All the Signs of Low T, but Bloodwork Says Otherwise

[mryanwalker]

I'm looking for help understanding some recent bloodwork. I asked my doctor to check for low testosterone because I’ve been feeling tired, sluggish, and struggling to lose weight and gain muscle. I don’t have morning erections and have low sex drive. I feel like I have all the signs of low T, but my numbers don’t seem to reflect it.

I'm 40 years old, 6'2", 190 lbs, with around 21-22% body fat and low muscle tone. I previously tried TRT but stopped about three years ago due to severe back acne and difficulty balancing my estrogen. I’m now wondering if I was on too high a dose back then.

Here are my recent test results:

• Total Testosterone: 827
• SHBG: 56.6
• Free Test Percent: 1.56
• Free Testosterone (Calc): 129
• Bioavailable Testosterone: 323
• TSH: 3.04 mIU/L

I know my diet isn’t the best, and I probably don’t get enough protein. I’m not looking for a diagnosis here, but I’d appreciate any insights on:

1. Possible causes of elevated SHBG.
2. Additional tests I should consider asking my doctor for.

Thanks for any guidance!

 

[Systemlord]

Possible causes of elevated SHBG.

Starvation, which would increase insulin sensitivity and increase SHBG.

 

[Seagal]

1. Additional tests I should consider asking my doctor for

Thyroid hormones free T4, free T3

 

[Systemlord]

Thyroid hormones free T4, free T3

Doubtful his thyroid hormones are the problem, his liver enzymes are excellent.

 

[Seagal]

Doubtful his thyroid hormones are the problem, his liver enzymes are excellent.

Can you explain the logic of this deduction?

 

[Systemlord]

Can you explain the logic of this deduction?

People with thyroid problems tend to have abnormal liver enzymes.

 

[Seagal]

People with thyroid problems tend to have abnormal liver enzymes.

Interesting. Prevalence is 15-76%
Hyperthyroidism can increase SHBG.
Anyway, no need for speculation. I suggest testing the thyroid hormones.

Hyperthyroidism and Liver Dysfunction: A Review of a Common Comorbidity - PMC

Deranged liver enzymes due to hyperthyroidism rather than intrinsic liver pathology are not uncommon. The reported prevalence of liver biochemical abnormalities in patients with untreated thyrotoxicosis varies widely ranging from 15% to 76%. The ...

pmc.ncbi.nlm.nih.gov