Other options in dealing with Secondary Hypogonadism

[MeanGreen]

Hello again.

I am a candidate for TRT and about to embark on this journey.
In discussing it with my wife, she asked a great question....

I believe I have Secondary Hypogonadism, which is when you have low T,
but normal LH and FSH levels. "This means that your pituitary is not recognizing
that your body is deficient in test as it is not sending a 'loud' signal to your testicles
to produce more test."

Assuming no trauma or tumors etc, is there a way of addressing this HPTA issue,
instead of the TRT option of introducing test through injections?

Seems like TRT circumvents the real cause and solves the symptom and not the root
of the problem.

Btw, TT=360, LH=7.1 mIU/mL (ref 1.7-8.6), FSH=6.3 mIU/mL (ref 1.5-12.4)

Thanks for the help.

 

[halfwit]

Hello again.

I am a candidate for TRT and about to embark on this journey.
In discussing it with my wife, she asked a great question....

I believe I have Secondary Hypogonadism, which is when you have low T,
but normal LH and FSH levels. "This means that your pituitary is not recognizing
that your body is deficient in test as it is not sending a 'loud' signal to your testicles
to produce more test."

Assuming no trauma or tumors etc, is there a way of addressing this HPTA issue,
instead of the TRT option of introducing test through injections?

Seems like TRT circumvents the real cause and solves the symptom and not the root
of the problem.

Btw, TT=360, LH=7.1 mIU/mL (ref 1.7-8.6), FSH=6.3 mIU/mL (ref 1.5-12.4)

Thanks for the help.

You got it backwards. A high LH/FSH with low testosterone is primary hypogonadism. Secondary is a low LH signal to the testes.

Sorry man, but as a fellow primary - there's not much you can do outside a testicular operation (if varicocele induced). In primary, the testes are the root cause of the problem.

 

[MeanGreen]

You got it backwards. A high LH/FSH with low testosterone is primary hypogonadism. Secondary is a low LH signal to the testes.

Sorry man, but as a fellow primary - there's not much you can do outside a testicular operation (if varicocele induced). In primary, the testes are the root cause of the problem.

Oh crap, did I get it backwards??

In the Basic TRT Overview sticky, Megatron says...

"If you have high LH and FSH in combination with low testosterone you have Primary Hypogonadism. This means your pituitary is yelling at your testicles to produce more testosterone but they are not responding.

If you have low or normal LH and FSH in combination with low testosterone you have Secondary Hypogonadism. This means that your pituitary is not recognizing that your body is deficient in testosterone so it is not sending a loud signal to your testicles to produce more testosterone."


HW, I guess when I looked at my LH (in ref range but little high) and FSH (right in middle of ref range) I assumed they were normal and went right to Secondary. You're saying they are actually high and I'm Primary? Huh.

 

[halfwit]

Oh crap, did I get it backwards??

In the Basic TRT Overview sticky, Megatron says...

"If you have high LH and FSH in combination with low testosterone you have Primary Hypogonadism. This means your pituitary is yelling at your testicles to produce more testosterone but they are not responding.

If you have low or normal LH and FSH in combination with low testosterone you have Secondary Hypogonadism. This means that your pituitary is not recognizing that your body is deficient in testosterone so it is not sending a loud signal to your testicles to produce more testosterone."


HW, I guess when I looked at my LH (in ref range but little high) and FSH (right in middle of ref range) I assumed they were normal and went right to Secondary. You're saying they are actually high and I'm Primary? Huh.

This depends on a few things. It depends on just how loud your pituitary CAN scream, and just for how long it has been screaming. The best way to know for sure is to try a round of clomid (SERM), and see if you actually gain any testosterone/LH.

I consider your LH on the high end; most clear-cut secondary cases around here are often guys with an LH of about half yours.

 

[Jimstigator]

This depends on a few things. It depends on just how loud your pituitary CAN scream, and just for how long it has been screaming. The best way to know for sure is to try a round of clomid (SERM), and see if you actually gain any testosterone/LH.

I consider your LH on the high end; most clear-cut secondary cases around here are often guys with an LH of about half yours.

Agreed 100%. When I read this earlier I though the same - this guys LH is screaming at the balls and they are sleeping.

My LH was down around 1-2 when issues started. Nolva/Clomid was able to raise it along with my T for a time, and even then never as high as your LH is on that lab.

Sure looks like primary hypo to me.

 

[3J]

there is an environmental factor in your t levels..

nutrition, amount of sleep, stress.. they all play a factor in test production or lack there of..

so start with some basics.. are you overweight?? is your nutrition poor??

do you have a stressful life?

do you sleep enough?

