1. #1

    Dutch 23M, Low Test, Low SHBG, High TSH

    Hi,

    About a year ago, May 2017, I finally decided to get my Testosterone levels measured after years of suffering and working out hard because I was semi-depressed, minimal progress in the gym, hard time concentrating/couldn't focus, no morning erections, little energy beyond school.

    I got general blood work done back then:

    My test level was 11.4 nmol/l on a range of 9-35.
    The rest of the bloodwork can be seen here:
    The only remark the GP had was that my vitamin D was low. When I asked her to refer me to an endo, she didn't want to because she thought I was fine. Her literal words were "Well, maybe if you were are 2 nmol/l I would refer you."

    A month later I got tested again:
    T = 12.4 nmol/l
    Vit D = 59

    For me, this explained a lot. I felt validated in that I had "bad genetics", and that my bad progress in the gym had nothing to do with my work ethic or my failings as a person. However, I had nowhere to go, as my GP didn't refer me to an endo. I was sulking about really hard, until I broke and talked with my dad about this. Via pulling some strings, he managed to get me a reference to an endo.

    September 2017:
    At the endo's I got more extensive blood work, that can be seen here:
    T at 12.8 nmol/l. However, endo also thought I was perfectly fine. He pointed out that my LDL and HDL were bad but that that probably has a strong genetic component (which is true, my dad has the same thing). He was also concerned about the prolactin levels I had, which he couldn't explain. He put me on 1mg Cabergoline/week for 3 months, then retest bloods after a month.

    February 2018:
    A couple months in I did my own blood testing (so while ON cabergoline treatment):

    I did my own blood testing because apparently doctors refuse to measure free testosterone. Complete suppression of prolactin likely increased my testosterone levels. Note that the estrogen measurement is not sensitive (they don't have this here). I was under the impression my test levels weren't that bad because of my relatively high bio-available test. Note that the ratio of bound (to SHBG) and bioavailable test is about 40:60 (for most its the reverse, 60:40). If I had first presented with these values, I probably would not have pressured further. I didn't feel much better on caber, but I got some strength gains, and people said I looked a bit bigger than normal. There were 2 days over those three months were I had raging erections.

    Early April 2018:
    A month after the caber, I got a blood test at my GP to bring to my endo to hasten the process, this can be seen here: . First time that I got more interesting thyroid values.
    Prolactin still very, very low, likely because there were still remainders of cabergoline in my system. Testosterone levels already decreasing again. TSH high at 4.6.

    I showed these results to my endo, and he said he thought TSH wasn't causing my issues. Said it might be an issue if "it was at 40 or something". Said he couldn't help me more and referred me to an andrologist/urologist (because of erectile dysfunction).

    After this went to my GP to talk about my TSH values, got the same result: "I don't really agree with the reference range used in this bloodwork, I personally maintain a reference range of ~0-10". She was willing enough to test for Hashimoto antibodies (runs in the family). My dad has no eyebrows.

    At this point I thought this was now more of a hypothyroidism issue rather than a testosterone issue. After more recent reading I have changed my viewpoint:
    my low SHBG isn't a good thing at all, despite it making my bio-available T look good. If I had higher SHBG it is likely that I would have corresponding higher T (something we saw while on cabergoline treatment - both SHBG and total T were higher). My high TSH might indicate a hypothyroidism issue which is known to lower SHBG.

    My fail-safe, if the healthcare system wouldn't help me, was that I could always start self-prescribing UGL test, despite all the difficulties that brings with it (quality control, limited international mobility, out of pocket blood tests/steroids). Now, with SHBG on the low-end, that doesn't seem like much of an option anymore either.

    Where I am at now is that I am overhauling my diet to attempt to resolve hypothyroidism and increase SHBG as much as possible:
    • Cutting Diary intake in half (drank 2l of milk, 1l of quark for YEARS; likely too much iodine intake)
    • Increasing fiber intake significantly (didn't eat enough veggies)
    • Minimizing high GI carbs, trying to control insulin as efficiently as possible


    However, I am skeptical about this resolving my issues. There are plenty of people who eat way worse than I do with perfectly fine test levels.

    TL: DR
    Low Test Symptoms:
    • low test values (currently 14.8 nmol/l, likely dropping as prolactin increases), likely as a result of SHBG (currently 16 nmol/l)
    • no morning wood, no spontaneous erections
    • fatigue
    • brain fog
    • no energy
    • little muscle-building/strength-building capacity (150kg Squat, 145kg Bench, 180kg Deadlift after 5+ years of training). Barely look like I lift.

    Hypo Symptoms:

    • Outside Eyebrow loss
    • High TSH values (4.6)
    • Low body temps in the morning
    • brain fog
    • fatigue
    • Father has no eyebrows at all and even higher TSH. Aunt/grandma both have Hashimoto's (all on my father's side).

