high SHBG ? quite high total Test

[vladx]

Hi Experts,

I ran a blood test back in Aug 2021, my free test was stupidly low 2.61 ng/ml, and a very high shbg 77.5 nmol/l
E2 was quite low too.

T3,T4, LH, all normal.

I decided to find a way to increase my total test (didnt think about how to lower shbg :/) and found these 2 herbs tongat and fadogia agrestis, took it for a few months and retested last week.

Total Test was a woping 13.5 ng/ml .... however SHBG still 70nmol/l , meaning my free test is still quite shitty.

So seems clear that these herbs do work...but my question is now... what to do to lower shbg...?
I did take boron, I take vit D, and mag/zinc on a regular basis... but not feeling the greatest and seems related to this mega high SHBG...

Any tested/verified suggestions ?

I just bought some liquid Nettle... hopefully it will bind/inhibit it?

Any thoughts , much appreciated

Regards,
Vlad

 

[Nelson Vergel]

Total Test was a woping 13.5 ng/ml .... however SHBG still 70nmol/l , meaning my free test is still quite shitty.

Not necessarily. Your SHBG stayed the same and your T went up, so your free T should be up. Why did you not test it?

 

[vladx]

last time I tested Free it was quite off, as someone here advised that in Europe the labs my not be doing a good job on it (Im in Germany)
... actually in the first blood test -while Total was 2.61 , shbg at 77.5 , free was showing 13.73pg/ml which made 0 sense.

So I tried to used the online calculator that counts for total test/shbg/albumin

Free & Bioavailable Testosterone calculator

I figured that first blood draw was a bit too low, but consistent with how I was feeling...
So even if it was 2x higher, it would still be average at best....

I havent used anything else but these 2 supplements (which I did hear could produce this type of 4x raise for guys coming from the low value).

But assuming normal albumin levels ... even at this hight total, I should still be very low in free, isnt it? :/

 

[Systemlord]

what to do to lower shbg...?

High SHBG may be a direct result of low-T.

 

[Cataceous]

last time I tested Free it was quite off, as someone here advised that in Europe the labs my not be doing a good job on it (Im in Germany)
...

If the test method is not equilibrium dialysis or ultrafiltration then you are better off using the calculators.

...
But assuming normal albumin levels ... even at this hight total, I should still be very low in free, isnt it? :/

This isn't the case. The Vermeulen calculator you mentioned now puts your free testosterone at 21 ng/dL, which is quite robust considering the reference range is about 8-23. For further comparison, the Tru-T calculator puts free testosterone at 45 ng/dL, with a healthy normal range of 16-31. That's a remarkable increase if accurate, and suggests there's little chance you're currently hypogonadal. Quite the contrary, with free testosterone apparently now in the top few percent even among young men.

...
So seems clear that these herbs do work...but my question is now... what to do to lower shbg...?
...

Even if you needed to raise free testosterone, the newer thinking is that changing SHBG in isolation does not affect free testosterone. Rather, if you lower SHBG it simply pushes down total testosterone. The fact that SHBG dropped only 10% with such as big increase in testosterone does suggest it's fairly intractable in your case. Fortunately high SHBG with normal free testosterone may not be much of a problem.

 

[vladx]

If the test method is not equilibrium dialysis or ultrafiltration then you are better off using the calculators.

This isn't the case. The Vermeulen calculator you mentioned now puts your free testosterone at 21 ng/dL, which is quite robust considering the reference range is about 8-23. For further comparison, the Tru-T calculator puts free testosterone at 45 ng/dL, with a healthy normal range of 16-31. That's a remarkable increase if accurate, and suggests there's little chance you're currently hypogonadal. Quite the contrary, with free testosterone apparently now in the top few percent even among young men.

Even if you needed to raise free testosterone, the newer thinking is that changing SHBG in isolation does not affect free testosterone. Rather, if you lower SHBG it simply pushes down total testosterone. The fact that SHBG dropped only 10% with such as big increase in testosterone does suggest it's fairly intractable in your case. Fortunately high SHBG with normal free testosterone may not be much of a problem.

That helped a lot, I was calculating it wrong.

Also to clarify, I am 45y, and note that I only started with the new herbs in very end of November. so might be that SHBG is still going down, correct?

 

[Systemlord]

so might be that SHBG is still going down, correct?

It's doubtful any supplement will affect your SHBG to a significant degree.

 

[vladx]

It's doubtful any supplement will affect your SHBG to a significant degree.

I read studies on this Nettle that blocks SHBG effect.
Also what I meant is now that my total test seemed to have recovered, would that in time help bring back SHBG.

SHBG wise:
I dont have any liver issues, or HIV for that I am aware .
I do take Metformin (for longevity reasons - and the fact that I eat lots of sugar), but based on this forum, it might not really be related.

 

[Cataceous]

...
Also to clarify, I am 45y, and note that I only started with the new herbs in very end of November. so might be that SHBG is still going down, correct?

That's possible, but more likely it's been long enough to reach a new equilibrium.

