High SHBG, otherwise meh but ...

[masfield]

got a few tests done this morning, with the results you see below. i am 67, with severe muscle wasting due to a disease called charcot marie tooth syndrome, in a wheelchair most of the time when outside the house, fairly well exhausted most of the time. stopped drinking 3 months ago and i'm still depressed about it. i used to be able to surf 3 - 4 x a week (in an adaptive board called a waveski) but now i'm lucky if i go out once a month. all in all, pretty bleh.

of course, it could all be due to lots of nerve loss in my lower legs and hands and elsewhere. but maybe the labs point to something else, as well. thoughts?

Testosterone (Male)	4.86 ng/mL	2.80 to 8.00 ng/mL2.80 - 8.00 ng/mL
Sex Hormone Binding Globulin	91 nmol/L	19 to 76 nmol/L19 - 76 nmol/L	H
Testosterone-Free, Adult Male, Calculated	46 pg/mL	47 to 244 pg/mL47 - 244 pg/mL	L
Tanner Stage IV: 35-169 pg/mL Tanner Stage V: 41-239 pg/mL
Testosterone, % Free, Calculated	0.9 %	%%

other tests done today:
TSH: 3.21 (.27 - 4.2)
Free T4 : 1.01 (.93 - 1.70)
estradiol: 16 pg/ml

thanks for any input you care to offer!

 

[Systemlord]

The good news is TRT can only help. The testosterone and especially the estrogen is low enough to cause osteoporosis. As for the thyroid no Free T3 was tested, the active hormone responsible for all the important things that happen.

That SHBG is gosh darn high and don't normally see it this high on these forums! The good news is TRT should suppress it for you allowing the Free T to increase substantially. Aside from TRT, there isn't really much else that is expected to lower your SHBG.

It would be nice to see baseline hematocrit, hemoglobin and iron status values which should always be checked and monitored on TRT, because someone on TRT uses more iron than someone not on replacement therapy.

I don't know many men that wouldn't be depressed with these hormone levels, let alone have adequate muscle mass and strength if low-T was the only problem. I had nerve problems, numbness when my testosterone was low, I would wake up to 100% numb arms with about the same Free T levels and TRT fixed all the nerve issues.

Just about all the diseases of aging can be found in men with low-T and TRT can treat and prevent many diseases.

As for a good starting protocol, 120-150mg weekly, 50mg twice weekly is a good starting point and if your doctor tries to put you on an every 2 week protocol, politely decline his/her offer as these protocols are notoriously infamous.

 

[masfield]

thanks much. i'll suggest what you say to my doctor but i suspect she will balk at the idea of home injections for T, at which point i'll have to go doctor shopping.

i've attached results for these same tests from May, 21, to see if you have any further thoughts or suggestions.

of particular note, i guess, is the dramatic change in SHBG levels. btw / those earlier results came shortly after i'd recovered from somehow forgetting to take my synthroid for 2 months and nearly falling into a myxedema coma or some such, so maybe that's involved in all this.

thanks again for your help.

 

[Systemlord]

i'll suggest what you say to my doctor but i suspect she will balk at the idea of home injections for T

Children with type 1 diabetes are taught to inject insulin, you're a grown man capable of injecting at home.

Most providers allow self injection and would be a red flag for any doctor not allowing at home injections.

 

[Systemlord]

i guess, is the dramatic change in SHBG levels. btw / those earlier results came shortly after i'd recovered from somehow forgetting to take my synthroid for 2 months

Thyroid meds increase SHBG. I do think you would still have low T even if you didn't have high SHBG.