T Nation

42 y/o. Normal T/Low-ish FreeT/Very High SHBG/High LH. Is TRT Right For Me?

’m 42 yrs old and the last 4 years my energy, strength, and stamina have plummeted. I am generally an athletic/slender guy but my midsection has increased a lot, and I have become very sluggish. My sex drive isn’t great so I thought I might take a stab at this TRT stuff…

Here is link to my blood results (https://imgur.com/a/JddUb)

Testosterone, Serum 649 ng/mL
Free Testosterone(Direct) 9.8 pg/mL
DHEA-Sulfate - 126 TSH - 1.880 ug/dL
Luteinizing Hormone(LH) - 14.4 mIU/mL
Prostate Specific Ag, Serum - 0.3 ng/mL
Estradiol, Sensitive - 16.4 pg/mL
Sex Horm Binding Glob, Serum - 90.6 nmol/L

649/ 9.8 seems pretty average. My thyroid and liver are in good health. I don’t drink and eat pretty healthy BUT my SHBG is a skyrocket 90.6. So I know my T is being sponged up and not utilized – hence why I might be having symptoms of low T?


Free Testosterone: 6.60 ng/dL = 1.02 %
Bioavailable Testosterone: 165 ng/dL = 25.4 %

Looking for some guidance. I have my initial consult w/ Defy in a few weeks. I hope they can help. But w/ 649 Total Test am i wasting time and money?

Thanks for the help!

My bloodwork was similar to yours (testosterone, SHBG, and LH were all bit lower), and my doctor said that I had subclinical or compensated hypogonadism.

Basically, your brain is signalling for your testes to produce more testosterone, which is why your LH is so high, and they aren’t responding.

There was also research about using free testosterone to diagnose hypogonadism in 2015. They found when it was below 220 nmol/L (6.35 ng/dL), symptoms were worse than for men with a total testosterone level of below 10.5 nmol/L (300 ng/dL).

I think that it’s probably worth a chat with Defy, and I hope it all goes well.

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That SHBG is pretty high.

Meds, past, present. How do you know your liver is fine? Labs?

Supplements? Keto?

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Thanks dude. Did you treat the compensated hypogonadism with TRT?

thanks for the help.

Well I have been investigating since I got results w/ gastroenterologist. They don’t know much about SHBG but we ran a bunch of tests and everything has been clean so far. Short of liver biopsy, I’m checking to make sure it is ok. I don’t drink alcohol either. So I’m not confident but no flags yet. AST/ALT have always been normal.

I have auto-immune issues. I have rheumatoid arthritis and take plaquenil - but that doesn’t affect liver or so i’m told. But I am prone to autoimmune hepatitis. I take vitamin d/magnesium. Started some boron also.

Yeah, my doctor put me on TRT.

I generally feel better, but it’s not been a massive change. I’ve put on about 5 kg / 10 lb of muscle over the last year, which is good, and seem to be sprouting a bunch more body hair than before, which isn’t so great.

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Hi @Graemsay i just read your thread. Interest to know how you have been since April 2017. Current TRT protocol? Are you still off the Zoloft? Latest Blood results?

@lowftplshelp I’ve been off Zoloft for a couple of years now. I’m not anti SSRIs, as some people are here, but I felt as though the side effects were worse than the symptoms they were clearing up.

Incidentally, I find that TRT is about as effective as a low dose SSRI in managing depression. But it’s not a cure-all for it, and I still have bad days.

My current protocol is 250 mg every ten days (equivalent to 175 mg per week), with half an Anastrozole tablet every five days.

In Australia we get preloaded syringes with 250 mg in them. The options are either to inject half at a time, or the whole lot. I’ve found that I feel better on the above, rather than 125 mg every five days, but I’ve got high SHBG. Unfortunately I tend to feel worse after day seven or eight.

My doctor doesn’t do HCG, so I’m not on that.

I don’t have blood work to hand.

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SHBG and liver inflammation are directly related. If you have autoimmune and say it can affect your liver, id say that’s where id be looking.