25 Y/O. Normal Total T, High SHBG, Memory Issues, Brain Fog, Tremors/Twitches

Hi everyone.

This will be my first post at T-NATION.
Please excuse bad grammer/sentence structure as English is not my primary language.

I’ve turned to this forum purely out of frustration and hopelessness. It’s a comfort reading these posts about so many individuals who are also struggling, it’s humbling to know that you are not alone, you are not the only person that has to cope with something scary.

I am currently seeking professional medical help and will therefore not use this forum as the basis for medical decisions. But I mean, there are so many knowledgeable people here I’d be a fool to pass up the potential help I could get.

I obviously want to give as clear and concise a picture as possible without rambling into unnecessary details.

Thank you if you are willing and able to respond.
Thank you for any form of assistance.
I’m giving some background history and yes, I did make bad decisions in 2017. Trust me that I’m aware of this.

A Quick Background About Me
I’m 25 years old.

Studied at varsity.
Exercised quite a lot.
Used to be a relatively lean guy, strong for my albeit small size.

Life used to be good. Sure, there was stress, exams, etc. but that was part of the package and I was handling it well. I was growing as a man, concerned about the conduct of my character, being able to care for and provide to a family. This changed end of 2016 (will get to that).

I’m generally a positive guy
I like understanding things / being academic
Health has always been a big concern for me and only last year have I realized how lucky I was to be as healthy as I’ve used to be.

I’m currently working a flexible job in accountancy. I am getting minimal stress (I deliberately resigned from my previous job to get this one, specifically for the slower pace)

My ‘stats’, etc
25 years old
6 feet
± 15% bodyfat

Body-shape: Hourglass, not the typical ‘V’ as I’ve got quite wide hips for a dude
Facial-hair: I can grow a beard, but not a mean one.
Body-hair: I have quite an amount of chest-hair. Further, it’s the usual (arms, legs, pubic, etc)
Storage of Fat - Mostly on my glutes, thighs, but I started getting more belly-fat and fat on my back/love-handle area.
Muscle - I never picked up muscle-mass easily - it just didn’t happen even if I tried eating towards a quality caloric-surplus. It was easier for me to measure strength and get lean. Sadly, I’ve been losing strength and muscle.

Previous Health Conditions
None (that I’m aware of).
I could think, I could progress, I could function at life. I could get stronger

Drugs, supplements, alcohol
I don’t use drugs
I do use supplements:

  • Vitamin-D 5000IU
  • Omega-3
  • Multi-vitamin
  • Probiotics
  • Digestive Enzymes

I don’t really drink alcohol. I might enjoy 100ml’s of wine once or twice every few months.

My Diet and Training
I used to eat quite little for my activity-level. I think that might have been why I’ve had lowish body-fat levels. I’d eat 1800cals a day with focus being on protein and carbs (neglecting fats).

I’m currently eating a bit more, giving much more focus to fats and pulling back on carbs except for days I workout.
I don’t do fastfoods. I don’t do processed meats. I try to minimize preservatives.

Out of desperation a doctor suggested cutting out (see the heading, Leaky Gut):

  • Gluten (no wheat, rye, barley, millet, spelt, oats)
  • Cow’s Milk (no yogurt, milk, cheese, cottage cheese)
  • Sauces
  • Most grains
  • Inflammatory Foods (such as corn, excessive nuts, simple sugars

When I train, I like to employ 4 - 5 workouts per week, each lasting about 40-50minutes. I’d focus on compounds, log my workouts and strive to beat them.
I would do the bodybuilding splits, but with much less volume (chest-day, back-day, legs, shoulders) and much more rest.

Taken October 2016 - All was still healthy and well here.

Testes Ache
Ironically, YES! And that started happening in the end of 2016 when things started going down.
I went to the urologist and he said I have a class-1 varicocele.
This has happened intermittently as well.
Heck, even as I’m sitting here.

Morning Wood
Not much. I would sometime wake up with a slight erection, though. But there’s has been like a 5-month period where I didn’t get ANY wood at all.
Libido was also pretty non-existent in 2017.

