Low free testosterone, high SHBG

[queek]

Hello,


I am 25 years old and recently got bloodwork (just out of curiosity actually):

Test	Result	Reference Range
LH	3.6 mU/ml | 1.5 - 9.3
FSH	2.7 mU/ml	1.0 - 18.0
Estradiol	36 pg/ml	12.0 - 41.0
SHBG	54 nmol/l	17.3 - 65.8
Testosterone (Total)	470 ng/dl	270 - 920
Bioavailable Test (measured)	0.79 ng/ml	1.1 - 3.1
DHEA-S	359 ug/dl	34 - 569
TSH	3.19 uU/ml	0.2 - 5.0
Vitamin D (25-OH)	67 ng/ml	30 - 150

More Blood tests (Was a few weeks later):

Test	Result	Reference Range
Sodium	141 nmol/l	136 - 146
Chloride	103 nmol/l	95 - 110
Calcium	2.30 nmol/l	2.20 - 2.56
Iron	96 ug/dl	59 - 158
Erythrocytes	5.23 T/l	4.4 - 5.8
Hemoglobin	15.6 g/dl	13.5 - 18.0
Hematocrit	47 %	40 - 52
MCV	89 fl	78 - 98
MCH	29.7 pg	27.0 - 33.0
MCHC	33.5 g/dl	31.5 - 36.0
Leukocytes	3.5 G/l	4.0 - 10.0
Blood sugar	86 mg/dl	74 - 100
BUN	24 mg/dl	8 - 20
Urea	52 mg/dl	17 - 43
Creatinine	1.0 mg/dl	0.8 - 1.3
Uric Acid	6.1 mg/dl	3.6 - 7.2
Bilirubin	1.1 mg/dl	< 1.2
HDL	49 mg/dl	> 40
CHOL/HDL	3.3	< 5.0
LDL	100 mg/dl	< 130
LDL/HDL	2.0	< 3.7
CRP	0.1 mg/dl	0.00 - 0.50



A doctor tested my hormones another time, but not as comprehensive: (Third blood test)

Test	Result	Reference Range
beta-HCG	0.0 mU/ml
Prolactin	7.8 ng/ml	4.0 - 15.2
LH	7.3 mU/ml	1.5 - 9.3
FSH	2.3 mU/ml	1.0 - 18.0
Testosterone (Total)	5.70 ng/ml	2.70 - 9.20

By assuming Albumin levels of 4.3 g/dl, BAT levels would calculate to 166 ng/dl and Free Testosterone would be at 7.06 ng/dl.


Symptoms:

• Hardgainer
• Trouble keeping bodyfat down
• Extremely tired and fatigued during the day
• Losing a lot of strength when cutting
• Rather emotional during last year
• No morning wood anymore, had problems with ED a year ago when I was partying a bit

Facts:

• 25 years old
• BMI: 26.9
• Bodyfat: 19% (DEXA)
• Perfect bone mineral density according to DEXA
• Perfect spermiogram
• Normal body and facial hair (could grow full beard)
• Carrying fat at hips and chest (since puberty) (Pseudogynecomastia)

Diet:

• Maintenance at 3000-3500kcal, Bulk 4000kcal, Cut 2700kcal
• Alcohol once a month max.
• Almost no sugar
• Symptoms don't seem to change with diet
• Currently cut with 25% carbs, 45% prot., 30% fat (Percent of calories)
• Not plant based at all
• Low soy

Training/Workout:

• 
1.5hrs Resistance Workout 3-5 times a week, essentially no cardio



Medication:

• No Rx
• Currently only VitD and Multi
• Have never touched DHT blocking meds
• Never touched AAS, Prohormones or similar

Oral Body Temperature:

• Morning: 97.0°F-97.2°F
• 2pm: 97.6°F

I got to know that my TSH is a bit elevated, my body temperature low, my free test outside of the reference range (low) and my SHBG and E2 a bit high. Symptoms seem match those of Low T and Hypothyroidism.

Any opinion on all of that very welcome!

Thank you in advance!

Disclaimer: I originally posted to another forum, but I value multiple opinions very much

 

[Systemlord]

You definitely have low T and thyroid issues, thing is once you begin thyroid treatment SHBG is expected to rise and by then you'll be over ranges, TRT however can counter that rise in SHBG therefore lowering it, then increasing your free T. If your SHBG was midrange I would recommend thyroid treatment only and work to increase your testosterone. You need to stay away from soy, all men should stay clear of it.


Your free T is lower than mine was when I came in at 225 ng/dL, free T was 7.2. This is just a reference for you to show you how SHBG is inflating your testosterone status, if your SHBG was midrange free T would be higher and TT significantly lower. Likely below low normal.

I would recommend one large weekly injection, you will need larger peaks to decrease your SHBG.

By the way, a very professional looking post!

How SHBG works--> https://naturalbiohealth.com/2015/05/06/shbg-critical-to-your-health/

 

[queek]

First of all, thank you very much for the reply, I appreciate it!

Now that the bloodwork I posted is already a few weeks old, I wondered what my current T levels looked like and got bloodwork done again:

Test	Result	Reference Range
Testosterone (Total)	6.0 ng/dl	2.70 - 9.20
SHBG	44 nmol/l	17.3 - 65.8
Bioavailable Testosterone	1.39 ng/ml	1.1 - 3.1

Those look way better but not optimal. Didn't get anything else done this time. The only thing I changed since back then was that I didn't train as often and as intense.

I guess this doesn't seem like low T anymore? Does this sound like overtraining? Maybe due to a underactive thyroid?

 

[Systemlord]

When thyroid output fluctuates so to does your SHBG levels, when happens it affects how you hold on to your testosterone. You have thyroid problems and only TSH is tested, huge red flag you're dealing with an inexperienced doctor, you need a full thyroid panel checking fT3, rT3, , fT4 and antibodies. TSH only checks function of the thyroid, not the actual thyroid hormones.

You have an underactive thyroid and when you address it, your SHBG will go up affecting your free T, therefore possibly requiring TRT. Your testosterone is low for your age group, well below average.

 

[queek]

I see what you mean. That makes sense.

They don't test for rT3 where I live. Can the others be enough to assess my thyroid function?

 

[Vince Carter]

Reverse T3 tests for a condition called pooling which would indicate the T3 hormone is not making it in to the cells. I would call it less necessary being Free T3 being the most important single factor in Thyroid testing. Free T3 is the active Thryoid hormone and is converted from T4

 

[queek]

Reverse T3 tests for a condition called pooling which would indicate the T3 hormone is not making it in to the cells. I would call it less necessary being Free T3 being the most important single factor in Thyroid testing. Free T3 is the active Thryoid hormone and is converted from T4

Thank you for the explanation!

So I'm getting T3, fT3, T4, fT4 then. Which thyroid specific antibody specifically should I get tested for?

 

[CoastWatcher]

Thank you for the explanation!

So I'm getting T3, fT3, T4, fT4 then. Which thyroid specific antibody specifically should I get tested for?

TPO and TGAb.