  2. # ADS
    Purchase From Our Affiliates
    Join Date
    Always
    Posts
    51
    Help Excelmale

    Defy
     

  3. #2
    Junior Member
    Join Date
    Apr 2018
    Posts
    5
    I will post the links to the bloodwork later as I'm not allowed to do that yet.
    Note that this is a rather extensive introduction, but I want to be able to refer back to it in later posts so I don't have to keep retyping everything.

    I want to say that my current situation feels somewhat like a nightmare:
    For years I have been semi-depressed, unmotivated, bad at lifting, and I always entirely held myself accountable. Then it turns out it is likely that it is all a result of Low T. THEN it turns out that injecting T is also going to be more difficult due to low SHBG. I'm honestly in quite a dark spot at the moment. I don't want to live like this for the rest of my life.

    Feels like I have been living a half-life up until this point. Feel like a shell of a man.

  4. #3
    Member Sean Mosher's Avatar
    Join Date
    Nov 2015
    Location
    Houston, Texas
    Posts
    454
    Where are you located?
    This will help in being able to determine the best treatment options for you.

  5. #4
    Moderator Vince's Avatar
    Join Date
    Feb 2014
    Location
    Milwaukee, WI
    Posts
    7,164
    Thyroid Function:

    The thyroid is a butterfly-shaped endocrine gland located in the lower front of the neck. It produces thyroxine or T4, which is converted to tririodothyronine, or T3. T4 production is controlled by thyroid stimulating hormone or TSH, a hormone produced by the pituitary. Hypothyroidism, or low thyroid hormone production, can cause sexual dysfunction as well as depression, fatigue, dry skin and hair, weight gain and increased sensitivity to the cold. Blood tests to measure TSH, T4 and T3 are readily available and widely used.

    The American Thyroid Association (thyroid.org) has great comprehensive information on how to determine if you have hypothyrodism that could be causing your fatigue.

    Testosterone may decrease levels of thyroxin-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.

    Once thyroid hormone blood levels have been normalized, testosterone tends to increase naturally.

    https://www.excelmale.com/content.ph...-Is-Not-Enough

    Make sure you have a complete thyroid panel with FT4, FT3 and RT3

    can cytomel by itself be used to treat hypothyroidism

    https://www.excelmale.com/showthread...hypothyroidism

    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.

  6. #5
    Junior Member
    Join Date
    Apr 2018
    Posts
    5
    Quote Originally Posted by Sean Mosher View Post
    Where are you located?
    This will help in being able to determine the best treatment options for you.
    I live in the Netherlands. The concept of Men's Health clinics barely exists here. I know of exactly one; an acquaintance of mine went to them because he had similar issues - he returned with the info that they would not treat someone of my age or test levels. Saved me a couple hundred bucks.
    Quote Originally Posted by Vince View Post
    Thyroid Function:

    The thyroid is a butterfly-shaped endocrine gland located in the lower front of the neck. It produces thyroxine or T4, which is converted to tririodothyronine, or T3. T4 production is controlled by thyroid stimulating hormone or TSH, a hormone produced by the pituitary. Hypothyroidism, or low thyroid hormone production, can cause sexual dysfunction as well as depression, fatigue, dry skin and hair, weight gain and increased sensitivity to the cold. Blood tests to measure TSH, T4 and T3 are readily available and widely used.

    The American Thyroid Association (thyroid.org) has great comprehensive information on how to determine if you have hypothyrodism that could be causing your fatigue.

    Testosterone may decrease levels of thyroxin-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.



    Once thyroid hormone blood levels have been normalized, testosterone tends to increase naturally.


    Make sure you have a complete thyroid panel with FT4, FT3 and RT3

    can cytomel by itself be used to treat hypothyroidism



    I will have to order the RT3 test at some point because doctors simply refuse to get it. It is rather expensive however.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. New to TRT. Low SHBG, High rT3/TSH
    By mrhat75 in forum Blood Test Discussion
    Replies: 23
    Last Post: 04-29-2018, 03:01 AM
  2. Blood Results: High SHBG, High Prolactin, Low Free T, Low E2
    By goodforwut in forum Blood Test Discussion
    Replies: 3
    Last Post: 09-26-2017, 12:53 PM
  3. Blood results: Low T, Low SHBG, High Prolactin, E2 not sure?
    By teep in forum Blood Test Discussion
    Replies: 8
    Last Post: 08-04-2017, 10:18 AM
  4. Normal T, low free T, low E2, High SHBG. Saw Palmetto?
    By lookingforhelp in forum Testosterone Basics & Questions
    Replies: 10
    Last Post: 06-26-2016, 07:32 AM
  5. Replies: 5
    Last Post: 11-20-2015, 09:32 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •