T Nation

Low LH & FSH. High E2, Moderate Test


#1

Hi guys…so I just got some blood work done and i’m very concerned about the low LH & FSH and of course the high E2. I will give as much info as I currently have. I do plan on seeing a doctor next week that my dad went to and he was put on test and arimidex so i’m hopeful that he isn’t an Idiot doctor. My current thoughts are to ask for HCG and/or clomid to increase my LH/FSH and Lower E2? I’m not sure that I need test at all. If you have time to read this, please let me know your thoughts.

-age - 29, Turning 30 in November 2016

-height - 5’ 9 1/2"

-waist - 34"

-weight - 189lb

-describe body and facial hair -

Not too much on my chest. Cant exactly grow a full beard but it’s not too bad, still kinda thick. Head hair has always been good and thick.

-describe where you carry fat-

Lower abdomen and love handles. Some on chest but probably gyno.

-health conditions, symptoms [history] -

I had a good amount of gyno removed Sept 2013. Got E2 checked after surgery and it was at 30.9 (ND-39). I had gyno since puberty and I believe taking Tren when I was 21 made it worse.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever-

Ran Tren prohormone when I was 21 like a dummy. Ran it for 6 weeks and used Tamoxifen + Natural test booster for PCT (young and dumb).

Taken 9/23/16 at 8:06 am.

WBC 5.3 (3.4-10.8)
RBC 4.48 (4.14-5.80)
Hemoglobin 15.1 (12.6-17.7)
Hematocrit 42.8 (37.5-51.0)
MCV 96 (79-97) Borderline High
MCH 33.7 (26.6-33.0) HIGH
MCHC 35.3 (31.5-35.7) Borderline High
Fasting Glucose 97 (65-99) Borderline High
BUN 21 (6-21) HIGH
AST (SGOT) 24 (0-40)
ALT (SGPT) 28 (0-44)

Testosterone LC/MS
Total 594.3 (348-1197)
Free 16.6 (9.3-26.5)
Estradiol 30.3 (7.6-42.6)
LH 3.8 (1.7-8.6)
FSH 0.9 (1.5-12.4) LOW
Prolactin 14.2 (4.0-15.2)
Cortisol - AM 17.2 (6.2-19.4)

Thyroid
TSH 5.360 (0.450-4.500) High due to 2 weeks 50mg Iodine. Temps did not increase.
Free T4 Direct 0.97 (0.82-1.77)
Free T3 3.0 (2.0-4.4)
Reverse T3 17.8 (9.2-24.1)

-lab results with ranges (August 30, 2016)-

Testosterone, Total - 551 (348-1197)
Testosterone, Free - Not taken but will take soon.
LH - 1.8 (1.7 - 8.6)
FSH - 1.0 (1.5 -12.4)
Estradiol - 42.2 (7.6 -4 2.6)
WBC - 4.2 (3.4 - 10.8)
RBC - 4.74 (4.14 - 5.80)
Hemoglobin - 15.3 (12.6 - 17.7)
Hematocrit - 45.5 (27.5 - 51.0)
AST 33 (0-40 IU/L)
ALT 29 (0-44 IU/L)

Everything else in CBC is normal (let me know if you want anything specific).
CMP all normal (let me know if you want anything specific)

-lab results with ranges (December 2015)-

TSH3 Ultra-Sens - 1.72 (0.55 - 4.78)
Free T4 - 1.03 (0.89 - 1.76)
Free T3 - 3.24 (2.30 - 4.20)
AST 40 (10-42)
ALT 35 (<40)
Hematocrit 48.8 (41.0-50.0)
RBC 4.88 (4.40 - 5.80)
WBC 4.6 (3.8 - 10.8)

-lab results with ranged (September 2013)-

Testosterone, Total - 383 (241-827)
Testosterone, Free - Not Tested
LH - 4.45 (1.5 - 9.3)
Estradiol - 30.9 (ND - 39.8)
FSH - Unknown, doctor only gave me first sheet with Test, LH and Estradiol.

Planning to get these done soon. Which do you think are absolutely necessary and are there any others that you suggest I get before going to the doctor?

Testosterone, Free
SHBG
Prolactin
Cortisol
PSA, Prostate Specific Antigen

-describe diet-

4 weeks ago I started to “cut” and changed to a Keto diet. My Daily Calorie needs are ~2900-3000 calories and I am consuming 2500 calories with 30 min low intensity cardio approximate 3-4 times a week. Carbs are 20g or less, Protein is 170g daily, and Fat is around 200g daily, whatever adds up to 2500 depending on carbs consumed. Usually split into 5 meals and rarely into 4 meals. All calories come from Food and no supplements are being taken except for a little fiber and multivitamin. Water is at 1gal daily.

