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21 Y/O, High SHBG Affecting Free Testosterone Levels?

I am a 21 y/o male who was very active before I ran into some issues. For the past couple weeks, I have been feeling a bit off. Symptoms included: fatigue, no muscle gain, no morning wood, loss of motivation, extremely low sex drive, feeling of detachment/lack of emotion, and memory being a bit hazy.

These were tests done at a clinic (taken in afternoon if that matters):

Hemoglobin 15.8 g/dL (13.8-17.2)
Hematocrit 47.6% (41-50)
Cholestorol 215 mg/dL (<200)
Triglycerides 55 mg/dL (<150)
HDL Cholesterol 82 mg/dL (>40)
TSH3 Ultra-sens 2.40 uIU/mL (0.55-4.78)
Free T4 1.33 ng/dL (0.89-1.76)

These were requested by an endocrinologist (done through LabCorp early morning):

Vitamin B12 569 (211-946)
LH 4.2 (1.7-8.6)
FSH 6.3 (1.5-12.4)
Prolactin 7.2 (3-18)
TT 775 (doesn’t show a reference range on my results)
% Free 1 (1.5-3.2)
FT 78 (52-280)
SHBG 74.1 (16.5-55.9 for 20-49 yo)

I noticed that my percentage of free testosterone is low and my SHBG extremely high. From this forum, I think I read that high SHBG could cause low free testosterone. I was wondering what the underlying problem could be and what should my future steps be. Also, I am very new to this forum (came upon this looking for more information of my symptoms), so let me know if there is something wrong with the post. Thank you!

Excellent Total T numbers, except your high SHBG is causing issue with bioavailable T effectively bind most of your free T. TRT is the only treatment that will allow you to decrease SHBG to create more bioavailable T and allow you free T to increase. You might as well have TT numbers near the bottom of the range. TSH is too high, need to get it closer to 1.0. Need to also take morning temperatures using a old fashion thermometer, read thyroid stickies.

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Thanks for the response! I will get a thermometer and post the temps.

What is a good range for free T? So if the endocrinologist won’t prescribe me TRT, there wouldn’t be anything else I could do to lower SBGH?

Nope, nothing else can lower SHBG. As far as ranges everyone is different, some people can function well on the lower range while others can’t. Clomid will only increase SHBG to insanely high levels, TRT is your only hope. I don’t see as reason why your doctors wouldn’t put you on TRT when it’s your only option.

https://naturalbiohealth.com/2015/05/06/shbg-critical-to-your-health/

Need total history of past and present medication. Meds make SHBG go up.

I am currently not on any medication and haven’t taken any in recent memory
(couple years). The supplements I am currently taking are: Zinc picolinate,
vitamin D3, omega fish oil (all started after tests). Are there other
factors that could be raising my SHBG levels?

As you age SHBG goes up, in your case it’s more than on average.

Are you around a toxic environment? Pollution? Chemicals of any sort? Skin creams? Alcohol? Street Drugs?

Next step would be to check your liver to see if it has elevated enzymes, if so, there could be your problem.

I think I’m in a pretty clean/safe environment. No abnormal skin products.
No drugs and barely any alcohol.

So it could be my liver or hypothyroidism. Thermometer comes in Wednesday,
so I should have temp readings end of the week. Would it be wise to start
TRT asap or tackle the possible liver/thyroid problems first?

You need to tackle all issues, otherwise you’ll only feel a particle recovery. A lot of guys go on TRT and don’t feel fine because the have undiagnosed thyroid issues. The reference ranges only complicate matters since most doctors think a TSH of 3.0 is fine.

Your total test looks good. (This could also be because your SHBG is so high, inflating this number) There is a chance you might not need TRT. Get your liver taken care of, the SHBG absolutely CHOKES off your free test and you will technically have low testosterone, at least symptom wise. Thyroid is also just as important.

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22 years old, and I was in the exact same position as you. I spent the last 2 years with high SHBG just like you as well as low T symptoms. My total T was great, but my free testosterone was rock bottom and I felt horrible. I spent thousands of dollars on natural doctors, special diets, Chinese medicine, supplements, etc… Every doctor told me the same thing regarding SHBG: “It’s produced in your liver, sooo… you should take care of your liver”.

Whatever the fuck that means. Let’s face it, nobody knows what causes elevated SHBG for sure. I did MULTIPLE liver cleanses, ate a perfect diet, avoided SHBG raising drugs, took care of my thyroid, etc… My SHBG consistently remained between 55 and 70 like yours at the very top of the range.

