SHBG - 95.6 nmol/L (Range: 16.5-55.9 = Abnormal)
ALT - 43 IU/L (Range: 0-44 = Normal)
AST - 70 IU/L (Range: 0-40 = Abnormal)
Have you been training and sore or non recovered muscles for labs? [AST/ALT] If not, there is some possible concern re liver function. SHBG is made in the liver to scavenge sex hormones and sometimes a liver problem is associated with high SHBG.
Sometimes SHBG is just high in some guys with no known reason.
High E2 can increase SHBG, you do not have that. Low T can increase SHBG and TRT might reverse this to some extent.
TT is not normal as high fraction of SHBG+T inflates TT which then overstates your T status and TT should be disregarded. On TRT your TT needs to go higher than normal and FT or Bio-T is your dosing guide. You will most likely need more T than others.
Neither E2 or prolactin is causing your secondary. Any blows to the head that could have damaged the pituitary? A MRI could visualize but would not change the outcome.
Night sweats or hot flashed could be low E2
Your bones and brain need more E2 to work right.
Prostate may change with TRT.
Was that lab work from Labcorp?
Thyroid and iodine: Please post oral body temperatures - see below.
At your age you would need hCG to preserver fertility. And hCG alone might work.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- 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.