Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 DAM this is taking a long time if your test was 59 what does he need to test that will show him anything more on high E2. He needs to get off his ass and give you some arimidex to get this down. When my E2 is this high I can have sex and have panic attacks every night. Primary Hypogonadism is when you first do your blood test and your T levels are real low and your LH and FSH levels are very high. This means your brain is sending the messages to your testis to make more T but they can't. Secondary Hypogoadism is when you blood test comes bad on the first test with low T and low LH and FSH meaning your Pituitary in your brain is not sending the messages to your testis to make T. In most cases adding HCG will make his testis make T and he can get by without T meds. One needs to have a MRI on his Pituitary gland to see if he has a tumor not a life or death problem and in most treatable. Phil Roy <chickenbirdtree@...> wrote: I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 For Secondary hypogonadism...when they say its pituatary or hypothalamic disorder...are those two different things. if one does not havea pituatary tumor than what are the other reasons that LH is not elevated to make T? other than one having high E2 which is tricking the brain into thinking there is enough T. So really...if one has no pituatary tumor, normal/great E2 numbers yet low T and normal/low LH/FSH levels is this considered secondary? philip georgian <pmgamer18@...> wrote: DAM this is taking a long time if your test was 59 what does he need to test that will show him anything more on high E2. He needs to get off his ass and give you some arimidex to get this down. When my E2 is this high I can have sex and have panic attacks every night. Primary Hypogonadism is when you first do your blood test and your T levels are real low and your LH and FSH levels are very high. This means your brain is sending the messages to your testis to make more T but they can't. Secondary Hypogoadism is when you blood test comes bad on the first test with low T and low LH and FSH meaning your Pituitary in your brain is not sending the messages to your testis to make T. In most cases adding HCG will make his testis make T and he can get by without T meds. One needs to have a MRI on his Pituitary gland to see if he has a tumor not a life or death problem and in most treatable. Phil Roy <chickenbirdtree@...> wrote: I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 Thanks Phil and Jack, I am beginning to understand the problems now much better. You guys are telling me more than either my MD or Endo or Uro have told me. I think he is getting on top of my problems though. He only saw me once and had all those blood test, so I go back the 28th to see what he has found out. Yes Phil it will be one month since I first saw him, had to wait for the blood test. I am getting impatient too, this has been a long road as most of you have found out. I am going to try to get him to write a script for Arimadex when I go back. Will keep you all posted on what we find out. I don't feel bad, just have no thoughts of sex anymore and probably because of the high E2. Roy philip georgian <pmgamer18@...> wrote: DAM this is taking a long time if your test was 59 what does he need to test that will show him anything more on high E2. He needs to get off his ass and give you some arimidex to get this down. When my E2 is this high I can have sex and have panic attacks every night. Primary Hypogonadism is when you first do your blood test and your T levels are real low and your LH and FSH levels are very high. This means your brain is sending the messages to your testis to make more T but they can't. Secondary Hypogoadism is when you blood test comes bad on the first test with low T and low LH and FSH meaning your Pituitary in your brain is not sending the messages to your testis to make T. In most cases adding HCG will make his testis make T and he can get by without T meds. One needs to have a MRI on his Pituitary gland to see if he has a tumor not a life or death problem and in most treatable. Phil Roy <chickenbirdtree@...> wrote: I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 Some can have both wrong but if one has low T most younger men have low E2. Normal LH/FSH can mean the testis are stressed or not working. This is why the Stim. test helps to find out what is going on. If one do this test and it drives up the LH/FSH real high and the T levels say down this the testis are not working and more testing is needed by an Uro to see why. Phil Jack <rockin813@...