Chronically high SHBG and low free test (not on trt)

[skiandmtbdirtbag]

I posted this else where ,so I apologise if you have read this before, but I didn't really get any clear answersL
I am hoping someone can shed some light on my current situation:

40 year old male, 5'10, 180 lbs

Symptoms: Low energy, zero libido, poor recovery from exercise, fatigue

Lifestyle: Don't drink, don't smoke, eat 40% carbs, 30% fat and 30% protein and 3000-4000 calories a day depending on energy expenditure on given day. Lift weights 3 times a week, cardio approx 8 hours a week. Sleep hygiene is good and no sleep apnea.

After having low T symptoms for the last 2 years and always getting good total T numbers around 20 nmol/l (ref 10-35) I went to the states (live in canada) to pay for a free testosterone test. Results were:

Total test : 596 ng/dl (ref 250-897)

Free test: 45.8 pg/ml (ref 46-224)

SHBG: 67 (ref 10-50 nmol/l)

I spent the next 4 weeks trying the following: Boron 9mg a day, increase carbs and calories, reduce exersize, stinging nettle root. I retested and had the exact same results

All other blood markers are normal (TSH, T3 and T4, lipid, liver, LH and FSH, A1C)

The only other issue is I for some reason have high BP, and was just diagnosed with WPW, waiting on cardiologist referral. I should be the poster boy for low bp

I have a trt clinic ready to script me as I know that exogenous test will lower SHBG, but want to make sure I have not missed anything. I have spoken to one doc who says technically she cannot script me as Canada only looks at total, and one doc at the trt clinic that says it's the answer.

Any ideas ?

 

[madman]

I posted this else where ,so I apologise if you have read this before, but I didn't really get any clear answersL
I am hoping someone can shed some light on my current situation:

40 year old male, 5'10, 180 lbs

Symptoms: Low energy, zero libido, poor recovery from exercise, fatigue

Lifestyle: Don't drink, don't smoke, eat 40% carbs, 30% fat and 30% protein and 3000-4000 calories a day depending on energy expenditure on given day. Lift weights 3 times a week, cardio approx 8 hours a week. Sleep hygiene is good and no sleep apnea.

After having low T symptoms for the last 2 years and always getting good total T numbers around 20 nmol/l (ref 10-35) I went to the states (live in canada) to pay for a free testosterone test. Results were:

Total test : 596 ng/dl (ref 250-897)

Free test: 45.8 pg/ml (ref 46-224)

SHBG: 67 (ref 10-50 nmol/l)

I spent the next 4 weeks trying the following: Boron 9mg a day, increase carbs and calories, reduce exersize, stinging nettle root. I retested and had the exact same results

All other blood markers are normal (TSH, T3 and T4, lipid, liver, LH and FSH, A1C)

The only other issue is I for some reason have high BP, and was just diagnosed with WPW, waiting on cardiologist referral. I should be the poster boy for low bp

I have a trt clinic ready to script me as I know that exogenous test will lower SHBG, but want to make sure I have not missed anything. I have spoken to one doc who says technically she cannot script me as Canada only looks at total, and one doc at the trt clinic that says it's the answer.

Any ideas ?

Would not jump the gun just yet!

What assays/lab was used?

 

[skiandmtbdirtbag]

Quest, not sure of assay.

 

[madman]

Quest, not sure of assay.

No need I found it.

Quest Diagnostics: Test Directory

testdirectory.questdiagnostics.com

Includes

• Testosterone, Total, Males (Adult), Immunoassay
• Albumin
• Sex Hormone Binding Globulin (SHBG)
• Testosterone, Free and Bioavailable (calculated)

Unfortunately, you wasted a trip to the US as you had your FT tested using the calculated method which is the same one used here in Canada.

Let alone your TT was not even tested using the most accurate assay (LC/MS-MS).

Hate to burst your bubble here but the only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG.

If anything you should have ordered this test through Nelson's discounted labs:

Search result for: 'testosterone-free-dialysis-and-total-ls-ms-ms'

www.discountedlabs.com

Or you would have the option of purchasing tests through LabCorp.

Whether using Quest Diagnostics or Labcorp when it comes to testing FT any one of these would suffice.


1. 500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp
Methodology: Testosterone: high-pressure liquid chromatography (HPLC)/tandem mass spectrometry; free testosterone: equilibrium dialysis


2. 070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp
Methodology: Free: equilibrium ultrafiltration; total: liquid chromatography/tandem mass spectrometry (LC/MS-MS)


3. Testosterone, Total, LC/MS and Free (Equilibrium Dialysis)
Methodology: Free: equilibrium dialysis; total: liquid chromatography/tandem mass spectrometry (LC/MS-MS)

 

[skiandmtbdirtbag]

Terrific, thank you for the information.

No need I found it.

Quest Diagnostics: Test Directory

testdirectory.questdiagnostics.com

Unfortunately, you wasted a trip to the US as you had your FT tested using the calculated method which is the same one used here in Canada.

Let alone your TT was not even tested using the most accurate assay (LC/MS-MS).

Hate to burst your bubble here but the only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG.

If anything you should have ordered this test through Nelson's discounted labs:

Search result for: 'testosterone-free-dialysis-and-total-ls-ms-ms'

www.discountedlabs.com

Or you would have the option of purchasing tests through LabCorp.

Whether using Quest Diagnostics or Labcorp when it comes to testing FT any one of these would suffice.


1. 500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp
Methodology: Testosterone: high-pressure liquid chromatography (HPLC)/tandem mass spectrometry; free testosterone: equilibrium dialysis


2. 070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp
Methodology: Free: equilibrium ultrafiltration; total: liquid chromatography/tandem mass spectrometry (LC/MS-MS)


3. Testosterone, Total, LC/MS and Free (Equilibrium Dialysis)
Methodology: Free: equilibrium dialysis; total: liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Awesome, thank you for the information. What would be your advice if I am to do this test and get the same under reference free testosterone?

 

[madman]

Terrific, thank you for the information.

Awesome, thank you for the information. What would be your advice if I am to do this test and get the same under reference free testosterone?

I would be getting full blood work done let alone using the most accurate assays when it comes to testing TT/FT/estradiol/DHT let alone using the same lab/same assays (most accurate).

TT, FT, estradiol, SHBG, DHT, prolactin, DHEA, LH/FSH, PSA, full thyroid panel, 4 point cortisol, VIT D, lipids, CMP, CBC.

Critical that blood work is done in a fasted state in the early am as we always want to test at peak (highest point) during the 24hr circadian rhythm.

If your FT levels are truly low/low normal and you are experiencing low-T symptoms then you can look into TRT or other options such as Natesto, enclomiphene, hCG mono.

Keep in mind that dysfunctional thyroid/adrenals can easily mimic low-T symptoms.

 

[skiandmtbdirtbag]

I would be getting full blood work done let alone using the most accurate assays when it comes to testing TT/FT/estradiol/DHT let alone using the same lab/same assays (most accurate).

TT, FT, estradiol, SHBG, DHT, prolactin, DHEA, LH/FSH, PSA, full thyroid panel, 4 point cortisol, VIT D, lipids, CMP, CBC.

Critical that blood work is done in a fasted state in the early am as we always want to test at peak (highest point) during the 24hr circadian rhythm.

If your FT levels are truly low/low normal and you are experiencing low-T symptoms then you can look into TRT or other options such as Natesto, enclomiphene, hCG mono.

Keep in mind that dysfunctional thyroid/adrenals can easily mimic low-T symptoms.

All those bar Vit D have been tested and are in range, I take 3000IU of Vit D daily so I would think that would be ok. TSH, T3 and T4 are all in range. LH is generally around 2.5-3 and FSH 5. Cortisol is all perfect. Thanks for the info man

 

[Vince]

I posted this else where ,so I apologise if you have read this before, but I didn't really get any clear answersL
I am hoping someone can shed some light on my current situation:

40 year old male, 5'10, 180 lbs

Symptoms: Low energy, zero libido, poor recovery from exercise, fatigue

Lifestyle: Don't drink, don't smoke, eat 40% carbs, 30% fat and 30% protein and 3000-4000 calories a day depending on energy expenditure on given day. Lift weights 3 times a week, cardio approx 8 hours a week. Sleep hygiene is good and no sleep apnea.

After having low T symptoms for the last 2 years and always getting good total T numbers around 20 nmol/l (ref 10-35) I went to the states (live in canada) to pay for a free testosterone test. Results were:

Total test : 596 ng/dl (ref 250-897)

Free test: 45.8 pg/ml (ref 46-224)

SHBG: 67 (ref 10-50 nmol/l)

I spent the next 4 weeks trying the following: Boron 9mg a day, increase carbs and calories, reduce exersize, stinging nettle root. I retested and had the exact same results

All other blood markers are normal (TSH, T3 and T4, lipid, liver, LH and FSH, A1C)

The only other issue is I for some reason have high BP, and was just diagnosed with WPW, waiting on cardiologist referral. I should be the poster boy for low bp

I have a trt clinic ready to script me as I know that exogenous test will lower SHBG, but want to make sure I have not missed anything. I have spoken to one doc who says technically she cannot script me as Canada only looks at total, and one doc at the trt clinic that says it's the answer.

Any ideas ?

How to lower your sex hormone binding globulin - Excel Male TRT Forum

This is part II of: Role of Estradiol and Sex Hormone Binding Globulin in Men HOW TO TREAT ELEVATED SHBG 1.Remove any of the agents or treat the condition, which lead to elevated SHBG. In some cases it may be difficult to identify the cause of elevated SHBG. 2.Use anti-aromatase meds such...

www.excelmale.com

@Mark Saur

One supplement I found that knocks down SHBG is Life Extension Mens Ultra Prostate formula! Mine had been running 50 and now 30. Highly recommend it and is good for prostate health-flow.

 

[Match]

OK. But since the specific purpose of this supplement is prostate-related and not to reduce SHBG, would there be problems? SHBG here 62 nmol/l

 

[Turbokox]

Any updates in your story?