High SHBG

[BCD19800]

Hi all,

I’ve been treating hypothyroidism over the last 2.5 years and finally after multiple medications and doses i’ve found what works well for me. I take a combination of unithyroid and cytomel along with some iodine. Unfortunately, since I started my treatment, my SHBG has been significantly elevated as well as my prolactin. My endocrinologist did prescribe cabergoline which controls my prolactin levels well. Still, my sexdrive is about 1/4th of what it used to be and my recovery from the gym is significantly reduced. I did have a lot of anxiety and depression but most of that has been resolved after starting my t3/t4/iodine treatment protocol. My last blood tests from LabCorp are as follows.

Testosterone: 951 ng/dL. (274-916)
Estradiol: 28.7 pg/mL (7.6-42.6)
Lh: 4.4 mIU/mL (1.7-8.6)
Prolactin: 8.4 ng/mL (4.0-15.2)
Albumin: 4.3 g/dL (3.5-5.5)
SHBG: 73.8 nmol/L (16.5-55.9)
Free Testosterone (direct): 13.5 pg/mL (8.7-25.1)

I’m actually surprised this latest blood test showed a 13.5 free test. I’ve had multiple over the last 2 years and it’s always been closer to 10. Anyhow, I’m creating this post to get some general advice. I don’t think my numbers warrant TRT, based on recommendations from multiple endocrinologists and urologists I’ve seen. Outside of TRT, is there anything I can do to lower my SHBG? My last urologist told me to take an AI which may increase my labido. After reading this forum, I’m reluctant to take the AI since my estrogen levels seem normal. I was thinking of trying boron or stinging nettle root. Thoughts? Thanks!

 

[Rhino 2.0]

How old are you? I’m in the same situation. The only way around high SHBG like that one large dose of testosterone a week. With those natural levels though it would be a bummer to have to go on TRT just to get around the high SHBG.

 

[BCD19800]

I’m 39 years old. I suppose I can live with my current symptoms but would prefer to be my old self. Did you ever try any over the counter supplements to reduce your SHBG?

 

[Vince]

Some members use Stinging Nettle to lower their shbg, I've never tried it.

 

[Rhino 2.0]

I’m 39 years old. I suppose I can live with my current symptoms but would prefer to be my old self. Did you ever try any over the counter supplements to reduce your SHBG?

Yes I have but unfortunately nothing seems to work to well. I’ve had a little luck with high doses of boron but the boost was short lived and only lasted a couple days.

 

[madman]

Hi all,

I’ve been treating hypothyroidism over the last 2.5 years and finally after multiple medications and doses i’ve found what works well for me. I take a combination of unithyroid and cytomel along with some iodine. Unfortunately, since I started my treatment, my SHBG has been significantly elevated as well as my prolactin. My endocrinologist did prescribe cabergoline which controls my prolactin levels well. Still, my sexdrive is about 1/4th of what it used to be and my recovery from the gym is significantly reduced. I did have a lot of anxiety and depression but most of that has been resolved after starting my t3/t4/iodine treatment protocol. My last blood tests from LabCorp are as follows.

Testosterone: 951 ng/dL. (274-916)
Estradiol: 28.7 pg/mL (7.6-42.6)
Lh: 4.4 mIU/mL (1.7-8.6)
Prolactin: 8.4 ng/mL (4.0-15.2)
Albumin: 4.3 g/dL (3.5-5.5)
SHBG: 73.8 nmol/L (16.5-55.9)
Free Testosterone (direct): 13.5 pg/mL (8.7-25.1)

I’m actually surprised this latest blood test showed a 13.5 free test. I’ve had multiple over the last 2 years and it’s always been closer to 10. Anyhow, I’m creating this post to get some general advice. I don’t think my numbers warrant TRT, based on recommendations from multiple endocrinologists and urologists I’ve seen. Outside of TRT, is there anything I can do to lower my SHBG? My last urologist told me to take an AI which may increase my labido. After reading this forum, I’m reluctant to take the AI since my estrogen levels seem normal. I was thinking of trying boron or stinging nettle root. Thoughts? Thanks!

