T Nation

27 Y/o, Low Free T, Low LH, Low E, High SHBG

Recent Labs (done at 8 AM):

SHBG - 111.6 nmol/L (Range: 16.5-55.9 = Abnormal)
Albumin, Serum - 4.6 g/dL (Range: 3.5-5.5 = Normal)
ALT - 58 IU/L (Range: 0-44 = Abnormal)
AST - 83 IU/L (Range: 0-40 = Abnormal)
Glucose - 69 mg/dL (Range: 65-99 = Normal)
Prolactin - 3.0 ng/mL (Range: 4.0-15.2 = Abnormal)
TSH - 1.470 uIU/mL (Range: 0.450-4.500 = Normal)
Estradiol - <5 pg/mL (Range: 7.6-42.6 = Normal)
LH - 1.5 mIU/mL (Range: 1.7-8.6 = Abnormal)
FSH - 3.8 mIU/mL (Range: 1.5-12.4 = Normal
Testosterone, Serum - 373 ng/dL (Range: 264-916 = Normal)
Free Testosterone - 3.2 ng/dL (Range: 9.5-26.5 = Abnormal)

Symptoms / Issues: Urinating frequently at night, occasional night sweats, little to no sexual desire, no morning wood, ED, lack of energy / motivation.

I take Iodoral and use iodized salt. I am not on a restricted diet and am well-fed. Never used gear.

Other stats: 5’11, 185lbs, exercise daily and lift weights 4 times per week. Estimated 11 - 13% body fat. Bench 275, Squat 365, Deadlift 450 as approximate maxes.

I have almost no Free T at all. Feels bad man.

Old thread with old labs:

Advice on getting better T levels and less SHBG? I’m getting an MRI next week, working with an endo now.

I took 2 seconds and looked at your old post. Seems like all your answers are there. Why did you make another post?

You are going to need TRT in the future, its almost certain. You have Post finasteride syndrome, could take years to fix.

You can try a liver detox to see if it lowers your SHBG. (calcium d gulcarate, TMG, milk thistle, Sam-e)

Long story short, Finasteride fucked you. Youll need to replace your T and work on lowering your SHBG.

I made another post because I was hoping for some more input on lowering SHBG. I should mention the endo is extremely hesitant on putting me on TRT due to my age. But I don’t know what else to do. Will TRT lower SHBG?

I’ve tried a liver cleanse supplement but I don’t think it did anything.

Is there a way to know for certain that my current issues can be attributed to post finasteride syndrome?

Lowering SHBG:

  1. Large testosterone doses (people with high SHBG do 1 injection a week, this increases your TT and in turn forces your SHBG down)

  2. Avoiding alcohol, medication, anything that is processed by the liver.

  3. Avoid keto and plant based diets.

  4. Depending on what the issue is, some liver detoxes have helped some people. (calcium d gulcarate, Milk thistle, Sam-e)

Your SHBG is insanely high. Your not on any meds or have never been on meds that would cause it. (besides finasteride of course)

Usually, when someone has PFS their E2, and SHBG is out of whack. You have no other reason that your SHBG would be out of whack, so I would bet money its because of finasteride. You might have other issues, but FIN definitely fucked you up.

Very important to get selenium with your iodine!

A multi-vit with trace elements including 150mcg iodine + 200 mcg selenium would be good.

AST/ALT easily elevated by sore or none recovered muscles. Stop training and recover for next lab work.

No known problem with low prolactin.

Low FT means low FT–>E2 so that is why and hot flashes.

Training in your state with low T and ??? thyroid function may be creating harm by stressing adrenals, a serious outcome.

TSH is too high, near 1.0 better, need you to check oral body temperatures, see below and post.

To attempt to lower SHBG:
Higher dose TRT, with anastrozole to get near E2=80pmol/L

SHBG is made in the liver to scavenge sex hormones, normally promoted by estrogens and decreased by free/bio testosterone.

Your frequent urination is a symptom. While diabetes can cause frequent urination, lower glucose contradicts that. A1C would be very definitive. Also can be prostate issues and while not age related BPH, prostatitis is a possibility. Google prostatitis and see if your doc can investigate or send you to a urologist. Any other symptoms down there.

You should pursue TRT with haste and make sure that you read everything that I have suggested.

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
  • 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.

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Wanted to say thanks for the help guys.

My body temperature is usually between 97.6 and 98.0.

I had an MRI and just discussed the results with my endo. She said I have a small 3mm cyst on my pituitary but it is of no clinical significance.

She is still reluctant to do TRT. I feel like I’m spinning wheels. She wants to re-test my bloods in 2 months after I’ve been off all supplements (amino acids, zma, etc.) and see if there is anything wrong with my gonads and do more of a genetic evaluation.

Realistically I’m going to talk to some older gentlemen at my gym who are on TRT and inquire with them about their doctors because I’m guessing they are more knowledgeable than my endo.

Your endo shouldn’t be so hesitant and should realise with SHBG numbers like those you can’t have normal free T numbers, it sounds like TRT is outside of her knowledge as is the case with just about all of them.

Your plan to speak with men at the gym is a smart move, preferably one who also deals with thyroid issues. Let us know how things go.