Low FSH, Low-normal Test, Low libido, ED Problems

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  1. 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)
    TSH 0.73
    C-Reactive Protein
    CBC
    Heliobacter AG, stool
    culture, stool
    clostridium difficile A & B Toxin
    Leukocytes, fecal smear
    Giardia AG

    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.
    TT: 278
    FT: 81
    LH: 1.8
    FSH: 0.6
    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.


  2. 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.

    PROCEDURE:
    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
    Snoring:

    CARDIAC ANALYSIS:
    Mean Awake HR: 58
    Mean Sleep HR: 58

    Bradycardia: No
    Asystole: No
    Sinus tachycardia: No
    Narrow Complex Tachycardia: No
    Wide Complex Tachycardia: No
    Atrial Fibrillation: No
    Other: None

    LIMB MOVEMENT ANALYSIS:
    Periodic Limb Movements of sleep (PLMS) (index, #): 22.5 (94)
    PLMS with arousals (index, #): 1.2 (5)

    OTHER ABNORMALITIES:
    No other unusual body movements were demonstrated and no seizure
    activity was noted.


    CLINICAL INTERPRETATION:

    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
    these periods.


    RECOMMENDATIONS:

    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.
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  3. 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.

  4. 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.

  5. 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:

    Test: 381
    Estradiol: 25
    LH: 1.1
    FSH: 0.6

    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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  6. Quote Originally Posted by TML499 View Post
    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:

    Test: 381
    Estradiol: 25
    LH: 1.1
    FSH: 0.6

    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.
    Yes I see a few factors which are red flags.
    Low creatine --> methylation issues BIG TIME..
    Bun being elevated that high not so good unless you where dehydrated.
    I agree it was secondary, but you need to back fill metabolic pathways address immune system, GI, other detoxifcation pathways.
    If you can not properly detox you will decrease inflammation ....end of story..
    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.

  7. Edit: See next post

  8. First off, sorry, I try to separate this into paragraphs and the board keeps bunching everything up.Ok guys first update in a while, I've been focusing on studies this fall but I do have an update.I decided to run clomid at 15mg EOD this quarter to see if it could improve mood/wellbeing etc. I am about to stop the clomid and I decided to get some bloods done to see if it did much, since it didn't exactly feel like it did. Results:Test: 679LH: 3.6FSH: 0.9 (low still)Estradiol: 45 (a little high)So it seems that running at a lower dose (as opposed to a higher dose like I have done before) results in my LH and FSH numbers not being boosted as high, but my test still falls right around the 600-800 range that is the target. The bad news is that I did not expect to see numbers that high. Just like when I ran clomid at a higher dose, I did not notice much improvement in the ED or Libido departments (still needed a little cialis to get/maintain good erections), and I again did not feel like I had high testosterone.It is frustrating because it seems the main problem is that my pituitary doesn't make quite enough LH (boosting from 1.5 to 3.6 raises test from 350 to 680), yet clomid for some reason does not provide me with the tangible benefits of high test (have heard about it interacting with estrogen receptors in brain, etc). I wonder if it would be worth trying out nolva or torem? Or maybe add in an AI like erase or aromasin? This is not a long term solution, just something I've been self administering to try to improve my condition while I wait for proper/better care. Or would it be just as fine to jump on TRT (the androgel my doc was proposing) until being properly evaluated? When I head home for the holidays, I have several more doctor appointments scheduled, one with hematology because my endo wants to look into why my blood is thick (high hematocrit, but usually still in range, he already ruled out apnea), as well as do a bone density test. However I believe both of these tests are to determine if TRT is safe/optimal to use on me, and I do not know if this is the road I want to go down yet at only 23 years of age. That being said I plan to give matrix a call when I'm home and have the time. I am tired of running in place and want some answers.Edit: Should I look into getting my fertility looked at with such terrible FSH numbers? I have no idea why it is so low, can something cause this?

  9. i feel you man, hope you can finally find out the cause...

    i think a lot of people can commiserate with what you're going through

  10. TML499,
    I now have capability to have Dr run blood work through insurance for further evaluation not a diagnosis. It has helped target nutritional recommendations and findings to present to an.open minded medical professional for.proper treatment if.needed
    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.

  11. Well I had a very frustrating doctor appointment recently. I had to visit a new PCP thats related to my current health insurance and he was condescending and trying to argue with me that I didn't actually have a problem without even having my medical records yet. He cited that I had a beard and muscles, what a joke. Although my endo seems to be pretty clueless himself, at least he was concerned and trying to help.

    BTW, Matrix could you check your PMs? Been trying to contact you but haven't gotten a response.

  12. My Doctor said i couldnt smoke, Couldnt do drugs, Told me not to do steroids. You know whati did.

    Got a new doctor

  13. Quote Originally Posted by TML499 View Post
    Well I had a very frustrating doctor appointment recently. I had to visit a new PCP thats related to my current health insurance and he was condescending and trying to argue with me that I didn't actually have a problem without even having my medical records yet. He cited that I had a beard and muscles, what a joke. Although my endo seems to be pretty clueless himself, at least he was concerned and trying to help.BTW, Matrix could you check your PMs? Been trying to contact you but haven't gotten a response.
    TML499 try me again..
    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.

  14. Well I met with a new doctor today and it went much better. He was very open minded into looking for root causes. Matrix I'll be PMing you shortly with more information.

  15. Awesome. I.am also.doing peer to.peer consults with doctors on.cases
    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.

  16. Quote Originally Posted by The Matrix View Post
    Awesome. I.am also.doing peer to.peer consults with doctors on.cases
    Matrix could you clear your PMs?

  17. PM sent
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