Low free testosterone, high SHBG

queek · Feb 21, 2018

Hello,

I am 25 years old and recently got bloodwork (just out of curiosity actually):

[TABLE="class: outer_border, width: 500"]
[TR]
[TD]Test[/TD]
[TD]Result[/TD]
[TD]Reference Range[/TD]
[/TR]
[TR]
[TD]LH[/TD]
[TD]3.6 mU/ml | 1.5 - 9.3[/TD]
[TD][/TD]
[/TR]
[TR]
[TD]FSH[/TD]
[TD]2.7 mU/ml[/TD]
[TD]1.0 - 18.0[/TD]
[/TR]
[TR]
[TD]Estradiol[/TD]
[TD]36 pg/ml[/TD]
[TD]12.0 - 41.0[/TD]
[/TR]
[TR]
[TD]SHBG[/TD]
[TD]54 nmol/l[/TD]
[TD]17.3 - 65.8[/TD]
[/TR]
[TR]
[TD]Testosterone (Total)[/TD]
[TD]470 ng/dl[/TD]
[TD]270 - 920[/TD]
[/TR]
[TR]
[TD]Bioavailable Test (measured)[/TD]
[TD]0.79 ng/ml[/TD]
[TD]1.1 - 3.1[/TD]
[/TR]
[TR]
[TD]DHEA-S[/TD]
[TD]359 ug/dl[/TD]
[TD]34 - 569[/TD]
[/TR]
[TR]
[TD]TSH[/TD]
[TD]3.19 uU/ml[/TD]
[TD]0.2 - 5.0[/TD]
[/TR]
[TR]
[TD]Vitamin D (25-OH)[/TD]
[TD]67 ng/ml[/TD]
[TD]30 - 150[/TD]
[/TR]
[/TABLE]

More Blood tests (Was a few weeks later):

[TABLE="class: outer_border, width: 500"]
[TR]
[TD]Test[/TD]
[TD]Result[/TD]
[TD]Reference Range[/TD]
[/TR]
[TR]
[TD]Sodium[/TD]
[TD]141 nmol/l[/TD]
[TD]136 - 146[/TD]
[/TR]
[TR]
[TD]Chloride[/TD]
[TD]103 nmol/l[/TD]
[TD]95 - 110[/TD]
[/TR]
[TR]
[TD]Calcium[/TD]
[TD]2.30 nmol/l[/TD]
[TD]2.20 - 2.56[/TD]
[/TR]
[TR]
[TD]Iron[/TD]
[TD]96 ug/dl[/TD]
[TD]59 - 158[/TD]
[/TR]
[TR]
[TD]Erythrocytes[/TD]
[TD]5.23 T/l[/TD]
[TD]4.4 - 5.8[/TD]
[/TR]
[TR]
[TD]Hemoglobin[/TD]
[TD]15.6 g/dl[/TD]
[TD]13.5 - 18.0[/TD]
[/TR]
[TR]
[TD]Hematocrit[/TD]
[TD]47 %[/TD]
[TD]40 - 52[/TD]
[/TR]
[TR]
[TD]MCV[/TD]
[TD]89 fl[/TD]
[TD]78 - 98[/TD]
[/TR]
[TR]
[TD]MCH[/TD]
[TD]29.7 pg[/TD]
[TD]27.0 - 33.0[/TD]
[/TR]
[TR]
[TD]MCHC[/TD]
[TD]33.5 g/dl[/TD]
[TD]31.5 - 36.0[/TD]
[/TR]
[TR]
[TD]Leukocytes[/TD]
[TD]3.5 G/l[/TD]
[TD]4.0 - 10.0[/TD]
[/TR]
[TR]
[TD]Blood sugar[/TD]
[TD]86 mg/dl[/TD]
[TD]74 - 100[/TD]
[/TR]
[TR]
[TD]BUN[/TD]
[TD]24 mg/dl[/TD]
[TD]8 - 20[/TD]
[/TR]
[TR]
[TD]Urea[/TD]
[TD]52 mg/dl[/TD]
[TD]17 - 43[/TD]
[/TR]
[TR]
[TD]Creatinine[/TD]
[TD]1.0 mg/dl[/TD]
[TD]0.8 - 1.3[/TD]
[/TR]
[TR]
[TD]Uric Acid[/TD]
[TD]6.1 mg/dl[/TD]
[TD]3.6 - 7.2[/TD]
[/TR]
[TR]
[TD]Bilirubin[/TD]
[TD]1.1 mg/dl[/TD]
[TD]< 1.2[/TD]
[/TR]
[TR]
[TD]HDL[/TD]
[TD]49 mg/dl[/TD]
[TD]> 40[/TD]
[/TR]
[TR]
[TD]CHOL/HDL[/TD]
[TD]3.3[/TD]
[TD]< 5.0[/TD]
[/TR]
[TR]
[TD]LDL[/TD]
[TD]100 mg/dl[/TD]
[TD]< 130[/TD]
[/TR]
[TR]
[TD]LDL/HDL[/TD]
[TD]2.0[/TD]
[TD]< 3.7[/TD]
[/TR]
[TR]
[TD]CRP[/TD]
[TD]0.1 mg/dl[/TD]
[TD]0.00 - 0.50[/TD]
[/TR]
[/TABLE]

 
A doctor tested my hormones another time, but not as comprehensive: (Third blood test)

[TABLE="class: outer_border, width: 500"]
[TR]
[TD]Test[/TD]
[TD]Result[/TD]
[TD]Reference Range[/TD]
[/TR]
[TR]
[TD]beta-HCG[/TD]
[TD]0.0 mU/ml[/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Prolactin[/TD]
[TD]7.8 ng/ml[/TD]
[TD]4.0 - 15.2[/TD]
[/TR]
[TR]
[TD]LH[/TD]
[TD]7.3 mU/ml[/TD]
[TD]1.5 - 9.3[/TD]
[/TR]
[TR]
[TD]FSH[/TD]
[TD]2.3 mU/ml[/TD]
[TD]1.0 - 18.0[/TD]
[/TR]
[TR]
[TD]Testosterone (Total)[/TD]
[TD]5.70 ng/ml[/TD]
[TD]2.70 - 9.20[/TD]
[/TR]
[/TABLE]

By assuming Albumin levels of 4.3 g/dl, BAT levels would calculate to 166 ng/dl and Free Testosterone would be at 7.06 ng/dl.

