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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Fatigue, Weight Gain. Diagnosed Low T, Apnea. No Improvement After Medication. Why Testosterone Drop?

I have had several symptoms for years. Primarily severe fatigue, concentration difficulty, brain fog, speech difficulties, and weight gain. 6 months ago I was diagnosed with low vitamin d, low t, and sleep apnea(mild to moderate). I have had treatment for all of these and never noticed the first bit of improvement. I went to an internal med specialist recently and had lower testosterone than before the first treatment. Very low lh levels. Tsh was 2.8, t4 was 6.9, and anti thyroglobulin was 50. Iron was 204 and bilirubin 1.4. My questions are can low t and low lh cause these problems? Is my thyroid normal? And why would my testosterone drop to lower than before treatment(316 to 280)? 24 year old male
Tue, 21 May 2013
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Endocrinologist 's  Response
Hi

We need to properly diagnose the actual cause for the low testosterone without blindly treating with Testosterone replacement. As far as your thyroid levels are concerned it is difficult to interpret without you mentioning the units ! However taking the standard units, your TSH is in normal range. Since you have a low LH , I would advice a full anterior pitutary profile for your problem and full male hypogonadism profile the tests would include

1. Testosterone- Free and total
2. SHBG
3. LH
4. FSH
5. IGF1
6. Prolactin

Please get done these tests are revert back.

Regards
Dr. Om Lakhani
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Had Fatigue, Weight Gain. Diagnosed Low T, Apnea. No Improvement After Medication. Why Testosterone Drop?

Hi We need to properly diagnose the actual cause for the low testosterone without blindly treating with Testosterone replacement. As far as your thyroid levels are concerned it is difficult to interpret without you mentioning the units ! However taking the standard units, your TSH is in normal range. Since you have a low LH , I would advice a full anterior pitutary profile for your problem and full male hypogonadism profile the tests would include 1. Testosterone- Free and total 2. SHBG 3. LH 4. FSH 5. IGF1 6. Prolactin Please get done these tests are revert back. Regards Dr. Om Lakhani