High total T, high SHBG, low free T and low estradiol

[Dudley]

Hi folks,

I am a newbie, not on TRT, have never taken T or steroids, am 66 years old and have been working out since a teenager.

Just got blood tests done at Quest (thanks, Nelson, Discount Labs worked great) and got back:

T total 984
Free T 59.1
Bioavailable T 111.2
SHBG 89
Estradiol (ultrasensitive test) 24

So as you can see, my total T and SHBG are above the top of the normal range; and my free T and bioavailable are at the very bottom of the normal range; and my estradiol is below the normal range.

I would appreciate help interpreting what this means.

I love working out and am doing solidly-ok for my age, but recovery is much less good than it used to be, and I am slowly adding body fat. Being in great shape (much less adding a little lean mass) has gotten a lot harder in the last couple of years. Sex drive and everything connected to that is a lot reduced over the last couple of years.

Is there a way for me to lower my SHBG so that my Free T would be higher?

Open to advice.

Thanks.

 

[madman]

Hi folks,

I am a newbie, not on TRT, have never taken T or steroids, am 66 years old and have been working out since a teenager.

Just got blood tests done at Quest (thanks, Nelson, Discount Labs worked great) and got back:

T total 984
Free T 59.1
Bioavailable T 111.2
SHBG 89
Estradiol (ultrasensitive test) 24

So as you can see, my total T and SHBG are above the top of the normal range; and my free T and bioavailable are at the very bottom of the normal range; and my estradiol is below the normal range.

I would appreciate help interpreting what this means.

I love working out and am doing solidly-ok for my age, but recovery is much less good than it used to be, and I am slowly adding body fat. Being in great shape (much less adding a little lean mass) has gotten a lot harder in the last couple of years. Sex drive and everything connected to that is a lot reduced over the last couple of years.

Is there a way for me to lower my SHBG so that my Free T would be higher?

Open to advice.

Thanks.

Post labs with reference ranges.

When it comes to FT the only way to know where it truly sits is to have it tested using an accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration.

I would not rely on the piss poor direct immunoassay let alone outdated calculated methods especially in cases of altered SHBG.


You most likely had this test panel done at Quest which includes TT (Immunoassay), FT/Bioavailable (calculated cFTV).

Testosterone, Free, Bioavailable and Total, Immunoassay

TRT Testosterone Panel that includes Testosterone, Free, Bioavailable and Total, Immunoassay , SHBG, albumin

www.discountedlabs.com

Testosterone, Free, Bioavailable and Total, Males (Adult), Immunoassay

The most accurate assay for TT (LC/MS-MS) and FT needs to be tested using the gold standard Equilibrium Dialysis or Ultrafiltration (next best) to know where it truly sits.


These are the assays you want to use when testing FT and they also include TT (LC/MS-MS).

You can get them through Nelsons Discountedlabs.
Either would suffice!

1. Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

2. Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)




If you did not use the assays listed above then I would retest before jumping to any conclusions as to where your FT level sits.

 

[Dudley]

Thanks, I appreciate the help. You are right that the T test was immunoassay -- got this through Discount Labs (via Nelson) which led me to Quest where the blood was drawn and tests run. I will get the additional tests you are recommending.

Here are the reference ranges:

Total T, reference range from 250 to 827 -- mine was 984 (hard for me to believe)
SHBG, reference range from 22 to 77 -- mine was 89
Free T, reference from 46 to 224 -- mine was 59.1
Bioavailable T, ref from 110 to 575 -- mine was 111
Estradiol, ref range < OR = 29 -- mine was 24

What motivated to get tested was that I feel like I have symptoms that might be associated with Low T both related to exercise and sex. Yet as you can see, the Total T number is, seemingly, terrific.

Trying to make sense of this.

 

[Vince]

Magnesium effect on testosterone-SHBG association studied by a novel molecular chromatography approach - PubMed (nih.gov)

 

[Dudley]

Thanks, Vince -- I just read the abstract; what's the practical application of this that I could consider? Taking a magnesium supplement? Thanks for your ideas.