If anything get retested using a more accurate assay as the one you had done for Free Testosterone -Direct analog enzyme immunoassay (EIA) is inaccurate and tends to underestimate.

In your situation with such a high SHBG get the- Free: equilibrium ultrafiltration; total: liquid chromatography/tandem mass spectrometry (LC/MS-MS)

I would rather use the calculated (Vermulen) method for Free & Bioavailable Testosterone than pay for the Direct analog enzyme immunoassay (EIA)

It can be accessed online for free Free & Bioavailable Testosterone calculator

Even though your TT 951 ng/dL and your SHBG 73.8 nmol/L if we use the calculated method above.....your FT is only 12.8 ng/dL= 1.35% and your BT is only 31.7%

Although your TT 951 ng/dL may seem robust your FT is on the lower end due to your very high SHBG.

TT is good to know but FT is what truly matters as it is the unbound active fraction of testosterone and FT is 2-3% of TT.....most men do well having FT in the 2-3% range.

 

[BCD19800]

@madman, thank you for your message.
Would most clinics treat men with a 1.35% free t? Are there any health risks associates with low free test such as my levels?

 

[Systemlord]

There are a lot of diseases associated with having lower than normal testosterone, the problems what's low for you specially as these ranges are everyone else. We are all biochemically unique, something garden variety doctors forget when they go chasing that reference number.

Heart disease, cardiovascular disease, dementia and alzheimer's is associated with lower than normal testosterone. Men with high normal testosterone are healthier, stronger and have the least chance of heart attaches as testosterone in the high normal ranges is cardioprotective.

Normal free testosterone is 2-3 percent, your's is obviously lower.

Abraham Morgentaler suggests men below Free T <15 pg/mL may benefit from TRT.

 

[madman]

@madman, thank you for your message.
Would most clinics treat men with a 1.35% free t? Are there any health risks associates with low free test such as my levels?

Treating symptoms is what truly matters and even though your FT is not flagged as low on your blood test results if you take the reference range or Free Testosterone (direct): (8.7-25.1) than 16.9 would be the mean (mid-range) and you are 13.5 (possibly overestimated) so your levels are under mid-range and as you stated in your first post "I’m actually surprised this latest blood test showed a 13.5 free test. I’ve had multiple over the last 2 years and it’s always been closer to 10 "

Your FT is sub-par due to your high SHBG!

There are many clinics.....a mixed bag (good/bad/horrendous) and it comes down to finding the right doctor who has the knowledge and expertise in treating men for low t.

I live in Canada so not familiar with the most reputable clinics aside from Defy and Prime Body that many on this forum get treatment through.

Others will be better in guiding you in the right direction.

 

[Vince]

Yes I have but unfortunately nothing seems to work to well. I’ve had a little luck with high doses of boron but the boost was short lived and only lasted a couple days.

I would not recommend that you start trt, find a way to lower your shbg. Supplement Jarrow zinc balance, magnesium, boron, D3 and eat lots of non-starchy vegetables like cauliflower and broccoli. Avoid alcohol and sugar. Your total T is just too high. I think if you started trt, you would end up being sorry that you did.

 

[BCD19800]

Thank you all for your input and advice. I greatly appreciate it.

 

[Vince Carter]

SHBG cannot be directly influenced, up or down, through any method. It is what it is. As noted the best sound advice given in this thread was the administration of a large single dose of Testosterone per week can typically lower SHBG to some degree though even then it's a spotty proposition. Most high SHBG guys have to run Total Test very high, >1000+ in order to try and overcome the SHBG and get Free T to come up.

I'm kind of surprised by the populace giving this OTC SHBG advice, I think this is pretty well known to be a waste of money.

 

[BCD19800]

If at some point in the future I decided to go on TRT, would the high total test cause greater issues? I already have a total test in the 900S. I’m assuming I should be more concerned about abnormal side effects with higher free test, correct? And sounds like with my high SHGB, I may not really end up with a high free test level.

