Bloodwork - 32 yo - help please!

[MOT192]

Hi all - just came across this community - thankfully, as I am trying to interpret my latest bloodwork/quite a confusing appointment at a TRT clinic in UK. Figures are below:



FSH: 1.7 IU/L (range: 1.0 - 12.0)

LH: 0.8 IU/L (range: 0.6 - 12.1)

Oestradiol: 56.0 pmol/L (range: 40-161)

SHBG: 49.5 nmol/L (range: 14-72)

Total Testosterone: 24.47 nmol/L (equates to 706 ng/dl) (range: 8.3 - 30.2 nmol/L)

Free Test: 0.423 nmol/L , 1.73% (equates to 12.2 ng/dl)



TSH: 2.012 mIU/L (range: 0.35 - 4.94)



All other results came back in normal range - happy to provide other figures if useful.



Symptoms: very low libido, poor mood, irritability, significant fatigue, no facial hair



Doctor thought my high SHBG was killing my free test total and, given the other figures, that this low free T was the cause of my symptoms. He recommended Clomid (given it avoids the infertility side-effects of Nebido), but said it doesn't work with 50% of people. As a "back-up option", in the event that Clomid doesn't work for me, Dr suggested freezing my sperm and trying Nebido.



I am a relative newbie to this discussion, but would really appreciate the thoughts of others. Many thanks!

 

[Cataceous]

In my experience it's uncommon for testosterone to be the primary issue when calculated free testosterone is over 10 ng/dL. I would avoid conventional TRT if at all possible. Clomid is problematic for guys starting with high SHBG because it tends to raise it further, sometimes limiting gains in free testosterone. If you could get enclomiphene instead then it would be a better option. However, I think the best option is a trial with Natesto or an equivalent generic product. The testosterone nasal gels can give you a boost without disrupting other hormones, which is what happens with regular TRT. If you saw substantial improvements with Natesto then it would provide evidence that you need more testosterone. Otherwise it could be an indication to look at other things, such as thyroid hormones, neurotransmitters, etc.

Have you had most of these tests?:

Few Common Tests That Men Pull - Peak Testosterone

Two very common questions I get on my forum are "If I suspect low testosterone, what tests should I get?"and "What testosterone tests will my doctor likely order?"

www.peaktestosterone.com

I would add progesterone to the list to test in advance. I believe low levels of this hormone may contribute to irritability. High serotonin combined with low testosterone is another possible cause.

 

[madman]

Hi all - just came across this community - thankfully, as I am trying to interpret my latest bloodwork/quite a confusing appointment at a TRT clinic in UK. Figures are below:



FSH: 1.7 IU/L (range: 1.0 - 12.0)

LH: 0.8 IU/L (range: 0.6 - 12.1)

Oestradiol: 56.0 pmol/L (range: 40-161)

SHBG: 49.5 nmol/L (range: 14-72)

Total Testosterone: 24.47 nmol/L (equates to 706 ng/dl) (range: 8.3 - 30.2 nmol/L)

Free Test: 0.423 nmol/L , 1.73% (equates to 12.2 ng/dl)



TSH: 2.012 mIU/L (range: 0.35 - 4.94)



All other results came back in normal range - happy to provide other figures if useful.



Symptoms: very low libido, poor mood, irritability, significant fatigue, no facial hair



Doctor thought my high SHBG was killing my free test total and, given the other figures, that this low free T was the cause of my symptoms. He recommended Clomid (given it avoids the infertility side-effects of Nebido), but said it doesn't work with 50% of people. As a "back-up option", in the event that Clomid doesn't work for me, Dr suggested freezing my sperm and trying Nebido.



I am a relative newbie to this discussion, but would really appreciate the thoughts of others. Many thanks!

I would definitely look into retesting your FT using one of the most accurate assays (ED or UF) especially seeing as you have high SHBG!

post #2

Advice/help for high shbg guy - Excel Male Men's Health Forum

Any guys here with normal total t and high shbg (pre trt) that could give me some advice please? Had blood tests done 4 time over the last year. Each time everything was right where it needed to be axcpet for my shbg. Total t has been 620-743. Shbg has been 56-75. Putting my free t between 9.1...

www.excelmale.com