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Is my testosterone normal?

Hi John,
Can you please take a look at my recent blood results from Kaiser. I don’t trust them when they tell me I’m in a normal range. I would really like your opinion.
Testosterone 308 ng/dl
FSH 4.7 mIU/mL
LH 3.0 mIU/mL

Thank you 🙂

Dear Mark,

Very complex question actually.  There is a certain amount of disagreement over what “normal” or “optimal ranges” for hormones are, particularly in men.  I will give you my opinion about the tests.

Normal FSH range in adult men is usually reported at 5-15 mIU/ml.  Yours at 4.7 is low, even by this broad range.  In men, FSH or Follicle Stimulating Hormone, is critical for sperm production.

Normal LH range in men is usually reported as 2-14 mIU/ml.   This again, is a pretty broad range.  Your level is 3.0, so it is barely in the lowest end of “normal” range.  LH, or luteinizing Hormone, stimulates the Leydig cells where there is testosterone production.  This is controlled by GnRH, Gonadotropin Releasing Hormone, from the hypothalamus.  There is a test using GnRH to stimulate LH release see where the problem is.

Normal testosterone range is usually reported as 300-1,000 ng/dl. Your level is 308.  This is obviously at the very lowest level of “normal”.

While many general practitioners would be fine with these levels, any reproductive specialist and many good mens doctors would be quite concerned.

This group of tests would be consistent with hypostimulation, or low hormonal pulsing, from the pituitary gland leading to marginal sperm production and low testosterone levels which can affect every aspect of male health.  These problems would include, but not be limited to, low libido or sex drive, low sperm count, weight gain, irritability, erectile dysfunction, infertility, difficulty in gaining or holding muscle mass, fatigue, cardiovascular problems, diabetes, etc.

In reproductive medicine, and many other conditions that I treat, this hypothalamic-pituitary communication is faulty.  In reproductive medicine this is looked at a lot along with adrenal and thyroid function which are controlled by the hypothalamic/pituitary system.

Greatly simplified example. The hypothalmus is the control center (think any movie with lots of dials and screens being monitored like a nuclear facility). The control room (hypothalamus) is constantly measuring temperature, nervous system activity, hormone levels etc.

The hypothalamus has a closed loop with the pituitary where it sends very small messages like GnRH.  The pituitary then sends out chemical messages to the various  glands to increase or decrease the hormonal output from the specific glands.  TSH or thyroid stimulating hormone stimulates the production of  thyroid hormones.  FSH, to stimulate the ovarian follicles in women and spermatogenesis in men.  LH to stimulate follicle release and corpus luteum production (for increased pregesterone.) Many others.

So, the key is find out where in this complex system the problem is.  In Chinese Medicine it is actually dramatically easier than with biomedical testing, although the testing is very cool.  We have many ways to balance the HPA (hypothalamus/pituitary/adrenal) axis.

In biomedicine the focus is on hyperstimulating various systems with pharmaceuticals which will have side effects. In TCM we assist the body to regain homeostasis or balance so that it can do it’s job properly.

In my opinion, based on my historical knowledge of your lifestyle, your particular test results arise primarily from:
-irregular and unnatural circadian rhythms as a result of your shift work schedule, which will dramatically affect HPA axis.
-relationship issues leading to neurohormone imbalance
-under exposure to “male” activities which would stimulate testosterone production
-over exposure to other types of life activities/events which will inhibit testosterone production.

Be well,

– Dr. John Nieters, L.Ac. DAOM, FABORM

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