My endo says high SHBG is good. Thoughts?

[raginghormone]

Hello, I'm new here but I've been lurking awhile. What my endo is saying contradicts a lot of knowledge on these forums. I recently had labs:

- Testosterone, serum -- 860 ng/dL (348 - 1197)
- Testosterone, % free -- 1.0% (1.5-3.2)
- Testosterone, free -- 86 pg/dL (52 - 280)
- SHBG -- 64.7 nmol/L (16.5 - 55.9)
- T3, free -- 3.2 pg/mL (2.0 - 4.4)
- T3, reverse -- 16.6 ng/dL (9.2 - 24.1)
- T4, free -- 1.66 ng/dL (0.82 - 1.77)
- DHEA-Sulfate, serum -- 105 ug/dL (33 - 416)
- ACTH-ICMA -- 67 pg/mL (6 - 48)

Testosterone (% free) is below range, SHBG is above range, ACTHA-ICMA is above range. I'm currently on 2 grains of natural dessicated thyroid for my Hashimoto's. I still suffer from lots of symptoms. Low libido, hair loss, dry skin, dry mouth, itchiness, puffy face, fatigue, muscle weakness, anxiety. It has gotten better ever since I started NDT about a year ago but I'm definitely not normal yet. I also donated a kidney 4 years ago which likely severed a vein to my left adrenal gland at the same time, thereby putting it out of commission.

Reading my doctor's dictation, he had this to say:

"His testosterone was 860, which is excellent. Free testosterone is also good at 86. SHBG is high at 64.7. It goes up with hyperthyroidism and is good to be high, rather than low."

I definitely don't agree with his stance on SHBG. Furthermore, my percent free testosterone is low so I don't think my testosterone numbers are "excellent" at all. My theory is the high SHBG is driving up my total but binding to it before it can become free.

What are your guys' thoughts? Should I be looking for another Endo? What do you recommend I do?

Thanks in advance.

 

[CoastWatcher]

Hello, I'm new here but I've been lurking awhile. What my endo is saying contradicts a lot of knowledge on these forums. I recently had labs:

- Testosterone, serum -- 860 ng/dL (348 - 1197)
- Testosterone, % free -- 1.0% (1.5-3.2)
- Testosterone, free -- 86 pg/dL (52 - 280)
- SHBG -- 64.7 nmol/L (16.5 - 55.9)
- T3, free -- 3.2 pg/mL (2.0 - 4.4)
- T3, reverse -- 16.6 ng/dL (9.2 - 24.1)
- T4, free -- 1.66 ng/dL (0.82 - 1.77)
- DHEA-Sulfate, serum -- 105 ug/dL (33 - 416)
- ACTH-ICMA -- 67 pg/mL (6 - 48)

Testosterone (% free) is below range, SHBG is above range, ACTHA-ICMA is above range. I'm currently on 2 grains of natural dessicated thyroid for my Hashimoto's. I still suffer from lots of symptoms. Low libido, hair loss, dry skin, dry mouth, itchiness, puffy face, fatigue, muscle weakness, anxiety. It has gotten better ever since I started NDT about a year ago but I'm definitely not normal yet. I also donated a kidney 4 years ago which likely severed a vein to my left adrenal gland at the same time, thereby putting it out of commission.

Reading my doctor's dictation, he had this to say:

"His testosterone was 860, which is excellent. Free testosterone is also good at 86. SHBG is high at 64.7. It goes up with hyperthyroidism and is good to be high, rather than low."

I definitely don't agree with his stance on SHBG. Furthermore, my percent free testosterone is low so I don't think my testosterone numbers are "excellent" at all. My theory is the high SHBG is driving up my total but binding to it before it can become free.

What are your guys' thoughts? Should I be looking for another Endo? What do you recommend I do?

Thanks in advance.

Welcome to Excelmale. You are not currently on a TRT protocol, these are your natural levels? How old are you?

 

[JPB]

You know adrenal function can affect thyroid, eh? I would say you may want to start with some DHEA and bring that number up at least 100% and see of you feel any better. Could help your thyroid, too. No worries with T levels, and SHBG is hard to sway.

 

[raginghormone]

You know adrenal function can affect thyroid, eh? I would say you may want to start with some DHEA and bring that number up at least 100% and see of you feel any better. Could help your thyroid, too. No worries with T levels, and SHBG is hard to sway.

Yep, aware of the adrenals. I'm becoming more and more convinced my root cause is my adrenals. If my adrenal is in fact lost during the surgery (which I'm 99% sure it is after speaking with other donors and reading literature), am I able to recover with just one adrenal or will I need supplementation for life?

How much DHEA do you think I should take? 25mg, 50mg?

 

[raginghormone]

Welcome to Excelmale. You are not currently on a TRT protocol, these are your natural levels? How old are you?

I am not on TRT. I believe it is my high SHBG that is pumping up my Testosterone serum so I'm not getting any benefits of that. My free T is still quite low. I am 30 y/o.

 

[JPB]

From the sounds of things with your adrenals you probably need some degree of supplement for life, but that's not too unusual. And if you are only running on one adrenal, you would probably want to work with a doctor because you may need cortisol, too. For DHEA, I'm sensitive with it and just take a little 2-3x weekly. I use this product: DHEA Instaceutic Spray Nature's Plus 2 oz Spray, which is just 12.5 mg per serving. But most other people here take at least 25 mg.

 

[raginghormone]

From the sounds of things with your adrenals you probably need some degree of supplement for life, but that's not too unusual. And if you are only running on one adrenal, you would probably want to work with a doctor because you may need cortisol, too. For DHEA, I'm sensitive with it and just take a little 2-3x weekly. I use this product: DHEA Instaceutic Spray Nature's Plus 2 oz Spray, which is just 12.5 mg per serving. But most other people here take at least 25 mg.

Thanks, I'm going to proceed with 50 mg DHEA every AM then and see how I do. I do have some hydrocortisone on hand and might experiment with 5 mg if I'm feeling especially fatigued that day to see if it has an effect.

 

[Vince Carter]

50mg DHEA is too much to start with, think about half that.

But your high SHBG means and it shows in your testing that you have a Free T problem, you're aware that besides the paltry Free T, the Total T is bound to albumin and can't be used by the body.