T Nation

38 Y/O Normal T, High FSH, TH and SHBG Levels. Opinions Wanted


First post for me. Thanks to all those who contribute on the forums. I’ve done a lot of good reading and have gained a lot of knowledge. I’m hoping @KSman and others could take a look at my results and provide any feedback. Would like to know if I can benefit from TRT/HCG or SERMs such as Clomid.

Disclaimer: I am seriously lacking education in all things TRT, but I’m reading posts, articles and listening to blogs daily in order to get up to speed. I’m also searching for a good endo/urologist while working abroad in New Zealand.

Age: 38
Height: 6’1
Waist: 32"
Weight: 180 20% body fat (estimated)
Weight changes: Have lost roughly 15 pounds in the last 6 months, but I was always up and down in the past.
Body & facial hair: No hair loss as of yet, hair on chest and some areas on back. Plenty of hair on the face. Easy to grow a beard etc. Outer eyebrows are normal.

Describe where you carry fat: Stomach/love handles (skinny fat)

Health conditions/sympoms:
Libido is on point. Can keep up with the wifey and rub one out many times a day, but do the deed only 3 times a week as we are trying to make babies. I have a lot of energy and have been doing HIIT for 2 hours a week and easily walk over 10-15 miles a weekend. Did 20 miles this weekend walking around the city.

Morning wood is good 3-5 days out of 7 mostly. I feel great otherwise.

Have no difficulty sleeping.

No head trauma.

Very impatient and used to go off the rails mad, but have been normal for many years since I started meditating and working out.

Semen Analysis was recently done (twice) and the counts were at 20 million both times. Morphology and Motility increased the second time, but still in the lower end of the spectrum.

RX, OTC drugs: None

Mens daily Vitamin. Vitamin D3 was taking only 1200 iui, but have upped that to 5000 IUI after noticing low levels as of today. I work a lot so I’m usually indoors except for weekends. Test Freak Testerone booster. Fish Oil 500 mg EPA and 900 mg DHA daily. Also started DAA a few weeks ago to see if it helps increase sperm volume. I’ll be cycling DAA for two weeks on/off. Wife bought a bottle of FertileAid after reading her baby making forums, but I have yet to start taking it.

I’m on a fairly balanced diet, low carbs with healthy fats. Two tablespoons of coconut oil, walnuts, brazil nuts and Avacado to get my fats. I’ll sometimes eat two teaspoons of peanut butter with chia seeds post workout.

Eat plenty of chicken, red meat and veggies, sweet potatoes etc each day. Avoid all processed foods and sugar. Wife cooks 3 meals a day and organic/grass fed meats are easy to find in New Zealand. We were in Italy for two weeks prior and both of us went crazy while on vacation for 2 weeks. Have been going easy on the cheat meals and doing them once every week and sometimes once every two weeks. Drink a cup of coffee and 3-4 cups of black tea each day. Never drink any soft drinks.

Drink once or twice a week. I would estimate 2 ounces of scotch per day on weekends. Do not smoke.

Low sperm count/volume. I did notice that edging increases my volume by 3 times, but not sure if the sperm are worthless when edging. Testes never ache.
I was diagnosed with ADHD when younger. I tend to jump back and forth between projects while working and have a difficult time focusing on single task for too long. It has not prevented me from achieving success in our business, but it is very noticeable and I can only imagine how much better things would be without monkey mind.

HIIT 3-4 times a week and cardio 1-2 times a week, but this has only been a routine for the last 3.5-4 months.

Stress level:
My work can be fairly stressful. I work long hours and in front of my CPU at all times trying to virtually manage our staff while working on my own projects. 12-16 hour days are not unusual. I’ve added meditation to my routine which has been helpful.

Two semen analysis which showed low count/volume and blood test on 01/02/2017 which is posted below.

My results show higher than normal LH, FSH and SHBG levels while having decent test levels. Below are my blood levels. I tried to google high LH and FSH with normal test, but found nothing useful. My urologist in the states is completely clueless when it comes to testosterone therapy or the like. I will most likely pay out of pocket to see someone in NZ or AUS, but also wanted to get some insight on this forum. Blood test results below. Thanks in advance!

