Help with Blood Results - High SHBG, Should I Be Concerned?

|Albumin - 40.8 |35 - 50|g/L|
|Cortisol - 428 |166 - 507|nmol/L
|Follicle Stimulating Hormone (FSH)| 10.9|1.5 - 12.4|
|Free Androgen Index|38.67|24 - 104|
|Free Testosterone (calculated)|0.378|0.2 - 0.62|nmol/L|
|Luteinising Hormone (LH)|10.1|1.7 - 8.6
|Oestradiol (Oestrogen)|41|41 - 159|pmol/L|
|Prolactin| 371|86 - 324|mU/L|27/11/2021|
|Sex Hormone-Binding Globulin|75|18.3 - 54.1|nmol/L
|Testosterone (total)| |29|8.64 - 29|nmol/L
|Thyroid Stimulating Hormone (TSH)|1.93|0.27 - 4.2|mU/L|
|Thyroxine (T4, free direct)19.2|12 - 22|pmol/L

“Overall a great set of results with the majority of measured markers in range. Your prolactin level is slightly raised, in keeping with normal physiological response to stress. Ensuring good sleep patterns will help. SHBG is a transport protein and being slightly higher end of range most likely explains why LH slightly raised to increase testosterone production to maintain balance between bound and free testosterone”

I’m aiming to raise free T to recover better for sport and have more energy. the Dr’s analysis seems to be everythings fine but my SHBG seems way above normal range (Im early 30’s)
should I be concerned about this high SHBG?
Ideally I’d like to increase my free T. Is working to decrease SHBG by methods suggested in other threads (increasing calorines, boron, tongkat etc) likely to be the best course of action or is there something else I should be doing?

If I where to start a cycle would around 200-300mg of test be a good starting amount to lower SHBG and increase test if I wanted to build muscle, as it seems this is a good level to increase free test without increasing negative side effects too much (looking at studies such as on Exactly How Much Muscle Does 25mg, 50mg, 125mg, 300mg & 600mg Of Testosterone Build? - YouTube) currently finding it hard to build muscle and train martial arts concurrently due to overtraining, and wouldn’t want to take a few months off training just to build muscle. I have a fair bit of muscle already (82kgs at 5’10 around 10-15 percent bodyfat)

TRT will likely be needed indefinitely unless you can lower SHBG with supplements. I’d be concerned with the high SHBG because it increases as we age binding up more and more T.

Your pituitary is working in overdrive and sadly it will never be able to fully counter the high SHBG.

You should start out at 100-140mg for a weekly dose and can split it up more often to alleviate any symptoms.

I’m surprised based on your lab results that recovery is your only conplaint! Most guys would be barely scraping by.

Given your stated goals, free testosterone and SHBG of 75, you’ll need a higher dose than many. I’d start at 200mg weekly.

Really is it that bad? The doctors analysis said they where overall a good set of results, im very confused now,
Im terms of symptoms lf low t i dont feel i have anything major really, i probably wake up with wood 3 days a week and although my sex drive isnt as high as when i was younger have no erectile problems, hard to tell of i have brain fog or not but im getting through quite a hard degree with a first.

Any suggestions what i should do? Maybe work hard to reduce SHBG then get re tested in a month by a soctor with a good hrt knowledge?

Yes your situation is starting to look concerning, your estrogen is low at 11.1 pg/mL and osteoporosis is a strong possibility if spent at these levels long enough. I have seen men on this forum diagnosed with osteoporosis with estrogen at 16 pg/mL.

A normal estrogen level for an adult male is 20>, healthy adult men are closer to 35 pg/mL.

TRT is a new field of medicine, male hormones isn’t taught in traditional medical schools and residency, so get used to doctors that aren’t up to date on male hormones, even one’s you would think are supposed to be the experts.

The upper end of a “replacement dosage” is 200mg, even this is too much for most guys and the average dosage to optimize men on TRT is 120-140mg. With sufficiently high normal free testosterone, you should be able to build muscle provided your diet is on par, training is solid and most importantly you have good genes.

Once you get your free testosterone optimized, I expect morning erections every single morning and a higher libido to boot. As it stands a man in his early 30’s should be waking up with erections every morning, erections 3 days out of a 7 day week is something that starts to happen when you get older.

A normal Free T percentage is 2-3%, yours is 1.02 %. I would also say most of your erectile issues are a result of the low estrogen level.

Damn, I have similar levels and barely scraping by. Never have morning wood and bad ed. Will be starting test cycle in a couple of weeks.

You aren’t on keto/low carb, are you? Heavy calorie deficit? Overtraining?

Im thinking this could be the problem
I eat carbs but not much in the daytime and maybe not enough for all the grappling ive been doing
Also ive probably been perpetually overtraining for a while and become acustomed to it.

Im thinking of having a 2 wweeks with very light training and eating loads of carbs throughout the day. Plus supplementing vit d, boron and tongkat then getting bloods done.

Is two weeks likely to show an impact?

This is unrealistic. I put your chances at lowering SHBG enough to make a difference low. SHBG is a difficult hormone to increase or decrease.

I don’t know. I’ve seen plenty to show that low carb can raise SHBG over time, but nothing showing the time to reverse it using carbs. I’d guess more than two weeks tho

Thanks for all the advice guys ill keep you posted on if i manage to turn this round with lifestyle and supplements.

Am i right in thinking the high level of fsh probably means im quite fertile at the minute?

hello, sorry if I write to you here in this post, I would have liked to write to you privately, but I just signed up and I don’t understand how to do it, I’m in a bad situation and you seem very experienced, I need help, could I please ask you some questions ? A thousand thanks!