Testosterone replacement therapy (TRT) needed? Age 23, no morning wood for years. Bloodwork Done.

[sphinxbrah]

TRT needed? Age 23, no morning wood for years. Bloodwork Done.

Hi all,

I haven't had morning wood in years despite being very young. I just turned 23 a few months ago.

I am very physically active and in great shape. I lift weights regularly and do lots of sports and cardio. I am 10-12% bodyfat. I am otherwise fully healthy so I don't know what the problem could be and why this is happening.

Symptoms of concern: no morning wood, lowered sex drive (still get horny at times.... but nothing like when I was in high school), weaker erections (I'd still give them a solid 7-8/10.... but when in high school i was off the scales hard... 10/10 if not 11/10), have not had a spontaneous erections (i.e. "no reason boner") in years.

Despite the above symptoms, I have a lot of muscle mass (avid bodybuilder - 5'11, 185 lbs at about 11% BF), do not have man boobs, gyno, or puffy nipples, I have tons of energy, and no mental fog. All of this combined - with my testicles being a very decent size and very hard to the touch - has me hopeful that my body IS still capable of producing adequate testosterone. However, it makes my negative symptoms (non-existent morning wood for years on end, etc) all the more complexing

I suspect this is all hormonal of course.... but I have never ran a cycle that could have throw my hormones off. The only thing I have ever "taken" is protein powder which I am sure is fine. I have now started zinc supplements, however, to try and get the wood back. So far, this has yielded no success.

My E2 seems to be in the high range of normal and my free test in the low range of normal. I think these two things could be related. Either way, I suspect this is the cause. Everything I am reading suggests you should not be in the low range of normal for test / high range of normal for E2 as a 23 year old male in excellent physical condition. Yet, as my results are all "in normal range", my doctor is convinced I am fine.

I had one thorough test done recently. The results are below. This was done after finally demanding to be referred to an endo. Prior to this my GP would only test for testosterone and also FSH+LH+TSH(which of course is not enough on their own to tell the whole story). These results are also posted.

I am getting another thorough reading done in the coming months and will post the results. I am in Canada so the wheels move slowly with the medical system. On the plus side, all my tests are free.

A few questions:

- Would and Aromatase inhibitor (AI) like arimidex be something to pursue?
- Should I continue with zinc supplementation(I started today) or will this risk seeing future tests giving a false reading?
- Could this be thyroid related even if my TSH seems normal? I do sweat a lot. Although I have no idea if that is due to an overactive thyroid or me just being a sweaty guy.
- Is my low range free test / high range E2 fine? Or is it a problem? I think the latter. Doctor seems to think former.

Thanks to all for any help!

Test results follow (all tests taken in the AM; for each test I have provided the entirety of what was tested for):

.
.
.

May 1 2013 Test Results

- DHEAS: 8.8 umol/L (ref range 2.3 - 18.7)
- Prolactin: 11 ug/L (ref range 3 - 13)
- LH: 3 IU/L (ref range 1-9)
- FSH: 2 IU/L (ref range 1-19)
- TSH: 1.88 mU/L (ref range 0.3 - 5.6)
- Total testosterone 18.8 nmol/L (ref range 6.1 - 27.1)
- Free testosterone: 333 pmol/L (ref range 110 - 660)
- Bioavailable testosterone: 7.8 nmol/ L (ref range 2.8 - 15.5)
- SHBG: 44 nmol/L (ref range 13 - 89)
- Estradiol: 132 pmol/L (ref range 40 - 160)

The less thorough tests that follow were done at a different lab, thus the different reference ranges

January 19 2013 Test Results

- TSH: 1.38 mIU/L (ref range 0.35 - 5)
- LH: 6 IU/L (ref range 2-9)
- FSH: 2 IU/L (ref range 2-12)
- Free Testosterone: 37.4 pmol/L (ref range 31 - 94)

January 12 2013 Test Results

- TSH: 1.38 mIU/L (ref range 0.35 - 5)
- Total Testosterone: 22.3 nmol/L (ref range 7.6 - 31.4)
- Free Testosterone: 46.6 pmol/L (ref range 31 - 94)

June 2012 Test Results

- Free Testosterone: 42.8 pmol/L (ref range 31 - 94)

 

[halfwit]

Your total test is actually about average, but one thing that jumps out at me is your prolactin and LH/FSH numbers combined with a slightly higher E2 (as you mentioned) figure. I'd talk to the endo about seeing if you might have a pituitary issue that is being caught in the early stages as this could cause all of the above as prolactin combined with higher E2 CAN cause libido issues, as well as secondary hypogonadism. I think you're really in tune with your body, and would jump on this ASAP. Keep in mind I'm not a doctor, but as a testosterone replacement therapy (TRT) patient myself, I wish I had paid attention to the warning signs and sought the appropriate medical attention sooner.