Testosterone 741 ng/dl Ref = (251-836)
SHBG = 73nmol/L Ref = (13-71)
Free Testosterone = 25.5 ng/dl Ref = (15.3-48.0)
FSH = 14.9 IU/L Ref = (2.0-12.0)
LH = 13.8 IU/L Ref = (2.0-9.0)
Progesterone = 1.0 nmol/L (no ranges given)
Estradiol = 151 pmol/L Ref = (< 161)
Prolactin = 183 mIU/L Ref = (<240) (wife and I went to town the night before so this might be elevated)

Cholesterol mmol/L = 5.4 Ref = (<5.0) I’ve been on a fairly high fat diet eating avacados, nuts and coconut oil.
HDL Cholesterol mmol/L = 1.42 Ref = (>1.0)
LDL Cholesterol mmol/L = 3.8 Ref = (<3.4)

Homocysteine = 10.2umol/L Ref = (5.0-15.0)

Fasting Insulin = 5.5 mU/L Ref = (5.0-13.0)

Vitamin D = 64 nmol/L Ref = (50-150). This was after spending over 12 hours outside over the weekend and taking 3000IUI of Vitamin D for the last week. Before this I was on 1200IUI of D3 via supps.

Free T4 = 4.63 pg/mL Ref = (2.72 - 5.45)
TSH = 1.7 miu/L Ref = (0.30-4.00)
Free T3 = 1.3 pg/mL Ref = (0.8-1.77)

WBC count = 3.6 Ref = (4.0-11.0)

I will start doing temp tests this week. What can I do to lower SHBG levels and normalize LSH and FH? Would someone like me be a candidate for TRT?

Thank you!

Ok so you seem to have a healthy weight level. You have energy. You have no problems with sexual performance. Why are you seeking help again?

Your results are bizarre, high LH and FSH over the range indicate damages testicles, yet you T levels look great. There’s no chance an experienced doctor would give you TRT with the symptoms you’re presenting, lot’s of guys have great T levels and are short tempered. In your case like myself ADHD causes aggression, excitability, fidgeting, hyperactivity, impulsivity, irritability, lack of restraint, or persistent repetition of words or actions.

Later in life your SHBG could become a problem seriously limiting your FT, at which time TRT would be more appropriate. Stay away from plant based diets, these diets raise SHBG.

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Thanks for the response.

I’m asking for help analyzing my blood test. As systemlord pointed out above, they are bizzare.

The damaged testes explains the low sperm count issues. How does one help testes issues without TRT?

And no, I do not do a plant based diet. Eating a nice grass fed steak with brussel sprouts for lunch today.

Your pituitary gland is seeing sperm count dropping and is kicking FSH into high gear. The same thing is going on with LH, for some reason your pituitary believes your testes aren’t producing any testosterone and I’m starting to think it’s because your SHBG is gobbling it all up do to your FT shrinking. Symptoms might happen at a later date, perhaps we have caught a glimpse of a developing problem in the works.

I think your HPTA system is perfectly fine, it’s your liver that’s ruining your day pumping out SHBG messing up everything. We see guys in here all the time with high TT, high SHBG and low FT. The high SHBG is actually inflating your TT when actually it would be lower if SHBG was lower possibly making you low T, but again you have no symptoms. If you had symptoms then the course of action would be simple.

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Thank you, Systemlord. Learning a lot here!

I should have tested LFT and DHEAS when doing my blood. I can walk over to the clinic and get these tested early next week.

Any tips on good ways to reduce SHBG while taking care of the liver.

Its hard to directly manipulate SHBG. There are a few things that can help, but are mostly junk. Boron, Avena Sativa, Tongkat Ali. Boron did give me a little boost, but it was transient.

I had success lowering mine when I added CDG to my supplements, and the only thing I can think of is that my liver had some form of dysfunction, and adding the CDG helped eliminate the toxins and helped it work better.

I don’t think there is 1 answer for everyone. Everyone’s SHBG is high for a different reason. I would try and detox, cleanse the liver.

You can try these, they may help with a dysfunctional liver, if that is the problem.

  1. Milk Thistle (Positively affected my liver values EXCEPT for shbg)
  2. Calcium D Glucarate (this gives your liver the needed supplies to detox certain toxins)
  3. NAC/TUDCA (I don’t know much about these 2, but they are liver support.)
  4. Sam-E

Almonds increase SHBG, and I think I read somewhere that Brazil Nuts do too.

