T Nation

What Could Be The Cause Of My Primary Hypogonadism?


Hi, everyone. I’m 40 years old. My testosterone has been no higher than 330 with normal prolactin, shbg, fsh for the last 5 years. My lh was slightly high a few times. When it was first diagnosed I was 35 and 5’ 9" 220 lbs. I got as high as 230 lbs. before I got serious about trying to regain my health and testosterone levels. I started counting calories and lifting weights 1 year ago. Today I weigh 185 and have some improved muscle tone but still struggle with some belly fat. I started Clomid around a year ago as well. This got my testosterone to 500 or so. Estradiol stayed in the normal range.

I went off of it the last 3 months at my doctor’s suggestion to see if I could produce on my own. This morning I found out my level is 99. I assume I have primary hypogonadism. What I don’t understand is I don’t fit any of the criteria for the causes of primary hypo. Any ideas on what could be the cause? I’ve been tested for the usual things such as hemochromatosis, Never had any known infections such as mumps. No physical injury. Negative for HIV, etc. I did have an inguinal hernia repaired 3 years ago, however. I developed secondary sexually characteristics normally and my testosterone came back at 750 in my mid 20s. Is there such a thing as idiopathic primary hypo where ther is just no known reason? I will be going back to my urologist in 2 weeks to start test and possibly hcg to maintain fertility. Thanks


hi there,
wow this is a deep question, and would require a much more thorough analysis than what we can type over a keyboard. counting calories, test. tests, and exercise are all great, but ultimately for issues in the endocrine system (the pituitary, gonads, thyroid, etc) it comes down to more of the food being eaten. those systems are more affected by chemicals, neurotransmitters, and nutrition. I would start with cleaning up the diet to include organic foods, hydrating with almost exclusively water, including proper amounts of essential fats, oils, and among other things…
good luck


HCG suppresses the top half of the testicles and stimulates the bottom half, this is why it doesn’t produce the results one gets from TRT. TRT is a bioidentical hormone the body evolved to process, so you will probably need TRT.

You will likely have to say goodby to this doctor as urologists and endocrinologists don’t usually specialise in TRT which is probably why your current doctor hasn’t prescribed it to you. They are running a business and the name of the game is profit, there’s no profit in prescribing unpatentable hormones, drugs are patentable therefore profitable.

There are not going to prescribe something that brings in little to no profit, otherwise no fancy cars or lifestyle. You need a private hormone specialists.

If you insist on staying within insurance suffering will likely continue.


What city do you live in? Always good to mention because there are some Endos and urologist who do specialize in TRT. I go to a urologist who actually has HCG in his office that he gets from a compound pharmacy.


I appreciate your opinion but I’m lucky I have a urologist that wants to help. He has already told me that he is going to prescribe trt for me.


Louisville, KY


Wanting to help and being able to help are two different things, if he suggests 200mg every 2 weeks run, don’t walk away from this doctor.