Five weeks ago, I started TRT. All I can say is, I finally feel normal again. My hair has stopped falling out. My extreme fatigue has slowly subsided. My libido is returning (not anywhere near 100% yet, but it’s improving daily). My anxiety has been cut in half. My joints stopped hurting. My digestion is 10x better. My mental clarity is back. My mood is fantastic. Overall, my life is changing slowly for the better. TRT hasn’t made me feel like super man. It has just helped me to feel NORMAL again. Looking back to even just a few weeks ago, I can’t believe the cloud I’ve been living in for so long.

By all means, take care of any obvious issues like thyroid, mineral deficiencies, sleep, diet, etc… Do NOT waste your time trying to lower SHBG though. It will drain your wallet and waste your time. I’ve spent literally hundreds of hours researching SHBG and have continued to come up empty handed as have most guys on these health forums. It’s not well understood, and once it’s high, it rarely goes back down without introducing exogenous testosterone.

Testosterone will most likely be your only solution. If you have any questions feel free to hit me up.

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Damn, that sounds frustrating as hell. What triggered your doctors to prescribe you TRT after telling you it was your liver for so long? Or was it a completely new doctor?

I met with an endocrinologist, and I was told that my free testosterone is perfectly normal, my SBHG is a little bit high but also normal (???), and that my total testosterone was high, so the cause of my symptoms are not testosterone related. Not sure what my next steps should be.

Also got my thermometer today so I will start taking morning and afternoon temps.

I went through 5 doctors before finding a doc who was willing to work with me. My TRT doc is actually just a basic GP. I found him via a Tnation thread that was listing doctors in my area.

Do NOT go to endocrinologists. I’ve been to 3, and they were all useless. They will laugh in your face and tell you that you’re fine even if you’re barely in range. Endocrinologists as well as most doctors place little importance on free testosterone and usually focus exclusively at total testosterone. This reasoning is hugely flawed considering studies now show that free testosterone is much more important for overall health/symptoms than total testosterone. I’ll find the study when I get home and post it.

You’re going to have to search hard to find a doctor willing to work with you. Like I said, the majority of doctors evaluate based on total testosterone which is useless for HIGH SHBG guys like you and me.

That’s bullshit, even you are way above range for SHBG and still the doctor refuses to act, this indicates that his understanding of male hormones is very poor. He’s just stupidly ignorant! You’re so far above the high range it ridiculous! If he truly understood the relationship of SHBG he wouldn’t hesitate to act.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582226/

Above is one of the government studies on free testosterone I mentioned. There are several more out there. Find a doc who will take a serious look at your FREE hormone levels. Finding a good doc willing to work with you is difficult, but they’re out there. It took me 2 years of searching and countless doctor appointments before I finally found one. He’s great though, and it was well worth the search. Good luck to you

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I see. Looks like a need another doctor then haha. Also, what would be the symptoms of my liver having elevated enzymes and how would I go about treating it?

Just measured my temperatures and I am a bit uncertain. My morning temp right as I woke up was 96°F. My afternoon temp was 97/97.3. Is the thermometer wrong or is 96 in the morning common for hypothyroidism? Will probably begin iodine supplementation if these temps are correct.

Elevated liver enzymes you would definitely have high SHBG, diet and exercise go a long way towards liver health. Avoid alcohol. It also looks like you have a thyroid issue as well, lower body temps indicate low free T3 which is the active hormone. You need a full thyroid panel, iodine could restore levels to normal.

Elevated liver enzymes have seldom correlated with any symptoms for me. My liver enzymes are typically always well within range, and it has not affected my SHBG in any way. Even when they have gotten higher though due to training, high protein dieting, or prescription drugs, my SHBG has always stayed around the same.

Need waking and mid-afternoon oral body temps. Avoid eating, walking, drinking and talking for a while.

Higher E2 increases SHBG, higher FT lowers SHBG. Some oddly have high or low SHBG with no known cause.

TT is high because it is inflated with more non-bioavailable SHBG+T. So your lab results are overstating your T status. Most docs will not understand.

You need to test/post E2 - estradiol and fT3.

Your FT is not good. Docs confuse statistical normal ranges with normal health - idiots.

TSH should be closer to 1.0, range is stupid.
Thyroid function is not a side issue.
Cause can be from not getting iodine via iodized salt and/or vitamins listing 150mcg iodine and 150-200mcg selenium.


Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

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