30 Yrs Old, Low T for 7 Years. What are My Next Steps?

Essentially I have been battling this since I was 23. You can see my previous results here (23 and 25 years old).

I did take Clomid when I was 25/26, and while it boosted my T levels into the high 500s/low 600s, I never felt anything different. As you will see with my new blood work, it appears it dropped back down.

I personally blame a lot of my hormonal problems on taking VEYR high dose Prednisone (80mg) at 21 for 6 months due to Crohn’s disease. I don’t feel like I have ever felt right since. I put on 30lbs to 160lbs, lost all my muscle mass, and became very very anxious, depressed, and moody. Libido is a non issue, however ED is becoming an issue. I did also take Prednisone at 16 for only a couple months at a slightly lower dose (60mg). I always wondered if that messed with my puberty. I have no proof of this however as no doctor would ever take me seriously about this and measure my cortisol/adrenal gland function.



  • Incredibly low muscle mass and the inability to gain muscle and/or loss fat easily at all

  • I hold so much of my weight in my face and stomach (to the point I actually had fatty liver for 2 years until I lost 20lbs (I dont really drink)). Prednisone did move a lot of fat to my face, but I have been off of it for 10 years, yet I still put any weight gain in my stomach and face. I’ll be honest, the face part is extremely depressing. I hate the way I look. At one point in my life I was a ladies man who was very fit.

  • ED; Need to maintain touch to keep an erection (otherwise its gone in no lie 20 seconds), but even then its about 75% hard 99% of the time. No morning wood unless I take Zinc the day before.

  • Diffuse hair loss, NOT receding. My hair has basically thinned out on the top and side of my head without much recession at all for the last 10ish years. I have been able to keep it at bay for the most part with Rogaine, but its slowly losing ground. This is the main reason why I didn’t go on TRT years ago (and tried Clomid first). I DO NOT want to go bald. You can save that speech for someone else about shave my head and look like the Rock. I can’t grow any facial hair (I’m not exegeting, I have maybe 30 hairs in my mustache area for example, basically I look like a 15 year old growing a beard) + combined with my fat face + and moles/birth marks on my scalp, I just can’t do it. I could feel like a million bucks with my hormones in check, but I would never be able to leave my house with moles and red birth marks all over my scalp. Is it possible to get on TRT and combine with something like fin, or is that going to create a new bucket of problems?

Bottom line is I finally have gotten to the point where I HATE how I look and feel. I have done everything else correct in my life, but my physical and mental state is trash. I have a great career and more money than I know what to do with, but I struggle to even get out of my house at this point and it has effected my romantic relationships and friendships. I play in several rec league sports and its so depressing to know what I need to do (I use to be a highly scouted football kicker in HS), but not have the athletics ability to do it. I get by using my knowledge to make up for my trash physical abilities and always being in the write place.

Primary care doctor didn’t want to order all the tests I wanted at first (In particular I wanted DHEA as it was trash years ago):

  • TSH : 2.52 uIU/ml
  • Reference Range:0.36 uIU/ml - 3.74 uIU/ml
  • FSH : 5.7 IU/L
  • 1.0 - 8.0 IU/L
  • Luteinizing Hormone : 1.8 IU/L
  • 1.0 - 6.7 IU/L
  • Vitamin D : 16 ng/mL (Low)
  • 30-100 ng/ml
  • Cortisol - AM : 23.67 ug/dl (High - I wonder if this has something to do with the Prednisone I use to be on)
  • 4.30 ug/dl - 22.40 ug/dl
  • Sex Hormone Binding Globulin : 12 nmol/L (Really cutting it close here)
  • 11-80 nmol/L
  • Testosterone Total : 278.5 ng/dL (Low)
  • 300.0-1080.0
  • Testos Free : 71.7 pg/mL
  • 47.0-244.0pg/mL

What should be my next move? See a endocrinologist? What blood tests should I ask for?

Thanks in advance!

This blows my mind every time. It’s literally no skin off their back what test you have done, doesn’t require any extra effort on your part, and what you glean from the results can be very helpful, yet they still will refuse to sign the req form. Just amazing

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Finasteride will stop/slow your hair loss. Couple links for reference.

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I wouldn’t recommend injections because of your low SHBG, injections will decrease it, not what you want, topicals however have little to no impact on SHBG levels.

The only instance where injections will not decrease SHBG is in diabetic patients which is why SHBG is low in the first place.

What are your fasting A1C values?

Also primary care doctors don’t usually specialize in hormones and normally you are referred to the appropriate doctor for further testing.

The problem is even these specialty doctors can be quite problematic as sex hormones training and education are completely absent in medical school and residency.

I’ve had several endocrinologist and none of them know what the f*** they’re doing!

For the love of God, don’t even think about finasteride before you do some research! There is some research done on the long-term health consequences of using DHT blockers.

You risk post finasteride syndrome for which there is no cure or treatment.

This is not true. Also, guys with low SHBG do as well as others with TRT.

There is no guarantee you will lose any hair on TRT.

I never said low SHBG men don’t do well on TRT, but many do struggle when SHBG is in the single digits.

I was already starting to thin out on the top backside of my head and receding hairline on my forehead prior to TRT, TRT didn’t accelerate any of it.

However in many other areas I have fuller hair, especially on my beard, it’s very dense.

As someone who has no idea what any of this means, what does this mean for me lol.

I have not found that to be true. Maybe, if anything, the opposite.


Well if you have diabetes, then I expect an increase in SHBG, if no diabetes than all it means is you have to be strategic with your treatment protocols.

They are finding out that SHBG may actually be involved in facilitating the entry of testosterone into cells by activating the androgen receptor. So, it is not a hormone that only binds testosterone to render it useless.

Circulating SHBG level as a biomarker of metabolic risk
In epidemiologic studies, low total testosterone levels have been associated with increased risks of diabetes and metabolic syndrome, a cluster of conditions including hypertension, insulin resistance, central obesity, and dyslipidemia, which predispose individuals to an increased risk of cardiovascular disease. In longitudinal analyses, SHBG levels rather than total or free testosterone levels have been independently and prospectively associated with incident diabetes and metabolic syndrome after adjustments for age, adiposity, and comorbid conditions (97, 98). Among children and adolescents, SHBG may also be a biomarker for metabolic syndrome risk (99), and lower levels were more robustly associated with the risk of metabolic syndrome in boys than in girls (100). We do not know whether SHBG is merely a marker of metabolic risk or whether SHBG plays a causal role in the pathophysiology of metabolic disorders such as diabetes and metabolic syndrome.

Which may be why one should not intentionally attempt to lower SHBG.