T Nation

Need Some Insight Please

I first wanted to Thank you all for the information you have put on here and continue to do. I have been a lurker on here for a long time reading all the stickies and trying to gain as much knowledge as possible about this subject. I unfortunately ran into the â??Your In Rangeâ?? from one doctor. And had an Endo not even examine me just ask if I wanted Viagra or Cialis. So Iâ??m now on to another Doctor who at least is running tests and is willing to listen to me. I am having some trouble interpreting data though. Especially FSH and LH.

Age 32
Height 5â??8â??
Waist 40â??
Weight 250 lbs
Lots of Hair
Carry Fat in abdomen and chest
Symptoms are more or less all Low T symptoms
Supplements-- Whey Protein, BCAA, Glutamine, Vitamin D, Magnesium
NEVER have done any steroids etc.

Lab results
I unfortunately only have some of the test results. It all started with my physical which everything came back excellent expect testosterone was Low. These are the only tests so far my new Doctor has ordered. The ones from May and July were from my previous doctor.

Testosterone 3 tests
May it was 240
July it was 393
This week was 390

TSH
July was 2.69 Body Temps are a little low in the morning but 98 and above mid morning on.

LH Range 1.7-8.6
In July was 3.3
This week was 9.0 High

FSH Range 1.5-12.4
Test this week was 1.1 Low

Prolactin Range 4.7-25.3
Test this week was 8.0

PSA range less than 4.0
Test this week was 0.8

Hematocrit Range 41-53
Test this week was 47.3 I think this is up a little due to a little dehydration at time of test and have been eating a lot or red meat lately.

Scheduled to do a semen analysis this week

I would like some advice if possible. The doctor is considering testosterone replacement therapy but wants to run some other tests first.

What is your take on the FSH and LH? From what Iâ??ve researched they are usually both elevated or both low?

My other question is if he prescribes TRT and I can convince him to give me HCG as described in the TRT protocol should I take less say 125 IU EOD instead of 250 IU EOD as LH is elevated already? Reason I wanted to know is because when I mentioned HCG he stated that if he prescribed it it would only be for one year. Then I would have to come off due to receptor downgrade and he could not prescribe again. That is the opposite of what Iâ??ve read on this forum.

I understand it could be something else or multiple things contributing to my Low T. I am just trying to research all that I can for reference and to be able to have an open discussion with my doctor.

Thank you in advance any help or insight would be greatly appreciated.

LH moves fluctuates throughout the day by so much that it is an unreliable indicator. Basically it’s tested to see, yes it’s there or, no it’s not. FSH on the other hand is a better indicator of long term gonadotropin release. TSH is too high and you should report more accurate temps as I know KSman will ask if he gets involved. If you aren’t already supplementing with iodine you may want to start. The symptoms of hypogonadism parallel those of hypothyroidism. I’m sure you’ve heard it all before but losing weight is most definitely going to improve a lot of your situation. There may be enough aromatase of T ->E2 because of your extra weight and this is the main natural suppressor of LH and FSH. If you lost 50-70lbs your T levels might come up dramatically.

Thank you for the reply I appreciate the feedback. My morning temps have fluctuated between 94.9 and 96.5 degrees. I also started supplementing with tri iodine capsules that contain 12.5mg consisting of (potassium iodide, sodium iodide and molecular iodine from kelp). I take one capsule every other day. I have also been trying to lose weight however, no matter what I do the weight will not come off. I am working with a dietician and weighing all my food and still nothing happens. This has been going on for months with the dietician and years on my own. Even low carb and carb cycling yield no results. I’m at a loss.

Your weight might not go down until you get your body temperatures fixed. Can you get to 98.6 mid-afternoon?

Your body temperatures indicate deep functional hypothyroidism.
Were you not using iodized salt for years?
Is your thyroid enlarged, asymmetrical or lumpy? [feel it yourself]

Taking hCG would drive LH–>0, this is not additive.

LH receptor desensitization is something that happens with high levels of LH and/or hCG. 250iu SC EOD will not do this. Your doc is not regarding the nuances.

What is your fasting glucose and A1C https://en.wikipedia.org/wiki/Glycated_hemoglobin

You should also get AM cortisol and do that at 8AM, 1 hour after waking.

Need:
TSH
fT3
fT4

When did all of these problems and weight gain start?

Ksman Thank you for the response. Only two times that I know of have I made it to 98.6 degrees. Usually I will reach 98 or 98.2 but not everyday either. Sometimes I do not go above 97 degrees. I have not used Iodized salt for years.

I started using it a couple months ago after reading your posts and Dr. Wilson’s book. My thyroid is not enlarged, asymmetrical or lumpy. I do not know the number for fasting glucose the doctor did say that it was excellent though. TSH has not been rechecked but in July it was 2.69 The problems started and weight gain years ago I would say 6+.

I go back to the doctor soon I will definitely ask about the cortisol, FT3, FT4 and TSH retest. Thank you for clarifying the HCG issue and taking the time to respond to my post.

It can take a long time to recover iodine stores in the thyroid, which can be 1 GRAM when loaded.

Suggest that you increase intake and get 750mg total ingested then down to maintenance dose. - watch temperatures

See the thyroid basics sticky.

YOU MUST HAVE SELENIUM, SUGGEST

  • high potency multi-vit that lists iodine, selenium and other trace elements

You could complete the iodine replenishment then do the other labs after that. If body temps do not recovery, we have to consider other issues such as rT3 or thyroid antibodies. Note that thyroid auto-immune diseases are thought to be a result of inadequate selenium and increased/restored thyroid function can be the trip-wire.

Thanks again Ksman! I will definitely try this protocol. Should I increase the iodine capsule dosage to 750mg a day? Or use iodized salt to achieve that amount? In conjunction with the selenium. Any recommended amount on the selenium dose also?