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Is low testosterone and high TSH related to anterior pituitary gland stimulation?

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Posted on Tue, 28 Jan 2014
Question: Hello Doctor, Subject : Low testosterone 44 ong/dl and High TSH 3.42 ulu/ml blood reading found in a 15 year old male. Is it related to Anterior Pituary gland stimulation? Blood readings also showed low Vitamin D 16.3 ng/mL This 15 year old male is very energetic and active in sports. Please give me a good suggestion for further treatments. Weight : 133 pounds Height 5 feet 9 Inches. We are redoing the test with Zinc level and estrogen levels and waiting for the blood results.
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Answered by Dr. Manjeth Kumar G (7 hours later)
Brief Answer: Needs further evaluation - assessment of sexual development and other Pituitary hormones,CT,MRI Detailed Answer: Hello, Welcome to XXXXXXX I have gone through your query and understand your concern. Now he is suffering from male hypogonadism. As you suspected, he may have Defect in pitutary gland stimulation. Because he have both High TSH and low testosterone. But it can also be due to Defect in testes and Hypothyroidism. First thing we have to check is his sexual development such as your pubic hair, muscle mass and size of your testes, is consistent with his age. because he may be suffering from Undescended testicles. Next we have to check other pituitary hormone levels. If they are all subnormal, then he is suffering from pituitary hypogonadism. He need further investigations like Pituitary imaging Like CT, MRI etc. Treatment depends on the cause for low testosterone. Please do the investigations said. Low vitamin d levels be due to low vitamin consumption like strict vegetarian diet or under exposure to sunlight. This can easily treated by supplementing the vitamin D and exposure to sunlight. Hope this helps. Please write back for further queries. Wishing you good health.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Manjeth Kumar G (2 hours later)
Thank You doctor for the reply. If he has pituitary hypogonadism, what are the step by step procedures? He is in 10th grade, and I am worried if it will hinder his studies or his self-esteem. According to my understanding and also from the questions asked by our doctor about his erection was sounded normal. What are the other symptoms associated with Pituatory Hypogonadism? I also found my son's hand temparature were cold. He doen't have any headaches. Is it curable? Anything related to Pituitary Gland?
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Answered by Dr. Manjeth Kumar G (12 hours later)
Brief Answer: Pituitary imaging CT and MRI. Pituitary Hormon Detailed Answer: Hello, He may have the following symptoms in puberty. 1. Decreased development of muscle mass 2. Lack of deepening of the voice 3. Impaired growth of body hair 4. Impaired growth of the penis and testicles 5. Excessive growth of the arms and legs in relation to the trunk of the body 6. Development of breast tissue (gynecomastia) Pituitary imaging with CT and MRI to rule out any pituitary hypoplasia or Pituitary tumor. Levels of other pituitary hormones. If a pituitary problem is the cause, supplement of pituitary hormones may stimulate sperm production and restore fertility. Testosterone replacement therapy can be used if fertility isn't an issue. A pituitary tumor may require surgical removal, medication, radiation or the replacement of other hormones. Hope this helps. Please write back for further queries. Wishing you good health.
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Manjeth Kumar G

General & Family Physician

Practicing since :2010

Answered : 1120 Questions

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Is low testosterone and high TSH related to anterior pituitary gland stimulation?

Brief Answer: Needs further evaluation - assessment of sexual development and other Pituitary hormones,CT,MRI Detailed Answer: Hello, Welcome to XXXXXXX I have gone through your query and understand your concern. Now he is suffering from male hypogonadism. As you suspected, he may have Defect in pitutary gland stimulation. Because he have both High TSH and low testosterone. But it can also be due to Defect in testes and Hypothyroidism. First thing we have to check is his sexual development such as your pubic hair, muscle mass and size of your testes, is consistent with his age. because he may be suffering from Undescended testicles. Next we have to check other pituitary hormone levels. If they are all subnormal, then he is suffering from pituitary hypogonadism. He need further investigations like Pituitary imaging Like CT, MRI etc. Treatment depends on the cause for low testosterone. Please do the investigations said. Low vitamin d levels be due to low vitamin consumption like strict vegetarian diet or under exposure to sunlight. This can easily treated by supplementing the vitamin D and exposure to sunlight. Hope this helps. Please write back for further queries. Wishing you good health.