Other Symptoms
This is the part that scares/confuses me. It is so hard to explain this properly.
These are the issues that I need to:

  1. Find the cause; and
  2. Address;
  • Hairloss ALL over my head, front, back, sides.
  • Brain-fog, I had to quit my previous job (software developer) because I had trouble following abstract thoughts, reasoning, conversations.
  • Math used to be awesome, now I’m struggling with the basics.
  • Forgetful, I would put my car keys in the fridge and be terrified to find it there.
  • I would read “789” but write it down as “798”
  • I would get suicidally-depressed. I’d have periods where I simply hate life because of my lack of LIVING even though I’d objectively be in a good place. Then others days would be better
  • I would forget why I was looking for something or what I was looking for. This happens continuously throughout the day.
  • I feel as if I’m on a drug, like the room is slightly moving around me. I don’t feel like I’m the driver of my body, but that I’m a passenger
  • My hands started developing a slight tremor during 2017, this is only when I flex my fingers and try to keep them still.
  • When I close only one eye I get involuntary twitches in the cheek right below
  • Aside from the twitching I would get sudden jerks as if though my brain is saying to my leg/arm/back/finger/toe ‘move’ but I didn’t issue that command.
  • For that last few months, every single Friday-night has been spent… going to bed at 7PM.

I don’t have the energy to train anymore and truth be told I’m not really living a life anymore - I’m just surviving from day to day.
This is not normal.

Doctor’s I’ve seen
I’ve been to the following doctors. I’ve been cleared by all of them.
Urologist x 2,
Endocrinologist x 1
Specialist Physician x 2
Neurologist x 1 - Had an MRI scan + EEG scan done. Came back normal.
Homeopath x 2
Functional holistic doctor x 1 → I’m currently still going to this gentleman. See Leaky Gut

Leaky Gut
Well, I’ll put my history of bloodtests in a heading below this one, but after searching from doctor to doctor who had NOTHING to say, I found a Function Doctor who suspects that

  • I have very low cortisol (had a sample of saliva sent to America for testing as they don’t do it in South-Africa)
  • I have leaky gut, leading to inflammation and even inflammation on my brain.

I’m not sure what to believe regarding leaky gut. Currently I’m desperate, so I haven’t eaten ANY gluten, cow’s milk, etc (see above) for about 2 months. I’ve been following this regimen very strictly.

I’m also not allowed to exercise as this may have a negative impact on cortisol?
Truth be told I’m not feeling much better, but results will take a long time and I am more than willing to give this a shot - although I want to blast something with a shotgun some days.

Bowel Movements have become once to twice a day where it used to be once maybe every 2 - 3 days

Past TRT
Everyone messes up at some point.
For me, that was May 2018 where I became too subjective and emotional. At this point, I was already forgetting things, stuggling at work, physically and emotionally.
I haven’t had the strange tremors/jerkings at this point, not was the brainfog so bad as it has become eventually.
This is where my journey of hormonal-fuckup begins.

Long story short is that with circumstances, friends and temptation I was provided with the option to self-administer TRT. I wasn’t strong or informed enough to realize what a mistake it is to take your hormones so lightly.

100mg/week Test CYP
Quality of life improved drastically, slept through an evening first time in the year.
Symptoms were alleviated, but never fully gone.

I only took Test for literally 2 months (May - June’17) to get me out of this emotional black-hole. Retarded, thinking back.

This is why I have a total test of 5.3 nmol/L on the 18th of September.
A urologist saw this reading and then prescribed me testosterone - I came with open cards and told him the entire story and he suggested we continue treatment.

Later, being worried about fertility I stopped TRT with tamoxifen and anastrazole. You’ll see that on 4 January 2018 my Total Test is 467ng/dL

Blood Tests Results from 2017 till date

At this point, I’m not really sure which way to turn. My total testosterone is not looking too bad, but my SHBG has been climbing as well. I’m not even sure if my brain-fog or memory-related symptoms have anything to do with this?

I’m just feeling TERRIBLE.
I’m a horrible person to be around with a short temper.
I’m putting stress on my family because everyone needs to tread lightly around me.
I’m wondering how I can provide and care for a family (one day) if I continue to be like this?
I’m lacking the drive that I used to have.
I’m losing muscle, becoming this skinny-fat guy.
I’m feeling dumber, much dumber.

