What is the interpretation of my hormone levels?

Interpretation of Hormone Levels

Your testosterone level of 64.3 ng/dL is significantly below the normal adult male range (300-800 ng/dL) and indicates testosterone deficiency that requires further evaluation and treatment. 1

Analysis of Your Hormone Profile

• Testosterone: 64.3 ng/dL - Severely low (normal range: 300-800 ng/dL)
• DHEA: 291 - Within normal range
• Estrogen: 40.9 - Within normal range for males
• FSH: 4.9 - Within normal range
• LH: 7.0 - Within normal range
• Thyroid: normal - No thyroid dysfunction

Clinical Significance

Your hormone profile shows a pattern of primary hypogonadism, characterized by:

• Very low testosterone level
• Normal LH and FSH levels (these would typically be elevated in primary testicular failure)

This pattern suggests secondary hypogonadism (pituitary or hypothalamic origin) rather than primary testicular failure. The normal LH level despite low testosterone indicates that your hypothalamic-pituitary axis is not responding appropriately to the low testosterone level. 1

Health Implications

Testosterone deficiency at this level can lead to:

• Decreased energy and libido
• Reduced muscle mass
• Increased body fat (particularly abdominal)
• Impaired glucose control and insulin resistance
• Decreased bone mineral density (osteoporosis risk)
• Depression and cognitive changes
• Increased cardiovascular disease risk 1

Recommended Next Steps

1. Confirm the diagnosis:

   • Repeat morning total testosterone measurement between 8-10 AM
   • Measure free testosterone by equilibrium dialysis
   • Measure sex hormone-binding globulin (SHBG) 1

2. Additional testing:

   • Serum prolactin (to rule out hyperprolactinemia)
   • Consider pituitary MRI if total testosterone remains <150 ng/dL with low/normal LH 1
   • Consider hemoglobin/hematocrit and cardiovascular risk factor assessment before treatment 1

3. Treatment consideration:

   • Testosterone replacement therapy should be considered given your severely low level
   • Options include transdermal preparations (gel, patch) or injectable testosterone
   • Target testosterone level within the normal range (300-800 ng/dL) 1, 2

Important Considerations

• Your normal LH level despite very low testosterone suggests hypothalamic-pituitary dysfunction rather than primary testicular failure
• If fertility is a concern, this should be addressed before starting testosterone therapy, as exogenous testosterone can suppress spermatogenesis 1
• Testosterone therapy has been shown to improve energy, libido, body composition, bone density, and mood in men with documented deficiency 1, 2

Monitoring After Treatment

• Testosterone levels should be monitored to ensure they reach the target range
• Hemoglobin/hematocrit should be monitored as testosterone therapy can increase red blood cell production
• Prostate screening should be considered according to age-appropriate guidelines
• Bone density testing may be warranted if osteoporosis is suspected 1

Remember that untreated testosterone deficiency can lead to significant health consequences including osteoporosis, cardiovascular disease, metabolic syndrome, and reduced quality of life. Proper diagnosis and treatment are essential for long-term health.