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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Low Testosterone Levels With Low Libido?

Dear Dr.

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,
Hassan Abbas


Wed, 15 Jul 2020
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General & Family Physician 's  Response
Hi,

Your hormone tests were all in normal range expect for the total testosterone level. The testosterone level fluctuates during the day, and it is important to get several measurements at different time points to make the diagnosis. Your doctor was trying to stimulate your testicles to produce more testosterone. After the hCG therapy your levels were in normal range.

To increase your testosterone level naturally you need to exercise, specially resistance training aka weight lifting. Eat a healthy diet high in protein. Also, you could use zinc supplements. If you do this for 3 months and still without improvement discuss with your endocrinologist the possibility of testosterone supplements.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Ahmad Nazzal, General & Family Physician
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What Causes Low Testosterone Levels With Low Libido?

Hi, Your hormone tests were all in normal range expect for the total testosterone level. The testosterone level fluctuates during the day, and it is important to get several measurements at different time points to make the diagnosis. Your doctor was trying to stimulate your testicles to produce more testosterone. After the hCG therapy your levels were in normal range. To increase your testosterone level naturally you need to exercise, specially resistance training aka weight lifting. Eat a healthy diet high in protein. Also, you could use zinc supplements. If you do this for 3 months and still without improvement discuss with your endocrinologist the possibility of testosterone supplements. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ahmad Nazzal, General & Family Physician