Thyroid, iodine, salt
I would like to hear any opinions on my thyroid readings as I think this might be where a big problem lies. It looks like my thyroid is working MUCH harder this year than last year.

I am a person who gets cold quite easily.
Oral temperature this morning was
08AM 36.45 deg celcius
12PM (noon) 36.3 deg celcius

When I took testosterone body-temps were higher and I didn’t feel so cold.

As for Iodine, I use Himalayan Crystal Salt (which I believe does contain iodine?)
I also have a bottle of lugols Iodine and would drink a drop or 2 in water on occasion.

As for selenium, I’m not supplementing any, but I do eat eggs, grass-fed beef, chicken and spinach which I believe contain some.

Any other points
None yet, but depending on how things proceed I might edit this post and put some info here.

Thank you, again, for anyone willing to comment or raise a point of observation.



You need to realize that your SHBG in overstating your testosterone production status and is choking your free testosterone, when SHBG is elevated it raises total testosterone and lowers free testosterone by binding up most of your bioavailable testosterone. Sometimes guy just have genetically high SHBG, other times it environmental or something we are eating that’s affecting our liver negatively.

SHBG is made in the liver and as we age our SHBG increases and lowers our free testosterone, so by the time we are in our 60’s you can bet our SHBG is higher than it was in our 20’s, so we have less free testosterone and less exercise capacity and doctors tell us we’re getting older and do to deal with it.

If your SHBG was somehow dropped to the middle ranges you would see your total testosterone drop to below the reference ranges, so you need to understand your testosterone production is already quite low and is just being elevated to look mediocre when it isn’t. Most doctors have poor knowledge regarding hormones and do to inexperience would fixate on your total testosterone alone and believe you are normal without realizing the consequences of elevated SHBG.

The one thing that lowers elevated SHBG quite well is androgens, so TRT is the solution as the large peaks of injectable testosterone will lower elevated SHBG back down to a healthy level freeing up the bound testosterone so your body can then utilise it. As of right now your bioavailable testosterone is quite low, free testosterone measurements are taken with a grain of salt as it is released in micro pulses throughout the day and can be elevated one hour and low the next.

Concerning is your ferritin level dropped to an unhealthy level in June 23rd 2017, your thyroid hormone production requires ferritin be optimal and optimal ferritin level for thyroid function is between 90-110 ng/ml. You need to investigate why your ferritin is fluctuating, it’s been dipping below ranges and also above ranges and it could be an iron storage disorder.

An iron storage disorder/hypothyroidism can expect to see hair loss and hair thinning and I believe it might explain your TSH fluctuations, hypothyroidism and iron deficiency frequently go together. Remember labs are a snapshot in time and your hormones are constantly changing so you may see one set of labs show good results and days, weeks later see a dramatic change.

Thyroid also requires good cortisol levels, cortisol messes with your thyroid hormones. Training with low testosterone, low cortisol will raise Reverse T3 negating good free T3 levels and stress out the adrenal glands. Himalayan Crystal Salt only has some iodine in it, you need iodized salt.

See thyroid sticky and measure morning and afternoon body temperatures, temperatures reflect Free T3 levels. You need to be checking Reverse T3, thyroglobulin antibodies and thyroid peroxidase (TPO) and these could help explain elevated TSH. I had optimal TSH, great Free T3 and Free T4 and very high Reverse T3 and very high thyroglobulin antibodies, you need to dig deeper or you’ll miss the bigger picture.

You can forget about your state healthcare footing to bill for these very necessary tests.


Hay Systemlord.
You must be quite the typist as I see you’re a very active on these forums.

Thank you for the elaborated response.
When I looked again, some of my lab results were missing, hopefully it’s all there now.

In March/April’17 my iron level just randomly dropped. Vitamin-D was also low. I started taking supplements and got it back up - as seen 26Sept’17.

What I’ll do is I’ll investigate the rT3. I’ve gotten iodized salt also. My oral thermometer broke today. Meh.

But it seems that my focus, before even considering TRT should be addressing thyroid/cortisol - am I correct in saying this?

