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FSH, LH, Prolactin & TSH

Also known as Hormonal Profile, Hormonal Panel, Infertility Profile
FSH, LH, Prolactin & TSH Includes 4 testsView All
8491063 20% Off
You need to provide
Blood
This test is for
Male, Female
Test Preparation
  1. In females, preferred sampling time is day 2 or 3 of menstrual cycle.
  2. Overnight fasting is preferred but not mandatory.
  3. Do not stop taking your thyroid medications on the day of the test unless otherwise advised by the doctor.

Understanding FSH, LH, Prolactin & TSH


What is FSH, LH, Prolactin & TSH?

The Hormonal Profile Test, encompassing Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin, and Thyroid-Stimulating Hormone (TSH), assesses the levels of key hormones that help regulate reproductive functions, thyroid function, and lactation. The test is vital for detecting and monitoring hormonal disorders, fertility issues, and thyroid dysfunction.

FSH, LH, prolactin, and TSH are all produced in the anterior pituitary gland and play vital roles in reproductive health, endocrine regulation, and overall well-being. Assessing their levels with this hormonal panel is often the first step in determining fertility in both men and women.

FSH is crucial for the development of eggs, regulating menstrual cycles in females and sperm production in males. LH encourages the release of an egg from the ovary in females and stimulates testosterone production in males. Abnormal levels of FSH and LH can indicate menstrual irregularity, fertility issues, and conditions such as polycystic ovary syndrome (PCOS) and pituitary disorders.

Prolactin is a hormone that stimulates breast development and milk production (lactation) in females. Additionally, it also influences the menstrual cycle. Elevated prolactin levels can interfere with fertility, cause menstrual irregularities, and be associated with conditions such as galactorrhea (inappropriate milk production) and pituitary tumors (prolactinomas).

TSH regulates the production of thyroid hormones (T3 and T4), influencing metabolism and energy levels. Abnormal TSH levels may indicate thyroid disorders, such as hypothyroidism (elevated TSH) or hyperthyroidism (decreased TSH).

In women, the doctor may suggest this test in case of symptoms of irregular or heavy menstrual periods, PCOS/PCOD, if you are facing difficulty in getting pregnant, and/or if pituitary or hypothalamus problems are suspected. In men, this test can be performed when fertility issues and signs of low testosterone levels, such as decreased sex drive and low muscle mass, are observed. 

Overnight fasting is required for this hormonal profile. Do not eat or drink anything other than water for 8-12 hours before the test. In women, the preferred time to collect the sample is the second or third day of the menstrual cycle. Your doctor may ask you to temporarily stop taking certain medications, such as birth control pills, as they may lead to some aberrancy in your test results. Prolactin levels can vary throughout the day as ​​prolactin is secreted episodically and may be influenced by factors such as stress, exercise, and sleep. Therefore, multiple prolactin tests may be needed to confirm the diagnosis.

Test result ranges are approximate and may differ slightly between labs depending on the methodology and laboratory guidelines. Talk to your doctor about your specific test results. The results will help them determine your medical condition and formulate your treatment plan.

What is FSH, LH, Prolactin & TSH used for?

An FSH, LH, Prolactin & TSH test is done to:

  • Evaluate infertility issues in males and females.
  • Assess menstrual irregularities and conditions such as amenorrhea or oligomenorrhea.
  • Diagnose and manage conditions such as hypothyroidism or hyperthyroidism and monitor the effects of treatment in patients with thyroid diseases. 
  • Investigate the cause of abnormal breast milk discharge (galactorrhea) in non-pregnant women.
  • Evaluate the role of prolactin in case of lactation failure in women after childbirth.
  • Diagnose disorders or tumors of the pituitary gland or diseases involving the testes or ovaries.

What does FSH, LH, Prolactin & TSH measure?

Contains 4 tests

The hormonal profile measures the amount of hormones, Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin, and Thyroid-Stimulating Hormone (TSH), to determine your reproductive health. This test is performed to address health issues such as delayed puberty, irregular menstruation, abnormal breast milk discharge, loss of libido, erectile dysfunction, and problems related to fertility.

These hormone levels are usually low at a young age, but the brain starts producing gonadotropin-releasing hormone (GnRH) as adolescence approaches. GnRH is responsible for initiating the changes in puberty and signaling the pituitary gland to release FSH and LH into your blood.

