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Q. Are my low sexual drive and reduced erection because of my high testosterone level?

Answered by
Dr. Zulfiqar Ahmed
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 08, 2022 and last reviewed on: Sep 26, 2022

Hi doctor,

I am around 37 years old and noticed that my sexual drive and erection have reduced than it was previously. So I consulted a doctor for the same and performed tests, including thyroid, kidney, STI, and testosterone, where my free testosterone came out high. Next, I was referred to a urologist who checked my total testosterone, LH, and prolactin. Total testosterone was high, and the others were within the normal range but on the high side. Kindly help.

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#

Hi,

Welcome to icliniq.com.

I understand your concern.

I have reviewed your reports (attachment removed to protect the patient’s identity). All are normal except total testosterone. Have you done LH-FSH (luteinizing hormone- follicular stimulating hormone)? Have you taken any testosterone medication or used any steroids? And what are your height and weight?

Kindly revert in case of further queries.

Thank you.

Thank you for your reply, doctor.

I have done LH and prolactin; the results are included in the attachment. I do not take any steroids or any Chinese medicines. I will redo the free testosterone test and see what the values are. As you can see from my results, LH and Prolactin are also high but still within the range. So is this something to be concerned about? Kindly help.

#

Hi,

Welcome back to icliniq.com.

I checked again but could not find LH (luteinizing hormone) and prolactin results in the attachment (attachment removed to protect the patient’s identity). It depends on how high is LH and prolactin. If they are in the normal range, there is nothing to worry about. I think you can do free testosterone levels and see if that is high. Testosterone exists in three forms in the body, bound to SHBG (sex hormone binding globulin), albumin, and free form. It is the free form that is active.

Kindly revert for more queries.

Thank you.

Hi doctor,

Thank you for the reply, doctor.

The LH and prolactin is on page three of the lab report.

#

Hi,

Welcome back to icliniq.com.

Sorry, again, it is not visible. So first, you sent me five attachments, which is not among them, and then you sent total testosterone and PSA (prostate-specific antigen) but not LH and prolactin. I am sorry, but I cannot see LH and prolactin.

Thank you.

Hi doctor,

Thank you for the reply, doctor.

LH is 7 mIU/ml and prolactin is 12.5 ng/ml. My height is 6 feet, and my weight is 65 kg.

#

Hi,

Welcome back to icliniq.com.

Both LH and prolactin are in the normal range. Your BMI (body mass index) is also in the normal range. I suggest doing free testosterone. If it is also normal, then nothing to worry about, but if it is high, you may need further testing.

Thank you.

Thank you for your reply, doctor.

1. What other things should I test for if free testosterone is high?

2. Is it possible that my total testosterone and free testosterone are high due to a temporary change, and will they return to normal?

3. Is this something to worry about if free testosterone is high? Kindly help.

#

Hi,

Welcome back to icliniq.com.

If free testosterone is high, we need to rule out any testicular or adrenal tumor, as I mentioned previously. It can be a temporary finding, especially when your testosterone is not very high. To be significantly high, it should be over 50 percent of normal. So do free testosterone, and if it is significantly high, you may need to do:

  • LH (luteinizing hormone), FSH (follicle-stimulating hormone), TSH (thyroid stimulating hormone), DHEAS (dehydroepiandrosterone sulfate), and 17-hydroxy progesterone.
  • Serum electrolytes like sodium, potassium, and chlorine.
  • Aldosterone and renin.

Depending upon these results, you may need a CT (computed tomography) abdomen.

Thank you.

Thank you for your reply, doctor.

What should be the ideal range of free testosterone for me?

#

Hi,

Welcome back to icliniq.com.

Usually, in a male of your age, it is 4.65 to 18.1 ng/dL, but it depends upon the laboratory as well. Every laboratory has its own reference ranges. It also depends on which units they use for measurement.

Thank you.

Hi doctor,

Thank you for the reply, doctor.

I retested my total testosterone, which is now in the normal range. Should I still test for free testosterone as well? Kindly help.

#

Hi,

Welcome back to icliniq.com.

I think it is normal, and if you do not have any symptoms, there is no need to repeat the test. As a caution, you can recheck the total testosterone after six months.

Thank you.

Thank you doctor for the reply,

To be safe, I also did a free testosterone test. Please see the attached results.

Is it possible that testosterone can swing up and down so much in just two weeks, or do you think my initial report resulted from a hormonal imbalance that has not been corrected?

#

Hello,

Welcome back to icliniq.com.

Your testosterone levels are normal from the attached reports (attachments removed to protect the patient's identity). The most important thing in the testing is appropriate preparation and an accredited laboratory. That is what I always emphasize, the blood sample should be taken in the early morning and at least after six hours of fasting, and test should be done in an accredited lab. Some labs are not good enough to give appropriate results.

Thank you doctor for the reply,

I had the opportunity to do a blood test again recently and noticed that the thyroid values are a bit low. Is this something to be concerned about? Please see the attached report.

#

Hello,

Welcome back to icliniq.com.

From the attached reports (attachments removed to protect the patient's identity), your TSH (thyroid stimulating hormone) is low. If T4 is low, TSH should be high in primary hypothyroidism, and if T4 is high, TSH should be low in primary hyperthyroidism. Still, both are low in your case, so either it is just non-significant, or the problem is above in the pituitary, which is very rare. So I think you should repeat the blood test after one month.

Thank you doctor for the reply,

I will repeat it after one month and let you know.

Could this be related to the previous testosterone results I initially contacted you for?

I am not sure if I am just overreacting or if I should just relax, as I am very surprised by all these findings as they came by pure chance during routine blood tests.

#

Hello,

Welcome back to icliniq.com.

I can understand how you feel, and your concern is genuine.

Hormones are inter connected, and one hormone can disturb others as well. But it seems less likely in your case. If you repeat it after four weeks, it should be normal, but if it persists, we need to do further tests. Then It might include some scans and other hormonal tests. The tests are quite expensive, and it is not logical to do all those right now. We can wait at least three weeks or so.


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