T Nation

27, Post Concussion. Labs: Low Test/Free Test, High SHBG


#1

13

Quick Conversion for above test levels 13.2 nmol/l =381 ng/dl

-27 years old
-5’9
-160 pounds
-32 inch waist
-No body hair, sparse facial hair
-Always thin/moderately strong, had a six pack no matter what until the last couple years. If i carry any fat it is on midsection
-Diet consists of Meat, eggs, vegetables, root vegetables, nuts seeds, rice
-When i train i usually do push, pull, legs. 6-12 reps. Probably 8-12 sets per workout plus some HIIT or light cardio. I have been doing less training lately(torn acl) usually 2-3 times a week. Generally active, walk hike, bike
-I occasionally get sharp pain in balls prostate area
-Rarely have morning wood or erections in general

History of serious gastrointestinal health problems starting at 18 and continuing until about 22. (Prime development years) I believe my gastro issues are gone. Myabe a little ibs still. Family history of depression anxiety which i also suffer from. Bad concussion 1.5 years ago. Labs are from about a year ago.
I suffer from all the typical symptoms of low T- Poor exercise tolerance/recovery, low libidio,poor erections (most of the time), low confidence, anxiety/depression, brain fog/poor memory
Attached below is some labs. I have low total T with high SHBG
I Calculated Free T using 13.2 nmol/l (My free T) , 55.6 nmol/l (my SHBG) and 4.5 g/dl albumin(mid reference range since i didn’t have it tested) I come out with .186 nmol/l Free T or 5 ng/dl free T.
The reference below for free T (#13) is the Mayo clinic reference range.
They have the bottom of reference range for my age as 5.05 ng/dl for free T.
I have been struggling with all these symptoms for the past several years on and off but since my concussion things seem to have gone downhill. I had a previous total T test at 550 in 2014
My hope is that I can do some sort of restart. Nolva/HCG etc… Or dial in nutrients, thyroid, adrenals and see if I cant get my levels and more importantly my symptoms /life back on track.

I have tested oral temps as per Thyroid sticky. Two mid day temps, 35.7 and 35.1
These seem really low, possibly my thermometer is crap although it is pretty new. I feel maybe a little colder than normal at times but not excessively. I use iodized table salt regularly.
My thyroid labs look mostly good or at least decent but I realize I dont have rT3 which may be the problem

I hoping someone with more knowledge than myself can send me in the right direction. I am ready to start TRT if i have exhausted my options and it is gonna improve my quality of life which is quite low atm.

I live a generally very healthy pro hormone lifestyle other than some stress and depression that i do my best to manage.

Its my understanding that lowering SHBG is near impossible and that that will always keep my levels fairly low so maybe all a lost cause…

My estrogen is below range and there is very little info out there if that has any detrimental effects

My DHEA S is also at the low end of the range and apparently should be peaking at my age. On the advice of John Crisler I tried taking 25 mg twice daily for a few months. Also adviced to take Pregnenalone but I forget the dosage although I believe it was 50 mg as well. Seemed to help with libido at times as well as general sense of well being. My skin really improved for a time (normally dry and pale-while on DHEA was shinier and more smooth). The first night I took the DHEA and Pregenealone I had a hard on all night with sex dreams. Felt great the next day full of confidence/energy and I felt really sharp mentally which was awesome since i normally feel braindead/terrible memory. This effect wore off rather quick but I still seemed to get a benefit and ended up dropping the preg pretty quick since I was getting bad anger /irritability.

Should I get more labs to see where I am currently at and then possibly try a restart. Maybe pursue if I am suffering some sort of adrenal fatigue(I have bee through serious bouts of stress). I will defiantly get rT3 and see if thats an issue. I dont wanna waist any more time stuck and feeling like crap. I have thought through all the implications of TRT that i can at this time and am ready if thats gonna really help. If youv’e read this far thanks and im grateful for any input


#2

No replies or input? Is the post too long/convoluted


#3

Keep taking DHEA. Low cholesterol could be a factor.

Are you taking Vit-D3? 5000iu suggested.

TSH should be closer to 1.0
fT4 shows some possible lack of iodine. Using iodized salt?
Where are you located?
Your fT3 should be supporting good body temperatures, rT3 would be a good explanation. See thyroid basics sticky for references to: stress, infection, inflammation ,acute, chronic, surgery, rT3, adrenal fatigue, Wilson’s book.