Good luck man, let us know how it goes!

 

[sphinxbrah]

Your total test is actually about average, but one thing that jumps out at me is your prolactin and LH/FSH numbers combined with a slightly higher E2 (as you mentioned) figure. I'd talk to the endo about seeing if you might have a pituitary issue that is being caught in the early stages as this could cause all of the above as prolactin combined with higher E2 CAN cause libido issues, as well as secondary hypogonadism. I think you're really in tune with your body, and would jump on this ASAP. Keep in mind I'm not a doctor, but as a testosterone replacement therapy (TRT) patient myself, I wish I had paid attention to the warning signs and sought the appropriate medical attention sooner.

Good luck man, let us know how it goes!

Cheers for the reply! Any other inputs are very, very welcome!

I will bring up the pituitary issue with my endo for sure. I am indeed very in tune with my body and at age 23 don't want to be having any sort of reproductive issues!

Re: prolactin, LH, FSH - what are the ideal ranges for these? I have looked all over the internet and cannot find out anything past reference ranges. But as we know.... simply being "in normal range" may not mean you are in a very good place. :O

Is E2 high enough that I should look into ways to reduce it slightly and that this might solve the problem e.g. arimidex? Or is that something I should not explore at this point?

I will for sure keep you posted.

 

[bigben34]

Cheers for the reply! Any other inputs are very, very welcome!

I will bring up the pituitary issue with my endo for sure. I am indeed very in tune with my body and at age 23 don't want to be having any sort of reproductive issues!

Re: prolactin, LH, FSH - what are the ideal ranges for these? I have looked all over the internet and cannot find out anything past reference ranges. But as we know.... simply being "in normal range" may not mean you are in a very good place. :O

Is E2 high enough that I should look into ways to reduce it slightly and that this might solve the problem e.g. arimidex? Or is that something I should not explore at this point?

I will for sure keep you posted.

I wouldn't start on Adex, or even try to change your current levels until you talk with an endo. I would try to get an MRI on your pituitary before anything else.

As far as ideal ranges go...everyone is different but you would really want to see your LH and FSH at the very least in the middle of the ref range.

 

[halfwit]

I wouldn't start on Adex, or even try to change your current levels until you talk with an endo. I would try to get an MRI on your pituitary before anything else.

As far as ideal ranges go...everyone is different but you would really want to see your LH and FSH at the very least in the middle of the ref range.

Couldn't have said it better. (Reference range if you are curious is: 1.7-8.6 (LH) and 1.5-12.4 (FSH)) They're not at the VERY bottom, but I see a trend in your labs which leads me to believe there is a potential problem with your pituitary gland. Definitely get in touch with your endo and gently push for an MRI/further investigation.

 

[sphinxbrah]

Thanks to both then! I will for sure push for some pituitary gland exploration. I have a few questions then:

- Could my E2 being on the high end of normal also have some sort of link to the pituitary if this is in fact the problem.

- I started supplementing with zinc in an effort to get my morning wood back. So far this has been unsuccessful.... but it has only been 48h. Should I continue with this zinc supplementation? Or might taking zinc cause my blood work to yield falsely high or low readings in certain areas?

 

[halfwit]

Thanks to both then! I will for sure push for some pituitary gland exploration. I have a few questions then:

- Could my E2 being on the high end of normal also have some sort of link to the pituitary if this is in fact the problem.

- I started supplementing with zinc in an effort to get my morning wood back. So far this has been unsuccessful.... but it has only been 48h. Should I continue with this zinc supplementation? Or might taking zinc cause my blood work to yield falsely high or low readings in certain areas?

Wow, I had never really thought about that to be honest. Estradiol is made by the negative feedback loop via the aromatase enzyme which turns testosterone into estrogen. Hmm, I really don't know off the top of my head which signal is sent by which part of the HPTA to tell the body when homeostasis has been achieved. This is likely where the breakdown has occurred as an elevated E2 would happen if this signal was interrupted, telling the body to keep up with the aromatization of your testosterone. Maybe one of the IMT guys or The-Det-Oak can chime in on this as I would have to look it up and don't want to give information that may or may not be accurate as I would have just learned it myself. I DO know however that prolactin being elevated is caused by a poorly functioning pituitary gland as this is where the hormone is made.

