To keep things short, I was diagnosed with Celiac Disease in 2009 and Addison's at the beginning of this year. Recently I went back to my Endocrinologist because of extreme fatigue and weight loss. Basically I just feel like I am sick all the time and doing anything has been a struggle. I thought maybe Addison's or Celiac was the causes, so I went to see my Endo. He is starting me today, on Testosterone Therapy due to my low numbers but when I called to ask what is the cause for low LH & Free T, he told me the damage to my adrenal gland is the cause.
1. I agree with him, I found information online that shows Addison's can cause low Testosterone because some T is produced from Adrenal's. But everywhere I look says if you have low LH/FSH as well, you need to have your Pituitary gland checked. Should I pursue this with my GP or is my Endo right to blame Addison's for both tests being low?
2. I am a 25 year old male, is a Free T of this level likely the cause of my symptoms lately and has anybody experienced this before?
3. I am just curious as to if this is a lifelong treatment. If my Endo is correct and the damage to my adrenals is the cause, then I'd assume my Free T will always be low as my adrenals will always be damaged, right?
Anyways, I know that nobody hear is a doctor but until I am able to see my Endo again, I am left in limbo. Thanks!!
LH as you correctly stated is a pituitary test... and if that is low and the T is low, then I would assume the pituitary is at fault for the faulty signal rather than the adrenal. I don't see in your testing the adrenal hormone that converts to testosterone - dhea sulfate - so your doctor is guessing, rather than knowing - that it is low.
So, given the information that you have, I don't know why you would assume adrenal when it looks more pituitary. I would seek out another opinion and get more testing - in particular, bioavailable testosterone which would test all forms, estradol as you need to check that even in men, dhea sulfate and I would ask for more pituitary testing like prolactin and if he suspects adrenal - cortisol and ACTH, renin, aldosterone etc.
Low T can be high cortisol as well! So, it is just not a simple thing. Please do more research and get more answers. As well, why is your blood count so low? I am not good at interpreting that but gee? Did your doc say anything?
He never mentioned anything about the low blood counts, so I assumed it was normal for a guy of my age to be a bit lower. I'll be sure to ask my GP though.
As for the Addison's, I was diagnosed earlier this year with low cortisol, high ACTH, low blood sugar, low blood pressure, low sodium, so it was an easy diagnosis of Addison's for him. He said because of this, the damage done is the cause. He did run a cortisol check on this blood work, but it only shows that my cortisol medication is working. He said that the cortisol will help mimic my adrenals producing cortisol, but wont help with the Testosterone. I am also on Florinef if it helps. Here were the other tests he ran, but no DHEA or Renin, he never mentioned it. He talks to me very little and just run tests and puts me on meds if needed, never communicates anything to me unless I nag his secretary life crazy.
So basically to sum it up, he feels my damaged Adrenal's are causing my Testosterone levels to be this low. As I said before, I can somewhat agree on that, but how would my damaged Adrenals affect an LH reading?
I have heard of and know people with elevated cortisol who have low testosterone - because high cortisol suppressed testosterone. However, I (as a layman) have not heard of anything cortisol or adrenal related that directly lowers T. Yes, DHEA converts to either T or E - but uh - he needs to test it. Having the high ACTH does indicate that your adrenals are the source of your issue as the pituitary is trying harder to signal the adrenals and they just are not listening. However, the low LH is far more likely to cause the low T than the adrenal. Just like with the other hormonal loop - if it was the LH, then it would be higher if it was trying to signal the other glands, not lower! It all works in feedback loops so you have to test the whole loop and find the issue.
There are some links in the health pages that may give you more help - have you tried those?
Are you on replacements for cortisol? Which one? I also take florinef.
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