1. #1

    T Too High For TRT

    Well I just got my blood work back from LabCorp for my initial consult with Defy. Surprisingly it came back at 626, even though I still have symptoms, fatigue, low libido, mild ED.

    My consultation is tomorrow. They already told me I probably wouldn't get TRT, because 525 is where they usually try other things. Seems my free T is low, SHBG is high.

    By the way, I am a 50 yr old male, with type 2 diabetes, non insulin, High blood pressure which both are controlled through meds. Also have a faint heart murmur, and have echos each year to keep track and they tell me it is no issue so far. I work out several times a week and do cardio twice a week. Eat pretty clean.

    Also my son was killed in a car accident in may and I have been quite depressed and my workouts and diet have suffered since then. Just started really trying to kick it in gear the last month or so.

    I was hoping some of you guys that have looked at a lot of bloods could take a look at mine and see what jumps out at you. Consultation is with a NP-C.

    Thanks for your time,

    EAH
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    Last edited by EAH; 12-06-2017 at 07:57 AM.

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  3. #2
    Moderator Vince's Avatar
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    Your labs look pretty nice. What is causing your heart murmur or innocent murmur. You may like to rum your labs through Clevelandheartlabs. https://www.excelmale.com/showthread...rt-Clinic-Labs
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  4. #3
    [QUOTE=Vince;89428]Your labs look pretty nice. What is causing your heart murmur or innocent murmur. You may like to rum your labs through Clevelandheartlabs.

    Its mitral valve regurgitation. My sister has a murmur as well and has had it since childhood. I have regular echos and they say I'm good. I don't suffer shortness of breath, do hard cardio elliptical, running, rowing, with no issues. I'll Check out Clevelandheartlabs.

    I'm just hoping Defy can help me. I just assumed I had low T because of the symptoms. I was checked by my regular MD a couple of years ago and it came back at 390. They didn't do any of the other tests though, and he couldn't care less as long as I was in the "normal" range. I was in pretty bad shape at the time. It would seem cleaning up my diet, working out with weights and cardio on a regular basis has made a huge difference in my levels. Also my symptoms have certainly gotten better from when I was at 390, but I'm still not where I want to be. Fingers crossed they can help me out somehow.

    EAH


  5. #4
    Your free testosterone is low, very low. That's not a surprise given your SHBG value, and that may well explain some of what you're feeling. While your TSH was solid, that's not a sufficient marker to rule out the possibility of thyroid issues. Have you discussed a full thyroid panel? Free t3, free t4, reverse t3, adn both antibody tests?
    Last edited by CoastWatcher; 12-06-2017 at 08:36 AM.
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

  6. #5
    Quote Originally Posted by CoastWatcher View Post
    Your free testosterone is low, very low. That's not a surprise given your SHBG value, and that may well explain some of what you're feeling. While your TSH was solid, that's not a sufficient marker to rule out the possibility of thyroid issues. Have you discussed a full thyroid panel? Free t3, free t4, reverse t3, adn both antibody tests?
    Honestly I'm just learning about all of these things. I didnt even know what TSH was. I will certainly make sure we discuss the possibility of thyroid issues during my consult. I dont mind doing more blood work. Thanks for the info.
    Last edited by CoastWatcher; 12-06-2017 at 08:36 AM.

  7. #6
    Sorry for the loss of your son. My relative has a mitral valve regurgitation. She is 75 and doing great. Stay in shape and eat right.

  8. #7
    Quote Originally Posted by Saul View Post
    Sorry for the loss of your son. My relative has a mitral valve regurgitation. She is 75 and doing great. Stay in shape and eat right.
    Thanks Saul,
    We are getting back to normal. That is great news about your relative...hopefully mine will stay at bay as well.

  9. #8
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    EAH
    are you on cholesterol meds?
    your ED probably has more to do with high blood pressure and perhaps partially blocked arteries. Even though Free T is on the “ slightly lower end”, i doubt thats the issue. Type 2 diabetes and being overweight have much more tondo with lack of energy and low libido. Last but not least, you losing your son is very traumatic and of course that will be a heavy weight on your mood. Im very sorry to hear that.

  10. #9
    That is probably the highest SHBG I have ever saw posted here.

    read about how SHBG affects levels of FREE (available) hormones. This will become obvious to you as to why you have decent total T levels but very low Free T levels.

    I'm DEFY will get you squared away. Make sure and post back here with the findings and how they plan to handle your SHBG levels. I'll be very interested in that.


    PS: I'm 33 and wish I had those total T numbers. You're just fine on that front if you can get SHBG to come way way down.