Zinc is a natural anti-estrogen, so while it might help a little - it's not very likely that it would lower your E2 enough to effect a diagnosis by a doctor as long as you tell him that you're taking it. Just be careful with dosages, too much zinc can upset the balance of metals in your body such as copper as it chelates.

My .02c

 

[sphinxbrah]

Wow, I had never really thought about that to be honest. Estradiol is made by the negative feedback loop via the aromatase enzyme which turns testosterone into estrogen. Hmm, I really don't know off the top of my head which signal is sent by which part of the HPTA to tell the body when homeostasis has been achieved. This is likely where the breakdown has occurred as an elevated E2 would happen if this signal was interrupted, telling the body to keep up with the aromatization of your testosterone. Maybe one of the IMT guys or The-Det-Oak can chime in on this as I would have to look it up and don't want to give information that may or may not be accurate as I would have just learned it myself. I DO know however that prolactin being elevated is caused by a poorly functioning pituitary gland as this is where the hormone is made.

Zinc is a natural anti-estrogen, so while it might help a little - it's not very likely that it would lower your E2 enough to effect a diagnosis by a doctor as long as you tell him that you're taking it. Just be careful with dosages, too much zinc can upset the balance of metals in your body such as copper as it chelates.

My .02c

I am only taking 25mg zinc after researching those very problems with it so I think this should be a safe dose.

Is it possible that not having morning wood ever simpy isnt a problem? I am very, very skeptical of this. But my family doctor told me this was the case as long as I could still get an erection. My endo echoed these thoughts saying I could easily just be sleeping through them and that they usually happen around 3AM. But to sleep through them every single night for years on end? I can't see that being very likely.... I used to wake up with them all the time in high school. He agreed to run these tests a 2nd time, however, so we have a 2nd reading. I get these results in late August.... the wait is killing me

 

[halfwit]

I am only taking 25mg zinc after researching those very problems with it so I think this should be a safe dose.

Is it possible that not having morning wood ever simpy isnt a problem? I am very, very skeptical of this. But my family doctor told me this was the case as long as I could still get an erection. My endo echoed these thoughts saying I could easily just be sleeping through them and that they usually happen around 3AM. But to sleep through them every single night for years on end? I can't see that being very likely.... I used to wake up with them all the time in high school. He agreed to run these tests a 2nd time, however, so we have a 2nd reading. I get these results in late August.... the wait is killing me

Ahhh, sounds like diabetes specialists dabbling in hormone therapy. Why on Earth would he make you wait until August??! Apparently it's been a long time since either of these guys have gotten their peckers out and realized how important to a man it is to be fully functional in that area. I went nearly a decade without morning wood and thought it was normal - I also had hormone levels of a teenage girl! So yeah, it's not normal, and I doubt you can sleep through it EVERY single night. Not to get into specifics, but as the joke goes: What's the difference between hard and light?

You can sleep with a light on.

It might be time to start looking for another doctor if these guys don't start taking you seriously. They work for YOU, not the other way around.

 

[sphinxbrah]

Ahhh, sounds like diabetes specialists dabbling in hormone therapy. Why on Earth would he make you wait until August??! Apparently it's been a long time since either of these guys have gotten their peckers out and realized how important to a man it is to be fully functional in that area. I went nearly a decade without morning wood and thought it was normal - I also had hormone levels of a teenage girl! So yeah, it's not normal, and I doubt you can sleep through it EVERY single night. Not to get into specifics, but as the joke goes: What's the difference between hard and light?

You can sleep with a light on.

It might be time to start looking for another doctor if these guys don't start taking you seriously. They work for YOU, not the other way around.

What mechanisms are there to find which doctors are good in your area for this sort of thing? I took a LOT of pushing just to get the referral to this endo from my family doctor (who also told me it was not a problem - but I persisted until he gave me the referral). I have tried Google but it has yielded nothing....

I am in Canada so you cannot just go see a specialist. Any endo requires a referral. The one I have now is nice enough and willing to run the tests again for a 2nd reading... but doesn't seem overly concerned that something is wrong since everything is in "normal range". I fear he may be a diabetes specialist, as you stated, and not really know much about hormone therapy.

