Low FSH, Low-normal Test, Low libido, ED Problems
- 04-09-2012, 08:29 PM
- 04-09-2012, 10:52 PM
keep bumpingI am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
- 04-10-2012, 12:14 PM
I shall do that. I appreciate the information in this post, as well as in the entire forum.
04-10-2012, 12:25 PM
04-10-2012, 12:56 PM
04-11-2012, 06:19 PM
Yesterday I went in to LabCorp to get bloods done again, exactly 2 weeks after i got a reading of test = 182 from my primary care doctor at about 4 in the afternoon. I went in at 10am, when I normally wake up, and got the following (more expected) readings:
Test: 362 (348-1197, although my doctor has this range as like 162-680)
LH: 1.0 (1.7-8.6)
FSH: 0.6 (1.5-12.4)
Estradiol: 20.0 (7.6-42.6)
Some other numbers that were a bit off, and have sometimes been similarly off in past bloodworks and sometimes within range. If I recall someone told me that some of these could be due to dehydration.
Bilirubin: 1.3 (0-1.2)
BUN: 23 (6-20)
RBC: 5.62 (4.10-5.60)
Hemoglobin: 17.1 (12.5-17.0)
As you can see from looking back at past bloodwork, these numbers fall within my typical no-serm baseline. Test between 340 and 400, LH around 1 or slightly above, FSH between 0.5 and 1. So I think it is obvious that I am secondary hypogonadic, as I still barely fall in the normal range of T with very low amounts of LH and FSH. When I run clomid, my LH increases to between 5-9, FSH goes up to around 1.3-1.4 near the very bottom of the range, and Test goes to 600-750, with Estradiol creeping up towards the top of the range. These results have been consistent while blood is drawn at baseline and at the end of a serm run. So I have been able to boost these numbers temporarily with clomid but they revert back to my secondary hypo baseline after administration ceases. The mystery here is why my pituitary is not secreting more LH and FSH.
One observation I can make: Bringing my vitamin D levels from below range at 25 (30-100) to ~50 or more did not seem to affect my baseline levels of LH, FSH, or Testosterone.
Another observation I can make: These baseline numbers were where they were after my very first cycle (I've done 3, all PHs). I waited 10 weeks after the end of my first PCT (legit nolva) to get tested and had similar numbers (despite feeling recovered at the end of PCT). Surprisingly, my first cycle either seems to have caused this issue, or I had it beforehand. This is surprising because my 2nd and 3rd cycles were longer/harsher, and they do not seem to have made the condition any/much worse.
Anecdotally, I haven't been that bad recently. Energy is lowish but I'm not constantly tired or anything, I might not even notice anything if I didn't have bloods. In the gym, strength, size, and muscular endurance fell slightly after coming off the clomid, but nothing drastic. Libido has been very minimal BUT existent (which I will consider a success for now). I have been using cialis with the lady so it's hard to tell if the ED is still an issue, but 6-9mg gets me hard as a rock even when i've had drinks. I also had a good quality erection about 3.5 days after my last administration of cialis this week (won't be seeing the gf again for a while), so I have hope that my guy can stand to attention normally. Still getting morning chubbys with the occasional morning erection. Ejaculatory volume has seemed about normal recently (although not clomid levels), and orgasms are not nearly as strong as they were on clomid (or before I had this issue if I remember correctly).
So now it is an issue of where do I go from here? I am going to be seeing a urologist covered by my insurance in early-mid June. That leaves me with 8-10 weeks. Should I take nothing at all and see what my body does naturally over this time period? Should I run clomid or nolva again at a low dosage (i.e. 12.5mg EOD) to see what kind of levels I can achieve with this dosage, and also to improve well-being and gym performance while I wait for June?
When I see the urologist, I am going to request a full hormone panel (not like the one I get at LabCorp or the half-assed one my doctor did) and a scan of the pituitary (these seem like obvious choices). What other tests should I ask him about running to try and get to the cause of this? What do I need to get looked at to get a complete picture? I am not going to be willing to go on TRT (at least not until all other options are completely exhausted). I was thinking maybe a nutrient panel, or some tests relating to GI integrity? (I realized I never mentioned that I have diarrhea quite often, but I assumed that was normal for high protein diets). Please advise what tests are important, and what route you think I should take until the appointment in June?