  11. #10
    Moderator Vince's Avatar
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    I would also check your vitamin D3 level, good levels can help lower shbg.
    https://www.excelmale.com/showthread...d-their-levels
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  12. #11
    Quote Originally Posted by lexer View Post
    EAH
    are you on cholesterol meds?
    your ED probably has more to do with high blood pressure and perhaps partially blocked arteries. Even though Free T is on the “ slightly lower end”, i doubt thats the issue. Type 2 diabetes and being overweight have much more tondo with lack of energy and low libido. Last but not least, you losing your son is very traumatic and of course that will be a heavy weight on your mood. Im very sorry to hear that.
    I got off of the statins last year after losing 40 lbs through diet and exercise. All of my cholesterol numbers were great at that time, and Dr. agreed I could drop them.. I have fallen off the wagon a bit since May, and although I have gained 5 lbs, I'm still not too fat. I wear 32 waist pants. I am short (5'8") and 180 with clothes on, but carry a good bit of muscle from working out for many years earlier in life.
    My blood pressure over the last year has been low 120's over 76-78. It was 136/74 when I got my physical this time, but I think it was affected by having a cup of coffee on the way...(I know I know), and I was nervous to be explaining to the Doc why I was getting the physical. My ed started soon after getting on statins and bp meds. Befor I was treated for bp I had no issues at all. Doc has adjusted meds several times to minimize ED sides. Actually now that I think about it, getting off od the statins could be what has helped my T levels?

  13. #12
    Youre with a great Dr, Dr Saya, he may be able to treat your Free T in some manner but typically SHBG can't be manipulated down (or up), you have to play it where it lies.

  14. #13
    I agree that your labs look good... except the SHBG and your Glucose. Of course the glucose depends upon what time your labs were taken. I hope that is under control. Perhaps Dr. Saya can find a way to increase your Free T. GoodLuck and keep us informed.

  15. #14
    Quote Originally Posted by ratbag View Post
    I agree that your labs look good... except the SHBG and your Glucose. Of course the glucose depends upon what time your labs were taken. I hope that is under control. Perhaps Dr. Saya can find a way to increase your Free T. GoodLuck and keep us informed.
    Glucose has usually been up a bit. But Doc has been satisfied that my A1c has been 5.5 - 5.9 for all of 2017 and most of 2016. My labs are all taken early in the a.m. and fasted. But the last ones were a.m. not fasted.

    A1C was getting close to 8 before I got back on the fitness kick.

  16. #15
    Member FeelingLost's Avatar
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    Hi EAH by the time you read this you will probably already had your consult. I would have rescheduled the consult and put my case to to Dr Saya not one of his nurses.
    Who most likely have to follow Defy's standard procedures. There is a good chance they can still help.
    Best of luck and so sorry to read about the loss of your son.

  17. #16
    Quote Originally Posted by FeelingLost View Post
    Hi EAH by the time you read this you will probably already had your consult. I would have rescheduled the consult and put my case to to Dr Saya not one of his nurses.
    Who most likely have to follow Defy's standard procedures. There is a good chance they can still help.
    Best of luck and so sorry to read about the loss of your son.
    I was actually thinking about that last night and this morning. I have asked for this to be rescheduled with Dr. Saya, and hopefully I hear back from them before she calls.

  18. #17
    So I did get rescheduled and the earliest available was Dec 26th. Seems like worth the wait to me. I'll be all right in the meantime.The biggest issue is the E.D. and usually Viagra makes that go much better. I'll probably ask about tri mix as well, as I hate the Viagra sides (headache and stuffy nose).
    But I really thank all of you, this has to be one of the most helpful forums I have been on, and I have been lurking here for a year.

    EAH

  19. #18
    Member FeelingLost's Avatar
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    Quote Originally Posted by EAH View Post
    So I did get rescheduled and the earliest available was Dec 26th. Seems like worth the wait to me. I'll be all right in the meantime.The biggest issue is the E.D. and usually Viagra makes that go much better. I'll probably ask about tri mix as well, as I hate the Viagra sides (headache and stuffy nose).
    But I really thank all of you, this has to be one of the most helpful forums I have been on, and I have been lurking here for a year.

    EAH
    That is great to here. There is still lots you can do to help getting your brain and body back in shape.

    What supplements are you taking?
    I will recommend DHEA 50 mg/day PURE is a very good brand.
    CoQ10 120mg/day
    Omega 3 fish oil 3000-4000 mg /day

    Investigate Gene's NO stack. I have been on his stack for a little over 2 months and to be hones it has helped my ED and libido more than 11 months of TRT.
    Since you have a possible heart problem do research the drugs and supplements to make sure they don't react with something you are taking now.

    hth and I really hope Dr Saya can help you out. I've been a Defy patient for 7 months and although my TRT has been very slow to work working with one of their doctors I have dropped my A1c from 6.4 to 5.5. I have lost 18# and I am now exersizing 6 days a week 4 days at a gym and 3 day mtn bike riding.
    Last edited by FeelingLost; 12-06-2017 at 12:55 PM.

