T Nation

On TRT for 6 Months, Low FSH/LH

Hi All,

Lurking for a long time now, was feeling very erratic. I had my urologist run a fresh lab panel. I do wish I found this place before I went so far down the road.

-age - 44 yrs
-height - 5’10"
-waist - 34"
-weight - 190 lbs
-describe body and facial hair - Hairy chest and legs, patchy facial
-describe where you carry fat and how changed - Was always quite thin 165 lbs, put it all on the abdomin
-health conditions, symptoms [history] - Bad back, 2 surgeries
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - ibuprofen, aspirin, occasional opiate
-lab results with ranges
-TT - 340 ng/dL (160-726)
-FT or bio-T
-Implications of injections VS transdermals [100 mg T-Enanthate (200mg/cc) every 5 days]
-E2 - 53 PG/ML (0-53)
-Prolactin 10.1 (2 - 17)
-DHT [should be checked, but perhaps not on-going]
-DHEA-s 52 ug/dl (95 - 530)
-LH - <0.1 (1-8 mIU/ml) very low
-FSH - 0.1 (1-11 mIU/ml) very low
-PSA - (Roche E170) - .556 ng/ml (0 - 4.0)
-DRE: the dreaded digital rectal exam [Your doc does not enjoy this either!] - Normal
THESE RESULTS WERE FROM BLOOD WORK TAKEN 1 HOUR BEFOR MY 100/ML INJECTION OR AT THE BOTTOM OF MY TROUGH.

Other test Results
-Glucose non-fasting - 130 (Abn:H) MG/DL (65 - 125) _ I had just downed a large Coffee with too much sugar
-Urea Nitrogen - 8 MG/DL (7 - 25)
-Sodium 140 MEQ/L (7 - 25)
-Creatinine 1.08 MG/DL (0.4 - 1.4)
-GFR 74 ml/min/1.73m2 (>60)
-Potassium 3.9 MEQ/L (3.5-5.3)
-Chloride 102 MEQ/L (98-107)
-Carbon Dioxide 23 MEQ/L (18-32)
-Calcium 9.7 MG/DL (8.6-10.5)
-Total Protein 7.2 G/DL (6.4-8.9)
-Albumin 4.7 G/DL (3.5-5.7)
-Globulin 2.5 G/DL (1.8-3.8)
-A/G 1.9 Ratio (1.0-2.5)
-Alkaline Phosphatase 87 U/L (30-132)
-AST 13 U/L (5-39)
-ALT 16 U/L (5-52)
-Bilirubin,Total 0.6 MG/DL (0.3 - 1.2)

-describe diet - Try to eat light, carbs in the afternoon, almost all fresh food, No wheat or dairy
-describe training - Light cycling, nothing else (keeping up w/ 8 year old)
-testes ache, ever, with a fever? - Ached months ago cant remember
-how have morning wood and nocturnal erections changed - Wood is inconsistent. For days in a row, morning and PM wood, then nothing and ED at times.

My GP started me on Androgel 1.62 - 2 pumps then to 4 pumps when 2 were not working. Dont know if it ever worked. Early morning T panel showed 79 ng/dL before daily application.
Went to urologist, started me on 200 mg Enanthate /2 weeks. After 4 weeks at trough 168 ng/dL.
Moved me to 200 mg every 10 days, felt better for a little while. Then moved myself to 100 mg every 5 days, self administering.
As mentioned above Testosterone Enanthate 200mg/cc is the script.

Now my Uro wants to send me to an Endo.
Wouldnt prescribe HCG (knew about it, but said never heard of it used for TRT) or AI.

The FSH/LH seems very low, I know my boys have shrunk. (will they come back)

Maybe some one can recommend a doc on LI, NY that I wont have to take by the hand.

Any advise would be greatly appreciated.

TRT should zero out LH and FSH, no point testing again.

Take 25 mg DHEA, with a meal that has fats/oils. Not with a high fiber meal.

Do you have data for TSH, T3, T4, fT3, or Ft4?

Need your body temperatures?

From the advice for new guys sticky - need:

  • body temperatures and iodine intake, also see the thyroid basics stick
  • describe stress levels and how you react, you are an adrenal fatigue candidate [surgeries and pain]

Failure to respond to transdermal T is a symptom of thyroid problems.

Read the protocol for injections sticky. You need E2 lab data and management.

Get AM cortisol test, do it at 8AM.

What TRT for that lab work and what timing?

[quote]KSman wrote:
TRT should zero out LH and FSH, no point testing again.

Take 25 mg DHEA, with a meal that has fats/oils. Not with a high fiber meal.

Do you have data for TSH, T3, T4, fT3, or Ft4?

Need your body temperatures?

From the advice for new guys sticky - need:

  • body temperatures and iodine intake, also see the thyroid basics stick
  • describe stress levels and how you react, you are an adrenal fatigue candidate [surgeries and pain]

Failure to respond to transdermal T is a symptom of thyroid problems.

Read the protocol for injections sticky. You need E2 lab data and management.

Get AM cortisol test, do it at 8AM.

What TRT for that lab work and what timing?[/quote]

Thanks KSman,

No data, except what I initially posted
When I visit the new doc my uro is sending me to I’ll request them.

I get an oral thermometer. I have a temporal, and check the reading against my 8 yo son. I am generally the same temp as he is.
I’d imagine his temps are normal, but I’m only guessing.
I don’t shy away from salt, used sea salt for a little while. Otherwise plain iodized salt. Salted nuts, chips now and then.
No supplements w/ iodine. I’ll get one when I get dhea.
I feel like I react we’ll to stress. I actually prefer pressure, especially at work.
As far as pain, I haven’t had a day free of it for 6 years in one form or another.

I have the E2 data in my first post: E2 -53 PG/ML (range 0-56)

For the lab work, I injected 100mg/ 50cc of 200/mg per cc testosterone enanthate 5 days prior to the labs.

Thanks for the time.

Commercial salted foods can be counted on to be iodine free. So that does not count and contributes to the problem.

50cc is about two ounces.

E2=53 and T was low. The first instinct is that there is something wrong with the liver or its too busy dealing with drugs or such to properly deal with your E2 removal.

We need liver data from labs.
ALT?
AST?

ibuprofen, aspirin - anything else that is OTC
ointments?
liniments?
cimetidine?
alcohol?

paint fumes or other chemical exposure?

For TRT you will need T+AI+hCG

Many uro’s are useless, but most endo’s are too. An enthusiastic PG is way better. Read the finding a TRT doc sticky. Search this site for doctor+NYC etc. That has been discussed before.

[quote]KSman wrote:
50cc is about two ounces.

E2=53 and T was low. The first instinct is that there is something wrong with the liver or its too busy dealing with drugs or such to properly deal with your E2 removal.

We need liver data from labs.
ALT?
AST?

ibuprofen, aspirin - anything else that is OTC
ointments?
liniments?
cimetidine?
alcohol?

paint fumes or other chemical exposure?

For TRT you will need T+AI+hCG

Many uro’s are useless, but most endo’s are too. An enthusiastic PG is way better. Read the finding a TRT doc sticky. Search this site for doctor+NYC etc. That has been discussed before.[/quote]

AST (SGOT) 13 U/L (5-39)
ALT (SGPT) 16 U/L (5-52)

No fumes, at least not in 20 plus years, friend owned a body shop, still dont think I was exposed to much even back then.
No Alcohol, no ointments, some sudafed over the last few weeks for a cold.
I live a pretty clean life, quit smoking 5 years ago.

Ill search around on this board for refs to a NY GP.

Again thanks for the help.