T Nation

30, High SBHG and Estrodial Low Free T

Seeking advise for my situation. Have done a lot of research but would like more opinions on my lab results and possible treatment options. I see others on the forum with similar situations and see advise ranging from “you cant lower SBHG without TRT” to promoting natural options. Ive had symptoms for years and finally got serious into investigating the last few months. I went and got these tests on my own dime as I do not have insurance currently. Ive always had problems with getting/staying lean, mild pubertal gyno (not bad really just puffy nips, small lumps behind nipple, strength training throughout my 20s built up my chest so its not too noticeable.) occasional depression, lack of motivation/energy/concentration issues/brain fog especially over the last couple years. Very low sex drive(no ED), morning wood maybe 1x per week.

Starting to think ive been dealing with a hormonal issue for a long time and just now figuring out. Even asked for my T levels to be checked about 5 years ago and the dr just tested total T and the result was 500 she said it was normal and that was the end of that thought for a while as I (and probably her) didn’t know much about hormones.

Any advise is appreciated.
also, does anyone take an AI on its own with the goal of reducing E2 and SBGH and raising free test?

An AI has no direct effect on SHBG, however E2 levels do have a connection to SHBG levels. E2 isn’t overly high though, optimal is 20-30 pg/mL. Your SHBG is grabbing onto most of your FT and is inflating your TT score, which is actually quite a bit lower. Let’s say somehow you managed to get your SHBG down to 30, your TT would drop significantly below reference ranges in quick order.

Most doctors will completely fail at understanding male hormones since it isn’t even covered in medical school, it’s like trusting a wannabe mechanic who dropped out of school. There’s more to male hormone than just testosterone, there are other elements at play here.

Thyroid looks fine on the surface, but fT3 is the active thyroid hormone, checking your body temperatures upon waking and between 12-2pm is the best indication of fT3 status. Sometime rT3 can prevent fT3 from entering your cells even with good fT3 numbers, if fT3 numbers are good and still have hypothyroid symptoms, high rT3 is suspected.

If temperature upon waking are 97.7 and 98.6 12-2pm, then this suggests thyroid is optimal. If slightly low this suggests iodine deficiency and can be solve with iodine and selenium. TSH should be closer to 1.0. Usually our E2 is converted from our FT, (SHBG+T->FT->E2), your liver doesn’t seem to be clearing out E2 well, suggest liver detox.

Do you drink tons of alcohol?

What’s your diet?


Thanks for the reply. That’s a lot of information. Over the past year my motivation for diet and gym hit an all time low. So my diet isn’t great compared to how it used to be. I’m 20 pounds heavier than normal. I was drinking more than normal late last year. Haven’t had a drop of alcohol since New Year’s Eve.

How can I liver detox? Is that an actual thing? So an AI won’t lower E2?

Also, is there any data/studies on how much higher levels of sbhg raise total testosterone levels? Could you speculate what my level might be if my SBHG was reduced to a normal level?

Testosterone is produced in the testes, SHBG is made in the liver, SHBG scavenages sex hormones. If you were able to cut SHBG in half your testosterone would easily drop into low testosterone land, you are low testosterone.

It’s going to take the best hormone specialist to realise this fact as most would only look at total testosterone and call it a day. You can cut out more than 80% of insurance doctors, most pay out of pocket in order to get proper care. It’s the only way to get a knowledgeable doctor these days.

The only thing that can drop your SHBG levels is TRT, more testosterone forces SHBG down.

I appreciate your responses. To clarify, you think when all is said and done TRT will be the solution? Even with the second test level at almost 700…

Your pituitary gland should be kicking into high gear attempting to produce enough testosterone to compete with that high SHBG, that isn’t happening here. We see guys in here with a natural TT over 1500 trying like hell to compete with high SHBG, it’ll never be enough.

Everyone that goes on TRT sees their SHBG levels decrease which is great, unless a guys SHBG is already low. We need some SHBG to activate sex hormones. You won’t have to worry about low SHBG, yours should drop to ideal levels once TRT commences, however some guys with high SHBG see no reduction.

That’s not common though.

Damn. The thought of injections 1-2x a week forever is a tough one plus I’m only 30 and want kids in the next couple years. At the same time I want to feel better than I did the last decade. Hormones are interesting. I appreciate you taking the time to respond. Out of curiosity, are you on a protocol? Does defy medical have generally favorable reviews on this site like they do others? Or is it wise to perhaps learn everything and go the UGL route? I have no insurance at the moment but will within the next year.

Your welcome.

HCG together with TRT greatly improve fertility, guys on TRT are having babies all the time.

I’m on 40mg twice weekly, no AI, no HCG.

Defy Medical, boy are they good! Most popular choice.

Curious what 40mg 2x week puts your total and free levels at?

I’ll find out in 2 months when I’m do for my yearly blood test. I was originally at 50mg twice weekly and did fine, except I want to see how I feel with slightly reduced levels. My testosterone levels were fine but had slightly emotional crying spells during moments of non-sad moments during movies which always indicates slightly high E2 levels.

E2 levels are a much larger factor for how a guy feels mentally and emotionally on TRT. Even slightly high E2 levels can cause fatigue as high E2 inhibits testosterone’s effect on the androgen receptors in the body. Unfortunately I never got labs when I was on 50mg twice weekly.

Any medications past or present?

I don’t recommend AI, at all. But if you do go that route, Aromasin lowers your SHBG because it is a steroidal AI.

You might have some luck trying to bring your e2 down which might lower your SHBG also. Look into cruciferous vegetables, Broccoli, brussel sprouts.

I cant point people to CDG, or DIM or even Sam-E anymore as they have absolutely TANKED my e2, even on very very small doses. I wont recommend them, but DIM is what you are looking for, and you can get it in those veggies.

How much broccoli should I eat to lower E2/SBHG? Any sources/studies for this?

Cruciferous vegetables have DIM, Which is what helps metabolize estrogens away from the bad e2 and more to the e1-e3.

I couldn’t tell you how much, but I usually eat it at lunch and dinner, everyday during the week. It helps when I have little e2 flare ups, like acne or lack of Am wood.

I cant link anything on here, but there is lots of stuff out there.

Will lowering E2 lower shbg for sure? But then if my SBHG lowers it will also lower my total Testosterone to a level that’s too low?

There are no guarantees when it comes to SHBG. If you lower your SHBG you will have more free test, which is what you want.

TRT in higher doses has lowered it for some people. It depends on why its high in the first place. Liver damage, alcohol, genes, meds.

I had my Test really high (1100-1300) range for a while and it did nothing to bring it down.

But if I lower SBHG, won’t that lower Total test as well?

I am not articulate enough to sit here and type out how SHBG and Total Test work. Ill try though.

Your not losing any testosterone by decreasing your SHBG. You are only freeing it up.

So changing your SHBG will not change your OVERALL test level. It will look like it was lowered, but that’s because it is now free and not bound.

alphagunner nailed it, the amount of SHBG determines how much of your testosterone is free and how much is bound. SHBG goes down free hormone go upwards, SHBG goes high, free hormones go down. Total T usually goes in the opposite direction, testosterone production is unchanged.

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