04-11-2012, 07:29 PM
With out optimal vitamin. D a e clomid will not be able to work.to its full potential. Again indentify other imbalance with in the body so you have a better chance of keeping the ball going rather then crashing
How can you build a mansion with out a strong base. It will just crumble like it just did..
I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
04-11-2012, 07:51 PM
04-11-2012, 09:07 PM
identifying GI integrity can be challenging and can elude medical professionals for years until alternative testing is done. If people have issues and can not afford then I go by symptoms. It makes it more of a challenge, but not impossible. Some people who do not have insurance, you find ways around getting the proper information needed. If they have access to open minded Dr's then I use them to help execute proper testing.
I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
04-12-2012, 04:11 PM
04-16-2012, 09:34 AM
04-16-2012, 09:36 AM
Hi Matrix. Was able to send the message, but only so far. It says you've exceeded your private message storage or something of the sort.
04-16-2012, 09:43 AM
04-20-2012, 05:33 PM
This is rather odd and surprising, but the past week or two I've had no problems getting hard without cialis, I've been waking up with good morning erections every morning, and I have a libido again. Orgasms are still slightly weaker than they used to be, but I'm happy to be making progress. Problem is, I have no idea what I did, I don't think I even changed anything. I will continue to only supplement with multi, fish oil, and vitamin d and see if i continue to make progress. I will not be doing another run of clomid soon since I seem to be making progress without it. I will probably retest bloods in another 4 weeks or so.
04-26-2012, 01:10 AM
TML499: I am having a very similar issue to yours. After PCT my LH and tes returned to normal but my FSH stayed alarmingly low and I am having symptoms indicative of that. I can't PM yet because I am new to the forum.
04-26-2012, 06:13 PM
^ Well actually my LH is low too (usually) and my test is low for my age as well (low-normal). I am not so sure the low FSH is what was causing any of my sexual problems, which have been somewhat alleviated and I'm not really sure why. I'm currently just waiting right now till I see a urologist in July, since my drive was getting better and I don't really feel like **** all the time. Do you have some bloodwork? You should start your own thread, I'll take a look at it and so will others I'm sure.
04-27-2012, 02:44 AM
05-03-2012, 06:29 PM
Update: Still have an existent (but not great) libido, and the ability to get erections without cialis (but not rock hard ones). Orgasms are still slightly weak, energy is OK not great. I am either staying in the same place or improving. I will get bloods done again in late may, and if things look like I expect them too I will schedule the urologist appointment for june.
05-16-2012, 05:47 AM
I have a question about varicoceles. By what mechanism would they cause a drop in testosterone? Logically I would think it would cause primary hypo (affecting the nuts functioning) and cause elevated LH. My problem seems to be secondary hypo, so is there any chance varicoceles could potentially decrease my LH leading to the T decrease? Or is this unlikely? I'm going to have my URO check for one when I go in.
05-18-2012, 02:51 PM
Went in for bloods checkup yesterday. Numbers are about the same, although I'm not having the ED hardly ever, and libido is still there but not very good. Can anyone guess why my bilirubin might be so high?
Bilirubin: 2.1 (0-1.2)
05-18-2012, 09:35 PM
Yep choleostasis is possibleOriginally Posted by TML499
Your not detoxifying bile properly through the liver
Gilberts is common as well
Bottom line your liver needs addressing majorly
05-19-2012, 06:28 PM
Interesting. I will look into this. My ALT and AST on this blood test were only 20 and 23 respectively, and they always seem to be down there. My bilirubin is sometimes just above the normal range, this was the highest I've seen it even compared to when I would get bloods done at the end of PCT when i cycled.
When I have my first visit with a urologist in June i will be sure to mention the digestion issues I seem to be having based on the bilirubin and my very common morning diarrhea.
Edit: Do you have any input on this question?
