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What Do These Following Lab Reports Indicate?
Question: Hello Doctor,
My primary problem was feeling fatigue, hence went to doctor he took different blood works and found my T level was low and also took different blood works and all seems to be normal including Pituitary MRI and semen analysis done as well and it looks to be normal.
Below are my values and please find the attachment for results,
My FSH is 14.4 miu/ml (1.4 - 18.1 range) and LH is 8 miu/ml (2-9 range) and total testosterone is 278
Prolactin 11.8 ng/ml (2.1 - 17.7 range)
Estradiol 21 pg/ml (0-42 range)
T4 is 1.2 ng//dl ( .8 to 1.8 range)
Free testosterone % - 2%
SHBG is 25 (11-80 mol/L range)
Pituitary MRI normal
Semen analysis done and sperm count is normal
Facial hair seems to be normal, its not too low and not too high and has pubic hair as well.
1.Is clomid 25mg daily for two month helps to improve T-levels without impacting sperm count?
2.are there any long term side effects? especially sperm count?
3.Would there any cause for low-T? If so any treatments available?
My primary problem was feeling fatigue, hence went to doctor he took different blood works and found my T level was low and also took different blood works and all seems to be normal including Pituitary MRI and semen analysis done as well and it looks to be normal.
Below are my values and please find the attachment for results,
My FSH is 14.4 miu/ml (1.4 - 18.1 range) and LH is 8 miu/ml (2-9 range) and total testosterone is 278
Prolactin 11.8 ng/ml (2.1 - 17.7 range)
Estradiol 21 pg/ml (0-42 range)
T4 is 1.2 ng//dl ( .8 to 1.8 range)
Free testosterone % - 2%
SHBG is 25 (11-80 mol/L range)
Pituitary MRI normal
Semen analysis done and sperm count is normal
Facial hair seems to be normal, its not too low and not too high and has pubic hair as well.
1.Is clomid 25mg daily for two month helps to improve T-levels without impacting sperm count?
2.are there any long term side effects? especially sperm count?
3.Would there any cause for low-T? If so any treatments available?
Brief Answer:
Clomid is safe, but not as effective as hCG
Detailed Answer:
Good day,
Noted your concern. Testosterone values are very variable. You may need to recheck testosterone in fasting state between 7 to 9 am. If a repeat value also is low, then you may need treatment.
If you are not planning to have kids now, you can use testosterone injections. But if you are plannnning to have kids soon, testosterone treatment is not advisable. You may use Clomiphene citrate ( Clomid) or hCG injections. hCG injections are better.
Clomid can improve Testo levels, but not as effective as hCG
No musch side effects.
Obesity, alcoholism, diabetes , snoring with sleep apnea etc are causes of low testosterone. You may need to reduce weight and do regular exercise.
For a male, FSH of 18, is certainly on the higher side.
Discuss with your endocrinologist to rule out above said causes. They are reversible causes of low testosterone
Regards XXXXXXX
Clomid is safe, but not as effective as hCG
Detailed Answer:
Good day,
Noted your concern. Testosterone values are very variable. You may need to recheck testosterone in fasting state between 7 to 9 am. If a repeat value also is low, then you may need treatment.
If you are not planning to have kids now, you can use testosterone injections. But if you are plannnning to have kids soon, testosterone treatment is not advisable. You may use Clomiphene citrate ( Clomid) or hCG injections. hCG injections are better.
Clomid can improve Testo levels, but not as effective as hCG
No musch side effects.
Obesity, alcoholism, diabetes , snoring with sleep apnea etc are causes of low testosterone. You may need to reduce weight and do regular exercise.
For a male, FSH of 18, is certainly on the higher side.
Discuss with your endocrinologist to rule out above said causes. They are reversible causes of low testosterone
Regards XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The T levels was measured twice and once was in early morning, hence why doctor went with measuring LH,FSH , Estrogen , thyroid and all seems to be within range.
My doctor suspected with the low-T the FSH & LH should be high to generate more Ts, however FSH & LH are within the range. Hence why he ordered the Pituitary MRI and came as normal too. Also tested the sperm count which seems to be normal.
Is there any possible causes for high FSH? would it be due to primary hypogonadism? I see people with Primary hypogondism have no or less than 2M sperm count and where in mine is 97M and i am confused now to see what would be possible causes for low-T.
Also planning to have a baby in few months, hence kindly suggest the best treatment what will affect the sperm count and also increase T level without any long term side effects.
Also help me to understand the possible causes ?
My doctor suspected with the low-T the FSH & LH should be high to generate more Ts, however FSH & LH are within the range. Hence why he ordered the Pituitary MRI and came as normal too. Also tested the sperm count which seems to be normal.
Is there any possible causes for high FSH? would it be due to primary hypogonadism? I see people with Primary hypogondism have no or less than 2M sperm count and where in mine is 97M and i am confused now to see what would be possible causes for low-T.
Also planning to have a baby in few months, hence kindly suggest the best treatment what will affect the sperm count and also increase T level without any long term side effects.
Also help me to understand the possible causes ?
Brief Answer:
Your semen analysis is normal.
Detailed Answer:
Not to worry. In primary hypogonadism, the sperm count will be low as well as T will be low. In your case, semen analysis is normal, so ignore the elevated FSH.I can reassure you that your semen analysis very much norml.
I agree with your doctor's approach.
Since you are planning to have a baby soon, the best option would be either hCG injections or Clomid. You could try with Clomid first for 3 months.
As i mentioned earlier, sleep apnea, obesity, smoking, excess alcohol intake, Marijuana and other such drug use, diabetes etc are few other causes of low testosterone
Your semen analysis is normal.
Detailed Answer:
Not to worry. In primary hypogonadism, the sperm count will be low as well as T will be low. In your case, semen analysis is normal, so ignore the elevated FSH.I can reassure you that your semen analysis very much norml.
I agree with your doctor's approach.
Since you are planning to have a baby soon, the best option would be either hCG injections or Clomid. You could try with Clomid first for 3 months.
As i mentioned earlier, sleep apnea, obesity, smoking, excess alcohol intake, Marijuana and other such drug use, diabetes etc are few other causes of low testosterone
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you again for the answer, I will proceed with clomid then as doctor suggested.
Brief Answer:
Best wishes
Detailed Answer:
Yes, that is a good choice. You may try Clomid for 3 months and see the response.
Please be patinet as it takes time.
Wish you good health.
Please feel free to ask further if you have any more questions
Regards
Binu
Best wishes
Detailed Answer:
Yes, that is a good choice. You may try Clomid for 3 months and see the response.
Please be patinet as it takes time.
Wish you good health.
Please feel free to ask further if you have any more questions
Regards
Binu
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. Chakravarthy Mazumdar
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