> wrote: For Secondary hypogonadism...when they say its pituatary or hypothalamic disorder...are those two different things. if one does not havea pituatary tumor than what are the other reasons that LH is not elevated to make T? other than one having high E2 which is tricking the brain into thinking there is enough T. So really...if one has no pituatary tumor, normal/great E2 numbers yet low T and normal/low LH/FSH levels is this considered secondary? philip georgian wrote: DAM this is taking a long time if your test was 59 what does he need to test that will show him anything more on high E2. He needs to get off his ass and give you some arimidex to get this down. When my E2 is this high I can have sex and have panic attacks every night. Primary Hypogonadism is when you first do your blood test and your T levels are real low and your LH and FSH levels are very high. This means your brain is sending the messages to your testis to make more T but they can't. Secondary Hypogoadism is when you blood test comes bad on the first test with low T and low LH and FSH meaning your Pituitary in your brain is not sending the messages to your testis to make T. In most cases adding HCG will make his testis make T and he can get by without T meds. One needs to have a MRI on his Pituitary gland to see if he has a tumor not a life or death problem and in most treatable. Phil Roy wrote: I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 This description off a Merck website describes the clomiphene citrate test as follows: <Clomiphene citrate test: Clomiphene citrate is a weak estrogen that inhibits the binding of estradiol on estrogen receptors and does not stimulate receptor activation. Because estradiol is an important inhibitor of serum gonadotropin secretion, receptor occupancy by clomiphene causes decreased negative feedback on gonadotropin secretion by circulating estrogens. The normal adult response to clomiphene citrate, 100 mg po bid, is a 50 to 250% increase in LH, a 30 to 200% increase in FSH, and a 30 to 200% increase in testosterone. These increases are impaired or are absent in hypothalamic or pituitary disorders.> If the response is there and the T levels do increase...it rules out there is no pituatary or hypothalamic disorder. So, what is it then? Why aren't the levels getting sent to the testes to make more T? It may very well be unknown...which is why clomid is a short term stimulation therapy to see if it can jumpstart the system...if the system was suppressed by certain meds (like finasteride for me). Thanks. I'm getting close to an appt with a referred Endo from my wifes colleagues...referred endo who treats this stuff. philip georgian <pmgamer18@...> wrote: Some can have both wrong but if one has low T most younger men have low E2. Normal LH/FSH can mean the testis are stressed or not working. This is why the Stim. test helps to find out what is going on. If one do this test and it drives up the LH/FSH real high and the T levels say down this the testis are not working and more testing is needed by an Uro to see why. Phil Jack <rockin813@...> wrote: For Secondary hypogonadism...when they say its pituatary or hypothalamic disorder...are those two different things. if one does not havea pituatary tumor than what are the other reasons that LH is not elevated to make T? other than one having high E2 which is tricking the brain into thinking there is enough T. So really...if one has no pituatary tumor, normal/great E2 numbers yet low T and normal/low LH/FSH levels is this considered secondary? philip georgian wrote: DAM this is taking a long time if your test was 59 what does he need to test that will show him anything more on high E2. He needs to get off his ass and give you some arimidex to get this down. When my E2 is this high I can have sex and have panic attacks every night. Primary Hypogonadism is when you first do your blood test and your T levels are real low and your LH and FSH levels are very high. This means your brain is sending the messages to your testis to make more T but they can't. Secondary Hypogoadism is when you blood test comes bad on the first test with low T and low LH and FSH meaning your Pituitary in your brain is not sending the messages to your testis to make T. In most cases adding HCG will make his testis make T and he can get by without T meds. One needs to have a MRI on his Pituitary gland to see if he has a tumor not a life or death problem and in most treatable. Phil Roy wrote: I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 > > For Secondary hypogonadism...when they say its pituatary or >hypothalamic disorder...are those two different things. if one does >not havea pituatary tumor than what are the other reasons that LH is >not elevated to make T? other than one having high E2 which is >tricking the brain into thinking there is enough T. > > So really...if one has no pituatary tumor, normal/great E2 numbers >yet low T and normal/low LH/FSH levels is this considered secondary? > I think failure of the hypothalamus is " tertiary " hypogonadism rather than " secondary " . The distinction seems to have little practical importance since hcg works in either case. In the presence of testosterone deficiency, " low " lh is taken as a sign of secondary (or tertiary) hypo while " high " is a sign of primary (testicular failure). The problem is quantifying " low " or " high " . If a patient has extreme lab values, the problem is relatively easily. A stim test may not be necessary to distinguish primary from secondary. If the lab values are not extreme, you are back to defining " low " vs " high " . If you are new to things, you naturally expect the answer to lie in the