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DrRussMd, Board Certified Physician
Category: Endocrinology
Satisfied Customers: 64977
Experience:  Internal medicine doctor. Years of experience with diabetes, both conventional treatments and diet treatments.
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It is related to Testosterone could you help, I have had

Customer Question

Customer: hello, it is related to Testosterone could you help
JA: Thanks. Can you give me any more details about your issue?
Customer: I have had lost of sex drive and some form of ED but I can still penetrate. I got my blood work done and checked for my T level. it came as follow 240 for T LH and FSH 1.7 normal but in low end I am 28 years old male
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Submitted: 1 year ago.
Category: Endocrinology
Expert:  Dr Basu replied 1 year ago.

Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

You may have prmary hypogonadism or failure of the testicular production of testosterone.

Assuming you never used anabolic steroids before, this will likely require life long testosterone supplementation.

Best wishes,
It was my pleasure to help you today.
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Expert:  DrRussMd replied 1 year ago.


With a total testosterone in the normal range, you do not have primary gonadal failure.

On some labs, however, low end would be 300 ng/ml. I don't see your lab reference range.

Even if the total is low, it is a spot test and not conclusive of anything. You need to see free and bioavailable testosterone along with sex hormone binding globulin.

You might have hypothyrodism: Just as an example'. This can throw off a total testosterone measurement. So can any illness that is chronic, or adrenal dysfunction.

To get a good hormonal picture:

testosterone, free testosterone, TSH, T4, sHBG, and an andrenal panel

As well as exam with all routine labs.

See an endocrinologist. There is no way in clinical medicine that we would conclude you need to go on permanent testosterone replacement at this point, or even any replacement, not necessarily.

This is not testosterone at this point without further testing.

I am a double board certified US doctor and I was ranked at the 100th percentile in endocrinology on the American Medical Boards. If you would like to go into a comprehensive approach beyond this question, find me, Dr. Thomas, in medical by request.

OK, so that is an initial answer….

Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.

Customer: replied 1 year ago.
Thank you for the response
In case of a primary hypo wouldn't the LH and fsh be very high. That's what I have been reading.
The total T range was from 250-888 so my total T is lowere than range. My shgb was also on the lower end.
Expert:  DrRussMd replied 1 year ago.

Yes they would, as they would be trying to stimulate production, but as I told you [this is the second expert, the us doctor, please review my extensive response] I don't think you have primary testicular failure at all.

Hypothyroidism would affect TSH and it would be over 2.5.

Lower shbg CAN indicate hypothyrodism, so there is more need to get the complete range of testing that I suggested.

It can suggest obesity, or adrenal insufficiency, which I have mentioned here already.

So, no, no no, not primary testicular failure and not even a need for replacement at this point.

See an endocrinlogist so you get the correct work up.

good luck.

Please don't forget a positive rating. This sees that I am paid for my accurate expertise.

Find me anytime in medical by request to save time and to get up to date medical answers.

Customer: replied 1 year ago.
Ok thank you once again
My TSh is 2.20. Range up to 4.5 is that considered bad ? Would it suggest hypothyroidism
Expert:  DrRussMd replied 1 year ago.

HI. The system will not let me edit the above, and I have not heard back from you.

If you would like to go over an integrative medical approach to these problems [yes I am also board certified in integrative medicine], then find me in medical by request, using a request lock and "for Dr. Thomas only" in the title.

Please do not forget a positive rating here: we are only paid Per positive rating and for bonuses.

Expert:  DrRussMd replied 1 year ago.


Your TSH is boarderline

Right now normal.

Over 2.5, can indicate hypothyroid.

Without complete testing you are not going to know why you had one low reading.

Again, you need to see an endo.

By the way, a high Shbg would be typical in hypogonasism, not a low one.

please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.