Scotsman's Bloods

I recently requested a full hormone profile, although doesn’t appear very comprehensive at all.

I thought I’d post the very few results which seem relevant. My testosterone levels do appear low for my age, and they didn’t test for free test for some reason, putting N/A beside it??? I think however I can calculate it using my SHBG results. I think therefore my Free Androgen Index should be 50.8?

LH 1.3 U/L
FSH 1.8 U/L
Testosterone 12.7 nmol/L (10.0-36.0) [which converts to 366]
SHBG 25 nmol/L (13-70)

Also, because of concerns re: subcutaneous fat loss to face post finasteride I have had blood work done to test for possible connective tissue disease. The results for Nuclear/Centromere Antibody on HEp2000 have come back as:

ANA screen: Very weak positive ANA - titre 1/40,
Pattern - homogeneous
Maybe associated with a range of autoimmune, inflammatory and infective disorders. Also found in some healthy people.

This has left me with inconclusive results re: ANA screen. I saw a dermatologist who specialises in connective tissue disease who acknowledged an assymmetry to my face (I appreciate that assymetry is normal, although at the time the fat loss was much more significant on left side). She said that if it was as a result of meds then she would imagine that it would just be one “hit” as it were, without further fat loss. My concerns however are that since seeing her at the end of July and not eating any less (probably more tbh), I feel that the right side of my face has lost more fat and my face is now less asymmetrical, so really don’t know if and when this might stabilise, although hoping that it has pretty much stabilised as I don’t feel that I’ve lost any more fat on the left side.

I don’t know if my own particular sides would improve (thinning of skin with resultant fine lines and wrinkles; subcutaneous fat loss to face, esp around eyes and cheeks; penile shrinkage/retraction/occasional loss of sensitivity; infrequent nocturnal/morning/spontaneous erections; lower libido; reduced volume and force of ejaculate; low motivation) with some kind of testosterone supplementation.

Any thoughts/input would be much appreciated.

Your LH and FSH are really low. Have you used steroids before? If not it looks like you are not responding to low androgens. What does your doctor think?

I’ve never used steroids. My doctor has said very little about my results apart from printing them out for me and questioning why my free testosterone wasn’t tested. I’d phoned the surgery previously for them and I was told that everything was fine so I only really looked at them once I had left.

I’ve managed to get hold of some results of blood tests for testosterone and thyroid function in early April this year. Unfortunately I’ve only been given in figures without units or range, so maybe not that useful:

T: 14.1 (I assume that this is nmol/L, which would convert to 406 ng/dl)
Free T: 201?
TSH: 5.1?
Free T4: 17?

From this it looks like my total testosterone has gone down from April (14.1) to August (12.7).
Unfortunately I have no idea what Free T units/range are, although from an internet search think that this maybe good???
Again, no idea what TSH units/range are, although again from internet search believe that I could have a propensity for hypothyroidism???
Again, no idea what Free T4 units/range are and I’m unsure what this means?

Scotsman - what time of day was the blood draw for serum testosterone? As early in the morning as is feasible is warranted.

You should get SHBG (sex hormone binding globulin) done at the same time so that you can calculate your free testosterone.

Clomiphene might help (raises LH, (and FSH in normal hypogonadism, but not PFS) and thereby testosterone. This will help a little but don’t expect it to be a cureall.

Thanks a lot for your reply kazman.

The test I had done in April was done at about 9.30am (approx, as it was at a drop-in clinic where I had to wait for a while after 8am and can’t remember exactly when I was taken).

For the test in April I only have the figures but no units/range for T, Free T, TSH & T4, although I have spoken to the clinic and hopefully the results will be forwarded to my G.P. so as I can have a copy.

For the test I had at my G.P. surgery in August I think it was at 10am. The results for that are in my first post on this thread. SHBG was tested, although do you not also need to test for albumin to work out free testosterone?