Symptoms:

Hardgainer
Trouble keeping bodyfat down
Extremely tired and fatigued during the day
Losing a lot of strength when cutting
Rather emotional during last year
No morning wood anymore, had problems with ED a year ago when I was partying a bit

Facts:

25 years old
BMI: 26.9
Bodyfat: 19% (DEXA)
Perfect bone mineral density according to DEXA
Perfect spermiogram
Normal body and facial hair (could grow full beard)
Carrying fat at hips and chest (since puberty) (Pseudogynecomastia)

Diet:

Maintenance at 3000-3500kcal, Bulk 4000kcal, Cut 2700kcal
Alcohol once a month max.
Almost no sugar
Symptoms don't seem to change with diet
Currently cut with 25% carbs, 45% prot., 30% fat (Percent of calories)
Not plant based at all
Low soy

Training/Workout:

 1.5hrs Resistance Workout 3-5 times a week, essentially no cardio

Medication:

No Rx
Currently only VitD and Multi
Have never touched DHT blocking meds
Never touched AAS, Prohormones or similar

Oral Body Temperature:

Morning: 97.0°F-97.2°F
2pm: 97.6°F

I got to know that my TSH is a bit elevated, my body temperature low, my free test outside of the reference range (low) and my SHBG and E2 a bit high. Symptoms seem match those of Low T and Hypothyroidism.

Any opinion on all of that very welcome!

Thank you in advance!

Disclaimer: I originally posted to another forum, but I value multiple opinions very much

Systemlord · Feb 21, 2018

You definitely have low T and thyroid issues, thing is once you begin thyroid treatment SHBG is expected to rise and by then you'll be over ranges, TRT however can counter that rise in SHBG therefore lowering it, then increasing your free T. If your SHBG was midrange I would recommend thyroid treatment only and work to increase your testosterone. You need to stay away from soy, all men should stay clear of it.

Your free T is lower than mine was when I came in at 225 ng/dL, free T was 7.2. This is just a reference for you to show you how SHBG is inflating your testosterone status, if your SHBG was midrange free T would be higher and TT significantly lower. Likely below low normal.

I would recommend one large weekly injection, you will need larger peaks to decrease your SHBG.

By the way, a very professional looking post!

How SHBG works--> https://naturalbiohealth.com/2015/05/06/shbg-critical-to-your-health/

queek · Feb 22, 2018

First of all, thank you very much for the reply, I appreciate it!

Now that the bloodwork I posted is already a few weeks old, I wondered what my current T levels looked like and got bloodwork done again:

[TABLE="class: outer_border, width: 500"]
[TR]
[TD]Test[/TD]
[TD]Result[/TD]
[TD]Reference Range[/TD]
[/TR]
[TR]
[TD]Testosterone (Total)[/TD]
[TD]6.0 ng/dl[/TD]
[TD]2.70 - 9.20[/TD]
[/TR]
[TR]
[TD]SHBG[/TD]
[TD]44 nmol/l[/TD]
[TD]17.3 - 65.8[/TD]
[/TR]
[TR]
[TD]Bioavailable Testosterone[/TD]
[TD]1.39 ng/ml[/TD]
[TD]1.1 - 3.1[/TD]
[/TR]
[/TABLE]

Those look way better but not optimal. Didn't get anything else done this time. The only thing I changed since back then was that I didn't train as often and as intense.

I guess this doesn't seem like low T anymore? Does this sound like overtraining? Maybe due to a underactive thyroid?

Systemlord · Feb 22, 2018

When thyroid output fluctuates so to does your SHBG levels, when happens it affects how you hold on to your testosterone. You have thyroid problems and only TSH is tested, huge red flag you're dealing with an inexperienced doctor, you need a full thyroid panel checking fT3, rT3, , fT4 and antibodies. TSH only checks function of the thyroid, not the actual thyroid hormones.

You have an underactive thyroid and when you address it, your SHBG will go up affecting your free T, therefore possibly requiring TRT. Your testosterone is low for your age group, well below average.

queek · Feb 22, 2018

I see what you mean. That makes sense.

They don't test for rT3 where I live. Can the others be enough to assess my thyroid function?

Vince Carter · Feb 22, 2018

Reverse T3 tests for a condition called pooling which would indicate the T3 hormone is not making it in to the cells. I would call it less necessary being Free T3 being the most important single factor in Thyroid testing. Free T3 is the active Thryoid hormone and is converted from T4

queek · Feb 22, 2018

Vince Carter said:
Reverse T3 tests for a condition called pooling which would indicate the T3 hormone is not making it in to the cells. I would call it less necessary being Free T3 being the most important single factor in Thyroid testing. Free T3 is the active Thryoid hormone and is converted from T4

Thank you for the explanation!

So I'm getting T3, fT3, T4, fT4 then. Which thyroid specific antibody specifically should I get tested for?

CoastWatcher · Feb 22, 2018

queek said:
Thank you for the explanation!

So I'm getting T3, fT3, T4, fT4 then. Which thyroid specific antibody specifically should I get tested for?

TPO and TGAb.