 

[halfwit]

Ouch, I am woefully ignorant to how things are done in Canada as I know you guys have different rules there. I usually use websites like healthgrades.com or ratemds.com and go from there. Google is a great tool, but you really need to be quite specific sometimes.

 

[bigben34]

What mechanisms are there to find which doctors are good in your area for this sort of thing? I took a LOT of pushing just to get the referral to this endo from my family doctor (who also told me it was not a problem - but I persisted until he gave me the referral). I have tried Google but it has yielded nothing....

I am in Canada so you cannot just go see a specialist. Any endo requires a referral. The one I have now is nice enough and willing to run the tests again for a 2nd reading... but doesn't seem overly concerned that something is wrong since everything is in "normal range". I fear he may be a diabetes specialist, as you stated, and not really know much about hormone therapy.

My Endo is alright, not great but he's a younger guy and not "old school" in his methods. I'm in the US but one of the things that I did was called Endocrinology offices and talked to whoever I could, receptionist, nurse, ect...and I just asked if thier docs treat many patients with testosterone replacement therapy (TRT) and if they also treat with an Aromatase inhibitor (AI) and Human Chorionic Gonadotropin (HCG) as part of their therapy. Surprisingly, the receptionist usually knew the answer and if she didn't, she would ask a nurse for me. Other than that, I'm not too sure what else you could do...

 

[sphinxbrah]

Okay, thanks to both! I will talk to my current endo when seeing my latest results in August and go from there. I will also make sure to keep you guys posted with those results once I get them. My plan of attack is to currently do that, pay particular note to what the prolactin/LH/FSH numbers are, mention these to the endo, and push for the pituitary examination.

Should I also bring up the higher end estrogen / non-spectacular free test? Prior to coming here I thought that might indeed be the problem - simply converting too much T to E. :S

Re: LH. It came back as 2 this time but last time came back at 6 which is in fact above mid range. I read somewhere that LH readings are often very different given that it is released in "pulses"... is this true? It makes me somewhat unsure of if LH would be the problem or not. But I will investigate it and everything else. I want to be as thorough as possible.

Re: FSH. This was low range every time but it is my understanding it is LH that control test and that FSH is only relevant with sperm. If that is true, low FSH might make me infertile - which I of course will want sorted out! - but I don't see how it could impact my lack of morning wood? Or is the thinking just that a frequently low FSH = possible pituitary problem = the lack of morning wood?

 

[Megatron28]

Just want to add to the conversation. I agree it is strange that you never have morning wood. But if you research morning wood you will find the following information on Wikipedia. The mechanism for morning wood is not fully understood, but it is thought to be connected to REM sleep. I know when I was 23 I was not getting a lot of sleep between all the studying and partying I was doing. So if you aren't sleeping well it could be affecting your morning wood and hormones. Just one more thing to consider. I agree with all the advice that has been given to you. This may just be one more piece of the puzzle.


Nocturnal penile tumescence

Nocturnal penile tumescence (abbreviated as NPT) is a spontaneous erection of the penis during sleep or when waking up. All men without physiological erectile dysfunction experience this phenomenon, usually three to five times during the night, typically during REM sleep.[1] NPTs are believed to contribute to penile health.[2]

Diagnostic value

Mechanism <collapse-section>

The cause of NPT is not known with certainty. Bancroft (2005) hypothesizes that the noradrenergic neurons of the locus ceruleus are inhibitory to penile erection, and that the cessation of their discharge that occurs during REM sleep may allow testosterone-related excitatory actions to manifest as NPT.[3]

Evidence supporting the possibility that a full bladder can stimulate an erection has existed for some time and is characterized as a 'reflex erection'. The nerves that control a man’s ability to have a reflex erection are located in the sacral nerves (S2-S4) of the spinal cord.[4] A full bladder is known to mildly stimulate nerves in the same region. This mild stimulus which during the day is normally suppressed in adult males by competing stimuli and other distractions; during sleep the absence of such factors could instigate a reflex erection.[citation needed]

The possibility of a full bladder causing an erection, especially during sleep, is perhaps further supported by the beneficial physiological effect of an erection inhibiting urination, thereby helping to avoid nocturnal enuresis.[citation needed]

 

[sphinxbrah]

Just want to add to the conversation. I agree it is strange that you never have morning wood. But if you research morning wood you will find the following information on Wikipedia. The mechanism for morning wood is not fully understood, but it is thought to be connected to REM sleep. I know when I was 23 I was not getting a lot of sleep between all the studying and partying I was doing. So if you aren't sleeping well it could be affecting your morning wood and hormones. Just one more thing to consider. I agree with all the advice that has been given to you. This may just be one more piece of the puzzle.