Before this keto diet I basically “bulked” for about 4 months and ate 3500-3700 calories daily at about 25% pro / 20% fat / 55% carbs. Lots of Chicken, brown rice, oatmeal, sweet potatoes, gold potatoes, egg whites, mct oil, nuts and avocado.

-describe training-

If you’re familiar with it, during bulk I did Arnolds Blueprint to Mass with a few slight variations at times if I got bored. I dont do 6 days straight then rest on the 7th like the blueprint says. I just go in order whenever I get a chance to workout. Usually 4 days per week.

http://www.bodybuilding.com/fun/arnold-schwarzenegger-blueprint-trainer-day-1.html

Now that I’m cutting i’m using Arnolds Blueprint to Cutting.

http://www.bodybuilding.com/fun/arnold-schwarzeneggers-blueprint-to-cut-day-1.html

-testes ache, ever, with a fever?-

I do remember them aching before but maybe only twice in my life (mid 20s) and it was completely random. They didn’t hurt for very long, maybe a few minutes. No fever at the same time.

-how have morning wood and nocturnal erections changed-

Morning wood still happens every morning. Nocturnal still pretty good. I have been noticing that sometimes there’s no desire to have sex with my gf before bed though…when I do remember in the past it was a MUST. I have no problem getting and keeping an erection.

@KSman


#2

Your E2 is high. If you treat that, there’s a good chance your T will get a boost. IIRC, the studies average T boost is 150 or better. A 150 boost would put you at 700, a respectable number.


#3

Thank you for the reply. I do understand that but of course a big concern of mine is the 1.8 LH and 1.0 FSH. Would a high E2 really bring those values down so low?
Current Testosterone is 551, LH is 1.8, E2 at 42.2
3 years ago my Testosterone was 383, LH 4.45, E2 30.9


#4

Also, should I be tested for any of the following before I go see the doctor? Or am I ok with what I have provided?

Testosterone, Free
SHBG
Prolactin
Cortisol
PSA, Prostate Specific Antigen


#5

E2 is the signaling method whereby the pituitary is told to stop making LH/FSH. So yes, high E2 will definitely cause low LH/FSH. (LH-FSH -> T -> E2)

I wouldn’t bother with PSA at your age. Prolactin would be nice. However, the doc is probably going to send you out for tests anyway.


#6

So Adex at .25-.50 E3D would work? Retest in how long?


#7

With lower FT we can expect that FT–>E2 is low. Then high E2 suggests poor E2 clearance by the liver. Can be a liver problem or meds or toxins that interfere with E2 clearance.

Adex is competitive with FT and must match your serum T levels. As T levels are not high, you cannot take 1mg per week. Suggest 1/2 per week, 1/4mg twice a week.

Labs:
AST/ALT - liver

Read these stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Thyroid:

  • TSH better near 1.0
  • T4 below mid-range
    This suggests that you might not be using iodized salt.
    Check overall thyroid status by taking oral body temperatures as per the thyroid basics sticky

Thyroid can affect LH/FSH and T


#8

Thank you @Ksman . I feel as though liver should be fine but I’ll get that checked asap. Keto diet have anything to do with the liver acting up?

I read your stickies yesterday and ordered a oral thermometer. I’m leaving town until Saturday night so I won’t be able to test temps til Sunday and no blood work until Tuesday because of the holiday.

I have Tamox, Ralox, Exemestane, and Clomid but no Adex. I’ll order Adex right now.

Can I take exemestane for the first week until I get the Adex? If yes, what dose and frequency? If no, understood.

Thanks for the help guys.


#9

25mg EOD would be OK


#10

Ok thank you @ksman.

Adex is on its way. I will start with the stane @ 25mg EOD for now.

How long until I test E2 again?

I’m guessing I should test TT, FT, LH, FSH and E2? Is FT necessary?

I ask because the price nearly doubles just to add FT. Thanks again.


#11

Get the “female hormone package”. They are usually bundled together at a discount.


#12

@gonadthebarbarian that’s the one I ordered for $66.99 but doesn’t include free test.

Option 1) Hormone Panel with F&T Testosterone LC/MS-MS

That one is $103.99 and is exactly the same but includes free test

Option 2) Hormone Panel with Prolactin
Does not include free test but includes prolactin for $99.99

Option 3) order option 1 for $103.99 and prolactin on it’s own for $47.99

Now how important is SHBG?

Option 4) Hormone Panel with F&T Testosterone & SHBG $156.99 plus prolactin for $47.99

Thanks for being patient with me guys.


#13

@ksman I’ve been taking the exemestane as directed. ADEX will arrive Wednesday. I am taking the 25mg exemestane today (Monday) I’m guessing it’s ok to take the .25 adex 2x/week starting on Wednesday?

