Repeat blood test results, seeing endo in about two months

ERO · Mar 14, 2016

Having high SHBG makes it difficult to get a good level of Free Testosterone. One may have a high Total T number but with high SHBG, a low Free T number, which can leave you with "Low T" symptoms because most of your T is bound to the SHBG. I would definitely ask your doctor how he handles this situation and if he has no answer or says it does not matter, that may be a red flag that perhaps this Doc is not as experienced with TRT as he has indicated.

SHBG levels - both high and low - are difficult to adjust. It is said that supplemental Vitamin D may help lower SHBG, and high levels of injected T can lower it, but all in all, one's SHBG level is not easily adjusted. I have low (below the lab range) SHBG so I know from experience.

AlcahueteJ · Mar 14, 2016

Here's my levels of total, free T, and SHGB.

Testosterone - 158 ng/dL
SHGB - 56 nmol/L
calcFT - 20 pg/mL

Would this mean I'm potentially a poor candidate for Clomid then because my free T may not increase with the pill?

ERO · Mar 14, 2016

That is a good question - one that Dr. Saya can likely answer the next time he checks in here. He has a ton of experience using Clomid.

Dr Justin Saya MD · Mar 14, 2016

Yes, Clomid often WILL raise SHBG...a good thing for lower SHBG guys, a neutral or bad thing for normal/higher SHBG guys.

With your initial LH 3.7 and testes only responding with a total T 158ng/dL it appears you may have a mixed primary/secondary picture going on. Couple that with the SHBG and, to be honest, I would give you a "less than average" chance of being successful with Clomid therapy. Still worth a try considering your age, but wouldn't be surprised if you end up on TRT sooner rather than later.

AlcahueteJ · Mar 15, 2016

Dr Justin Saya said:
Yes, Clomid often WILL raise SHBG...a good thing for lower SHBG guys, a neutral or bad thing for normal/higher SHBG guys.

With your initial LH 3.7 and testes only responding with a total T 158ng/dL it appears you may have a mixed primary/secondary picture going on. Couple that with the SHBG and, to be honest, I would give you a "less than average" chance of being successful with Clomid therapy. Still worth a try considering your age, but wouldn't be surprised if you end up on TRT sooner rather than later.

Thanks for responding, and thanks for the advice!

I am still thinking I'll try the Clomid to start as well. All I lose is time if it doesn't work, I have side effects, or the symptoms don't improve. It's no fun to feel like this, but I want to the most logical course of action.

I will discuss all of this with my doctor at the follow-up as well.

AlcahueteJ · Mar 26, 2016

I'm on Clomid, 50 mg 3 x per week for two months. Then follow-up blood work and an appointment.

I'll be sure to report results here.

Fireproof · Mar 26, 2016

AlcahueteJ said:
I'm on Clomid, 50 mg 3 x per week for two months. Then follow-up blood work and an appointment.

I'll be sure to report results here.

Great to see your update. Let us know how you are feeling along the way too...

AlcahueteJ · Mar 28, 2016

Fireproof said:
Great to see your update. Let us know how you are feeling along the way too...

I definitely will, thanks again for the well wishes. If anything else, I'm curious how it will go (and obviously I want to feel better too).

Repeat blood test results, seeing endo in about two months

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