Elevated FSH-Normal Testosterone (male)

[paulvand]

I am a 52 year old male.  have had many symptoms on and off for several years. I will list the ones that I still have:
1. Oily Skin. Started about 1 1/2 years ago. Skin is very oily 2-3 hours after shower. Has begun to cause acne
2. Waking in the middle of the night (typically either 3am or 4am)
3. Cramps in feet (mostly left)
4. Heat intolerance.
5. Muscle twitching (legs, feet fingers)
6. Elevated blood pressure.  25+ years of around 105/65.  Consistently 125/75 now.
7. Sinuses regularly clogged
8. Weight gain (abdomen area)
9.  Joint pain (back, knees, thumbs)
10.  Muscle twitching
11. Tinnitis

I have just had some blood tests at the University of Penn Endocrinology and here are the results (abnormal first). Tests were done at 8am:
1. TSH: 4.85 mlu/ml H (range .4 - 4.5). This has be up (4.0 - 6.5) for about 1 1/2 years
2. FSH: 8.1 mlu/ml H (range 1.6-8.0). First test
3. IGF I, LC/MS: 150 ng/ml (no reference range provided)
4. ACTH, PLASMA: 44 pg/ml(no reference range provided)
5. CORTISOL, TOTAL: 15.9 mcg/dl (range 3-22)
6. PROLACTIN: 12.9 (range 2-18)
7. LH: 4.4 mlu/ml (1.5-9.3)
8. TESTOSTERONE, TOTAL, MALES (ADULT), IA: 520 ng/dl (250-827)
9. T4 (THYROXINE), TOTAL; 6.8 mcg/dl (4.5 - 12)
10. FREE T4 INDEX (T7): 2 mch/dl (1.4 - 3.8)
11. T3 UPTAKE: 29% (22-35%)

I have read that a normal testosterone with an elevated FSH can be a pituitary issue.  My doctor doesn't seem worried.  Just asked that I repeat TSH in 6 months.

[rumpled]

If it was a pituitary secreting FSH it would be super high... Like my ACTH secreting tumor is near 4000 (6-48).

However, the doctor did what is sadly so typical. They saw you have signs and symptoms of a pituitary disorder in you symptoms... Ran ONE set and now will just give up when you could be cyclical... The standard is at least 3.

Oh that TSH is the old range it is now .3-3.0 so you are quite hypo. Are they at least treating the thyroid?

Eh.... I would still ask for more testing. Elsewhere. That bp any renin or aldosterone testing?

[paulvand]

Thanks for the reply.  I see you reply to a lot of people, so I appreciate all of your help.  They are not treating the thyroid.  My weight continues to climb. It just reached 183.  I have been within 2 or 3 lbs. of 167 for 20+ years.  Some of my symptoms seem not to match what I read about Hypo (heat intolerance, oily skin, twitching), while others sure do.

I am sorry, I didn't follow, "That bp any renin or aldosterone testing?"  

[rumpled]

With an elevated bp, your doc should have tested renin and aldosterone.

Sorry I was not clear.

I would find another doc - they should treat the thyroid at that level.

[paulvand]

Okay got it. No apologies needed.  This is my second Endo and I went to University of Penn Medicine hoping for better.  I will try again. Thanks.

[rumpled]

Good luck with another place (been there done that - hubs calls it have tumor, will travel)... so it can take a few. I was actually at that same center with no luck myself... but know others that have had luck there... go figure!