Nocturnal penile tumescence

Nocturnal penile tumescence (abbreviated as NPT) is a spontaneous erection of the penis during sleep or when waking up. All men without physiological erectile dysfunction experience this phenomenon, usually three to five times during the night, typically during REM sleep.[1] NPTs are believed to contribute to penile health.[2]

Diagnostic value

Mechanism <collapse-section>

The cause of NPT is not known with certainty. Bancroft (2005) hypothesizes that the noradrenergic neurons of the locus ceruleus are inhibitory to penile erection, and that the cessation of their discharge that occurs during REM sleep may allow testosterone-related excitatory actions to manifest as NPT.[3]

Evidence supporting the possibility that a full bladder can stimulate an erection has existed for some time and is characterized as a 'reflex erection'. The nerves that control a man***8217;s ability to have a reflex erection are located in the sacral nerves (S2-S4) of the spinal cord.[4] A full bladder is known to mildly stimulate nerves in the same region. This mild stimulus which during the day is normally suppressed in adult males by competing stimuli and other distractions; during sleep the absence of such factors could instigate a reflex erection.[citation needed]

The possibility of a full bladder causing an erection, especially during sleep, is perhaps further supported by the beneficial physiological effect of an erection inhibiting urination, thereby helping to avoid nocturnal enuresis.[citation needed]

Thanks for the input! However, my sleep patterns are excellent so I don't think this could be it. I almost always get a full 8 hours. Often times more on weekends.

Also, I never have done drugs, very rarely drink alochol, exercise regularly, am in great shape, do not smoke, and have a stress-free life. So none of these could be the cause, that much I am sure of.

The full bladder point is fair enough. Bit I never get morning wood. Even on the (rare) occasions I wake up in the AM having to pee so badly I feel as if my bladder is going to burst.

 

[sphinxbrah]

Quick notes/musings for those thinking my lack of morning erections might well be related to the pituitary.

I have read now in my research that LH and FSH are pulsatile hormones. Thus, they fluctuate quite a bit and it is possible you simply catch (or do not catch) them when they are 'peaking'.

I am starting to think again that this might well be primarily a high E2 issue more than anything else - as opposed to pituitary based - for the reasons that follow.

1) My testicles are a very healthy size, shape, and hardness. Would this not indicate they are getting adequate signaling from the pituitary? I haven't had morning wood in *years*... surely they would have decreased in size and/or hardness by now if the pituitary was the problem?

2) Although my LH checked in as 2 on my most recent test.... it was 6 on the test prior which is quite good. As LH can fluctuate a lot, the reading of 2 certainly has me on notice.... but also not ready to push the panic button just yet or finger the pituitary as my main suspect.

3) Although my free testosterone is a bit lower than it likely should be (perhaps too much conversion to E?)... my total testosterone both times it has been tested has been quite decent (22.3 nmol/L and 18.8 nmol/L, respectively). Surely, this would not be the case if the pituitary was not functioning as it should be?

4) FSH has been more consistent coming back at the low end both times at 2. But it is my understanding that this hormone is merely related to fertility. If so, why would it even impact my lack of morning wood to begin with?

All of this leads me to believe my lack of morning wood probably is not due to my pituitary. In the interest of being thorough, however, I for sure still plan on pushing for further examination on it! It is very important to me this gets sorted out so I want no stone un-turned.

By contrast the following has me thinking it might well be due to too much E2.

1) Normal total testosterone readings (see above)

2) Free testosterone consistently in the lower 1/3rd with the following readings: 333 pmol/L (ref range 110 - 660), 37.4 pmol/L (ref range 31 - 94), 42.8 pmol/L (ref range 31 - 94), 46.6 pmol/L (ref range 31 - 94).

3) I took ZMA a few months back and awoke with morning wood like when I was in high school - raging! Unsure if the effects would last as I promptly stopped not wanting to possibly interfere with future blood work.... but my morning wood was indeed back that day and I know zinc is an anti-estrogen.

Thoughts?