 

[bixt]

Even if you needed to raise free testosterone, the newer thinking is that changing SHBG in isolation does not affect free testosterone.

I agree. Body will reduce total T to compensate so that free T remains the same. Unless of course some lifestyle intervention also takes place such that the brain now wants a new setpoint (think thermostat setting for T).

Do you think this is because the brain only measures or "sees" free T and not total T?

 

[Cataceous]

I agree. Body will reduce total T to compensate so that free T remains the same. Unless of course some lifestyle intervention also takes place such that the brain now wants a new setpoint (think thermostat setting for T).

Do you think this is because the brain only measures or "sees" free T and not total T?

With a normal HPTA, the body is regulating testosterone production according to free testosterone, both directly at the hypothalamus and indirectly via estradiol at the hypothalamus and pituitary. However, this is not the only reason for SHBG's lack of influence on free testosterone. The same thing should be observed in guys on TRT who have no endogenous regulation of free testosterone. The reason why SHBG doesn't affect free testosterone at steady state is because testosterone is basically used up in direct proportion to the amount of free testosterone. This in turn implies that free testosterone must be proportional to the rate of testosterone production—or to the dose rate for those on TRT. Therefore free testosterone is essentially independent of SHBG.

It is true that if the body were regulating the level of total testosterone then we would have the situation predicted by conventional wisdom, in which forcing down SHBG would raise free testosterone. But this is not the case in normal physiology.

 

[vladx]

With a normal HPTA, the body is regulating testosterone production according to free testosterone, both directly at the hypothalamus and indirectly via estradiol at the hypothalamus and pituitary. However, this is not the only reason for SHBG's lack of influence on free testosterone. The same thing should be observed in guys on TRT who have no endogenous regulation of free testosterone. The reason why SHBG doesn't affect free testosterone at steady state is because testosterone is basically used up in direct proportion to the amount of free testosterone. This in turn implies that free testosterone must be proportional to the rate of testosterone production—or to the dose rate for those on TRT. Therefore free testosterone is essentially independent of SHBG.

It is true that if the body were regulating the level of total testosterone then we would have the situation predicted by conventional wisdom, in which forcing down SHBG would raise free testosterone. But this is not the case in normal physiology.

You lost me never heard about free test being independent of shbg

 

[Systemlord]

You lost me never heard about free test being independent of shbg

You want to use the Equilibrium Dialysis or Ultrafiltration method.

 

[Match]

With a normal HPTA, the body is regulating testosterone production according to free testosterone, both directly at the hypothalamus and indirectly via estradiol at the hypothalamus and pituitary. However, this is not the only reason for SHBG's lack of influence on free testosterone. The same thing should be observed in guys on TRT who have no endogenous regulation of free testosterone. The reason why SHBG doesn't affect free testosterone at steady state is because testosterone is basically used up in direct proportion to the amount of free testosterone. This in turn implies that free testosterone must be proportional to the rate of testosterone production—or to the dose rate for those on TRT. Therefore free testosterone is essentially independent of SHBG.

It is true that if the body were regulating the level of total testosterone then we would have the situation predicted by conventional wisdom, in which forcing down SHBG would raise free testosterone. But this is not the case in normal physiology.

As my TF is normal, even though half at the lower limits of the range - 9 ng/dl - without TRT, it means that it would not help to reduce in any way my high SHBG of 62 to increase TF, ok? It would even be the case of some direct addition in TT. (already suggested to me Natesto

 

[Systemlord]

without TRT, it means that it would not help to reduce in any way my high SHBG of 62 to increase TF, ok?

It's highly likely TRT is the only option to significantly lower your SHBG.

already suggested to me Natesto

I doubt Natesto would suppress your SHBG in the same way injections would.

 

[Cataceous]

As my TF is normal, even though half at the lower limits of the range - 9 ng/dl - without TRT, it means that it would not help to reduce in any way my high SHBG of 62 to increase TF, ok? It would even be the case of some direct addition in TT. (already suggested to me Natesto

Yes, lowering SHBG should have little effect on free testosterone. If you lower SHBG in isolation then you should see a drop in total testosterone such that free testosterone is maintained. I've seen no evidence that there's any value in this.

Think of exogenous testosterone as contributing to free testosterone, not total. This is because the testosterone is added over a period of time, as is the case with natural production. It's not as though you are instantly adding the entire dose and increasing total testosterone. Instead you are increasing the rate of testosterone entering the body, with free testosterone ending up proportional to this rate.

A testosterone nasal gel such as Natesto will increase free testosterone in pulses. It works because it's not too suppressive of natural testosterone production—so you are able to increase the rate of testosterone entering the body, and thus increase free testosterone.

 

[Match]

I understand. But I didn't want to spend it on doctor to prescribe Natesto (if you would prescribe with TT +-600) Without a prescription you can't, it seems to me

 

[Match]

It's highly likely TRT is the only option to significantly lower your SHBG.



I doubt Natesto would suppress your SHBG in the same way injections would.

It was not to suppress SHBG, but rather to add the TF