Update:
Met with the doctor again after 3 weeks on low-dose t3/t4. I felt noticeably better for 2 of the 3 weeks (non-consecutively – several good days followed by 1-2 bad days) so Dr. decided to increase my dose of t3/t4. He says that this is the maximum dose he is willing to prescribe me based on my labs, so we’ll see if it makes a difference. Meeting again in another 3 weeks to discuss symptoms and have labs done. Hopefully thyroid medication continues to help and we can talk about altering some of my other strange numbers; primarily E2 and SHBG.
Update/ Questions:
Currently on 60 mg of a t3/ t4 compound prescribed by my doctor. Feeling somewhat better – particularly less fatigued – although feelings of weakness, lack of drive/ motivation, and mental fog persist. Also beginning to notice a decrease in sex drive compared to several months ago.
Here are my current labs:
TSH: 2.730 uIU/mL (0.450 - 4.500)
Thyroxine (T4): 11.4 ug/dL (4.5 - 12.0)
T3 Uptake: 24 % (24 - 39)
Free Thyroxine Index: 2.7 (1.2 - 4.9)
Testosterone, Serum: 655 ng/dL (348 - 1197)
Free Testosterone(Direct): 9.7 pg/mL (9.3 - 26.5)
Sex Horm Binding Glob, Serum: 88.4 nmol/L (16.5 - 55.9) HIGH
Based on these labs, my doctor advised that I stay on my current dose of thyroid hormone for 3 months and then come in for a follow-up and possibly more labs. He also says that he’s stumped about my high SHBG, and that he’s unwilling to prescribe me testosterone so my levels “are what they are.”
My questions are as follows:
- Why has my TSH barely changed in response to exogenous T3/T4 being used? Is this typical?
- Given that this test confirms my earlier low fT result, should I consider TRT? I have called two separate TRT clinics in the area (out of curiosity) and both have said that I meet their criteria for treatment based on my fT levels. So the question isn’t if I can get treated, its if I should.
Any advice would be greatly appreciated.
@TrevorLPT
Any update? I am facing a similar situation with high SHBG and low FT.
Sort of.
I feel a lot better now (but still have challenging periods), which is likely a result of the lifestyle changes I’ve made. If I had to guess, I’d say the most impactful things I’ve done are:
- Breathing exercises
- Regular low intensity cardio
- Learning how to manage overall training stress and training load better
I haven’t found a definitive mechanism for this or how it relates to SHBG and FT, but there seems to be correlation between SHBG and certain stress hormones, and a correlation between low FT and states of overtraining and extreme physiological stress. My current thinking is that this kind of blood profile MIGHT be related to the endocine stress response and by extension, chronically elevated stress levels.
The other thing that I have experimented with is a combination of zinc, magnesium, boron, vitamin D3, and fish oil. At least in my N=1 experiment, this supplement stack appeared to lower SHBG very slightly and caused a disproportionately large increase in FT (and slight increase in TT). So, it put a small dent in my SHBG but raised FT back into the normal range. Your mileage may vary.
Just saw this thread, my labs look very similar to yours and have been suffering symptoms from 3-4 years. I have low stress life really, apart from certain episodes but i cannot say that any one stays away from stress entirely, it’s just not feasible. My cortisol, progesterone etc. look great so adrenals don’t seem to be a big factor. It’s the fatigue that is really holding me back. I practice yoga, cut out the overtraining, eat quality food most of the time and don’t feel better. fT has been consistently low in the past 4-5 months that i have gotten tests done monthly. Zinc, Boron, D3, and Fish oil i have always supplemented, when i got my first test done, i wasn’t supplementing Zinc/Magnesium so i started then, it raised my TT from 500 to 600 but fT remained the same. I am about to give in and start on TRT in a couple months, i think pros outweigh cons if dosed properly and i don’t want to spend anymore of youthful years like an old man and have deep regrets later on life when i’d probably need it. I haven’t had sex more than 2-3 times a month in 3-4 years, i don’t want to be like that at 25. Link between SHBG and adrenals is not very prominent, yours is even higher than mine. I too had an eating disorder for 1-2 years close to when problems started so that maybe the culprit. Links between former anorexia sufferers and SHBG/T problems are strong.
How does your fT look like now?