"I have a question about varicoceles. By what mechanism would they cause a drop in testosterone? Logically I would think it would cause primary hypo (affecting the nuts functioning) and cause elevated LH. My problem seems to be secondary hypo, so is there any chance varicoceles could potentially decrease my LH leading to the T decrease? Or is this unlikely? I'm going to have my urologist check for one when I go in."
05-19-2012, 07:15 PM
Those blood results will not show true functionality of liver. Had case where woman was non knowing stage 3 cirrhosis with high normal liver enzymes. Suggest to her to get Ultrasound from Dr. She finally convinced him to do it.Dr was shocked it confirmed my suspections because symptoms where obvious but drs where going by labs instead. This is common what I deal with on daily basis. Since I am not a Dr I just made the recommendations for her to suggest to Dr to.get ultra sound done. Do not let normal blood levels be the be all..Originally Posted by TML499
05-19-2012, 08:03 PM
05-19-2012, 09:40 PM
I did that one time made me a crying freak. Times have changed and so has proper jump start procedures. Glad it worked but less is more with. ClomidOriginally Posted by Neoamerican
05-19-2012, 11:59 PM
05-20-2012, 12:06 PM
Following this approach has led to greater success rate. You are trying to build a mansion with a crappy foundation and its only going to crumble. One needs to create the optimal environment for a restart to occur by many medical professionals only look at it one sided. I prefer to look at things 3-dimensiob in the approach suggested to drs. This approach is to encompass all the systems working in harmony to get optimal health benefits on a multi level scale.Originally Posted by TML499
06-10-2012, 05:26 PM
Update: I found out one of my parents has always had bilirubin usually above range as well. I think I might have Gilbert's after hearing this, but my other parent isn't sure if they have it and it sounds like it is recessive. I will be sure to bring this up with the urologist, first appointment is in a couple weeks. Also going to mention the problems I've been having with my digestive system.
Also, when I go to see the urologist, I am going to bring in the bloodwork done by my primary care doctor, but this is very limited bloodwork (only really shows T, bilirubin, CBC and some other stuff). Should I also bring in bloodwork I have gotten done privately at private md labs/labcorp? Or do they usually frown upon this/discard this? This will show him my depressed LH and FSH levels and even higher bilirubin. I imagine he would do testing soon after and find this stuff out anyways but can it hurt to give the process a jumpstart by bringing in the labcorp labs?
06-10-2012, 08:15 PM
06-21-2012, 07:53 PM
Update: So i saw the urologist today. He basically took down all of my symptoms and checked for structural problems (varicocele, etc). I showed him the bloodwork from my primary care doctor showing low testosterone. He referred me to both an endocrinologist and a gastroenterologist for the digestion issues, both of which I will be seeing sometime in the coming month. Frustrating I have to wait again with no additional testing, but I'm optimistic that they are at least looking at my problems from multiple angles.
06-21-2012, 08:35 PM
07-07-2012, 05:35 PM
Good thread. It seems the Clomid did what it was supposed to do in your case. I am using Clomid now at 25mg daily for TRT/HRT as I can't afford test. But it seems to work for people....The "crash" or how your body responds to coming off is the most troubling. I think tapering off will do you fine. Your blood work dictates that the clomid "worked" - which is great.
As for low FSH...I suffer from it too...and hypogonadism.
Maybe Gonadtrophins could be used to help stimulate the production of sperm / FSH?
07-07-2012, 05:36 PM
Another thing I"m curious about is if FSH (although it works directly with sperm production) - if its low or low normal can affect your libido or sex drive (which is the problem I've had going for years....)
My LH and FSH have fluctuated...LH being low normal which in turn will not produce as much TEST.
But I'm curious is anyone with just low / low normal FSH and everything else normal (low test and LH) have problems with sexual function....
07-17-2012, 06:47 PM
Bump, have some appointments in the next week or so.
