The T Club by Warren Willey

Author:Warren Willey
Language: eng
Format: epub
Publisher: BookBaby
Published: 2013-03-17T04:00:00+00:00

Brain Hormones - LH, FSH, Prolactin

The brain hormones need to be tested at the initial evaluation for low T to help your doctor decipher among the different causes of low T. High levels of Luteinizing Hormone (LH) are usually seen with the diagnosis of primary hypogonadism (T is low due to testicular failure, LH will be elevated). LH levels below the normal range are consistent with secondary hypogonadism, also called hypogonadotropic hypogonadism. A really low LH in combination with a low T can mean secondary failure due to a pituitary or hypothalamus disorder, or the presence of acute stress or injury such as surgery, infections, dietary induced inflammation, or even a heart attack. It is also seen between TRT dosing, for example such as injectable T: if labs were drawn too far out from a shot, the T level would be low, and the brain would not have enough time to get LH elevated again in an attempt to increase T release.

Normal levels of LH in the presence of low T can be found in older men or in obesity. It is hard to classify, as it is either primary or secondary. If I were to place a term on it (remember - medical terms have to sound official), I would call it normogonadotrophic hypogonadism. In the older male, this is likely due to failure of the entire hormonal cascade from the hypothalmic-pituitary-testicle axis. In obesity, it is due to the toxic fat around the liver (visceral obesity) causing an increase in T metabolism and impairment of the hypothalamic-pituitary axis to respond to the increased need. This impairment, as I stated previously, is due in part to food-based high inflammatory markers, leptin resistance, and increased levels of estrogen, as fat has high aromatase activity.

Follicle Stimulating Hormone (FSH) is occasionally asked for by doctors as part of the initial low T work up. Elevated levels indicate failure of the gonads Sertoli Cells or nurse cell’s function. Their job is literally to nurse the little sperm cells awaiting export. A low level of FSH is indicative of pituitary failure and would indicate a much greater work up being called for. Elderly gentlemen tend to have higher levels of FSH with a low to normal LH.

Prolactin is also occasionally part of the initial work up as a high prolactin level called hyperprolactinemia presents as hypogonadism. Elevated levels of prolactin can be found in rare pituitary tumors, hypothyroidism, severe kidney and/or liver disease, and in persons taking psychotropic drugs such as risperidone and/or one of the tri-cyclic antidepressants (among others). Metoclopramide, a drug used to treat various gastro-intestinal complaints such as nausea or slow gastric emptying, can also cause high levels of prolactin and therefore low T.

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