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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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I Was Diagnosed With Low Testosterone. Pirtuitary Gland Seemed Normal After MRI Scan Done.

I was diagnosed with low testosterone last year when my sex drive basically nose dived to nil. I went to see a urogolist and then an endocrinologist and also got an MRI scan done. As per the MRI the pirtuitary gland seemed normal however the results I did not have time to show to the endocrinologist. The doctor also did a physical and said that the testes seemed perfectly normal however he advised me to get a few tests done the results of which are as follows; Dated: Feb 17, 2010 LH= 2.82 mlU/ml ref range: (0.8 – 7.6) FSH= 3.47 miU/ml ref range: (0.7 – 11.1) T3=100ng/dl ref range: (84 – 172) T4=7.81 microgram/dl ref range: (4.5 – 12.5) Total Testosterone= 216 ref range: (262 – 1593ng/dl) Prolactin= 4.6ng/ml ref range: (2.5 – 17) ESR= 11 ref range: (0 – 15mm/1st hour) After the tests I went to see the doctor and he advised me HcG injections and advised Gonacor5000 innjection once a week for 6 weeks. I got the injection for 3 weeks and again got my testosterone test done. This I did in August first week 2010. Test date: August 8, 2010 Total testosterone: 548ng/dl Since I had to fly out of the country I did not complete the course. After 3 months I got the test done again Test Date: November 23rd, 2010 Testosterone: 307ng/dl ref range: (262 – 1593) Since there was an alarming decrease in testosterone I went to see the doctor and he advised HcG injections 2X a week IVF-C HcG 5000IU. I had to fly out of the country so I got only one shot and as per the advice of the doctor got the following tests done before discontinuing the treatment: Test Date: Nov 29th 2010 Free T4= 1.3ng/dl ref range: (0.89 – 1.76) LH= 1.280miU/ml ref range: (0.8 – 7.6) Testosterone=417ng/dl ref range: (262 – 1593) Prolactin= 14.1ng/ml ref range: (2.5 – 17) ALT= 17U/L ref range: (10 – 50) AST= 25U/L ref range: (10 – 50) At the same time the doctor advised me to start taking folic acid tablet one every morning and vitamin E tables 400 before going to bed. I am a 32 year old Male and have hada pretty healthy sex life up until last year and am not sure what could be the reason for this. I have had a hernia operation but a doctor said except for varicose veins in my scrotum all else is fine. If I have an erection I am able to hold it as well. Please advise on what the solution to this problem is. I am married but have no kids. We are planning to have kids soon. Thanks,
Sat, 1 Jan 2011
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General Surgeon 's  Response
from the history as narrated it seems the onset is rather sudden
regarding testosterone level it is better to consult an endocrinologist to find out the reason pf low level
you have not mentioned about your blood sugar level
it is very important .fasting and 2hr pp blood sugar level should be done
you should not be over weight
regular physical exercise will help
the worry about sexual performance before the act is hindrance to proper erection.
should have active support from partner in this situation
should pass tension free pleasant time with partner
.you have mentioned you get erection and it sustains
ITS GOOD THING
it seems you have some major degree of tension and you should be free of it.
regarding having issues is altogether another line of investigations and management
DO NOT WORRY
YOU WILL BE ALRIGHT

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I Was Diagnosed With Low Testosterone. Pirtuitary Gland Seemed Normal After MRI Scan Done.

from the history as narrated it seems the onset is rather sudden regarding testosterone level it is better to consult an endocrinologist to find out the reason pf low level you have not mentioned about your blood sugar level it is very important .fasting and 2hr pp blood sugar level should be done you should not be over weight regular physical exercise will help the worry about sexual performance before the act is hindrance to proper erection. should have active support from partner in this situation should pass tension free pleasant time with partner .you have mentioned you get erection and it sustains ITS GOOD THING it seems you have some major degree of tension and you should be free of it. regarding having issues is altogether another line of investigations and management DO NOT WORRY YOU WILL BE ALRIGHT