 

[halfwit]

Quick notes/musings for those thinking my lack of morning erections might well be related to the pituitary.

I have read now in my research that LH and FSH are pulsatile hormones. Thus, they fluctuate quite a bit and it is possible you simply catch (or do not catch) them when they are 'peaking'.

I am starting to think again that this might well be primarily a high E2 issue more than anything else - as opposed to pituitary based - for the reasons that follow.

1) My testicles are a very healthy size, shape, and hardness. Would this not indicate they are getting adequate signaling from the pituitary? I haven't had morning wood in *years*... surely they would have decreased in size and/or hardness by now if the pituitary was the problem?

2) Although my LH checked in as 2 on my most recent test.... it was 6 on the test prior which is quite good. As LH can fluctuate a lot, the reading of 2 certainly has me on notice.... but also not ready to push the panic button just yet or finger the pituitary as my main suspect.

3) Although my free testosterone is a bit lower than it likely should be (perhaps too much conversion to E?)... my total testosterone both times it has been tested has been quite decent (22.3 nmol/L and 18.8 nmol/L, respectively). Surely, this would not be the case if the pituitary was not functioning as it should be?

4) FSH has been more consistent coming back at the low end both times at 2. But it is my understanding that this hormone is merely related to fertility. If so, why would it even impact my lack of morning wood to begin with?

All of this leads me to believe my lack of morning wood probably is not due to my pituitary. In the interest of being thorough, however, I for sure still plan on pushing for further examination on it! It is very important to me this gets sorted out so I want no stone un-turned.

By contrast the following has me thinking it might well be due to too much E2.

1) Normal total testosterone readings (see above)

2) Free testosterone consistently in the lower 1/3rd with the following readings: 333 pmol/L (ref range 110 - 660), 37.4 pmol/L (ref range 31 - 94), 42.8 pmol/L (ref range 31 - 94), 46.6 pmol/L (ref range 31 - 94).

3) I took ZMA a few months back and awoke with morning wood like when I was in high school - raging! Unsure if the effects would last as I promptly stopped not wanting to possibly interfere with future blood work.... but my morning wood was indeed back that day and I know zinc is an anti-estrogen.

Thoughts?

1. Sorry, but having big healthy looking balls does not equate to everything being okay. That was the first thing I mentioned to the doc as I got my results for my total test being scary low. Trust me, I could have used them to crack walnuts.

2. You're right, LH is a fluctuating hormone - but a 4 point drop is pretty significant and is something your doctor should be looking at when painting a bigger picture here. I wouldn't panic as that will do absolutely NOTHING for you, but that is often seen as a precursor to hypogonadism. I'd dig up the study I saw regarding this, but I'm eating steak right now, so I'm trying to type one-handed as is.

3. You're right, your testosterone is at about average. The problem is that your prolactin is at the upper end, which IS made by the pituitary gland and very well could be causing issues for you. Loss of libido is often the first warning sign of elevated prolactin.

4. Yes, FSH is related to spermatogenesis, which isn't a big deal at 23, but if/when you decide you want to have kids - it can be a very BIG deal. As far as I know, FSH does not influence your ability to get or maintain an erection, but as it is a hormone made by your pituitary - seeing it decline with your LH lets a doctor know that something may be wrong.

I do agree that your E2 might be causing you problems, but there's a lot more to just taking an Aromatase inhibitor (AI) (sorry, zinc won't kill your estradiol by THAT much) or an OTC herbal pill when it comes to what's going on with your HPTA. Again, I'm not a doctor, but I would most certainly push yours to take you seriously on this as it might be something easily remedied.

 

[sphinxbrah]

1. Sorry, but having big healthy looking balls does not equate to everything being okay. That was the first thing I mentioned to the doc as I got my results for my total test being scary low. Trust me, I could have used them to crack walnuts.

2. You're right, LH is a fluctuating hormone - but a 4 point drop is pretty significant and is something your doctor should be looking at when painting a bigger picture here. I wouldn't panic as that will do absolutely NOTHING for you, but that is often seen as a precursor to hypogonadism. I'd dig up the study I saw regarding this, but I'm eating steak right now, so I'm trying to type one-handed as is.

3. You're right, your testosterone is at about average. The problem is that your prolactin is at the upper end, which IS made by the pituitary gland and very well could be causing issues for you. Loss of libido is often the first warning sign of elevated prolactin.