Matrix I do have a question about the relationship between the GI tract and T levels. My LH and T are typically around 1.5 and 350. When my LH goes up (to around 5.0 or so via clomid) my T goes up (to around 650). Would fixing an unfit GI tract just cause my body to produce more T given the amount of LH I have? Because I seem to be producing appropriate amounts of T per the LH available. Or rather, would fixing up the GI tract actually cause my pituitary to secrete more LH? Because if not there may not be a lot to be gained from being secondary and fixing my GI tract.
I assume the benefit in fixing up the gut would be improved nutrient absorption and balance. But does this affect the bodies ability to produce LH and FSH, or does it rather affect the process of making T with your given LH levels?
07-17-2012, 07:37 PM
08-02-2012, 04:17 PM
Update: So I had appointments with a GI doctor and an endo.
GI doctor started with stool samples, ruling out parasites/bacteria. He ordered these tests:
Celiac's Disease (I didn't have a wheat allergy)
Sedimentation Rate (ESR)
Comprehensive Metabolic Panel (My Glucose was low, 54 out of 70-100 this time. Last time when I wasn't fasted it was over 100)
Heliobacter AG, stool
clostridium difficile A & B Toxin
Leukocytes, fecal smear
Everything came back negative. I think next I'm going to have a GI scan or something.
The endo ran new bloodwork to see my test levels in the morning and see my LH and FSH levels which weren't on the first text my primary doctor did.
Prolactin: 16.7 (2-17)
Testosterone was about 50-100 points lower than usual but I think it might be because the bloods were drawn a week after a long vacation that involved much more drinking than normal for me. The only time I ever got prolactin tested before it was 9. He also tested iron, iron binding, and iron saturation, which were all fine.
He says the next step is a pituitary MRI and a sleep study. He says my hemoglobin is elevated (16.7, always around the upper range), so he thinks I may have sleep apnea.
Edit: I also have noticed that as of late I am getting restless leg syndrome more frequently than I have in the past.
08-23-2012, 03:29 PM
Update: Results from the sleep study. I don't have sleep apnea. I did mention that I had been getting restless leg syndrome at night. I have a pituitary MRI coming up in the next week or so.
This attended polysomnogram montage using Compumedics Profusion 3
Software included recorded video, 6 EEG electrodes for frontal,
central, and occipital monopolar recordings, 2 EOG electrodes,
ECG, and chin EMG electrodes, snoring microphone, thermistor,
airflow pressure, thoracic, and abdominal respiratory effort,
pulse oximetry, leg movement, body sleeping position, and body
movement. The 30 sec. epochs were scored according to The AASM
Manual for the Scoring of Sleep and Associated Events: Rules,
Terminology and Technical Specifications (2007).
SLEEP SCORING DATA:
Lights Out / On (clock times): 22:59:45 / 0546
Total Recording Time (TRT) (min): 370.0
Total Sleep Time (TST) (min): 250.5
Sleep Efficiency: 67.7%
Sleep Latency (min): 59.5
Stage REM Latency (min): 77.0
Wake after sleep onset (WASO) (min): 60.0
Stage N1 Sleep (min, % of TST): 10.0 (4.0%)
Stage N2 Sleep (min, % of TST): 106.0 (42.3%)
Stage N3 Sleep (min, % of TST): 88.0 (35.1%)
Stage R Sleep (min, % of TST): 46.5 (18.6%)
Supine Sleep (min): 128.5
Arousals (index, #): 10.5 (44)
RESPIRATORY ANALYSIS: (index = #/hr)
Apnea/Hypopnea Index (AHI): 0.2
NREM AHI: 0.3
REM AHI: 0.0
Non-Supine AHI: 0.0
Supine AHI: 0.5
Respiratory Disturbance Index (RDI): 2.6
NREM RDI: 1.8
REM RDI: 6.5
Apneas (index, #): 0.2 (1)
Obstructive Apneas (index, #): 0.0 (0)
Mixed Apneas (index, #): 0.0 (0)
Central Apneas (index, #): 0.2 (1)
Hypopneas (index, #): 0.0 (0)
RERAs (index, #): 2.4 (10)
Mean Awake SpO2: 96%
Mean Sleep SpO2: 96%
Minimum Sleep SpO2: 92%
Sleep Time with SpO2 < 88% (min, % of TST): 0.0 (0.0%)
Cheyne Stokes breathing: No
Mean Awake HR: 58
Mean Sleep HR: 58
Sinus tachycardia: No
Narrow Complex Tachycardia: No
Wide Complex Tachycardia: No
Atrial Fibrillation: No
LIMB MOVEMENT ANALYSIS:
Periodic Limb Movements of sleep (PLMS) (index, #): 22.5 (94)
PLMS with arousals (index, #): 1.2 (5)
No other unusual body movements were demonstrated and no seizure
activity was noted.