lab reference range. If you haven't read this article, you may find it helpful. http://www.labtestsonline.org/understanding/features/ref_ranges.html Sometimes the reference ranges are not nearly so helpful as we expect. Do you really think to low end of the total testosterone reference range is helpful in identifying testosterone deficiency? I'd say the usefulness is extremely limited. A patient with secondary hypo isn't necessarily going to have lh below the lower limit of the reference range. Judging by what I've seen here over the years, most have an lh value slightly above the lower limit. Once treatment begins the lh level may fall below the reference range. A patient with primary hypo won't necessarily have out of range (high side) lh either. If we've ever had a primary patient post out of range lh values, it's been very, very rare. Being on clomid doesn't count. Brad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 Have you read this it is the AACE Guildlines. http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf Phil Jack <rockin813@...> wrote: This description off a Merck website describes the clomiphene citrate test as follows: If the response is there and the T levels do increase...it rules out there is no pituatary or hypothalamic disorder. So, what is it then? Why aren't the levels getting sent to the testes to make more T? It may very well be unknown...which is why clomid is a short term stimulation therapy to see if it can jumpstart the system...if the system was suppressed by certain meds (like finasteride for me). Thanks. I'm getting close to an appt with a referred Endo from my wifes colleagues...referred endo who treats this stuff. philip georgian wrote: Some can have both wrong but if one has low T most younger men have low E2. Normal LH/FSH can mean the testis are stressed or not working. This is why the Stim. test helps to find out what is going on. If one do this test and it drives up the LH/FSH real high and the T levels say down this the testis are not working and more testing is needed by an Uro to see why. Phil Jack wrote: For Secondary hypogonadism...when they say its pituatary or hypothalamic disorder...are those two different things. if one does not havea pituatary tumor than what are the other reasons that LH is not elevated to make T? other than one having high E2 which is tricking the brain into thinking there is enough T. So really...if one has no pituatary tumor, normal/great E2 numbers yet low T and normal/low LH/FSH levels is this considered secondary? philip georgian wrote: DAM this is taking a long time if your test was 59 what does he need to test that will show him anything more on high E2. He needs to get off his ass and give you some arimidex to get this down. When my E2 is this high I can have sex and have panic attacks every night. Primary Hypogonadism is when you first do your blood test and your T levels are real low and your LH and FSH levels are very high. This means your brain is sending the messages to your testis to make more T but they can't. Secondary Hypogoadism is when you blood test comes bad on the first test with low T and low LH and FSH meaning your Pituitary in your brain is not sending the messages to your testis to make T. In most cases adding HCG will make his testis make T and he can get by without T meds. One needs to have a MRI on his Pituitary gland to see if he has a tumor not a life or death problem and in most treatable. Phil Roy wrote: I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 Brad that link to what is 'normal range' was long but it is very helpful to understand all the reasons why the lab always give you a range. Thanks for that. I think I also understand primary and secondary much better, thanks guys for your input. Roy brad999us <no_reply > wrote: > > For Secondary hypogonadism...when they say its pituatary or >hypothalamic disorder...are those two different things. if one does >not havea pituatary tumor than what are the other reasons that LH is >not elevated to make T? other than one having high E2 which is >tricking the brain into thinking there is enough T. > > So really...if one has no pituatary tumor, normal/great E2 numbers >yet low T and normal/low LH/FSH levels is this considered secondary? > I think failure of the hypothalamus is " tertiary " hypogonadism rather than " secondary " . The distinction seems to have little practical importance since hcg works in either case. In the presence of testosterone deficiency, " low " lh is taken as a sign of secondary (or tertiary) hypo while " high " is a sign of primary (testicular failure). The problem is quantifying " low " or " high " . If a patient has extreme lab values, the problem is relatively easily. A stim test may not be necessary to distinguish primary from secondary. If the lab values are not extreme, you are back to defining " low " vs " high " . If you are new to things, you naturally expect the answer to lie in the lab reference range. If you haven't read this article, you may find it helpful. http://www.labtestsonline.org/understanding/features/ref_ranges.html Sometimes the reference ranges are not nearly so helpful