T Nation

35Y/O, Results In. High Total, High SHBG

I had a full panel done due to [nearly all] the classic symptoms of low T, but now I’m not so sure if it’s a problem. Didn’t expect anything near an 844, but I realize that may not be the full story. The bioavailable test and SHBG are interesting.

35m, 5’6, 160, 16% BF
lifting for ~10 years.

Lab: Quest Diagnostics

  • TSH: 3.14 [0.40-4.50 mIU/L]
  • T4 Free: 1.3 [range: 0.8-1.8 ng/dL]
  • T3 Free: 3.7 [range: 2.3-4.2 pg/mL]
  • Testosterone Total: 844 [250-1100 ng/DL] (note: Two years ago, total tested @ 575, no free test #s)
  • Testosterone Free: 60.6 [46.0-224.0 pg/ML]
  • Testosterone Bioavailable: 132.6 [110.0-575.0 ng/dL]
  • SHBG: 71 (HIGH) [10-50 nmol/L]
  • IFG 1: 200 [53-331 ng/mL]
  • Prolactin: 10.6 [2.0 - 18.0 ng/ML]
  • Estradiol (Ultrasensitive LC/MC/MS): 28 [< OR = 29 pg/mL]
  • Homocysteine: 12.4 (HIGH) [<11.4 umol/L]
  • Cholesterol, Total: 207 (HIGH) [<200 mg/dL]
  • HDL: 98 [>40 mg/dL]
  • LDL: 65 [<150 mg/dL]
  • Triglycerides: 65 [<150 mg/dL]

Test came back with out or range (HIGH) for:


Quite surprised by that 844 total test.

Two years ago total came back at 575 (at 33), but didn’t have a free range to compare against.

Thoughts? Does this look normal, or does the high total vs. relatively lower free (+SHBG) look off? Thanks.

SHBG and thyroid are definitely the problem, all you Free T is bound up unavailable for use, you might as well have a Total T of 100 ng/dL. You’re going to need large T injections in order to bring down your SHBG, nothing else will affect SHBG more than androgen activity. TSH is also too high, most doctors will say TSH is fine.

You need to list your current and past medications if you are having high SHBG. Past alcohol, pills? Your high SHBG can inflate your total testosterone number. So, you may not have had high SHBG when you first tested and it was 500’s. Now there is less free and more “bound” test, which inflates the total test number.

Meds… What medications are you on.

Thanks for chiming in.

Ambien 10mg/night; 12 years. :grimacing:

Intermittent use of benzos (xanax, klonopin); prescribed; 2000-2015, typically taken a few months at a time with months to years off in-between. Haven’t touched one in 2 years and won’t again. I’ve read that these drugs can certainly affect SHBG. Poison, really. Bad news.

Spring & summer: 2-3x drinks a week [cardio; cycling]
Fall & winter: 0-1x drinks a week [heavy lifting]

relatively clean w/ high protein [alternate higher carb/higher fat depending on the training season];

Peak performance:
475lb deadlift, 17:30 5K at 150lbs, 2015.

I’ve always felt like I’ve been running uphill my whole life. Successfully for the most part, sure, but uphill nonetheless.

Thanks for your feedback.

Benzos are what caused mine to skyrocket, and unfortunately, the damage may already be done. However, you need to look at the Ambien for sure, I know most sedatives cause SHBG to increase, so I think ambien would classify, but im not 100%. I have heard a doctor call it a benzo, but its not, its actually a hypnotic.

Anyway, this may help bring your SHBG down into an 'ok" range. When I first started TRT, I was around 50 SHBG, then I had to start a BP med because of increased BP from TRT. I was on lisinopril and my SHBG went up to 70!!! Huge increase, I stopped the lisinopril and it came back down to 49.

I still take benzos, VERY VERY rarely, maybe once or twice a month, small dose. I also have been supplementing with Milk Thistle everyday.

Currently trying Aromasin out for its SHBG lowering properties. I have been doing pretty well, gaining in gym and good libido.

Can you get off the ambien?

Damn, sedatives increase SHBG too? Any studies? I regularly rotate between Sonata, Ambien, OTC sleep aid, and Benadryl to help with chronic insomnia. Maybe that’s why mine has been elevated.