Second Test(Full Panel) Update. High SBHG and Estradiol

first test:https://www.excelmale.com/forum/sho...Free-Testosterone-Guidance-Needed-Appreciated
Not sure where to go from here. I am glad my total isn't crazy low, but it appears all my free is getting eaten up by SHBG and? Estradiol. How do I lower these to free up my free testosterone? Does anything else in the lab stand out? FSH? Prostate serum? Perhaps Ive had this imbalance most of my life that attributed to my pubertal gyno and difficulty staying lean.

This test was taken at 7:30am fasted from 7 the night before. My first test for reference was taken in the early afternoon.

Help with what to do next is greatly appreciated.

SHBG Is what it is, you have to play it where it lies, it can't be directly manipulated. I think you otherwise have excellent natural numbers, you're spot on with the Free T though and SHBG.

Thanks for the reply. So you're saying there's nothing I can do? I believe I have symptoms related to my low free T. What about my Estradiol?

36 isn't high inspite of what the lab states, there's no DR or scientist that has made the determination that 35 is a cutoff. Lab ranges are only representative of the population the lab tests, that's it. I wouldn't imagine with those numbers that any competent Dr would start you on TRT. Though in Jay Campbells book he mentions stinging nettle root for SHBG but that's pretty well an old wives tail as if you could change SHBG then every one would be doing it. And no one is.

So you're saying I just have to accept my low free t level? That's a bummer. Im glad I don't have to do TRT, I just thought there would be a solution to lower my estrogen/sbhg to raise my free t.

I can think of one Dr might be Dr Saya/Defy that might consider treating your Free T and related low Free T symptoms with TRT though your first set of labs were quite a bit lower. Defy is a site sponsor, would be an easy call to ask.

What about trying a low dose AI to lower estradiol a bit and see if it frees up available T and improves how I feel? I cant find concrete data on doing that though.

Seeing conflicting info online whether I could possibly use a serm or AI to help lower estradiol/sbhg

What is your protocol? How often do you inject? Did you do your labs just before your next injection?

I don’t inject and not on a protocol. I got bloods taken after experiencing low t symptoms the last few years. I have low free T and high(?) estradiol/sbhg

Hot Wings said:

Thanks for the reply. So you're saying there's nothing I can do? I believe I have symptoms related to my low free T. What about my Estradiol?

Click to expand...

What sysmpoms are you experiencing?

Pubertal gyno(not too bad). Through my 20s I always thought it was extremely difficult to gain strength and stay not fat. I was pretty religious with a solid(not perfect) diet and lifting at least 4x a week in my mid 20s. At my best I was around 210 12-14% BF. Seasonal depression especially 24 onwards. Last few years it’s gotten worse with my brain fog/lack of drive/rare morning wood/extremely decreased sex drive. I don’t have a problem getting/staying hard though. Currently in a rut of almost a year with no consistent gym schedule besides badminton 2x a week. I’m the chubbiest/weakest I’ve been in 10 years. Just turned 30. I also haven’t had any alcohol since NYE so the tests I took I had gone weeks with no booze so I feel like my estradiol/low free T isn’t a byproduct of alcohol. Im about to finish a tech degree and have been in a new role for about a year making more money than ever. This should be the best part of my life thus far but unfortunately my body/mind aren’t agreeing.

In case anyone is still interested in my thread, I had my consultation with Defy this morning. It went as expected and honestly I seemed to know most of what he was explaining already when we went through my blood tests. I attribute that to all I’ve learned on this forum and a couple other sites. Thanks to everyone who shared in this thread.
The only thing that came as a surprise is he recommended I go on a thyroid medication to raise free T3 levels. I’m currently at 3.0 pg/mL range 2.0 - 4.4
We agreed to wait until I start Testosterone so I have a baseline of how I feel instead of starting both at once. I also wanted to research on my own since I know thyroid meds are not something to mess around with.
Another thing is he said even though my estradiol is at 36.8 pg/mL, I could still be experiencing symptoms of low estradiol since I have a high SHBG that binds it just as it does testosterone. Regardless, he recommends .125 AI twice a week and if I start experiencing high E2 side effects to take 3 or 4 doses per week.
Overall my starting protocol is 160 mg of Testosterone a week split into 2 injections every 3.5 days + 1000 iu HCG and .125 AI twice a week(more if needed.)
I asked about taking one large dose of Test once a week to drive down SHBG, but he still said to do twice a week.
If anyone has any thoughts or input to about anything please share. I feel nervous and excited at the same time. Hoping this ends up a positive in my life going forward.