Despite having symptoms which match post finasteride syndrome (changes to penis size, low normal t, low fsh & lh, high end tsh, etc etc), I’ve never experienced some of the other classic symptoms like crashing, complete erectile dysfunction, brain fog etc. (although I’ve experienced less commonly reported symptoms including thinning skin and facial lipoatrophy) I am kind of hoping and praying that I’m asymptomatic of pfs and that I do respond to some kind of hormone therapy. I would like to at least give it a try and I am looking to get much more extensive blood work done to work out where to go from here.

Subsequent to my previous posts I’ve had my TSH re-tested several times and it has gone down to a more acceptable level from 5.1 to 2 point something on both subsequent tests (I don’t have the exact figures at hand).

I’ve also received a letter from the clinic which carried out the tests last April 2012 to confirm the figures but unfortunately no range:

Serum testosterone: 14.1
Free testosterone: 281
SHBG: 34
Thyroid function test: free T4 of 17
TSH: 5.1

I was also referred to an endocrinologist in February where I discussed my concerns. Thankfully he took me seriously although thought that any penile shrinkage would have occurred whilst I was on finasteride and not after. I informed him of this site and of the many who had similar reactions and I said that although not easily explained now, history would prove us right. He said that my previous results were fine and when I mentioned my low lh/fsh he said that the snapshot of all the hormone levels as a whole demonstrated that everything was working wonderfully as it should. He agreed however to check my hormone levels again just to be sure.

(Bloods taken at 8am:)
Oestradiol: Value: <70 Range: <160 Unit: pmol/L
LH: Value: 1.4 Range: 1.0 - 9.0 Unit: U/L
FSH: Value: 2.1 Range: 1.0 - 12.0 Unit: U/L
Prolactin: Value: 273 Range: <400 Unit: mU/L
Testosterone: Value: 12.1 Range: 10.0 - 36.0 Unit: nmol/L
SHBG: Value: 33 Range: 13-70 Unit: nmol/L
Free Testosterone: Value: 241 Range: >200 Unit: pmol/L
IGF1: Value: 135 Range: 65-350 Unit: ug/L

My total testosterone has gone from 14.1 (406 ng/dl) in April 2012, to 12.7 (366 ng/dl) in August 2012, to 12.1 (348 ng/dl) in February 2013. My free testosterone has also dropped from 281 pmol/L in April 2012 to 241 pmol/L in February 2013. The endocrinologist I saw at the follow-up appointment again said that everything was fine. Again, he hadn’t heard of pfs although googled this site prior to seeing me. Also, he didn’t dismiss the possibility of these side effects occurring which is always a plus.

The endocrinologist didn’t appear to have any concerns regarding my IGF1 levels. This is something that I raised in February as I believe that some of my symptoms are similar those attributable to adult growth hormone deficiency. I feel that the ranges that the National Health Service in the U.K. use are extremely broad and that as long as you are “in range” then everything is “fine”. What I don’t know however is whether in my case everything is indeed “fine” or whether my test results are reflective of a sliding scale where I am not operating at optimum and some symptoms of low hormone levels will start to manifest themselves, or whether my symptoms are reflective of something else. I feel that an IGF1 value of 135 ug/L seems low, and with my LH and FSH also seeming low, it makes me wonder whether my pituitary is functioning as it should.

Your TSH is extremely high. Bringing this down may help with some of your symptoms.

I requested my testosterone levels to be taken again last year and the Dr agreed due to my symptoms. They came back in range with the usual everything’s fine, nothing to see here. I got hold of the details today. Not exactly comprehensive.

The bare bones given to me:

Total T: 12.1 (10.0 - 36.0)
SHBG: 28 (13 - 70)

I appreciate that PFS ain’t hypogonadism, but I suppose that we’re all reaching for that sticking plaster.


My G.P. ordered this blood work after my reporting the drop in semen volume during/following anti-depressant withdrawal and my general symptomology.

@Scotsman How did you get your TSH back to normal? Are you on thyroid meds?

I’m not on any thyroid meds. Time is probably the only factor I can think of.