Thyroid - constant readings under minimum temps. Suspected hypothyroidism. Morning temps 96.9-97.2 and daytime temps maximum at 98.3. It is 1:30pm right now and just tested at 97.9 at the very back under my tongue. If I do mid tongue area i get 97.6

Iodine tabs - I took 12.5mg twice. Once in morning and the other around 8pm. The 8pm one gave me a slight stomach ache. I’ll stay at 25mg until I build a tolerance.

Labs - No new labs yet. How soon can I do labs to check up on E2? A few weeks after starting Adex? Should I do labs on the day that im supposed to take an Adex dose but before actually taking the dose?

Side notes.

Altitude sickness or first ever migraine at 9k elevation over the weekend. I live at sea level. Throbbing headache, pain at nose/eyebrow area, sensitivity to light and vomiting. It got pretty intense over the period of about an hour and a half until i vomited and everything felt better and I was able to sleep. I wanted to rule out AI as a cause. I honestly think it was due to dehydration, elevation and poor fast food diet over the weekend. This is At least my 20th time visiting the same place and this never happened.

Blood Pressure - Just tested at 130/60 with heart rate of 42 bpm.

Suspected hyperthyroidism in girlfriend. She is 5’2" and struggles to hit 100lb. Has always struggled to gain weight. Her temp readings are constantly 1 degree higher than mine. Around 98 when waking and 98.9 during the day. Her mother survived thyroid cancer a few years ago. Any labs or anything you can recommend her to do?


#14

Just bumping the thread.

Thank you @KSman for everything that you do. I hope you get a chance to check out my recent post.


#15

If I’m taking 50mg iodine daily, how much Selenium should I be taking?

Anyone?


#16

I’m not familar with exemestane.

I dose my arimidex daily, dissolved in water. You see people dose it 2x a week because they are injecting 2x a week and T is highest (thus t->e2 is highest) at time of injection. You seem to have naturally high E2, consider daily dosing.


#17

@gonadthebarbarian you think I should dose daily because I have naturally high e2 so dosing e3d isnt really effective?

Should I still dose .5mg per week?


#18

Well, if you like spikes and valleys in your E2, e3d is fine.

I dose around 1/10mg daily and arrived at that through symptoms only. I’m scheduled for bloodwork in another 3 months.


#19

I understand. So you’re taking .7/week

I was going based off of KSmans advice. I’ll cut the dose down to a daily dose.

It seems my iodine tolerance is better. I haven’t gotten stomach pain lately. Today will probably be the first day that I get the full 50mg. I’m also taking in a total of 460mcg selenium per day (60 from iodine tabs and 400 from multi vitamin (200 twice per day)).

I’ve been on an AI for 8 days now, i’m guessing i’ll test again at the 30 day mark to see where i’m at. I decided i’ll do the following panel + prolactin. I feel as if my prolactin levels are probably high. I actually had discharge from my nipple when I ran tren by itself when I was 21. Like I mentioned, I had my gyno removed when i was 26 but i feel like some of it came back on my left side as it is still tender while the right side is not.

Includes:
Lipid Profile: Cholesterol, total; high-density lipoprotein (HDL) cholesterol; low-density lipoprotein (LDL) cholesterol (calculation); triglycerides; very low-density lipoprotein (VLDL) cholesterol (calculation).
Complete Blood Count (CBC) with Differential: (Hematocrit; hemoglobin; mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration (MCHC); red cell distribution width (RDW); percentage and absolute differential counts; platelet count; red cell count; white blood cell count; immature granulocytes)
Estradiol, Sensitive
Insulin-Like Growth Factor I (IGF-I)
Comprehensive Metabolic Profile (CMP) (includes eGFR): (A:G ratio; albumin, serum; alkaline phosphatase, serum; ALT (SGPT); AST (SGOT); bilirubin, total; BUN; BUN:creatinine ratio; calcium, serum; carbon dioxide, total; chloride, serum; creatinine, serum; globulin, total; glucose, serum; potassium, serum; protein, total, serum; sodium, serum.)
Testosterone, Free (Equilibrium Ultrafiltration) With Total Testosterone
Prostate-Specific Antigen (PSA)
Thyroid Profile w/ TSH: Free Thyroxine Index (FTI);Thyroxine (T4); Thyroid Hormone Binding Ratio (T3 Uptake); Thyroid-Stimulating Hormone (TSH)


#20

@KSman I had the AST (SGOT) and ALT (SGPT) this whole time. Tested 8/31/2016, I’ll update my first post also.

AST 33 (0-40 IU/L)
ALT 29 (0-44 IU/L)

Should I be donating blood with Hematocrit - 45.5 (27.5 - 51.0) ? On 12/17/2015 my Hematocrit was 48.8 (41.0-50.0).