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Follicle Stimulating Hormone

The Follicle Stimulating Hormone test measures the level of FSH in your body. FSH is produced and subsequently released into the blood by the pituitary gland. Its production is controlled by a feedback mechanism involving a hormone situated in the hypothalamus in the brain. The released FSH travels through your blood and then attaches to receptors in the ovaries and testes. It exerts functional effects on the reproductive organs, such as sexual development, puberty, and maturation. FSH levels vary throughout the menstrual cycle in response to estradiol and progesterone. Any disruption or issue in this feedback mechanism can prevent the normal function of the testicles or ovaries. Thus, determining its level provides crucial information regarding your health.

Know more about Follicle Stimulating Hormone

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TSH (Thyroid Stimulating Hormone) Ultrasensitive

The TSH (Thyroid Stimulating Hormone) Ultrasensitive test measures the levels of TSH hormone in the blood. TSH is produced by the pituitary gland located in the brain. Its function is to stimulate and regulate the functioning of the thyroid gland. It signals the thyroid gland to increase or decrease the production of thyroid hormones T3 and T4 (essential for regulating our body’s metabolism, temperature, heart rate, and growth) when their levels are low or high, respectively. Therefore, when the levels of T3 & T4 decrease, the pituitary gland is stimulated to release TSH. This high TSH level, in turn, stimulates the thyroid gland to release more thyroid hormones (T3 & T4); the vice-versa happens when the levels of thyroid hormones increase.

Know more about TSH (Thyroid Stimulating Hormone) Ultrasensitive

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Serum Prolactin

The Serum Prolactin test measures the levels of prolactin hormone in a person’s body. During pregnancy, prolactin, estrogen, and progesterone hormones stimulate breast milk development. Following childbirth, prolactin helps initiate and maintain the breast milk supply. If a woman does not breastfeed, her prolactin concentration will soon drop back to pre-pregnancy levels.

Besides pregnancy, the most common cause of elevated prolactin concentration is prolactinoma, a prolactin-producing tumor of the pituitary gland. Prolactinomas are the most common type of pituitary tumor and are usually benign (non-cancerous). They develop more frequently in women but are also found in men.

If the pituitary gland and/or the tumor enlarge significantly, it can put pressure on the optic nerve, causing headaches and visual disturbances, and can interfere with the other hormones that the pituitary gland produces.

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Luteinising Hormone

The Luteinising Hormone test determines the level of luteinizing hormone that promotes the functioning of the gonads, i.e., testes in men and ovaries in women. LH is produced by the pituitary gland, a pea-sized gland situated at the base of the brain. The production and release of LH are controlled by a system known as the hypothalamic-pituitary-gonadal axis. A hormone called GnRH is released from the hypothalamus of the brain and binds to the cell receptors in the anterior pituitary gland, which in turn prompts the synthesis and release of luteinizing hormone. LH then travels across the blood and attaches to its target cells in the testes in men and ovaries in women to facilitate optimal sexual and reproductive activities.

Know more about Luteinising Hormone

Interpreting FSH, LH, Prolactin & TSH results


Interpretations

The reference range of FSH is age- and gender-specific. As for women, the reference range is menstrual cycle phase-specific.

The reference range for follicle-stimulating hormone (FSH) is as follows (3rd generation immunochemiluminescence assay):

 Females 

  • Age 0-7 years: <6.7 mIU/mL
  • Age 8 years to adult:
  • Follicular phase: 3.1-7.9 mIU/mL
  • Ovulation peak: 2.3-18.5 mIU/mL
  • Luteal phase: 1.4-5.5 mIU/mL
  • Postmenopausal: 30.6-106.3 mIU/mL

Males

  • Age 0-7 years: <6.7 mIU/mL
  • Age 8 years-adult:1.3-19.3 mIU/mL

The following values are considered to be normal, LH blood levels measured in international units per liter (IU/L):

Women:

  • The follicular phase of the menstrual cycle: 1.9 to 12.5 IU/L
  • LH surge: 8.7 to 76.3 IU/L
  • The luteal phase of the menstrual cycle: 0.5 to 16.9 IU/L
  • Pregnancy: less than 1.5 IU/L
  • Post-menopause: 15.9 to 54.0 IU/L
  • Women using contraceptives: 0.7 to 5.6 IU/L

Men:

  • The age group of 20 and 70 years: 0.7 to 7.9 IU/L
  • >70 years of age: 3.1 to 34.0 IU/L

The following values are considered to be normal, prolactin blood levels measured in international units per liter (ng/mL):

Patients (Age)                                           Reference Range(s)

Males ≤ 18 Years

 

  Tanner Stage 1 (< 9.8 Years)    

  Tanner Stage 2 (9.8 - 14.5 Years) 

  Tanner Stage 3 (10.7 - 15.4 Years)  

  Tanner Stage 4 (11.8 - 16.2 Years)   

  Tanner Stage 5 (12.8 - 17.3 Years)    


Males > 18 Years

                   

< 10 ng/mL

< 6.1 ng/mL 

< 6.1 ng/mL

   2.8 - 11.0 ng/mL

   2.8 - 11.0 ng/mL

  

    2.10 - 17.70 ng/mL

In Females ≤ 18 Years

 

  Tanner Stage I (< 9.2 Years)

3.6 - 12.0 ng/mL

  Tanner Stage 2 (9.2 - 13.7 Years)

2.6 - 18.0 ng/mL

  Tanner Stage 3 (10 - 14.4 Years)

2.6 - 18.0 ng/mL

  Tanner Stage 4 (10.7 - 15.6 Years)

3.2 - 20.0 ng/mL

  Tanner Stage 5 (11.8 - 18.6 Years)

3.2 - 20.0 ng/mL

Adult Females

  Non Pregnant                                             


2.80 - 29.20 ng/mL

  Pregnant  

  Post Menopausal

9.70 - 208.50 ng/mL

1.80 - 20.30 ng/mL

The following values are considered to be normal, TSH blood levels measured in international units per liter (mIU/L):

Patients (Age)                                              Reference Range(s)

Premature Infants (28-36 Weeks)

 

  1st Week of Life

0.20-27.90 mIU/L

Term Infants (>37 Weeks)

 

  Serum or Cord Blood

1.00-39.00 mIU/L

  1-2 Days

3.20-34.60 mIU/L

  3-4 Days

0.70-15.40 mIU/L

  5 Days-4 Weeks

1.70-9.10 mIU/L

  1-11 Months

0.80-8.20 mIU/L

  1-19 Years

0.50-4.30 mIU/L

  ≥20 Years

0.40-4.50 mIU/L

Pregnancy

 

  First Trimester

0.26-2.66 mIU/L

  Second Trimester

0.55-2.73 mIU/L

  Third Trimester

0.43-2.91 mIU/L

A lower TSH level than the normal reference range indicates hyperthyroidism.

A higher TSH level than the normal reference range indicates hypothyroidism.

Note: TSH levels show circadian variation (fluctuates during the 24-hour cycle), reaching peak levels between 2-4 am and at a low between 6-10 pm. 

The reference range may vary from lab to lab*

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about FSH, LH, Prolactin & TSH


Frequently Asked Questions about FSH, LH, Prolactin & TSH

Q. Why is an FSH, LH, Prolactin & TSH test done?

An FSH, LH, Prolactin & TSH test is done to assess the levels of follicle-stimulating hormone, luteinizing hormone, prolactin, and thyroid-stimulating hormones. This test provides a comprehensive analysis of hormones crucial for determining reproductive health and fertility in both men and women.

Q. When should women get screened for hormonal imbalance?

Women with hormonal imbalances often experience heavy or irregular periods, mood swings, blood sugar issues, bloating, fatigue, excessive facial hair growth, and unexplained weight changes. These signs might be an indication for women to get screened for hormonal imbalance.

Q. What factors can affect the levels of FSH, LH, Prolactin & TSH?

There are various factors that can affect the levels of FSH, LH, Prolactin & TSH and may interfere with your test results. These factors include stress, physical activity, medications, and underlying health conditions.

Q. What can cause infertility in females?

The primary cause of infertility in females is failure to ovulate. This problem can occur due to polycystic ovarian disorder (PCOD) and primary ovarian insufficiency. Nearly 10% of women deal with infertility of some kind, and the chances of being infertile increase as a woman ages.

Q. What causes infertility in males?

Male infertility can be caused by various biological factors and environmental factors such as the inability to produce sperm or poor quality sperm, medical issues such as varicocele, ejaculation problems, undescended testicles, hormonal imbalances, and unhealthy habits including alcohol, smoking, and drugs.

Q. Which factors can affect the FSH levels?

The levels of FSH can get affected by certain conditions such as uncontrolled thyroid disease, sex-dependent hormone tumors, ovarian cysts, and unusual vaginal bleeding. Moreover, medicines like birth control pills, cimetidine, clomiphene, digitalis, levodopa, and phenothiazines, as well as medicines used in hormone replacement therapies, can also affect the levels of FSH. Multivitamins containing biotin or vitamin B7 may also affect the accuracy of the FSH test.

Q. What happens if the test results show high FSH levels in women?

High levels of FSH in women can indicate loss of ovarian function or ovarian failure, menopause, polycystic ovarian syndrome (PCOS), chromosomal abnormalities (e.g., Turner's syndrome), and reduction in the production of good-quality eggs.

Q. What are the causes of high levels of FSH in men?

High levels of FSH in men may indicate Klinefelter’s syndrome, absence of testicles or impaired functioning of testicles, damage to testicles by a disease such as alcohol dependence, and testicular damage by treatments such as X-rays or chemotherapy.

Q. What do low levels of FSH mean?

Low levels of FSH may indicate decreased ovulation in women, reduced sperm count in men, problems at the level of the hypothalamus or pituitary gland, which are the hormone control centers in the brain, and stress.

Q. Is prolactin hormone present in men?

Yes, prolactin hormone is present in men. However, its high levels have been associated with low sex drive and decreased erectile function.

Q. What is prolactinoma?

Prolactinoma is a non-cancerous tumor of the pituitary gland in which there is an excessive production of prolactin. It is more common in women as compared to men. This leads to a decrease in estrogen hormone in women and testosterone hormone in men.

Q. What happens if my prolactin levels are lower than the normal range?

If your prolactin levels are below the normal range, this could mean your pituitary gland is not functioning properly. This is known as hypopituitarism. However, lower levels of prolactin usually do not need any medical treatment.

Q. What conditions can affect the functioning of ovaries causing increased LH levels?

levels? The conditions that can affect the function of the ovary and cause an increased level of LH include polycystic ovary syndrome (PCOS), adrenal disease, and thyroid disease.

Q. What happens when LH levels are high?

In females, the rise in LH levels triggers ovulation and also progesterone levels. However, too high LH is associated with polycystic ovary syndrome and infertility. Further, high levels of LH cause early puberty, poor sperm morphology and motility, and may indicate damaged testicles in males.

Q. What happens when LH levels are low?

Low LH levels can signify that your pituitary gland is not making sufficient LH which is needed to induce changes in your body that support sexual development or reproduction.

Q. Can lifestyle changes affect FSH, LH, and prolactin levels?

Yes, lifestyle changes such as consuming a balanced diet, exercising regularly, reducing stress, and avoiding excessive alcohol consumption can influence these hormone levels.

Q. How can hyperthyroidism affect a pregnant woman and her baby?

An untreated hyperthyroidism during pregnancy can lead to miscarriage, premature birth, low birth weight of the baby, preeclampsia (a very high rise in blood pressure in late pregnancy), thyroid storm (a sudden, severe worsening of symptoms of hyperthyroidism), and congestive heart failure.

Q. What are the causes of high TSH in a newborn?

Congenital hypothyroidism is an important cause of elevated thyroid-stimulating hormone (TSH) in newborns. Other causes of an elevated TSH include transient hypothyroidism due to neonatal illness, premature birth, and iodine excess or deficiency. High TSH can also be seen in case the mother is taking some medicines that could affect thyroid hormone levels or the mother has some underlying thyroid disease.

Q. What other tests can be advised along with an FSH, LH, Prolactin & TSH test?

The tests that can be ordered along with an FSH, LH, Prolactin & TSH test are CBC (complete blood count) test, Anti-Mullerian hormone (AMH) test, Insulin (fasting) test, and Hb1Ac (glycated hemoglobin) test.
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FSH, LH, Prolactin & TSH test price for other cities


Price inBangaloreRs. 848
Price inNew DelhiRs. 849
Price inMumbaiRs. 849
Price inKolkataRs. 849
Price inPuneRs. 849
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References

