T Nation

Normal LH, FSH, Prolactin, Still Low T

T Replacement
#1

Hi All,

I am 25 years old. Weight 85 kg, height 5’9’’(175 cm), BMI 28.1
My test results:

FSH 2.61 (1.4-18.1)
LH 4.78 (1.5-9.3)
Prolactin 10.86 (2.1-17.1)
Total Testosterone 256.88 (164.94-753.88)

I am feeling low energy and brain fog most of the time. Though sleeping for 8 hours, i am feeling restless and in need to take rest more.

Please tell me why inspite of normal levels of lh, fsh and prolactin i am having relatively less testosterone for my age. Is low T driving my weekness. I thought my weight was the reason but When i was 78 kg also, my testosterone was some where around 270-300.

So please let me know why i am having low testosterone levels and do i need T-injections. What are the implications of taking T-injections.

Note: I am not married yet. My erections, libido everything i feel normal.

#2

Your testosterone levels are very low, those are disease state levels. Low thyroid hormones also mimic low testosterone. Your ranges are whacked, the endocrine society defines low testosterone below 300 ng/dL, it’s a bit conservative and the majority of men have symptoms long before they reach these levels.

You need a Free T, estrogen and SHBG tested. It would be a good idea to have a sleep study done to check for sleep apnea. Your SHBG must be very low for you to have erections in those ranges.

Most men start having problems when dipping below 500 ng/dL, some experience low energy and feeling tired, then libido and erection troubles later down the road.

#3

Have your thyroid evaluated as well, TSH, free T4, free T3, reverse T3.

#4

Hi,

T3: 123 (60-200)
T4: 6.7 (4.5-12)
Tsh: 4 79 (0.3-5.5)
Free T: 11.33 (4.25-30.37)
Shbg: 11.92 (18.3-54.1)
Estradiol: 18 ( 0-40)

My sleep study is fine and there are no abnormalities. Yes as you said my shbg is pretty low. Please let me know by loosing weight and waist circumference can I get the normal testosterone levels. Or I need to go for the testosterone injections. Please let me know the affects of T injections on my fertility as well.

Thanks.

#5

TSH is terrible, I don’t see any Reverse T3 tested which could explain high TSH. Reverse T3 blocks Free T3 at the receptors, I don’t see any antibodies tested either.

I knew SHBG would be very low, a good doctor would start looking at thyroid problems when SHBG is below 20, Free T3 speeds up every cell in your body, including the livers output of SHBG. So if Free T3 is low you would expect to see SHBG suppressed. T4 should be midrange.

Many doctors agree that the ranges for TSH go to high, most progressive doctors act when TSH >2.5. I’m going to be honest with you, your current doctor likely will not be able to offer a proper TRT protocol, most are TRT ignorant.

Starting TRT with your thyroid problem will yield poor results, thyroid and testosterone work together to restore metabolic rates. It will be next to impossible to lose weight with low T and low thyroid hormones as your metabolic process is halted, hence the lack of energy.

TRT will affect fertility, HCG and FSH will improve fertility while on TRT.

Managing estrogen while SHBG is super low will be difficult, frequent injections EOD or ED is important. I wouldn’t target anything above 500 ng/dL, otherwise your Free T and Free E2 will be out of control and you will be symptomatic.

#6

+1 to everything that systemlord has said.

I would treat thyroid first and see what happens to low T. Maybe nothing, but it will be easier to treat one disease at a time.