 

[MeanGreen]

there is an environmental factor in your t levels..

nutrition, amount of sleep, stress.. they all play a factor in test production or lack there of..

so start with some basics.. are you overweight?? is your nutrition poor??

do you have a stressful life?

do you sleep enough?

Well, I live a bodybuilding lifestyle. 6'1", 206lbs, about 17% bf,
sleep 7-8 hours per day, eat clean 6 meals per day at maintenance calories,
heavy split lifting routine 5 days on 2 off.

As far as stress, well...... I am married with 2 kids about 10 years old, so no stress here. Lol!

 

[MeanGreen]

Agreed 100%. When I read this earlier I though the same - this guys LH is screaming at the balls and they are sleeping.

My LH was down around 1-2 when issues started. Nolva/Clomid was able to raise it along with my T for a time, and even then never as high as your LH is on that lab.

Sure looks like primary hypo to me.

Thanks for the input. It seems ref ranges have way too much latitude for what is considered normal.

 

[MeanGreen]

I consider your LH on the high end; most clear-cut secondary cases around here are often guys with an LH of about half yours.

Yeah, looks like the issue stems from the testicles are not performing their job well at all. They are not completely malfunctioning if I'm 360 though. HW, what kind of operation are we talking about here? ..... Just wikipedia'd varicocele. Oh man.....

 

[halfwit]

Yeah, looks like the issue stems from the testicles are not performing their job well at all. They are not completely malfunctioning if I'm 360 though. HW, what kind of operation are we talking about here? ..... Just wikipedia'd varicocele. Oh man.....

Lol, it depends if that's what is going on. 3J pointed out that something as simple as a lack of sleep can drive levels down. I don't think that's your case given the blood work, but it's something many overlook.

Usually a kink in the tubing can be felt manually (varicocele), and that's really the only operation I can think of that can fix hypogonadism if that's the cause. Otherwise, there isn't much else than taking your shots, watching estradiol, and keeping hematocrit in check.

Yes, your testes are putting some out, as you're about triple where I was when diagnosed. However, I did spend some time at 400ng/dL while dialing things in with my dose, and didn't care much for that either.

 

[Ziegler]

The lack of sleep is a major issue with me and my levels. I always no that I have gotten enough sleep. When I wake up and the gas gauge is pointed up to full. Sometimes takes ten minutes to go down so I can pee.

 

[MeanGreen]

The lack of sleep is a major issue with me and my levels. I always no that I have gotten enough sleep. When I wake up and the gas gauge is pointed up to full. Sometimes takes ten minutes to go down so I can pee.

Yeah I definitely wake up in middle of night and in morning with a salute. No problem there.

 

[Megatron28]

Well, I live a bodybuilding lifestyle. 6'1", 206lbs, about 17% bf,
sleep 7-8 hours per day, eat clean 6 meals per day at maintenance calories,
heavy split lifting routine 5 days on 2 off.

As far as stress, well...... I am married with 2 kids about 10 years old, so no stress here. Lol!

Have you used AAS before?

 

[MeanGreen]

Have you used AAS before?

Nope.

I've been lifting seriously for about 1-1/2 years now.

Right now, I take a multi, pre-workout, BCAAs during workout. No creatine. No AAS.

Couple years ago, I dropped from 270lbs to 200lbs, mostly doing cardio and portion control.

Now, no cardio just lifting, eating and sleeping.

 

[3J]

so you can do hcg therapy instead of straight up trt.. but in the end i think trt would work best given all other things i mentioned are equal

 

[MeanGreen]

so you can do hcg therapy instead of straight up trt.. but in the end i think trt would work best given all other things i mentioned are equal

If we have determined that I am Primary, and its the testicles, not the pituitary that is malfunctioning, what would be the benefit of hcg therapy only?

 

[3J]

If we have determined that I am Primary, and its the testicles, not the pituitary or HPTA pathways that are malfunctioning, what would be the benefit of hcg therapy only?

well have we determined that for a fact?? i dont see anything giving factual intake on that..

with all due respect to everyone here we are giving the best guess based on info we are provided.. you should see a specialist to figure out exactly what it is

 

[Megatron28]

Trying hCG or Clomid would allow you to see if you are Primary or Secondary. Your LH and FSH are a little ambiguous. You should discuss giving this a try before beginning injections with your doctor.

 

[300winmag]

I would potentially try clomid or HCG first. It may fix it and your done forever or a while. While 360 is low its bottom basement yet. TRT is a long road to go down, not saying that's it bad, but its forever thing.