Mine has been low, Reference Range: 19.3-76.4 nmol/L
(17.2 on March 21) the past 2 labs, which I think may have something to do with a high total T (1096), and a low free T (19). Estradiol, 26. I take 1/2 Anastrozole once a week.
I knew something was “off” because the libido and energy levels are blah.
Lower dose… If you have insulin resistance or hypothyroidism, fix that
Otherwise nothing aside from like, taking synthetic/bioidentical estrogen. Why do you care thought… SHBG almost certainly isn’t why you may be feeling off… Androgens bind to and lower SHBG. 19 isn’t exactly low for FT (depending on type of measurement 19 may be mid/upper range)
The only way you can increase SHBG is if it’s being suppressed by obesity and/or insulin resistance, I got my SHBG to increase from 13->24 is a couple of weeks of treating the diabetes with insulin and restarting TRT.
You might be able to change SHBG by changing your diet. You might have to live with low SHBG, you might be able to minimize low SHBG by injecting smaller doses more frequently since injectable T suppresses SHBG.
It’s always a good idea to post ranges on all labs. TT, FT and E2. Helps to interpret the labs.Also can you please post your protocol. Dose and frequency. That has a big impact on recommendations and interpretation of the labs.
Regardless, the numbers do seem odd. Low SHBG will result in a faster metabolism of T in the liver and that should lead to lower TT. High SHBG, protects T from metabolism and results in higher TT but lower FT.
Regarding the anastrozole. Why? Your TT is not that high, so your E2 should stay within the normal range without the AI. Even if it does go even moderately out of range, it’s not a bad thing. I’d consider ditching it.
As far as raising SHBG, supplementation with thyroid hormones in euthyroid individuals (i.e., no thyroid disorder) has been shown in at least one paper I’ve read to increase SHBG. I’ve seen it myself in the labs. My SHBG was high to begin with, and it went progressively higher as I added in Armour Thyroid and raised the dose from 30 to 60 to 90 mg/day. I’ve now backed off to 60 mg and it is still high, but I compensate with added T.
Hmm, in my experience the free T test seems to accurately reflect what I’m feeling. In fact I can predict what the number is gonna be before I even get the labs back.
What comes as a surprise to me is total T. That number is all over the map and has zero to do with how I’m feeling. And it seems to have little correlation with my free T number. Yet only my free T number has any effect on how I feel.
What is your free t? If that’s fine why mess with shbg?
My urologist never checks shbg unless I specifically ask. Out of the 2+ yesterday on trt I checked shbg for nothing. It’s the free t that matters regarding trt. Shbg changes throughout the day. Now if you can never get free t right, then further study may be necessary.
They are conditions like insulin resistance that cause low shbg but again regarding trt you adjust protocol to get free t in a good range.
Agree with your first statement. Same with me. Free T is a good indicator of how I feel and for guys with high or low SHBG, it is a much better number to watch than TT. See my graph below, in my experience, it correlates very well with the total weekly dose of injected T-cyp.
As i said in my first response, this has me perplexed with your numbers too. We really need to understand your total protocol to give any substantial advice. In particular, what’s your T dose and frequency?
While I don’t disagree with you, take a close look at the graph I posted above. Data from my testing shows an 89% correlation coefficient between the T-cyp dose and Free T as measured by the direct method. While there may be other methods that work, it appears that the test is a good one for me. I suspect that the criticism the test receives is overblown.