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Low T, Average FSH, LH after Finasteride

Hi guys, I’m hoping to get some insight from this knowledgable forum. I took three small doses of Finasteride back in late January. From that point forth I noticed my libido decrease notably, loss of sensation in my penis, and I became significantly flatter and less emotionally reactive.

I first saw a doctor about this in April, and the test results demonstrated normal hormonal levels. Doctor ruled out any hormonal issue.

I noticed no improvement aside from 4 days and then another 3 days where my mental affect as well as libido returned to normal before disappearing again. As a consequence, I went back and saw the doctor, requesting another blood test, this time testing a wider range of hormones.

Please find the results attached. Note that the first number is from the test in April, and the second from the one this month (July).

S FSH 4.8 IU/L (1.5-9.7)
S LH 7.4 IU/L (1.8-9.2)
S PROLACTIN 246 mIU/L (90-400)
S OESTRADIOL 54 50 pmol/L (<160)
S PROGEST 1.0 nmol/L (0.7-4.3)
S TESTO 21.9 11.3 L nmol/L (12.0-31.9)
S SHBG 51 50 nmol/L (17-56)
cFreeTesto 349 165 L pmol/L (260-740)
S DHEAS 9.3 umol/L (4.3-15.0)
S 25OH VIT D 55 nmol/L (50-250)

Serum and Free testosterone have plunged over the past four months since the last test. LH and FSH look rather mid-range which is unusual.

Any further thoughts on these results? It’s peculiar that I felt the effects of hypogonadism well before I reached the state which I am now in.

Many thanks guys.

You have high SHBG which as a consequence reduces your Free T and can cause the same symptoms as hypogonadism. Are your FSH/LH from the first or second set of tests?

I’m on the same boat. Good luck

High SHBG creates more non-bioavailable SHBG+T which reduces FT and inflates TT, so TT then overstates your T status. So TT=11.3 is worse than it appears.

FT is released in pulses from LH pulses. Both FT and LH have short half-lives, so lab numbers have a lot of noise. You could have sampled a LH peak levels.

E2=50 is low and FT–>E2 must be low. Suggesting that average FT levels are low, which we do see.

It seems like your testes are not working properly.

For those who are damaged by finasteride, there may be multiple aspects to the damage. The mental effects of low T take time to evolve as brain patterns change and that actually is physical.

Where are you located? Affects your diagnostic and treatment options…

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.

The LH/FSH values are from the second test.

I realise I haven’t been on this forum in quite a while but I thought I’d provide an update to my PFS-related situation and discuss possible TRT treatment.

Back in April 2019 I had another blood test and the following results came in:

Testosterone [12-31.9 nmol/L] 22.5
Free T [260-740pmol/L] 288
SHBG [17-56 nmol/L] 67H

So it seems like my total T has edged up but my free T has fallen and SHBG as risen to well above range.

Symptom wise I am largely unchanged but for the past few months libido has been almost non-existent.

I have a few questions to put to the helpful informative members of this forum:

  1. I’m in Australia. I don’t know if any doctors would be willing to provide TRT if my total T levels are so ‘normal’. I don’t know how I could twist any arms to be able to access it.

  2. I’m not a big fan of needles. Would using a cream/gel based form of administration of T be an inferior option to an injectable form? If so, why?

  3. I’m a small guy. 5’2" and about 120lb. What would be reasonable starting dosage given my size and hormonal profile?

Thanks all.

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There are creams available in the US that are strong enough to work… gel is only about 2% T but creams can be made that go up to 20%, so 10x stronger, and they absorb better, so it’s a huge improvement over gel. If you can’t find that, going to 28-30g 1/2" insulin syringes and injecting in the delt is the best option I’ve found… I’d try that if you do end up having to do injections.

I’d say start around 120mg, maybe more, only because your SHBG is fairly high and you’ll probably need a decent amount to get your free T up. Normally I’d say 150mg but I don’t know how well the dose scales with body mass to be perfectly honest.

My SHBG was very high after fin/dut too… though a lot higher than yours (150 something), so I ended up at 210mg/week

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Thanks for those tips. How are you finding TRT? Would you recommend it?

I am in the US where there are a variety of clinics available that will prescribe TRT if you are low’ish and have symptoms, so it was pretty easy to get

My story is a long one, but the short version is I’d recommend it if you have symptoms that are impacting your life that it could help improve.

Thanks. So in summary I take it that it improved your symptoms noticeably and with minimal downside?

Dr. Adrian Zentner in Perth, Brisbane and/or Dr. Zentner in Melbourne will be able to help you.

These guys aren’t your average TRT docs, they are better.

That’s why I suggest insulin syringes, they are painless and once you get used to it, it’s no big deal.

Thanks for that systemlord. Have you dealt with Dr. Zentner from Melbourne?

Why do you suggest injections instead of cream/gel?

You have almost my exact PFS numbers. I got on 240mg test a week and am better than normal. Unfortunately it’s likely going to be your only shot. Ncsu had luck with gels and creams but many do not. Learn to inject yourself and move on from this nightmare.

Cream yes, but I wouldn’t bother with trying any gel. Injections is the more tried and true method IMO so honestly I’d start there so you have fewer variables working against you.

Thanks sam and nscugrad for your advice. I just have a bit of a needle phobia so might consider buying a jet injector (they retail for about 300USD).

What are both of your thoughts on using HCG? From my understanding it’s recommended with many TRT treatments to maintain testicular function and prevent atrophy and loss of fertility. I suppose my fear is being on this for life, with all the risks which come with it.

Would trying HCG alone be a better starting point than Testosterone and only if that fails go onto Testosterone?

Thanks again.

I usually wouldn’t recommend this, but I’ve recently seen on another pfs related forum where several PFS people have had improvements on HCG only. So… I’d try HCG only first for a few months and just see what happens. Normally for regular people needing TRT I would not suggest that but I think it’s worth a shot.

You’re probably just going to have to get over the “it’s for life” thing. It kind of is what it is.

Yeah I’m going to basically guarantee that you’ll be on it for life.

I would never go back to the PFS boards either. Very toxic community with a lot of disinformation about treatments and people trying everything under the sun.

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It’s incredibly depressing reading those all the time. I guarantee you won’t feel better as long as you’re doing that.