What Causes Persistent Migraine With Aura And Loss Of Libido?

Posted on Sat, 19 Dec 2015

Question: What is the significance of my abnormal hormone results?

I am a 29 year old male without any current medical conditions. Over the course of the last year I have been experiencing many physical symptoms which my primary doctor has attributed to be "psychosomatic" in nature. I have been battling migraines "with aura," giddiness, and changes in visual perception. Over the last 6 months I have noticed a decrease in sexual functuon and decided to have my testosterone tested at a private lab. They also tested some of my endocrine function. The results were: Testosterone: 342 (low), LH: 9.2 (high), FSH: 6.3, TSH: 2.140, Cortisol: 12.2, Prolactin: 29.6 (high).

Answered by Dr. Binu Parameswaran Pillai (3 hours later)

Brief Answer:
Please repeat a Testosterone, LH and Prolactin

Detailed Answer:
Good day,
Noted your concern.
I agree that your Prolactin is a little high. The result of testosterone is not so low. Testosterone values fluctuate in a person so widely and hence, we need a second sample in fasting state. Most endocrinologists consider a low testosterone value as less than 300. Your value is low normal. Are you on any medications like Omeprazole ( acidity pills) which can raise prolactin values? Stress indeed is a cause of mild rise in prolactin levels.

I would recommend that you repeat the Prolactin, Testosterone s well as LH once again.Preferably a morning fasting sample. Many a times, hormones fluctuates due to external factors and we would like to have a secoond sample, especially for testosterone.

TSH is normal, LH is little high and the cortisol is normal(provided it is an 8 AM cortisol value).

I have few questions. What is your weight and height? How is your sleep? Do you snore? Alcohol and smoking status?
I would appreciate if you could answer these questions.

regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (14 minutes later)

I am 6'4, 210 lbs. My sleep is fine, I don't snore. I do suffer from daily migraines and chronic fatigue. I usually still feel tired even after a full night's sleep though. I drink a glass of wine maybe once a week at most. I smoke almost a pack everyday.

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Free testpsterone ( by calculation)

Detailed Answer:
Thank you. Your weight is appropriate for height . You don't seem to have snoring and obstructive sleep apnea ( these are important causes of tiredness, and low testosterone). In that case, I would strongly recommend to do a fasting ( between 7 to 9 am) serum Testosterone, SHBG, Albumin, Prolactin and LH.

We can calculate free Testosterone levels based on your SHBG, Albumin and Testosterone levels. Free testosterone is more appropriate to assess testosterone levels.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar