When boosting LH isn’t the fix, and what that means for your clients

In the world of hormone optimization, low testosterone is one of the most discussed — and misunderstood — topics, especially among coaches working with high-performance clients or men over 30. One common misconception is that increasing luteinising hormone (LH) can solve all cases of low testosterone.

But here’s the reality: if LH is already elevated and testosterone remains low, the problem isn’t the signal — it’s the response.

Let’s break this down.

What Does Luteinising Hormone Actually Do?

Luteinising hormone is released by the pituitary gland and acts like a messenger to the testes. Its job is to stimulate the Leydig cells in the testes to produce testosterone. Think of LH as a manager shouting orders, and the testes as the workers producing the goods.

In a healthy system, when testosterone drops, LH goes up to tell the testes, “Make more!” — and they do.

But when LH is high and testosterone remains low? That’s a different story.

Primary vs Secondary Hypogonadism

Low testosterone can come from two main sources:

• Secondary Hypogonadism: The brain isn’t sending the signal (low LH and FSH).

• Primary Hypogonadism: The testes aren’t responding to the signal (high LH and FSH, low T).

If LH is low and testosterone is low, we often look upstream — to the hypothalamus or pituitary. In these cases, certain interventions (like increasing LH through lifestyle or medical therapies) might help restore the signal.

But if LH is already elevated, the body is trying to fix the problem — and failing. This tells us the issue lies within the testes themselves.

When LH Is Not the Solution

Here’s the key point: you can’t “supplement” or “stimulate” your way out of a testicular failure. If the Leydig cells are damaged or dysfunctional — due to aging, trauma, inflammation, toxin exposure, or genetic issues — all the LH in the world won’t fix the problem.

This is where many over-the-counter "T boosters" or supplement stacks fall short. They might increase LH or try to "optimize" the hypothalamic-pituitary-gonadal axis, but if the testes can’t respond to LH, it's like stepping on the gas in a car with no engine — nothing happens.

What Coaches and Clients Need to Know

If you're working with a client who has low testosterone and their LH is already high, it’s likely a case of primary hypogonadism. This isn’t a lifestyle tweak or supplement fix — it often requires medical evaluation, possibly testosterone replacement therapy (TRT), and deeper functional assessments.

Trying to "boost" LH further won’t help, and can sometimes make symptoms worse by overstimulating a system that’s already trying and failing.

The Takeaway

When testosterone is low, don’t just assume it's a signalling issue. Check LH levels. If they’re high, the testes aren’t responding — and it’s a testicular issue, not a hormonal communication issue.

As a coach, your role is to understand the physiology, guide clients toward appropriate testing, and know when it’s time to refer to a medical professional. Not all low testosterone is created equal — and not all of it can be solved with lifestyle changes.