 

[Systemlord]

High SHBG men rarely have to deal with side effects of high Free T or estrogen related issues since T & E2 bind to SHBG. Total T should be ignored when SHBG is high and Free T should be paid close attention.

 

[BigBamBoo]

Uhhh...well prior to starting TRT my SHBG was 75. I was placed on a every 3.5 day protocol. The theory was it would lower my SHBG.
And this whole, “high SHBG guys need one or two large doses” is not always correct.

It only lowered my SHBG down to about 65. Not a significant amount at all.

And...those larger doses coupled with hCG shot my E2 up to 75.

I then went to M-W-F protocol and lower doses and ditched the HCG. That lowered my E2 down to the high 30’s. My SHBG is still in the 60’s.

I am now doing EOD injections. Blood work will tell the story, but so far each time I moved to more frequent doses, my overall well-being has improved.

It gets kind of tiring to hear high SHBG guys always need one or two large doses and this will fixed your SHBG issues.

 

[BenM]

I too have found my SHBG has only come down marginally even on a 125mg weekly injection. I don’t mind this personally as it means my E2 also stays within a healthy range, and I would probably prefer not to inject more frequently as it’s just another (minor) inconvenience.

 

[fifty]

@madman, thank you for your message.
Would most clinics treat men with a 1.35% free t? Are there any health risks associates with low free test such as my levels?

Some clinics will treat whoever pays.

Nettle and fenugreek and herbal stuff doesn’t work effectively to lower shbg. To lower it you need proviron or danazol or other. Madman knows more about all that than me.

 

[ta406]

If anything get retested using a more accurate assay as the one you had done for Free Testosterone -Direct analog enzyme immunoassay (EIA) is inaccurate and tends to overestimate.

In your situation with such a high SHBG get the- Free: equilibrium ultrafiltration; total: liquid chromatography/tandem mass spectrometry (LC/MS-MS)

I would rather use the calculated (Vermulen) method for Free & Bioavailable Testosterone than pay for the Direct analog enzyme immunoassay (EIA)

It can be accessed online for free Free & Bioavailable Testosterone calculator

Even though your TT 951 ng/dL and your SHBG 73.8 nmol/L if we use the calculated method above.....your FT is only 12.8 ng/dL= 1.35% and your BT is only 31.7%

Although your TT 951 ng/dL may seem robust your FT is on the lower end due to your very high SHBG.

TT is good to know but FT is what truly matters as it is the unbound active fraction of testosterone and FT is 2-3% of TT.....most men do well having FT in the 2-3% range.

Maybe slightly off topic (I apologize to the OP if it is) but how accurate have you found this calculator to be? Ive had over 20 blood tests done since starting TRT a few years ago. I ran about 10 of them through this calculator and a few were accurate, and the others were way off. The ones that were off, my FT was always considerably lower on my bloodwork than on the calculator. My SHBG has remained the same.

 

[Gman86]

Uhhh...well prior to starting TRT my SHBG was 75. I was placed on a every 3.5 day protocol. The theory was it would lower my SHBG.
And this whole, “high SHBG guys need one or two large doses” is not always correct.

It only lowered my SHBG down to about 65. Not a significant amount at all.

And...those larger doses coupled with hCG shot my E2 up to 75.

I then went to M-W-F protocol and lower doses and ditched the HCG. That lowered my E2 down to the high 30’s. My SHBG is still in the 60’s.

I am now doing EOD injections. Blood work will tell the story, but so far each time I moved to more frequent doses, my overall well-being has improved.

It gets kind of tiring to hear high SHBG guys always need one or two large doses and this will fixed your SHBG issues.

I agree. It seems to be a common theme, but has anyone ever actually had blood work done on one large dose per week, and also had blood work done on a more frequent injection schedule, and actually proved that one large dose will lower SHBG more? I think this whole thing about high SHBG guys needing to do one shot per week is all theoretical. I personally have never seen any studies, or anecdotal evidence to back it up.

 

[fifty]

I started TRT at 80mg 2x/wk and my shbg went up a point at ~12wks from pre TRT labs.