1. Periodic Limb Movements of Sleep. These limb movements,
however, did not occur throughout the night. Instead, they
occurred during two blocks of time, one at 2 AM and another at 5
AM. The patient was sleeping on his right side during both of
1. Clinically significant obstructive sleep apnea was not
observed on this night
2. During this recording, periodic leg movements of sleep (PLMS)
were noted. After adequate management of patient’s
sleep-disordered breathing, clinical correlation is recommended
to determine whether he might benefit from treatment of the PLMS.
Screening for the restless legs syndrome (RLS) could be
beneficial (as the patient endorsed limb symptoms on the patient
questionnaire). Serum ferritin levels ( < 50 ng/ml are
associated with RLS/PLMD), BUN, creatinine, and TSH may be
evaluated to exclude subclinical iron deficiency, thyroid
dysfunction or renal disease contributing to RLS/PLMS/PLMD.
Antidepressant medications can also worsen PLMS. An empiric
trial of a dopamine agonist (e.g. ropinirole or pramipexole) can
be considered for primary RLS/PLMD.
3. Unless we have instructions to the contrary, we usually
recommend that the patient discuss the results and treatment
options with the referring physician.
08-31-2012, 10:03 PM
Update: MRI scan shows that my pituitary is normal. The scan also showed some cysts/polyps in my sinuses, which makes sense, i feel like i am chronically stuffy.
The gastro stool results came back normal, and now he wants to do a colonoscopy. I really doubt that will "reveal" anything or help at all.
Anyways, my endo messaged me after the results came in. He suggested I go visit him again to discuss beginning testosterone treatment. I assume this means TRT. I also assume it is quite understandable that I do not want to yet jump on TRT at my age (22) without exploring other areas besides just a sleep study and pituitary MRI (GI, etc). I will tell him this at the appointment, and if he does not have another direction to go in... well matrix you may be receiving that call from me soon.
09-06-2012, 04:11 PM
Update: Had a follow up to sleep study and MRI with my endo. He was surprised I didn't have sleep apnea since my hemoglobin was high, and wants to send me to a hematologist consult (he wrote the word polycythemia, I don't know what that is.) He also wants me to do a bone density test, I think he is having me do these things because they are issues that TRT can cause.
I mentioned to him that at this point I was more concerned for looking for a cause than hopping on TRT at a young age. He said that most causes actually are of the unkown variety. I told him about my concerns with my diet (not very many fruits or veggies), but he says something like that can't cause low testosterone. Starting to feel like im running in place now.
09-26-2012, 12:01 AM
Bump: Well I have moved away for school again, and I decided to do a privatemdlabs blood draw to see where I was at, since my last draw showed 275 or so test, and first thing am i am usually 340-380. I basically wanted to see if the last draw was a fluke due to a vacation beforehand, or things were getting worse. Some numbers:
So basically, it seems things are not getting worse which is comforting.
BUN: 24 (6-20)
Creatinine: .75 (.76-1.26)
BUN/Creatinine Ratio: 32 (8-19)
Don't know if that means anything? I think I was actually taking creatine less frequently when this blood was drawn.
Anyways, since I'm probably going to go on 12.5mg clomid EOD for this quarter of school now to improve how I feel, although I am not feeling "terrible" per say I definitely don't feel close to 100%.
Anyone still checking in on this thread? Matrix you still here? I think I'm planning to call you soon, if it's still ok with you.
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