Also, don’t you think my total testosterone will stay at its current point even if SHBG comes down?

Yeah I’ve noticed quite some time ago. Even having these tests done or prescribed is hard as people are very hesitant to test for many of the above.

If your cortisol, ferritin is too high, it will effect your thyroid hormone production. Guys who start TRT with thyroid problems often feel worse as TRT attempts to restore metabolic rates and thyroid is unable to be a team player slamming on the brakes.

Excessive supplementation can cause problems if you end up overdoing it and can cause other deficiencies as a result, only supplement actual deficiencies. People spend thousands on supplements that are completely unnecessary and do more harm to the pocket book and your body.

You need to start thyroid and TRT together with your cortisol issues. I’m not going to lie, it will take a damn good doctor to get you right again, you may need to go private. I know there are a few members here in Canada who have found golden gooses in Canada within the last week, scroll down the list as they are there. I’ll keep an eye out for them.

I hoped to chime in today with cortisol results, but alas the appointment has been postponed till Monday.

Unfortunately (well, I actually count myself fortunate) I’m from South-Africa. That means I go private, always. But when it comes to thyroid and hormones, a lot of private specialists here are quacks and only want your money.

I’m quickly gonna search the forums and see if I can find someone with a case similar to mine.

sorry to high jack thread. may i ask why injecting test was a horrible mistake when you felt fine and overall improvement of symptoms? have you tried calling defy?

Hey man. There are two reasons for this

  1. I had to break the law to self-administer. I wasn’t following a doctor’s prescription. For some very odd reason my conscience just really bothered me. I’ve also been reprimanded by every doctor I’ve seen and explained my story to.

  2. I’m wondering whether I didn’t do some damage to my HPTA.
    At that time my was SHBG was much lower, (±40 nmol/L), it’s 68nmol/L now.
    My prolactin started going up, nipples actually became sore and remains puffy.
    My thyroid seems to be working much harder now.
    My brain-fog symptoms, slight tremors and memory wasn’t nearly as bad as it is now.

But yeah, if I’m thinking about it objectively the testosterone lifted my mood considerably (my one friend commented that he hasn’t seen a person’s outlook change so much in a positive way).
It helped me sleep better, libido came back in a way that I couldn’t imagine. Energy, life, more passion. But during this time the shakings and twitches started.

It felt like my lowish testosterone was only a symptom and I was only treating the symptom, neglecting the root cause.

well its because im right around your age and considering trt since i’m hypo secundary (from my own research because docs havent diagnose me yet). i’m going straight to defy BUT i still have other problems that they might not work on. i have a pituitary tumor and my growth hormone is low. and to be honest, i haven’t seen anyone getting treatment for this. do you really think 100mg cyop test did that to you in two months? i mean i see that dosage around here and its not a lot. thats my fear, i dont want to take it because i might feel bad

Shucks bro. It might be because I had ‘underground’ testosterone. So I have no idea whether that might have been truly 300mg/ml as it claimed or whether there was rat urine in it. In fact, my heartrate sometimes raced quite a lot and I actually wondered whether that was ‘normal’. And there were definitely times when I took more than 100mg purely because I had 3ml syringes and it was hard to measure so precisely.

As far as my understanding goes, testosterone in and of itself is gold for the male body. I don’t think it’ll cause issues, it’ll definitely solve issues where there are testosterone-deficiencies. But I’ve always been a smaller guy, lower libido than most. I think it’s possible that I have a brittle HPTA-axis. And even if I have a brittle HPTA, it might be that my symptoms are related to a pituitary tumor or something as well and not the past exposure to test.

The scary thing about TRT is the lifelong commitment, I guess.
I’m also concerned about fertility even though I’m aware of HcG/HMG. But bro, where I’m at, I’ll do anything just to be able to function again.

As for Defy, I haven’t contacted them - can I do so, being from S-A?

I cannot help you out with this, but I’m curious. What are the treatment options for pituitary tumor? Also, did you find it with MRI scan?

thanks a lot mate defy is located in tampa. well you can see a tumor with an mri and the treatment depends on the hormone that is secreting. it can be prolactin, fsh lh or acth (from what i understand).