T Nation

26. Low Test, High Shbg, Very Low Estradiol


#1

Here are my blood test results. A little history. Serious gastrointestinal issues starting at 18 after travel and antibiotics. Spent 2 years extremely sick gradually got better and now I have gut issues on and off. Depression/anxiety at times, worse in the winter (generally everything worse in winter). I had a concussion in May. Definitely affected sex drive, emotions etc… Generally feel like crap, low energy, confidence, poor SLEEP, libido.
Anyhow I am so tired of feeling terrible and not being able to get on with my life and be productive. Any help interpreting my results would be hugely appreciated. My doctor has not been very helpful at all. Estradiol seems very low, Shbg high and test low. I posted the pic with age corrected references. Should Also ad that I generally live a healthy pro testosterone lifestyle and I am 26, 5’9, 155. Probably 12-15 BF. Also i calculated free test as 5.45 ng/dl
And bioavailable test as 128 ng/dl. I did this using average albumin level since this wasnt tested for
Thanks!!


#2

E2 is low because, FT is probably low. You are better measuring FT directly if available. When guys are on TRT, we like to see them near 80 pmol/L, so your number does not look so bad. If you get T levels up, E2 will follow. SHBG can be low because of low E2, so no problem.

A blow to the head can damage the pituitary and lead to lower T.

IGF-1 a bit low for your age.

“everything worse in winter” can be from low Vit-D. Get 5,000iu Vit-D3 capsules which are typically very small oil based gel caps. Take 25,000iu for first 5 days.

You may also have post concussion syndrome. You may have read up on that already. Essential fatty acids are very important for development and maintenance of nerves and brain tissue. Try fish oil, also flax seed oil/meal and nuts.

Take above two items with meals that are low fiber.

T4 is below midrange.
This might be from not using iodized salt to support thyroid hormone production.

You can check overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. They are connected.
Are outer eyebrows sparse?
Feeling cold easily?

DHEA is a bit low for your age suggesting possible involvement of the adrenal glands. You can also test AM cortisol, at 8AM please.

CBC, RBC, hematocrit?
Occult blood test to check for GI bleed?
Total cholesterol to see if too low.

Sleep: Can you get melatonin where you are? 5-6mg in a time release formula would be good. Vitamin C also before bed.

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

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Extreme low fat and low BF can be harmful to hormones.


#3

Thanks for the thoughtful reply. Shbg is High not low. It is basically at the very top of the range. I am taking 6-8k iu vit D already. Also taking fish oil. I believe my post concussion symptoms are gone except it seems lingering hormonal problems possible from pituitary damage. I would say I do feel cold easily at times but not all the time. The outer edges of my eyebrows have always been sparse. I also know my aunt has a visible thyroid… I will work on getting the rest of the blood test info or a updated test since this is about 5 months old.

Any thoughts on giving myself clomid in the hopes of raising test etc… I have had others suggest doing that with dhea and pregenelone as well. It seems like if you start actually supplementing hormones you shut down your own production. I know it works this way with test but is it the same with dhea and preg? Other than making sure I consume enough iodine what can i do for thyroid. Does test/estrogen etc… influence the thyroid. Ie. will raising test help out the thyroid
Thanks!


#4

Please get as much from the stickies as you can.

Also see the HPTA restart sticky.

TT is middle of the road bad.
SHBG is high and elevated E2 is not the cause.
FT will be low and this is not helping.

SHBG can be reduced with higher FT levels and lower E2. You can’t lower E2. When T levels are high range, E2=80 pmol/L is a great goal.

While thyroid labs do look reasonable…
You have not tested fT3 or fT4

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.


#5

I believe E2 is below range. In pg/ml converted from pmol/l I am at 12.8. I am gonna get a oral thermometer today. I don’t eat iodized salt bread or milk so I am thinking I might just start supplementing. I defiantly feel cold a lot of the time. After reading the thyriod sticky it is not clear to me the mechanism behind hypothyroid and low t only that the connection between the two exists