Family, Internal Medicine, General Medical Questions/Low testosterone levels


QUESTION: I am a 45 year old male and just got my testosterone checked.  here are my results.  
Total = 300ng/dl,  Free=60pg/ml,  FSH= 11mIU/ml, LH=10.2, Sex Steroid Binding Globulin =27nmol/L.  Total is very low and not surprising LH is very high.  Thoughts about what this may mean and path forward.

ANSWER: The results are borderline..... you are not horribly low but could justify replacement therapy.  I tend to go by symptomatology.....   depression, fatigue, decreased sexual function/libido.   Although these symptoms can have many causes, if they are present it would be worth a trial of replacement for a few months.

I assume since you had all these fancy tests that you also had thyroid and basically a complete workup........

That is my approach.

---------- FOLLOW-UP ----------

QUESTION: Thank you for your reply and is what my endocrinolgist said as well.  Just waned a second oppinion and apprecaite your insight. I have no fatigue and work out daily and still able to maintian muscle mass but did notice that my facail hair does not grow as quick as it once did.  No ED issues and able to perfrom sexually but do not have the normal semi-erection I used to have every morning unstimulated. I did have my thryoid removed in 2010 (papillary carcinoma)  all good since then.  Negative blood work and lymph node untra sounds clean.  My thyroid hormone replacemet is good and TSH levels close to 0 and feel good with regards to that (although too some time to get the dose right).  I know there are a lot of negative consequences of having low testosterone levels (heart disease, metabolic etc...) and do not want to be low if I have a chance to increase into a more normal range.

Thanks again


TSH close to zero might be too much synthroid......   optimally, your tsh should be 1.0 plus or minus 0.5

Too much thyroid replacement might result in heart rythym problems or accelerated bone loss or some other stuff, so double check that one......

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Robert Borucki


I am an expert in Family Medicine and Emergency Medicine.


I am trained and boarded in Family Medicine and have also worked extensively in emergency medicine for over 10 years.

BA in Natural Sciences; MD in 1986\borucki

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