4. Yes, FSH is related to spermatogenesis, which isn't a big deal at 23, but if/when you decide you want to have kids - it can be a very BIG deal. As far as I know, FSH does not influence your ability to get or maintain an erection, but as it is a hormone made by your pituitary - seeing it decline with your LH lets a doctor know that something may be wrong.

I do agree that your E2 might be causing you problems, but there's a lot more to just taking an Aromatase inhibitor (AI) (sorry, zinc won't kill your estradiol by THAT much) or an OTC herbal pill when it comes to what's going on with your HPTA. Again, I'm not a doctor, but I would most certainly push yours to take you seriously on this as it might be something easily remedied.

This all good to know. Many thanks. I guess I will be most curious about my LH at the next test - although I eagerly await all results. If it comes back low again it will for sure send up another red flag. If it is closer to 6 this time around I might conclude the 2 reading was just catching it at a non-peak time. Although even still, as it fluctuates, I would also not want to assume I am out of the woods! If only this were not all so complex haha.

Re: (elevated) prolactin. Curious to see what average is, as opposed to just the reference range. I have came across one study posted on another forum where one sought the 'ideal' prolactin level (can we link to other forums? if so I will provide the link to the thread). This study indicates 11 is in fact right at the average. Is this true or is the study off base? Thoughts on this? I wish I could find more studies backing up this. It would make me feel a lot better in its claims. Study: bmj.com/content/4/5999/738

 

[halfwit]

This all good to know. Many thanks. I guess I will be most curious about my LH at the next test - although I eagerly await all results. If it comes back low again it will for sure send up another red flag. If it is closer to 6 this time around I might conclude the 2 reading was just catching it at a non-peak time. Although even still, as it fluctuates, I would also not want to assume I am out of the woods! If only this were not all so complex haha.

Re: (elevated) prolactin. Curious to see what average is, as opposed to just the reference range. I have came across one study posted on another forum where one sought the 'ideal' prolactin level (can we link to other forums? if so I will provide the link to the thread). This study indicates 11 is in fact right at the average. Is this true or is the study off base? Thoughts on this? I wish I could find more studies backing up this. It would make me feel a lot better in its claims. Study: bmj.com/content/4/5999/738

It will be interesting to see what your next results are. I don't understand why the need to make you wait 3 months, but that's just me. Prolactin is one of those hormones that men don't actually need at all as we do not need to make milk with our mammary glands. I have yet to read anything stating how the reduction of this hormone has negative side effects in men in fact. I read that study from 1975, and if you're going by the chart to see if you fall in the ranges, you should note the units are different than what your results have. Sorry, I have no clue how to convert mU/L to ug/L. (I don't even know what the heck an mU is LOL - milliunits?) I don't think linking other forums is allowed, but AFAIK there isn't an "optimal" prolactin level other than low.

Please be sure to update us on when you do get your new results, I always like to learn new things and would be happy knowing that everything works out in the end.

 

[sphinxbrah]

It will be interesting to see what your next results are. I don't understand why the need to make you wait 3 months, but that's just me. Prolactin is one of those hormones that men don't actually need at all as we do not need to make milk with our mammary glands. I have yet to read anything stating how the reduction of this hormone has negative side effects in men in fact. I read that study from 1975, and if you're going by the chart to see if you fall in the ranges, you should note the units are different than what your results have. Sorry, I have no clue how to convert mU/L to ug/L. (I don't even know what the heck an mU is LOL - milliunits?) I don't think linking other forums is allowed, but AFAIK there isn't an "optimal" prolactin level other than low.

Please be sure to update us on when you do get your new results, I always like to learn new things and would be happy knowing that everything works out in the end.

3 months is the next time I can see the endo as he is booked up for lots of summer and then goes on vacation. I have the requisition and can get the blood work done, however, at any time I wish. I plan on going next week. Although I will not be able to discuss the results with the endo until August.... it is my hope that I can obtain a copy of them for my own viewing much sooner! It would be better than nothing I suppose. I will for sure post the results here.

This is all so frustrating. I just want to be like I was at 18.... raging morning erections every day, extremely horny and wanting to have relations with every attractive woman that passed. At age 23 and in excellent shape I feel this should all still be the case. On the other hand, I try not to be too upset. Despite less libido and no morning wood for years my member has been fully functioning throughout and I (*knock on wood*) definitely don't have any sort of ED, my sex drive although not near what it once was is hardly at 0, and I am at least on the track to resolving this.