  20. #19
    Sound like you have made some great progress.
    My wife and I work out in the gym 5 days a week, 3 days weights and 2 days cardio and abs.
    I do take CoQ10 and omega 3 fish oil, but will have to check dosages as I just take whats on the bottle.
    I also take D3 and E, Saw Palmetto, Zinc and magnesium. Will definitely check into the DHEA and Genes NO stack.
    Thanks,

    EAH

  21. #20
    I’m in the same boat as you. My total testosterone sits anywhere between 500-750 but free test is always on the low end of normal. I also have high normal Shbg. From what I’ve read there is no really effective way in lowering shbg besides trying vitamin d. Very interested to hear how dr saya will treat you, keep us informed.

  22. #21
    Quote Originally Posted by CoastWatcher View Post
    Your free testosterone is low, very low. That's not a surprise given your SHBG value, and that may well explain some of what you're feeling. While your TSH was solid, that's not a sufficient marker to rule out the possibility of thyroid issues. Have you discussed a full thyroid panel? Free t3, free t4, reverse t3, adn both antibody tests?
    Dr. Saya has requested I get another round of testing before our consult on 12/26
    I will update then.

    Thyroxine (T4) Free, Direct, S
    Triiodothyronine,Free,Serum
    Prolactin
    Hemoglobin A1c

    Also have ordered everything for Gene's NO Stack, except for the Daxo which I am waiting to hear from my Doc on. I'm already on a Calcium channel blocker, as well as an ACE inhibitor, so I'm holding out on that until my Doc approves or not. Already have script for Tadalafil.

    Thanks all again,

    EAH

  23. #22
    The thing about type two diabetes, insulin levels will be high, raising SHBG. Yeah the SHBG is difficult to manage because it is secondary to other things. The better you do with your type two diabetes, the better other things should get. I also noted your DHEA levels could be better.

  24. #23
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    Quote Originally Posted by JPB View Post
    The thing about type two diabetes, insulin levels will be high, raising SHBG. Yeah the SHBG is difficult to manage because it is secondary to other things. The better you do with your type two diabetes, the better other things should get. I also noted your DHEA levels could be better.
    A person with Type 2 Diabetes will have increased insulin levels that decrease SHBG, not increase. Higher insulin levels is hard on the bodies organs.

  25. #24
    A good site for diabetes is www.bloodsugar101.com they claim that the ADA (american diabetes association) have their target levels too high. This means they allow much higher blood sugar than is healthy and it's assumed the reason for this is if they set the levels lower the medical system would go into overload because so many Americans are pre-diabetic. So bs101.com recommends that you keep your glucose lower than what the ADA recommends. It's all backed up by research and data. The ADA has been questioned on this numerous times and they have never responded.

  26. #25
    Quote Originally Posted by Systemlord View Post
    A person with Type 2 Diabetes will have increased insulin levels that decrease SHBG, not increase. Higher insulin levels is hard on the bodies organs.
    Yes you are correct I missed on that one.. trying to multi-task and failing!! For the original poster, the combination of type two diabetes and high SHBG, is unusual. Given that insulin levels are typically high with type two diabetes.

  27. #26
    Thanks everyone,
    I am really looking forward to finally having a real expert (Dr. Saya) on my team that can work out these issues. I waited far too long with Dr.'s who only looked at the numbers and said you're okay, regardless of my symptoms. Never even checked my Testosterone til I demanded it, and then didn't check estradiol, or most of the other things that should have been checked. It may be a long road ahead still, but I am already relieved that I found this forum & finally stood up for myself. I will give an update after my consult on 12/26.

    EAH

  28. #27
    Quote Originally Posted by EAH View Post
    Thanks everyone,
    I am really looking forward to finally having a real expert (Dr. Saya) on my team that can work out these issues. I waited far too long with Dr.'s who only looked at the numbers and said you're okay, regardless of my symptoms. Never even checked my Testosterone til I demanded it, and then didn't check estradiol, or most of the other things that should have been checked. It may be a long road ahead still, but I am already relieved that I found this forum & finally stood up for myself. I will give an update after my consult on 12/26.

    EAH
    You aren't the first man who came to Excelmale after having been for a ride on the road to physician-induced frustration. You're on a path that should lead to far better health. We look forward to hearing your progress.
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

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