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High Serum T, Low Free T. Need TRT?

I just got my labs back. I am confused

Syrum T 902
Free T 4.2
Eatradiol 36.9
Lh 15.1
Fsh 11.7
Psa 0.4

Does that mean that I need TRT or something to block the T conversion to E and something to keep the Shbg in check?

What are the ranges for these test? Man it looks like your pituitary gland is in overdrive.
Without the ranges your numbers don’t tell us much.

Testosterone, Serum 902 Range: 264-916 ng/dL 01

Free Testosterone(Direct) 4.5 Low pg/mL Range: 6.8 - 21.5 02

LH 15.1 HIGH Range: 1.7-8.6 mIU/mL 01

FSH 11.7 NORMAL Range: 1.5-12.4 mIU/mL 01

Estradiol 36.9 NORMAL Range: 7.6-42.6 pg/mL

Prostate Specific Ag, Serum 0.4 ng/mL 0.0 - 4.0 01

I am calling Serum T, Estradiol, and FSH High, since they are near the top of the normal range. The only thing that is low is my Free T.**

Testosterone, Serum 902 Range: 264-916 ng/dL 01

Free Testosterone(Direct) 4.5 Low pg/mL Range: 6.8 - 21.5 02

LH 15.1 HIGH Range: 1.7-8.6 mIU/mL 01

FSH 11.7 NORMAL Range: 1.5-12.4 mIU/mL 01

Estradiol 36.9 NORMAL Range: 7.6-42.6 pg/mL

Prostate Specific Ag, Serum 0.4 ng/mL 0.0 - 4.0 01

I am calling Serum T, Estradiol, and FSH High, since they are near the top of the normal range. The only thing that is low is my Free T.**

A high TT and low Free T is seen a lot around here. If you would have had your SHGB tested it is probably over range as well. SHGB is what binds your FreeT and makes it useless.

As to why your LH and FSH is in over drive I hope your doc noticed that and you are going to have your pituitary gland looked into. The last think you need is a cancerous tumor on your pituitary gland.

Are you overweight? This is a reason many have high E2. Just losing some body fat can drop your E2.

You need TRT, your SHBG must be very high. SHBG binds androgens and when elevated handcuffs Free T. You require supraphysiological doses of testosterone to hammer down SHBG and increase Free T.

You may need a private specialist as sick care doctors will not allow supraphysiological doses of testosterone do to strict guidelines by insurance companies.doctors will force you to stop TRT if you are over 800 ng/dL which is exactly what you’ll need.

Your pituitary gland is responding appropriately, sadly it will never be enough to overcome your liver’s over production of SHBG.

The free testosterone measuring unit can’t be right
image

His SHGB is over 200 if free t is ng/dl

Won’t any exogenous T be also be humped into submission by the SHBG?

Also, here’s a brief history, which may have a bearing on my numbers.

Rowed competitive in HS.
Went to college started getting fat.
Topped 450lb at age 31.
Took diet/exercise seriously then
Dropped down to 207lb by age 41 and got very fit
Joined national rowing team at 43
On flight back from an international race got a dvt had to back off training
Now can’t seem to shed excess weight at 48.

It’s the other way around, exogenous T will force SHBG to decrease. Naturally we produce 5-7mg daily, injecting large doses of exogenous T will lower SHBG.

We see cases like yours everyday, quite common.

Are you taking supplements or any other pharmaceutical grade prescriptions for hair or ssri or anything?

Your body is producing the T at great levels but not converting to free t. This happens to guys on different prescriptions and I would back off anything I’m taking before jumping on trt for life. Look up shbg as others commented.

Just taking an ECA stack, D3 a few amino acids, and glucosamine.

I just ordered the SHBG test, which I will get on Monday.

I would like to get to the bottom of this quickly. I feel I am doing all the right things with my diet and at the gym, with no results except sweaty clothes, sore muscles, and nice eye candy in the mornings.

I read about a transdermal called AIFM that is an OTC Aromatase Inhibitor that does a good job lowering SHBG. Does anyone here know about it?

Thanks!

Have you looked these up and reeeatched any side effects they may cause.

I have not found anything that says it would affect T in any way.

Ok just checking. I personally would abstain to see if it helps. Shbg is an unknown. They have not figured it out. It’s a testing ground.

I know you say trt because we have no clue how to lower shbg enough when his is obviously so high . But there must be investigation into ones environment and diet to see if that is causing it. I know it’s a far fetched idea but he’s almost perfect. He just has high shbg. Almost makes me mad to think he needs trt.

If he was on an SSRI and that was causing the highest SHBG, then the solution would be simple. If any other reason that would mean liver scarring do to the liver attempting to repair itself and that can’t be undone.

His pituitary gland is amazing in the way that it is performing. The problem is severe in the way that is pituitary is responding and is more than likely irreversible. He’s neither primary or secondary, his liver is ruining the day.

It is madding to shutdown such a strong HPTA!

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I am fine with doing TRT, however, I would like to explore possibilities that preserve my ability to naturally produce T. Partly because of financial concerns and partly because I like my testicles just how they are.

In that vein, should I pursue some sort of liver function test. I have never been a huge drinker. I have been bouncing in and out of ketosis for the past 15 years.

All that being said, thank you for taking the time to give me your opinions. I have found that the medical community is either uninformed about T. My doc, back a few months ago drew blood for total T, and told me I was great and sent me on my way. When I ordered my Free and Total T tests, I went to my trainer who helped me get in shape years ago and his response was “Ignore the numbers. Do more cardio, if you are doing 90min/day, shoot for 2 1/2 hours.”

I imagine that my it will be a challenge to find a doc that will write me a script for cipanate with my TT being north of 900.