normal total testosterone, low free

[pereira951]

hello everyone.
I have had a very frustrating few years in regards to absence of libido, and finding a doctor in to digging for the cause. i first had my t tested 3 years back, both free and total came back in the very bottom of normal range. i was 35 at the time. I did research and had my doc check shbg and estradiol. At the time shbg came back at 75, and estrodial at 72.

i saw a few endocronoligists, they both told me that i was to young for testosterone and most likley my libido issues were psychological. bioavailable t always came back in the mid normal range. i was not seeking testosterone, i was seeking awnsers. i felt as though the assumption was that i was after testosterone

i gave up at the time believing it may be psychological but always feeling something was off.

i am now close to 38, i still have no libido, mood swing all over the place with no overall feeling of well being.

i had a physical done,the docs called me back because of my free t.
it is now officially low. my total t is normal and shbg is 3 times normal range estrodial is at midlow normal. I will post numbers.

my doc has now prescribed androgel, he is very willing to help out but admits he is not to knowledgeable in the area. i have not started treatment as i really want to know if shbg can be lowered? what is the cause? i would rather treat the cause then bandaid the symptoms.

also wont any exogenous t bind with shbg anyway?
i have hit many road blocks with docs in past trying to sort this. now that numbers are officially low i may get a different response
i am hoping i may be able to get some guidance in where to start, what to test.

these are my current stats
38 male
6'1
184.5lbs
13.3% body fat
total t 17.1nmol/lL rr 7.6-31.4
free t 108pmol/L rr 196-636
shbg 149nmol/L rr12-'60
estradiol <60pmol/L rr <159

Also some pretty important history:
I am recovery from active addiction. It has been 6 years.I was a very heavy user of many substances for many years.
Opiates,alcohol,ghb,ketamine,benzos ,cocaine
i was also extremley over weight in the past,270lbs, non active for years and smoked 3 packs a day.

i currently train daily, eat healthy and am extremley active and gave up all bad habits except i struggle with binge eating from time to time. i have not had my libido return since recovery. As i said it has been 6 years.

i would really appreciate any help or guidance. all my standard liver function tests come back normal as well as thyroid in the past. however the standard tests only.

thanks in advance

 

[BigBamBoo]

Welcome to the forum.

Sounds like you have some VERY serious life decisions to make. If you have strong internal fortitude, you can probably turn things in a more positive direction.

Substance abuse is a life/health wrecker.

Sounds like you are on the right track with working out and getting diet in control.

TRT would most likely help you...IF...if you work with a doctor who knows what they are doing. Many doctors are not up to speed on TRT and can make things worse.

As for libido...there are many things that can effect it. Both mentally and physically.
The long history of substance abuse can have even longer effects on libido.

Good luck on a new chapter in your life.

 

[Systemlord]

Opiates, alcohol, benzos will all raise SHBG, once the liver is damaged SHBG will increase. You likely won't be able to absorb enough topical testosterone given your SHBG level, the standard protocol for very high SHBG is large infrequent doses of injectable testosterone above the normal ranges, something an insurance doctor will not allow.

Your only hope is to go private and seek a specialists who knows what their doing.

Are you still taking benzos or opiates?

 

[pereira951]

Thank you for your response.
I have been clean for 6 years. I take no medication and live an extremely healthy lifestyle. I have tried all natural ways as supplement goes...
Boron, magnesium, zinc, fish oils, nettle root etc...

The puzzling thing is that a few years ago my shbg was in the 90 range. There must be something else going on to signal the liver to produce so much shbg.

 

[BigBamBoo]

Some men just have high SHBG. I am one of them. Mine runs 70+. I don’t drink, use drugs, drink coffee, sodas, etc.

Drank a bit when I was in the Army and for a little bit afterwards, but never heavily and have not drank in over 20 years.

So, sometimes it is what it is.