as we expect. Do you really think to low end of the total testosterone reference range is helpful in identifying testosterone deficiency? I'd say the usefulness is extremely limited. A patient with secondary hypo isn't necessarily going to have lh below the lower limit of the reference range. Judging by what I've seen here over the years, most have an lh value slightly above the lower limit. Once treatment begins the lh level may fall below the reference range. A patient with primary hypo won't necessarily have out of range (high side) lh either. If we've ever had a primary patient post out of range lh values, it's been very, very rare. Being on clomid doesn't count. Brad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 Yes not only have I read that article but I printed it out for my Endo 8 days from now. Roy philip georgian <pmgamer18@...> wrote: Have you read this it is the AACE Guildlines. http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf Phil Jack <rockin813@...> wrote: This description off a Merck website describes the clomiphene citrate test as follows: If the response is there and the T levels do increase...it rules out there is no pituatary or hypothalamic disorder. So, what is it then? Why aren't the levels getting sent to the testes to make more T? It may very well be unknown...which is why clomid is a short term stimulation therapy to see if it can jumpstart the system...if the system was suppressed by certain meds (like finasteride for me). Thanks. I'm getting close to an appt with a referred Endo from my wifes colleagues...referred endo who treats this stuff. philip georgian wrote: Some can have both wrong but if one has low T most younger men have low E2. Normal LH/FSH can mean the testis are stressed or not working. This is why the Stim. test helps to find out what is going on. If one do this test and it drives up the LH/FSH real high and the T levels say down this the testis are not working and more testing is needed by an Uro to see why. Phil Jack wrote: For Secondary hypogonadism...when they say its pituatary or hypothalamic disorder...are those two different things. if one does not havea pituatary tumor than what are the other reasons that LH is not elevated to make T? other than one having high E2 which is tricking the brain into thinking there is enough T. So really...if one has no pituatary tumor, normal/great E2 numbers yet low T and normal/low LH/FSH levels is this considered secondary? philip georgian wrote: DAM this is taking a long time if your test was 59 what does he need to test that will show him anything more on high E2. He needs to get off his ass and give you some arimidex to get this down. When my E2 is this high I can have sex and have panic attacks every night. Primary Hypogonadism is when you first do your blood test and your T levels are real low and your LH and FSH levels are very high. This means your brain is sending the messages to your testis to make more T but they can't. Secondary Hypogoadism is when you blood test comes bad on the first test with low T and low LH and FSH meaning your Pituitary in your brain is not sending the messages to your testis to make T. In most cases adding HCG will make his testis make T and he can get by without T meds. One needs to have a MRI on his Pituitary gland to see if he has a tumor not a life or death problem and in most treatable. Phil Roy wrote: I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2006 Report Share Posted March 20, 2006 Yes I've read it...will be taking to Endo this Thursday afternoon. Also, have much more literature from a medical website that he in fact is in total agreement...where this literature/clinical studies talk about subnormal ranges need to be treated for men. I'm ticked off i didn't do this research for my 2/8 appt. instead i did research for hypothyroidism and actually got treated for it (by referencing the website i just talked about). its the same stuff that's on the web..only its categorized better and includes more clinical studies and supporting documention...also helps that this endo supports it...i just wish he'd research it more often!!!!! regards jack Roy <chickenbirdtree@...> wrote: Yes not only have I read that article but I printed it out for my Endo 8 days from now. Roy philip georgian <pmgamer18@...> wrote: Have you read this it is the AACE Guildlines. http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf Phil Jack <rockin813@...