Based on your symptoms if it was me knowing what I know now I would have a complete thyroid panel done. Hypothyroidism and low testosterone symptoms are very much identical. Here is a good link from a thyroid expert:

https://www.restartmed.com/thyroid-symptoms-men/

Too many of us think healthy T levels is the ticket. It’s very very important for optimizing our health and quality of life but without optimal thyroid levels, the symptoms are not going to change. Took me 3 years to discover that. Good luck!

Thanks for the input. My T3 and T4 levels came back in the top 50% of the reference range, which is good according to that article you posted. My TSH came back twice at 1.65 and 1.69 with goal being <2.0 also according to that article. I don’t have a reverse T3/T4 test though. I will add those to my 90 day blood test.

Can you share more of your experience? Are you on both TRT and Thyroid medicine now. What Thyroid test showed you had hypothyroidism?

Hot Wings said:

he recommended I go on a thyroid medication to raise free T3 levels. I’m currently at 3.0 pg/mL range 2.0 - 4.4

My T3 and T4 levels came back in the top 50% of the reference range

Click to expand...

Not sure how you calculated that, your FT3 is lower than 50% and even if it was, it's still too low which is why they want to increase your T3 to a number they know is optimal. For them to fully understand your thyroid (as mentioned) you will need RT3 and Ferritin and FT4 and antibodies labs. This is a good example of Defy knowing how to improve your well-being. They know increasing your FT3 will make you feel better. The average MD doesn't understand that, they only look at ranges the way you do and make the assumption you are normal.

ratbag said:

Not sure how you calculated that, your FT3 is lower than 50% and even if it was, it's still too low which is why they want to increase your T3 to a number they know is optimal. For them to fully understand your thyroid (as mentioned) you will need RT3 and Ferritin and FT4 and antibodies labs. This is a good example of Defy knowing how to improve your well-being. They know increasing your FT3 will make you feel better. The average MD doesn't understand that, they only look at ranges the way you do and make the assumption you are normal.

Click to expand...

Dang, you're totally right. I was doing the math as if it was 2.0-3.4 instead of 4.4. Wow, I think I had that in my mind when the Dr first told me I had low T3. I feel dumb now. Thanks for pointing that out.

Ive read it should be in the top 50-75% of the range. If that's the case I should be at least 3.2 or 3.8 respectively.

Are you on T3 medication? cost/side effects?

Thanks

Don't start looking for a number. Everyone responds differently. I'm on T3 and I found keeping it at the very top of range makes me feel best. Again everyone is different. One of the most import questions your MD will ask you upon each visit is: How do you feel? It's a critical question. Here is a link to a video that best explains why increasing T3 levels higher than average is beneficial.

https://www.youtube.com/watch?v=XEB_rGOWsGU

ratbag said:

Don't start looking for a number. Everyone responds differently. I'm on T3 and I found keeping it at the very top of range makes me feel best. Again everyone is different. One of the most import questions your MD will ask you upon each visit is: How do you feel? It's a critical question. Here is a link to a video that best explains why increasing T3 levels higher than average is beneficial.

https://www.youtube.com/watch?v=XEB_rGOWsGU

Click to expand...

Thanks. What is your T3 at if you don't mind sharing? Also, how much is the cost of the medicine? You need a prescription?

I use a different lab than you and I'm in Canada so there is nothing to be compared with labs or costs. But it is the very top of the range. In your case that would be 4.4 My MD does Rx it yes.