Bizarre bloods, what are your thoughts?

[Iron1]

A little back story on me.

I do not produce test naturally, <10ng/dl.
Been on TRT for 15 years now.
100mg/wk split into two 50mg doses.
That brings me to 428ng/dl (ref 200-1100) tested last week.

Bloods came back with:
FSH: 2.8 (ref .6-11)
LH: .7 (ref 2.7-7.7)

Why would those two be that "high" when on TRT?

I've got a prognosis from 3 endo's why those levels might be the way they are but want to see what you guys think.

What say you UGB?

 

[DF]

Very strange indeed. Endos love to poke around your pituitary.... have they sent you for an MRI on your pituitary?

 

[DocDePanda187123]

Did the insurance thing go through for the MRI?

 

[Iron1]

Very strange indeed. Endos love to poke around your pituitary.... have they sent you for an MRI on your pituitary?

A follow up question to this is why do they poke around in the pituitary?
Do you think they're trying to determine primary or secondary hypogonadism?
My medical history makes it painfully obvious which one it is and it's not secondary.

 

[DocDePanda187123]

If the doctors are aware of your history I doubt they're looking for info on primary or secondary hypogo

 

[DF]

So your saying that they didn't send you for an MRI?

 

[Iron1]

Long story but they're hammering out the kinks in the MRI order.


DF, you're good at this game and hit the nail on the head right from the get-go.
The docs seem to think I've got a tumor on/in my pituitary that's causing weird FSH/LH numbers when they should be 0 or close to it.
If something shows up in the scan, I'm not sure what "fixing it" is going to do.
It will definitely not restore endogenous test production.

 

[Iron1]

Speaking just from a hormonal point of view, disregarding any mental effects of a pituitary tumor, wouldn't having LH/FSH floating around in my system be better than not having it?

 

[corvettels3]

A little back story on me.

I do not produce test naturally, <10ng/dl.
Been on TRT for 15 years now.
100mg/wk split into two 50mg doses.
That brings me to 428ng/dl (ref 200-1100) tested last week.

Bloods came back with:
FSH: 2.8 (ref .6-11)
LH: .7 (ref 2.7-7.7)

Why would those two be that "high" when on TRT?

I've got a prognosis from 3 endo's why those levels might be the way they are but want to see what you guys think.

What say you UGB?

These are questions for your doctors not forum members. Unless we have endocrinologist amongst us.

 

[Iron1]

These are questions for your doctors not forum members. Unless we have endocrinologist amongst us.

I know.
I've had three endocrinologists review the bloods.
They came to a certain conclusion.

I wanted to see if the members here would come to the same conclusion based on what little info I provided.
A second opinion if you will.

DF hit the nail on the head.

 

[creekrat]

I agree with the possibility of a tumor as well. Fot clarification though, benign tumors can cause this as well. Not just cancerous. Look at achromegaly. It is gigantisism caused by benign tumors. If that is the case the removal wouldn't restart endogenous test production but it would make it easier to maintain the hrt and prevent or help diagnose future problems

 

[DF]

I've read through quite a few HRT forums and it would seem that Endo's do like to send patients with low test for the pituitary MRI. I have yet to see anyone post that they indeed had a pituitary tumor.

Iron I hope all goes well & you'll let us know the outcome.

 

[Iron1]

Thanks guys, this is really driving me up a wall.
I still don't have a usable order for the MRI, the doctors office keeps screwing it up.

I just want a definitive answer.

 

[Iron1]

Just another follow-up, my MRI order was written on Oct 17th.
Here it is Nov 4th and I STILL do not have a usable order.

I'm on the phone with these idiots day after day and it's always this excuse or that excuse.

 

[DF]

Just another follow-up, my MRI order was written on Oct 17th.
Here it is Nov 4th and I STILL do not have a usable order.

I'm on the phone with these idiots day after day and it's always this excuse or that excuse.

Your insurance is denying the need for the MRI?

 

[Iron1]

Your insurance is denying the need for the MRI?

Na, it's just one thing after another with the paperwork.
I make a call to the office and won't get a response for at least a day and a half. Two business days is the norm.

First the order was filled out wrong.
Then they missed some crucial information that made the order unusable.
When they got approval they ignored my request to have it done locally.
Despite that they then scheduled it for a day where I'm going to be traveling on business.
Now because they need to reschedule, they're resubmitting for approval again.

It's just this long stream of BS with these guys.

When they gave me the order I said that I wanted to have it done locally.
I have an MRI imaging center in town, no reason to drive over an hour past it just to use someone elses.
At the time that wasn't a problem for them. I'm a patient in both places and both are approved through my insurance.

Now they're telling me they have no idea how to schedule the scan through a different office.
So I called my insurance.

They see the approval sitting in their system but mentioned that the office i'm seeing can't schedule the scan through my local office.
The insurance is telling me that now despite having approval sitting in their system I need to schedule an appointment with my GP in town, have him review the order, resubmit for insurance approval and then I MIGHT be able to schedule the appointment.

It's just an endless series of hoops that are getting me nowhere fast.

 

[DF]

Damn! that's a whole lot of BS go to through. Sounds like you need to grab someone by the neck & shake them until dead.

 

[Iron1]

Damn! that's a whole lot of BS go to through. Sounds like you need to grab someone by the neck & shake them until dead.

I wish I could DF, hah.
This has been a very long painful road with this TRT stuff.
I've started looking for competent doctors in my home town and when they proved inept, moved outward.
Right now I'm 50 miles out from where I started and it looks like I'll have to go even further.
As it is I have to take a half day off from work and drive 3 hours just to see these knuckleheads.

Oh well, that's the unfortunate place I'm stuck in.
Just gotta keep fighting the good fight.

 

[Iron1]

MRI has been scheduled, finally!
Tuesday Nov 19th.

 

[DF]

MRI has been scheduled, finally!
Tuesday Nov 19th.

Nice! congrats!

Now I'm willing to bet that the MRI comes back normal.