> wrote: This description off a Merck website describes the clomiphene citrate test as follows: If the response is there and the T levels do increase...it rules out there is no pituatary or hypothalamic disorder. So, what is it then? Why aren't the levels getting sent to the testes to make more T? It may very well be unknown...which is why clomid is a short term stimulation therapy to see if it can jumpstart the system...if the system was suppressed by certain meds (like finasteride for me). Thanks. I'm getting close to an appt with a referred Endo from my wifes colleagues...referred endo who treats this stuff. philip georgian wrote: Some can have both wrong but if one has low T most younger men have low E2. Normal LH/FSH can mean the testis are stressed or not working. This is why the Stim. test helps to find out what is going on. If one do this test and it drives up the LH/FSH real high and the T levels say down this the testis are not working and more testing is needed by an Uro to see why. Phil Jack wrote: For Secondary hypogonadism...when they say its pituatary or hypothalamic disorder...are those two different things. if one does not havea pituatary tumor than what are the other reasons that LH is not elevated to make T? other than one having high E2 which is tricking the brain into thinking there is enough T. So really...if one has no pituatary tumor, normal/great E2 numbers yet low T and normal/low LH/FSH levels is this considered secondary? philip georgian wrote: DAM this is taking a long time if your test was 59 what does he need to test that will show him anything more on high E2. He needs to get off his ass and give you some arimidex to get this down. When my E2 is this high I can have sex and have panic attacks every night. Primary Hypogonadism is when you first do your blood test and your T levels are real low and your LH and FSH levels are very high. This means your brain is sending the messages to your testis to make more T but they can't. Secondary Hypogoadism is when you blood test comes bad on the first test with low T and low LH and FSH meaning your Pituitary in your brain is not sending the messages to your testis to make T. In most cases adding HCG will make his testis make T and he can get by without T meds. One needs to have a MRI on his Pituitary gland to see if he has a tumor not a life or death problem and in most treatable. Phil Roy wrote: I read about you guys talking all the time about being primary or secondary. How do you classify the difference. I have been on T for many years and only in the last two years have I had no libido, no morning wood, no desire to have sex at all. My Dr. got me up to 1900, range 300 - 1200 on Total T and then backed off now I am playing catch up again so still no libido. My E2 is 59 range 10 - 50. He said this was too high so I am waiting now on test and see him the 28 to decide how to get it back down. Thanks guys, you all help in some way. Roy --------------------------------- Bring photos to life! New PhotoMail makes sharing a breeze. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2006 Report Share Posted March 21, 2006 Brad how long have you been on T? You sound rather knowledgeable on the subject. I was on T long before doctors had much knowledge of how to treat Hypo. The only thing he did was give me shots and never checked at what level I was. I did find the article on " labtestonline " very helpful but it doesn't go into all the details in what catagory one is in. He didn't even tell me how much T I was getting at that time. The nurse just game the shots 'once' a month. Now I am doing my own shorts every week, which helps the high's and the lows. Thanks, Roy brad999us <no_reply > wrote: > > For Secondary hypogonadism...when they say its pituatary or >hypothalamic disorder...are those two different things. if one does >not havea pituatary tumor than what are the other reasons that LH is >not elevated to make T? other than one having high E2 which is >tricking the brain into thinking there is enough T. > > So really...if one has no pituatary tumor, normal/great E2 numbers >yet low T and normal/low LH/FSH levels is this considered secondary? > I think failure of the hypothalamus is " tertiary " hypogonadism rather than " secondary " . The distinction seems to have little practical importance since hcg works in either case. In the presence of testosterone deficiency, " low " lh is taken as a sign of secondary (or tertiary) hypo while " high " is a sign of primary (testicular failure). The problem is quantifying " low " or " high " . If a patient has extreme lab values, the problem is relatively easily. A stim test may not be necessary to distinguish primary from secondary. If the lab values are not extreme, you are back to defining " low " vs " high " . If you are new to things, you naturally expect the answer to lie in the lab reference range. If you haven't read this article, you may find it helpful. http://www.labtestsonline.org/understanding/features/ref_ranges.html Sometimes the reference ranges are not nearly so helpful as we expect. Do you really think to low end of the total testosterone reference range is helpful in identifying testosterone deficiency? I'd say the usefulness is extremely limited. A patient with secondary hypo isn't necessarily going to have lh below the lower limit of the reference range. Judging by what I've seen here over the years, most have an lh value slightly above the lower limit. Once treatment begins the lh level may fall below the reference range. A patient with primary hypo won't necessarily have out of range (high side) lh either. If we've ever had a primary patient post out of range lh values, it's been very, very rare. Being on clomid doesn't count. Brad Quote Link to comment Share on other sites More sharing options...
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