
Hi, I Have Low LH (.4), FSH (1.2), And Testosterone

Question: Hi,
I have low LH (.4), FSH (1.2), and testosterone (137). I took a 24 hour urine sample and my free cortisol was high (95.7) and creatinine was high also (2.88). Ferritin level is 250, progesterone is .6, free t3 is 3.7, free t4 is 1.07. I did an iron test to check to see if iron is binding to my organs and it all came back fine. My two main symptoms are loss of appetite and anxiety. Had MRI on pituitary gland and there was no tumor. What might be causing my problem?
I have low LH (.4), FSH (1.2), and testosterone (137). I took a 24 hour urine sample and my free cortisol was high (95.7) and creatinine was high also (2.88). Ferritin level is 250, progesterone is .6, free t3 is 3.7, free t4 is 1.07. I did an iron test to check to see if iron is binding to my organs and it all came back fine. My two main symptoms are loss of appetite and anxiety. Had MRI on pituitary gland and there was no tumor. What might be causing my problem?
Brief Answer:
About hormonal imbalance;
Detailed Answer:
Hello and thank you for asking!
I have gone through your concern.
The low level of LH, FSH, and testosterone are suggestive for hypothalamic or pituitary pathologies even though there is no pathology in MRI.
You need to check prolactin as it may be a cause of the low hormonal level.
Regarding high urinary cortisol level, it needs other tests ( dexamethasone suppression test, salivary cortisol) to judge if there is any pathology causing it, or is due to overweight or anxiety.
As the renal function is impaired you need to check both testosterone and SHBG to judge about free testosterone level.
Hope the information will help.
Best wishes
Dr.Mirjeta
About hormonal imbalance;
Detailed Answer:
Hello and thank you for asking!
I have gone through your concern.
The low level of LH, FSH, and testosterone are suggestive for hypothalamic or pituitary pathologies even though there is no pathology in MRI.
You need to check prolactin as it may be a cause of the low hormonal level.
Regarding high urinary cortisol level, it needs other tests ( dexamethasone suppression test, salivary cortisol) to judge if there is any pathology causing it, or is due to overweight or anxiety.
As the renal function is impaired you need to check both testosterone and SHBG to judge about free testosterone level.
Hope the information will help.
Best wishes
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Arnab Banerjee


I did have a saliva cortisol test. It was 4.1 nmol/l in the am and 36 nmol/l in evening. I believe this is the opposite of what it should be.
My doctor did give me a testosterone cyprionate injection of 200 mg on 7/3. When retested 7/13 total testosterone was 398 and free testosterone was 151. My symptoms haven’t seem to improved though.
If it is hypothalamic or pituitary pathologies how do they treat this? Also you don’t believe any of this could have something to do with my adrenal glands?
Thanks, XXXXXXX
My doctor did give me a testosterone cyprionate injection of 200 mg on 7/3. When retested 7/13 total testosterone was 398 and free testosterone was 151. My symptoms haven’t seem to improved though.
If it is hypothalamic or pituitary pathologies how do they treat this? Also you don’t believe any of this could have something to do with my adrenal glands?
Thanks, XXXXXXX
Brief Answer:
About adrenal and pituitary pathologies;
Detailed Answer:
Hi again,
To confirm or rule out an adrenal pathology, 2 out of three tests (salivary cortisol, urinary cortisol and a dexamethasone supression test) should be positive .
So you need to do also dexamethasone supression test as you have a high urinary cortisol.
Regarding the pituitary pathologies, the most common one is prolactinoma ( manifested with high prolactine level).
That is why i suggested to check prolactine.
Hope the information will help .
Regards,
Dr.mirjeta
About adrenal and pituitary pathologies;
Detailed Answer:
Hi again,
To confirm or rule out an adrenal pathology, 2 out of three tests (salivary cortisol, urinary cortisol and a dexamethasone supression test) should be positive .
So you need to do also dexamethasone supression test as you have a high urinary cortisol.
Regarding the pituitary pathologies, the most common one is prolactinoma ( manifested with high prolactine level).
That is why i suggested to check prolactine.
Hope the information will help .
Regards,
Dr.mirjeta
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Raju A.T

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