Did you ever take any meds?

Oh and stay away from Keto.

@anon10035199 I’ll take a look at the mentioned supps and get my liver functions tested as well.

I have never been on any meds.

I did try Keto in the past, but only for a few months. It’s been more than a year since I was in ketosis. I do snack on walnuts quite a lot and was eating 4-6 brazil nuts each day. I actually just ran out of brazil nuts and while try to see what happens if I stop.

TRT is the most effective method a lowering SHBG, unlike your natural testosterone production which has almost no effect on SHBG do to how it’s released in very small micro pulses several times throughout the day and the fact that your T rises and falls so quickly. TRT provides a consistent slow fluctuation of T that drops throughout the weeks instead of hours.

Yes, going off what System said, you could do 1 large injection a week instead of breaking it into multiple injections. The higher TT will eventually force your SHBG down. (Theoretically)

I have read a few forums where it did not work for people, myself included.

Good to know!

One thing I forgot to add was my Serum Glucose was in the normal high range at 5.3 mmol/L Refs = 3.5-5.4.

Your labs present some conflicting data, hard to understand.

With guys at high normal T levels on TRT, most do best near E2=22pg/ml - 80 pmol/L. With middle ground FT, FT–>E2 production rates are not high. This suggests impaired E2 clearance in the liver. Lab work for AST/ALT would show if from something serious. Sore muscles from training or injury can spike AST/ALT, so you would need some days off training.

Your high SHBG is leading to more non-bioavailable SHBG+T that inflates TT that then overstates your status while lowering FT.

High LH/FSH could be from that supplement if spiked with a SERM. That then could lead to high E2 from T–>E2 inside your testes. Stop using that then repeat LH/FSH and E2 in 3 weeks.

Where is your home base?

Your pituitary is working hard. This is odd because your FT is not very low and elevated E2 should be suppressing LH/FSH. LH/FSH is blind to sperm count. Elevated E2 causes liver to produce more SHBG and lower T levels also.

TSH should be nearer to 1.0
fT3 and fT4 are good center of ranges. So we need to consider that rT3 might be blocking some of your fT3 causing increased TSH.

You need to post your oral body temps, see below.

Thyroid is more complex than TRT.

In any case, with your high LH/FSH and midrange FT, your testes seem to be weak. You can test DHEA-S to see if that is low limiting DHEA–>T, but we rarely see that.

I started this post a few days ago before getting a cold, so it may be more disorganized than typical.

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.

My numbers are similar to yours, although I had many more symptoms. I also had low sperm count and low volume, and high fsh/lh indicating testicle damage, like was mentioned above.

Based on your words, the SHBG doesn’t seem to be taking away from your arousability, which is great. Mine did the opposite, causing it to drop substantially, even though morning wood remained.

I updated my thread today that my latest blood results show boron and stinging nettle are helping to reduce my SHBG levels. But like systemlord said, you don’t have any symptoms.

The only thing I can say is that I missed the symptoms when I was younger - but could not miss them as I aged.

Good luck.

Thank you KSman. Will take some temps this week.

@traveling-man were you able to increase sperm count. I bought some nettle this week and already started using it. Going to take another blood test in a months time and see where we end up. Thanks!

I tested sperm count only once and never thought about anything affecting it … doctor told me nothing would make a difference. It was never suggested to try any supplements for that.

I’ll be interested in seeing if it makes any change. In my case, boron+nettle reduced my SHBG. I plan to add tongkat ali in a few weeks to see if it makes any difference.

alphagunner what is the reason that you say stay off the keto diet ?

It has been shown to increase SHBG. Women who have POCS from too many free floating androgens are advised to follow a Keto diet, to increase their SHBG and bind up any “free” androgens, which is causing some of the symptoms.

Ty for the reply, but not sure that you can compare the effect in PCOS women with men.

Have you read this study: www.ncbi.nlm.nih.gov/pubmed/28399015

LOL, well, considering men cant have PCOS, I wasn’t comparing them. I was comparing the effect of the Keto diet, on SHBG.

It also happens with men, I was just using an example. It increases it so much, that it is used to curb a disease process (PCOS)