Dr. Divakara. P
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am in my mid-twenties. I exercise and eat healthy, have good friends, and have a good job. I am 188 cm tall and weigh 88 Kg. However, I have had low energy and sex drive for over a year, maybe more. I have been using Testogel for one month and I am not happy with the results. Therefore, I have attached (attachment removed to protect the patient's identity) my test result. As you can see, my LH (luteinizing hormone) and FSH (follicle-stimulating hormone) are low. My androstenedione levels are also low. I believe the value range on the internet is a statistic of what a human from 18 to 85 years has been measured. It is not what is healthy. This also applies to testosterone levels. I should have about 35 nmo/L, which I think is about 800 ng/dl. The doctor gave me Testogel, which I have been using for a year now, but I think I need shots and a good follow-up on this one. What do you think about this situation? Could I have secondary hypogonadism?
Hi,
Welcome to icliniq.com.
I understand your concern. The normal range of FSH (follicle-stimulating hormone) in adults is 1.5-12.4 IU/L, and LH (luteinizing hormone) levels are 1.8-8.6 IU/L. So your FSH is low but not LH. Also, normal testosterone levels in males are 9-38 nmol/L which is well in the normal range (with gel application), so the gel is doing its work (you did not mention your testosterone levels before gel application). So I do not think your low sex drive is because of your testosterone levels, and there is no need for any shots. I hope you have entered your androstenedione value correctly because the normal range is 175-768 nmol/L. Unfortunately, your value is too less. If that value needs to be corrected, we must evaluate the cause of low androstenedione levels. There are certain conditions like CAH (congenital adrenal hyperplasia) and 17-alpha-hydroxylase deficiency that could be a cause of hypogonadism. Also, we need to find what is the cause of low FSH. So I advise you to get serum prolactin, and serum estradiol tests. So the bottom line is it is not your testosterone that is the problem, and hence do not bother to take any shots of testosterone, but it is your FSH and androstenedione which needs to be focused.
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Internal Medicine
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