Am I suffering from Klinefelter syndrome?

Question

Hello doctor,

I am an 18 year old, who weighs 209.4 lbs, and I am obese. I have small testicles and penis. My testosterone level is 7.8.The test was done at 9 AM. I have very less body hair, little hair on my legs, and a lot of pubic hair. I have less beard growth and no hair in the armpits. I am concerned that I am suffering from KS because I have many obese friends, who have a lot of body hair and they have normal physical attributes. Even then, I have less development than them. Please help me because I am suffering from constant emotional and sociological breakdown. Just in case you wanted to know, I masturbate once daily, but the semen is quite less in amount. The amount has stayed the same from the onset of my puberty. I am attaching all my test reports.

Answer 1

Hello,

Welcome to icliniq.com.

I just read your query and saw your detailed reports (attachment removed to protect patient identity) and from the history that you mentioned, it does seem that you might be possibly having Klinefelter syndrome (KS) but, there are some tests which are not confirming your diagnosis of KS. They are as follows:

Your LH (luteinizing hormone) is not raised as should be in KS.
Your FSH (follicle-stimulating hormone) is also not raised as should be in KS.
Testosterone is slightly decreased.

The reasons are:

Could be a mixed mosaic of KS.
Hypothalamic or pituitary hypogonadism.

All these tests are not enough to reach a proper diagnosis. So, I suggest you get the following tests done:

Repeat your testosterone again one more time in the morning.
Sex hormone-binding globulin test.
Inhibin B test.
Anti-Mullerian hormone test.
Scrotal ultrasound.
Semen analysis.
Chromosomal karyotyping.

After we have a confirmation of your diagnosis, we can begin your treatment.

Hope you find my advice of some benefit. Good luck.