  1. Orlowski M, Sarao MS. Physiology, Follicle Stimulating Hormone [Internet]. Treasure Island, Florida: StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535442/External Link
  2. O'Herlihy C, Pepperell RJ, Evans JH. The significance of FSH elevation in young women with disorders of ovulation. Br Med J. 1980 Nov 29;281(6253):1447-50. [Accessed 01 Nov. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1714809/ External Link
  3. Raju GA, Chavan R, Deenadayal M, Gunasheela D, Gutgutia R, Haripriya G, Govindarajan M, Patel NH, Patki AS. Luteinizing hormone and follicle stimulating hormone synergy: A review of role in controlled ovarian hyper-stimulation. J Hum Reprod Sci. 2013 Oct;6(4):227-34. [Accessed 01 Nov. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963304/ External Link
  4. Simoni M, Weinbauer GF, Gromoll J, Nieschlag E. Role of FSH in male gonadal function. Ann Endocrinol (Paris). 1999 Jul;60(2):102-6. [Accessed 01 Nov. 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/10456180/#:~:text=In%20the%20male%20FSH%20is,maintenance%20of%20normal%20sperm%20production. External Link
  5. Santi D, Crépieux P, Reiter E, Spaggiari G, Brigante G, Casarini L, Rochira V, Simoni M. Follicle-stimulating Hormone (FSH) Action on Spermatogenesis: A Focus on Physiological and Therapeutic Roles. J Clin Med. 2020 Apr 3;9(4):1014. [Accessed 01 Nov. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230878/ External Link
  6. Behre HM. Clinical Use of FSH in Male Infertility. Front Endocrinol (Lausanne). 2019 May 24;10:322. [Accessed 01 Nov. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543808/ External Link
  7. Arslan AA, Zeleniuch-Jacquotte A, Lukanova A, Rinaldi S, Kaaks R, Toniolo P. Reliability of follicle-stimulating hormone measurements in serum. Reprod Biol Endocrinol. 2003 Jun 18;1:49. [Accessed 01 Nov. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC165593/#:~:text=FSH%20levels%20peak%20during%20the,result%20of%20ovarian%20function%20cessation. External Link
  8. Gordetsky J, van Wijngaarden E, O'Brien J. Redefining abnormal follicle-stimulating hormone in the male infertility population. BJU Int. 2012 Aug;110(4):568-72. [Accessed 01 Nov. 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/22177092/#:~:text=FSH%20reflects%20the%20status%20of,may%20indicate%20primary%20testicular%20failure. External Link
  9. Follicle-Stimulating Hormone (Blood) [Internet].Rochester, NY: University of Rochester Medical Center; [Accessed 01 Nov. 2023]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=follicle_stimulating_hormone External Link
  10. Nedresky D, Singh G. Physiology, Luteinizing Hormone [Internet]. Treasure Island, Florida: StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539692/ External Link
  11. Luteinizing Hormone [Internet].Rochester, NY: University of Rochester Medical Center; [Accessed 01 Nov. 2023]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=luteinizing_hormone_blood External Link
  12. Al-Chalabi M, Bass AN, Alsalman I. Physiology, Prolactin [Internet]. Treasure Island, Florida: StatPearls Publishing; Jan. 2023. [Accessed 01 Nov. 2023]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507829/External Link
  13. Utiger R. Prolactin [Internet]. Britannica; 14 Jul. 2023.[Accessed 01 Nov. 2023]. Available from: https://www.britannica.com/science/prolactinExternal Link
  14. Prolactin [Internet]. ScienceDirect; [Accessed 01 Nov. 2023]. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/prolactinExternal Link
  15. Freeman ME, Kanyicska B, Lerant A, et al. Prolactin: Structure, Function, and Regulation of Secretion. Physiological Reviews. 2000;80(4):1523-1631. [Accessed 01 Nov. 2023]. Available from: https://doi.org/10.1152/physrev.2000.80.4.1523External Link
  16. Prolactin (Blood) [Internet].Rochester, NY: University of Rochester Medical Center; [Accessed 01 Nov. 2023]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=prolactin_blood External Link
  17. Thyroid Function Tests [Internet]. Alexandria, VA: American Thyroid Association; [Accessed 07 Feb. 2023]. Available from: https://www.thyroid.org/thyroid-function-tests/External Link
  18. British Thyroid Foundation. Thyroid Function Test [Internet]. Scotland: British Thyroid Foundation; 2021 [Accessed 07 Feb. 2023]. Available from: https://www.btf-thyroid.org/thyroid-function-testsExternal Link
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