasing of snoring while on TRT? Up until the past few month, the only time I have ever snored was when I was sick with a head cold or something that involved sinuses, or when extremely tired. I currently am not sick and not tired but my snoring is so bad that the wife got up and slept on the couch last night. This is the worst side effect I could possibly think of.


#19

This happens quite often. Its really making soring worse. I suspect that if one happened to have naturally high T levels, they would be snoring and it may be that age related decline in T levels reduces snoring and TRT restores the potential. I suspect that the problem is worse with higher T doses; so those getting 200mg/week roid doses from TRT clinics are probably worse off. It is the wive/GF who suffers.


#20

Damn. Being on 100mg a week is doing this to me!