Do you feel cold easily?
Are your outer eyebrows sparse?

DHEA-S seems low, is cholesterol low. Is your diet including enough fats?

Blows to the head can damage the pituitary.


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
  • HPTA restart <<<<<<<<<<<<<<<<<<
  • 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.


#4

-Currently taking 10 mg dhea 4 times a day.
-I take 5000-8000 iu Vit D every day
-I have been using iodized salt for 4 months. Before that I was supplementing with kelp derived iodine. I will start taking the supplemental iodine at recommended dosage via thyroid sticky
I am in Canada
-Gonna work on getting rT3 lab. As far as things that raise rT3, I would say stress/adrenal fatigue is a definite possibility. Will a lab test for serum cortisol levels help determine this?
-I would say I feel colder than other people at times but not extremely so. My outer eyebrows are defiantly sparse and as far as I can remember have always been
-Diet includes lots of fats-4eggs/avocado/butter/fatty meat -daily
-BTW my aunt had goiter at one point

In terms of things that damage hormone levels
Other than a concussion, stress/depression(genetic) and poor sleep at times my lifestyle is pretty good. Good diet with lots of nutrient dense foods-minimal exposure to damaging chemicals- exercise/weightlift regularly

I just saw a doc told him about concussion and symptoms he gave me lab work for LH FSH GH Cortisol TSH and Testosterone. (checking my pituary output)
**How long do I have to be off DHEA for the metabolites not to affect acurate Testosterone reading?? Half life of DHEA is 30 mins so I would have no problem after 24hours. However half life of DHEA S is 7-22 hours so I would need to wait a long time. SInce DHEA turns into DHEAS and I have been taking DHEA for a while do I need to wait for my DHEAS level to lower to what my body is naturally making so I can get a accurate Test reading. This doc seems a little clueless he didnt even tell me to get the blood drawn in the morning. I dont want a inacurate Test reading If I am gonna need him to help me do further testing etc…
Thanks!


#5

I noticed more pronounced thyroid symptoms especially being excessively cold after being put on a corticosteroid for a while and then coming off. I wonder if this downregulated my thyroid


#6

Sorry to respond this way, but I couldn’t read through all of that.

Are you on any medications? Past or present? Think hard. (regarding high SHBG)


#7

No medications in the past 2 ish years. Dexamethasone(corticosteroid was after oral surgery 2 years ago


#8

Any thoughts on low dose proviron. Would the SHBG binding/lowering effects outweigh the possible suppression?


#9

We have a wildly similar story. I was rear-ended (low impact) 1.5 years ago and since have chronic shoulder blade pain (daily) along with calf/ foot irritation.

My testosterone level dropped (I think due to a concussion from my head hitting the seat). I’ve lost major libido and find myself getting injured frequently. To put this in perspective, prior to the accident I was playing competitive ice hockey 5x/ a week.

I’m on 100mg Test cyp but my libido has yet to return. Any thoughts?

My most recent labs were:

TSH 1.77 mIU/L 0.40-4.50
T4(THYROXINE),TOTAL 5.9 mcg/dL 4.5-12.0
ESTRADIOL 33 pg/mL < OR = 39
C-REACTIVE PROTEIN <0.2 mg/L <8.0
TESTOSTERONE FREE 65.2 pg/mL 46.0-224.0
TESTOSTERONE BIOAVAILABLE 153.8 ng/dL 110.0-575.0
SHBG 48 nmol/L 10-50


#10

You need to create your own thread where you can get individual attention dedicated to your case.


#11

There is a threat floating around with someone using Proviron WITH TRT.


#12

I am not on TRT so I was wondering about using it to lower SHBG without TRT.
I just had bloods done
LH -4 (1-9)
FSH -4 (2-18)
Testosterone 21.5 (5-26.5)
TSH 1.65
Cortisol 400 (150-600)

My test level is good but based on the way im feeling I assume my SHBG is same as before 55.6(top of range) or even higher which is driving up my TT but leaving my FT low. My doc wouldnt test E2 or SHBG so Im gonna see a different doc and pay out of pocket to get it done. I have been taking DHEA 10 mg x 3 a day but didnt take any for 4 days pre bloods.

I have noticed that my balls are a lot smaller than they used to be. Any benefit in running HCG with controlled E2 for a while to increase there size and function??