SHBG 97

[supertrampsecurity]

SHBG 96
TotaL T 899
Albumin 4.9

Am I a candidate for TRT in your experience?

I have all the symptoms of low T. Libido and ED and Focus issues

I am taking supplements like Boron, Stinging Nettle, and others for a couple of weeks and no difference.

Should I go straight to TRT if recommended?

What do you think?

 

[madman]

Age 52
SHBG 96
TotaL T 899
Free 13
Albumin 4.9

Am I a candidate for TRT in your experience?

I have all the symptoms of low T. Libido and ED and Focus issues

I am taking supplements like Boron, Stinging Nettle, and others for a couple of weeks and no difference.

Should I go straight to TRT if recommended?

What do you think?

Although having an extremely high SHBG would result in low FT levels if one had an average TT say of 600 ng/dL.....seeing as your TT is on the higher end 899 ng/dL.....even with an extremely high SHBG of 96 nmol/L your FT levels are by no means low!

As an example if your TT was only 600 ng/dL (average for most healthy young men).....with an extremely high SHBG of 96 nmol/L and Albumin 4.3 g/dL (mean).....than your FT would be LOW 14.24 ng/dL (below the reference range of 16-31 ng/dL).

The only way to truly know where your FT levels sit is to have testing done using the most accurate methods such as the gold standard Equilibrium Dialysis or Ultrafiltration or simply use the newer TruT calculated method which has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis.

It is available online for free to the general public.

Using the newer calculated method if we take your TT 899 ng/dL, SHBG 96 nmol/L, Albumin 4.9 g/dL than your FT is 22.14 ng/dL(slightly under the mean of 23.5 ng/dL which would be just under mid-range of the reference range of 16-31 ng/dL).

So believe it or not even with an extremely high SHBG of 96 nmol/L your FT is just under mid-range.....due to your high TT 899 ng/dL.

Now does that mean your levels are optimal or that there is no way you would experience low-t symptoms at such level..... highly doubtful!

You may very well need to have your FT levels in the upper end/slightly above the top end of the reference range as most men do well having FT levels in the 30-30+ ng/dL range.

What is critical is you also look into thyroid/adrenals as dysfunction in these areas can also mimic low-t symptoms such as low energy levels/ negative effects on mood/low libido/erectile dysfunction.

Also understand causes of low libido/ED are multifactorial and men with descent testosterone levels can still experience such issues.

 

[madman]

Read post over used Albumin 4.3 g/dL (mean) and meant to use your Albumin of 4.9 g/dL which would cause your FT level to be slightly lower.

With a TT 899 ng/dL, SHBG 96 nmol/L and Albumin 4.9 g/dL than your FT levels are 22.14 ng/dL.....just under mid-range of the reference range.

 

[madman]

Age 52
SHBG 96
TotaL T 899
Free 13
Albumin 4.9

Am I a candidate for TRT in your experience?

I have all the symptoms of low T. Libido and ED and Focus issues

I am taking supplements like Boron, Stinging Nettle, and others for a couple of weeks and no difference.

Should I go straight to TRT if recommended?

What do you think?

Unfortunately you had your FT tested using the piss poor direct immunoassay which has been shown to be inaccurate let alone no longer recommended and tends to underestimate FT levels when compared to the most accurate testing method (gold standard Equilibrium Dialysis).

 

[supertrampsecurity]

You are saying TRT would not benefit me?

 

[Systemlord]

Am I a candidate for TRT in your experience?

Your FT levels are probably overestimated because as Madman pointed out testing direct immunoassay is not very accurate and can overestimate FT by 40 percent.

I never seen a man with optimal FT levels with SHBG half your value, unless medications can explain high SHBG, you are a candidate for TRT.

The only problem is a lot of doctors will only look at the TT value and will not understand the implications of astronomically high SHBG.

It was Dr. Abraham Morgantaller an expert in testosterone stated that men <15 pg/mL will show benefit on TRT.

 

[Vvs1]

Although having an extremely high SHBG would result in low FT levels if one had an average TT say of 600 ng/dL.....seeing as your TT is on the higher end 899 ng/dL.....even with an extremely high SHBG of 96 nmol/L your FT levels are by no means low!

As an example if your TT was only 600 ng/dL (average for most healthy young men).....with an extremely high SHBG of 96 nmol/L and Albumin 4.3 g/dL (mean).....than your FT would be LOW 14.24 ng/dL (below the reference range of 16-31 ng/dL).
View attachment 8351




The only way to truly know where your FT levels sit is to have testing done using the most accurate methods such as the gold standard Equilibrium Dialysis or Ultrafiltration or simply use the newer TruT calculated method which has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis.

It is available online for free to the general public.

Using the newer calculated method if we take your TT 899 ng/dL, SHBG 96 nmol/L, Albumin 4.9 g/dL than your FT is 22.14 ng/dL(slightly under the mean of 23.5 ng/dL which would be just under mid-range of the reference range of 16-31 ng/dL).
View attachment 8352


So believe it or not even with an extremely high SHBG of 96 nmol/L your FT is just under mid-range.....due to your high TT 899 ng/dL.

Now does that mean your levels are optimal or that there is no way you would experience low-t symptoms at such level.....doubtful!

You may very well need to have your FT levels in the upper end/slightly above the top end of the reference range as most men do well having FT levels in the 30-30+ ng/dL range.

What is critical is you also look into thyroid/adrenals as dysfunction in these areas can also mimic low-t symptoms such as low energy levels/ negative effects on mood/low libido/erectile dysfunction.

