T Nation

Considering TRT - Low Free T, High SHBG, Symptoms

Hi Guys, I am considering TRT and would appreciate your input:

32 years old
Waist 106cm

I have very little facial hair. Am only able to grow on chin and moustache with sparse hair on sides. Very little hair on chest and overall body.

I carry fat heavily on my obliques. I also have really fat thighs and pseudogynecomastia. Endomorph.

Health - depression, anxiety, fatigue, brain fog. I have a large varicocele on left side of testicle.

Medication - I have been taking an SSRI since forever. At the moment I only take a tiny dose of SSRI to lessen anxiety.

Labs -

October 2017 Morning

FSH 5.9 IU/L (1.5 - 9.7)
LH 5.7 IU/L (1.8 - 9.2)
Oestradiol (E2) 55 pmol/L (<160)
Prolactin 244 mIU/L (90 - 400)

Total T 19.7 nmol/L (12.0 - 31.9) This is 568ng/dL
SHBG 52 nmol/L (17 - 56)
Free T 312 pmol/L (260 - 740) 89.9 pg/ml

March 2017
TT 17.4 nmol/L (12.0 - 31.9) 502 ng/dl
SHBG 51 nmol/L (17 - 56)
Free T 277 pmol/L (260 - 740) 79.8pg/ml

When I was 25 I had a reading and my free T was approximately 560 pmol/L - so there has been a substantial drop off. With age comes increased stress and responsibilities which is surely contributing.

Diet - I eat fairly clean and try to get healthy fats in with enough cholesterol consumption and adequate calories.

Training - I have been doing HIIT for a year and am now doing more traditional weight training so no over training concerns. I am unable to lose much bodyfat despite good diet and exercise.

My testes have never ached either with or without fever.

I have morning wood on some days.

It would seem that if I can control SHBG then maybe symptoms would improve. However, I have no liver issues so am not sure how to lower it. There is anecdotal evidence that the varicocele could be increasing SHBG.

Getting the varicocele repaired seems like a lot of effort for very little improvement, therefore I am considering TRT.

Do you think this is a smart option considering the above? Thanks for any input,

Also with age comes high SHBG which shrinks you free T, less freeT for the body can contribute to depression and anxiety once you get low enough. Problem you have is doctors in your country wouldn’t blink at your high SHBG. They will tell you you’re normal. What SSRI medication? Their not created equal.

I take sertraline (Zoloft) @ only 25mg. I am trying to learn whether this could increase SHBG in the liver but liver enzymes and their effects are pretty complicated.

Zoloft made me super positive even though I wasn’t depressed (used for ADHD), but destroy my libido and erections. These ssris are known to disrupt people’s hormones and have been known to increase SHBG.