Q. I have chronic fatigue with high LH. How to treat it?

Answered by
Dr. Shaikh Sadaf
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 11, 2021

Hello doctor,

I am 51 years old. I have been fighting chronic fatigue for six years. It is like having the flu permanently. I have tried natural supplements, but I cannot seem to kick it. I have been doing a lot of reading lately, and I think the root cause is hormone-related. My symptoms seem to match low T, hypothyroidism, or Hashimoto's. So, I had a blood test done looking for thyroglobulin antibody and thyroid peroxidase (TPO). The TPO was 10, which falls into the range, but several articles have said the reference should be less than 2. My LH is high. I am in over my head now, so I am turning to the experts. My family doctor has no idea how to help. It has been a long struggle, and I would like to get to the root cause. Can you look at the test and let me know what you think? I am open to more tests done if it will get me to a cure.

I have muscle aches, lack of energy, extreme fatigue crashes, no sex drive, mood swings, sporadic depression (5htp seems to fix), aching joints, sore throat off and on. Three years ago, I took Adderall to get through the day. It was extended-release, and it worked, but it made me cranky. A year ago, I tried TRT, and it helped, but I did not want to keep taking it unless I ruled out a thyroid problem first.



Welcome to icliniq.com.

I just read your query and your reports (attachment removed to protect patient identity), and it appears that you have slightly high LH levels but thankfully, normal testosterone. It could be possible because of your natural supplements or possible food allergies like celiac disease. The TPO falls in the normal range, and that is more important, and it does not matter whether it is 10 as long as it is normal.

It would be better if you repeat your LH, FSH (follicle-stimulating hormone), testosterone, and Prolactin after three to six months. Try to go gluten-free it might help you.

Secondly, stop natural supplements. Over the counter medications seem to cause a lot of side effects. Try doing gradual exercises in parts and not all at once.

I hope this helps.

Thank you doctor,

I have been gluten-free before, and it does not have a significant effect one way or the other. The articles I have read said high LH and testosterone. Chronic fatigue still has a root cause.



Welcome back to icliniq.com.

Well, your testosterone is not low or in the lower bracket either. Chronic fatigue is an immune-mediated condition that usually occurs due to a previous viral infection. Many viruses have been studied as potential causal agents, including EBV, HHV-6, coxsackievirus B, spumaviruses, and even human T-cell leukemia virus strains; however, no definitive causal relation has been determined.

Thank you doctor,

But it has been six years. Should not any infection be gone by now? My white blood cell count is never high. I usually get blood tests every six months. Some of the articles are saying T levels are optimal at 900 to 1000. When my T levels were in that range, I felt better?



Welcome back to icliniq.com.

Yes, I am sure that your infections have gone but your body certainly had a lifelong immune reaction as result of which you could be having chronic fatigue syndrome. Actually, I had answered your question about what could be the reason behind your chronic fatigue syndrome.

I am sure 900-1000 are idealistic numbers but certainly in a bit lower age group. It might improve further once you are off over the counter medications that you had mentioned in your first query. Let us hope that you regain your numbers.

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