Also understand causes of low libido/ED are multifactorial and men with descent testosterone levels can still experience such issues.

What exact thyroid/adrenal tests can he run?

 

[madman]

It was Labcorp

You are saying TRT would not benefit me?

No and although you state that you are experiencing low libido/ed issues I would look into making sure that your thyroid/adrenals are healthy before jumping on trt.

Your FT levels are just below mid-normal.....definitely not optimal but by no means low.

If there are no underlying issues regarding thyroid/adrenals than you may very well need to start trt.




THYROID Panel - COMPREHENSIVE
Thyroid-Panel-Comprehensive
This test panel includes most tests needed to more deeply explore the possibility of a hypothyroidism and/or Hashimoto's disease diagnosis. It includes:

- TSH
- Free T3
- Free T4
- Reverse T3
- Thyroglobulin Antibody
- Thyroid Peroxidase Antibody (Anti-TPO)




4-Tube Cortisol-Salivary
4-Tube Cortisol-Salivary
This test for adrenal insufficiency includes 4 measurements of your salivary Cortisol level during one day. Cortisol, also known as the "stress hormone" can be either too high or too low which may be a sign of adrenal distress. This is a take home kit that you pick up at the closest lab location when you take the emailed lab request form, then follow the collection times shown in the table below, and finally return the kit to the lab. Your test results will be emailed 5 business days later.






DHEA-Sulfate
DHEA-Sulfate
Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal gland. It is also made in the brain. DHEA leads to the production of androgens and estrogens (male and female sex hormones). DHEA levels in the body begin to decrease after age 30. Lower DHEA levels are found in people with hormonal disorders, HIV/AIDS, Alzheimer's disease, heart disease, depression, diabetes, inflammation, immune disorders, and osteoporosis. Corticosteroids, birth control taken by mouth, and agents that treat psychiatric disorders may reduce DHEA levels.

 

[Gman86]

I would definitely check all other hormones, especially thyroid related hormones. Obviously opinions vary on what you should do in regards to TRT, but if I were you, I would personally find a good hormone specialist or clinic, such as Defy, and do a trial of TRT. Even if your free T is normal with the tru-T calculator, you have to remember that there is something called testosterone resistance. Which is basically just when your numbers look good, but things like xenoestrogens are blocking the testosterone receptors, preventing your testosterone from doing its magic.

Due to your age, what do you have to lose by seeing if TRT can improve your symptoms? If it didn’t work, the only thing you would lose is a little bit of money. If you were to come off of TRT, your numbers would go right back to baseline within a month or two. So I see no reason to not at least try it. The possible reward highly outweighs any risk. And again, the only risk I can see is the tiny bit of money you will need to trial it.

TRT was one of the best things I’ve ever done. I feel extremely lucky that I was able to get on it at the early age of 27. That means I get to have optimal levels of testosterone for basically my entire life. I won’t ever have to deal with the ups and downs that come with being natural and having to deal with poor testosterone levels every time I’m stressed, don’t eat good, don’t get enough sleep, overtrain, etc. I look at TRT as a blessing, not a burden.

Also, for what it’s worth, these were my labs when I was 27 right before I started HRT. Some guys might of told me that I shouldn’t try TRT, but I definitely felt way better on TRT than I did with these levels below.

Total T - 601(250-1100
Free T - 54.3 (46.0-224.0) Bio T - 116.4 (110.0-575.0)
SHBG 53 (10-50)
E2 NOT Sensitive - 23

 

[Gman86]

According to the tru T calculator my free T would of been around 18 on those labs, and yours is around 22. So considering our free T levels are pretty similar, and TRT helped me out a bunch, I don’t see any reason why it couldn’t help you out as well.

 

[Vince]

Age 52
SHBG 96
TotaL T 899
Free 13
Albumin 4.9

Am I a candidate for TRT in your experience?

I have all the symptoms of low T. Libido and ED and Focus issues

I am taking supplements like Boron, Stinging Nettle, and others for a couple of weeks and no difference.

Should I go straight to TRT if recommended?

What do you think?

Do you have any insight a why your shpg is so high. Any problems with diabetes, thyroid or liver disease.

 

[supertrampsecurity]

Do you have any insight a why your shpg is so high. Any problems with diabetes, thyroid or liver disease.

Diabetes does not run in my family. I'm in good shape for my age.

Now the Libido is going and loss of focus at work.

 

[Cataceous]

A SARM like ostarine might be beyond your comfort zone, but you can read about it and see what you think. I mention it because there are some anecdotal reports of its being used to lower SHBG with minimal HPTA suppression, e.g. here.

 

[Vince]

Diabetes does not run in my family. I'm in good shape for my age. I do a lot of 1 hour workout swim with a team 4-5x a week. I have a few drinks some nights. I have high cholesterol. I was eating low carb and have been skipping breakfast for the past year to keep my weight down. I work hard to keep my weight down and it's getting harder and harder.

My ED is horrible without Cialis for the past 10 years. With Cialis I'm fine. Without it, I have nothing. Now the Libido is going and loss of focus at work. One of my main concerns is work. I'm growing my business and have less energy and focus.

I do follow your stack Vince but only add Cialis when I have plans with my girlfriend. As I said it's the Cialis that makes a difference for me.

I was wondering should I get my thyroid checked with another blood test before seeing the DR? Or simply go with TRT and see if it cures my situation as suggested by @Gman86 ?

By going on trt, you may just be covering up a symptom of something else. Cover all your bases make sure you know why you have high shbg. Then I would consider trt, only as a last resort.