T Nation

38 Y/O, Low Free T, Low DHEA, High SHBG

Hi all, new to the forum and thought I’d share my bloodwork results. I’ll update as I talk with the dr’s and share their advice. Maybe if anyone has similar labs they can either share their experiences or gain insight from my journey, as I have from others here.

I’ve battled excessive fatigue, lack of motivation, low sex drive and brain fog for a few years now. After checking out the forum here I decided to contact Defy and get my bloodwork checked.

Small bit about myself, Im 38 years old, 6’0” and 180lbs, never have issues gaining belly fat but find it hard to gain muscle. I workout 4x/week which is mostly weight training and not much cardio.

I’m not entirely sure how to interpret the results but I also haven’t had my initial consultation with Defy. Labs are as follows:

WBC 4.6
RBC 4.56
Hgb 14.1
Hct 41.7

Glu 87
BUN 11
Cr 0.87
Gfr 109
K 4.3
Prot total 6.7
Albumin 4.4
Alt 21
Ast 27

Total Test 674 (274 - 916)
Free Test 8.0 (8.7 - 25.0) Low
SHBG 89.6 (16.5 - 55.9) High
IGF-1 133 (83 - 233)
Estradiol 16.7 (8.0 - 35.0)
DHEA-Sulfate 52.1 (102.6 - 416.3) Low
LH 4.7 (1.7 - 8.6)

TSH 1.090 (0.450 - 4.500)
Free t4 1.84 (0.82 - 1.77) High
Free t3 3.2 (2.0 - 4.4)
Rev t3 pending

To be honest, Im surprised my total testosterone was that high, I expected it to be much lower based on how I felt.

Hopefully my Rev t3 results soon so i can schedule my initial consult and see where to go from here

In your case you should ignore total testosterone, the bioavailable or free testosterone is what matters as it’s the free hormone circulating in your blood. Most guys start to have real problems when it dips down to 10.0, high SHBG is getting greedy and binding up the majority of your free testosterone, that’s why it’s so low.

TRT will mostly likely lower SHBG if you inject larger dosages which may be a problem going through insurance since the majority of doctor fixate on total testosterone only and will not allow you to have supraphysiological doses which is exactly what you need.

Once or twice weekly should work well for you. DHEA is also low, IGF-1 is a little low. Teenagers see IGF-1 and grown hormone high normal. If TRT doesn’t increase it, peptides wil.

Interesting results for Free T4, the river of thyroid hormones is reverting over to one side more than the other Free T3 side. Dr .Saya will figure it out.

Defy Medical is the solution.

I have very similar numbers to you
Total T 754
Free T 4.4 LOW
SHBG 80.9 High

I got on board with defy and started my TRT last wednesday and doing twice weekly injections.

Good luck and Call defy

Appreciate the responses. My reverse t3 came back as normal today so tomorrow I’ll schedule my initial consult with Defy.

@yarmish Thanks for sharing, it’s conforting to know there are others with similar numbers and experiences. Did you feel better when you went on trt? More energy, more motivation,etc…?

A Reverse T3 of 15 and a Reverse T3 of 22 would both be considered normal, one is good and the other has negative consequences.

Reverse t3 keeps free t3 in check.

With hormones you really need more than 1 lab to make any treatment decisions. Hormone levels can change greatly during a day.

I am just on my second week now but have noticed some improvements with mental clarity, seem to have a larger gas tank when working out. I think in the 4-6 weeks some marked improvements are supposed to happen

Rev t3 was 16.7 (9.0 - 23.0).

I had my consultation this morning with Dr Calkins and everything went good. He was nice, took his time to explain everything well, and answered all my questions.

He basically said the same as you @systemlord . My SHBG is high, free T is low and the TT doesn’t mean much when the shbg is that high. He noted my thyroid numbers and wants to re-check in 3 months to see how it looks after trt and how I feel. He felt the numbers were within normal range but borderline.

The starting regimen is going to be Test C 180mg/week (2 inj) and hcg 1000iu/week. Vit d3 5000 iu, dhea 25mg, zinc 25mg, a multivitamin with 1-2mg of Copper, and fish oil 2-3 grams/day… i think thats all correct but dont have my paper in front of me this second

He wrote for anastrozole and gave me the option of taking it or not. Basically, start taking it if I experience signs or symptoms of high estrogen. He said he’s fine with an e2 level of about 35-45. He wouldn’t want me starting it for at least 2-3 weeks.

So, it looks like my trt journey soon begins

I appreciate everyone checking in and sharing your thoughts and experiences with this. You all have a lot of knowledge and real life experiences with this stuff while I have near zero of both.

Excellent news! Higher SHBG men can tolerate more estrogen than lower SHBG men since more androgens (T & E2) are binding to more SHBG, free testosterone and free estrogen are lower than that of someone with lower SHBG.

This is why an estrogen slight higher is perfectly alright for a higher SHBG man most of the time.

Keto or Intermittent fasting?

i dont do keto or any fasting, other than before the labs. Something I should look into?

Your SHBG is just really high. If your with defy, they will address it with the appropriate amount of testosterone.

No kidding about the SHBG! Dr Calkins mentioned it and said it was most likely genetics and then didnt really get into other factors that could influence it.

Do you think Keto and intermittent fasting could help with it, or is likely to worsen it?

I’ve read about diet a lot over the years and at some point its paralysis by analysis, just so much info, and so much conflicting info.

This article has some good info. Including about diet and shbg.