T Nation

Extremely High SHBG, Feel Horrible, Please Help

Hello. I am 38 years old. I am 6’1 220, probably 20% body fat. I have always been a very positive, assertive, athletic guy. I noticed my sex drive and overall zest for life decrease about 3-4 years ago. I had all the symptoms of low T, so I went to my doc. My T checked out in the mid 600s at that time, so I thought I was fine. My PCP thought that I was going through a bout of depression, but I thought he was crazy. Around the same time, a co-worker noticed a lump on my neck. Ended up having a benign thyroid nodule. Had a partial throidectomy in 2014. My current symptoms are horrible sex drive (I have a very attractive wife and I would rather sleep than have sex with her). When we do have sex, I usually wake up around 3-4am with an erection. It is difficult for me to get a good erection most of other times. My wife gets very frustrated. I have lost my assertiveness and overall drive for the things I enjoy. I love hunting and fishing, but I have had a lost less fun doing it the last couple years. I also have lots of fatuige. I make no gains in the gym. I usually weight train 4 days a week. I have not added much weight to my major lifts in over a year. 2000-2500kcal a day. Usually around 160-200 grams a protein a day. I carry a lot of my fat on my lower belly and legs. I have a nice full head of hair. I have good facial hair, although I did have a bald spot on face that eventually grew back. I just knew I was not myself, so I seeked the help of a HRT clinic. They seemed very knowledgable, and recommend. I had my labs drawn, but my appointment with that doc isn’t until later in July. Current meds: synthyroid 75mcgs a day. I started supplementing with 5000 vitD and 1000mg of stinging neetle root due to my high SHBG. Have you ever seen an SHBG this high? Is there any hope for me? I think it is due to exogenous thyroid hormone, but not sure. Would exogenous testosterone help my symptoms?

TSH: 2.01 (0.450-4.5)
DHEA: 263 (102-416)
Total test: 659 (348-1197)
Free Test: 10.7 (8.7-25.1)
LH: 3.2 (1.7-8.6)
Estradiol 24.7 (8-35)
PSA 0.2
SHBG 81.3 (16.5-55.9)

My cbc with diff was all good.

TSH should be closer to 1.0, you might be under medicated. Please see last paragraph in this post.

Do you feel cold easily?
Are your outer eyebrows sparse?
What has been your life time history of [not]using iodized salt?

Can you post TSH, T3, T4, fT3 fT4?
fT3 is the active hormone and should be tested!
Some on T4 meds do not do well because they have poor fT4–>fT3 conversion.

TRT with high FT levels will help reduce SHBG, but SHBG can be slow to fall.

Should test LH and FSH as FSH can be a better measure of LH than LH itself because LH change rapidly.

High SHBG is lowering FT creating non-bioavailable SHBG+T which inflates TT and then TT overstates your T status.

SHBG can be increased by high E2 [not you], low FT or livers conditions/disease.

“SHBG levels increase with estrogenic states (oral contraceptives), pregnancy, hyperthyroidism, cirrhosis, anorexia nervosa, and certain drugs. Long-term calorie restriction of more than 50 percent increases SHBG, while lowering free and total testosterone and estradiol”

Both low-T and suspected thyroid issues could be contributing to your issues.

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
  • thyroid basics
  • 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.

Thanks for the reply. I do not get cold easy. Outer eyebrows are not sparse. Never looked into iodized salt, so I would say I have had a very low intake. I use Mediterranean Sea salt mainly. Doc never tested T3,T4, fT3 fT4; just TSH. Will check my oral temperatures tomorrow.

Have you seen people with SHBG this high? Hope to get it under control. I want to fee like my old self. I have read a study that exogenous T+Hcg lowers SHBG and improves symptoms.

Your SHBG is exceptional.

posted above:

"SHBG can be increased by high E2 [not you], low FT or liver conditions/disease."

“SHBG levels increase with estrogenic states (oral contraceptives), pregnancy, hyperthyroidism, cirrhosis, anorexia nervosa, and certain drugs. Long-term calorie restriction of more than 50 percent increases SHBG, while lowering free and total testosterone and estradiol.”

I have really high SHBG also, not as high as yours, but up there. 70 on my last test. I tried boron, stinging nettle, and did get some passing results ,but nothing permanent. What other medications are you on? Benzo’s? BP Meds? I’ve spent hours researching the subject.

I seem to be doing well after changing my Blood pressure medication from Lisinopril to Losartan. Lisinopril lowers free testosterone by increasing SHBG, like benzos and some other medications. Do you drink a lot? Like KSMAN said, its created in the liver, so if you have liver dysfunction, that can be an issue also.

There are some that say a liver detox can also help, Milk Thistle. I tried this and cant say I saw amazing results, but couldn’t hurt.

I have labs coming up in a few weeks so I will know for sure if my change in medication has lowered it. Good luck.

The only prescription med I take is synthyroid. The only supplements I take are vitD, stinging nettle, and fish oil. I probably drink 30 beers a year(couple at deer camp, few at fish camp, and maybe a few on 4th July). It’s gotta be my thyroid. I have read that exogenous thyroid hormone can increase. I have to take more synthyroid for my elevated TSH, but I am afraid of raising my SHBG even more. Hopefully my new doc can help me. His resume was pretty impressive.

Get those oral body temperatures. Temperatures can be a guide to dosing thyroid meds.

keep us posted on this thread