T Nation

High SHBG. Advice?


#1

Hi All,

Didn’t know if this was the right section to be posting this but thought I’d throw it out there!

Im 31 years of age, train regularly and in decent shape. I finished a 5 week epi cycle 7 months ago followed by clomid PCT. Once I finished the PCT I felt great and libido back with a bang. Then a few weeks later my libido just dropped off and hasn’t really gotten much better aside from the odd few days here and there but overall not great. I have had several bloods since then for total test, e2, shbg. Generally all good except SHBG!

I had some more done 2 weeks ago and some a few days ago and they are as follows

TESTOSTERONE 25.62 nmol/L (7.600 -31.400)
FREE-TESTOSTERONE(CALCULATED) 0.338 (nmol/L 0.300 -1.000)
SEX HORMONE BINDING GLOB *70 (nmol/L 16.000 -55.0001)
7-BETA OESTRADIOL 102 (pmol/L 44.000 -156.000)

As you can see, my SHBG is well above reference and my free test on the low end of normal. My doc then sent me for LH/FSH, Prolactin, Liver and Thyroid function, Diabetes tests etc and all bang on perfect so now he doesn’t know what is causing the elevated SHBG. Can anyone shed some light? Doc says the main culprits of liver and thyroid issues are ruled out completely.

He has also written to endo for advice along with a request to put me on androgel (which at this point is a bit premature) so he’s waiting for a response. The doc probably has less knowledge than me ha!

Any advice would be appreciated as I know there are plenty of knowledgeable and experience members on here.


#2

Do not be too sure about that. Please post all labs with lab ranges. Docs are not very good at things unless they see a disease and miss a lot of things.

TT high and FT low:
liver not clearing E2, E2 increases increasing SHBG, lowering FT, increasing SHBG+T inflating TT
or
T production is low and SHBG is high from yet unknown reasons

With high normal T levels on TRT, we like to see E2=22pg/ml. With your low FT [calculated] you are very estrogen dominant that that contributes to low LH/FSH

Also need CBC, complete blood work and hematicrit.

Can you self-inject T cyp/eth there?
Transdermal T has highest cost and T–>E2 potential and your already have high E2.

Please get labs up here and do not start anything until I have a chance to look at things.

Meanwhile, start reading:
Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Your TRT will need to be T+hCG+AI
If you have to inject hCG, not injecting T does not may any sense at all.

Thyroid needs iodized salt. How are you doing on that?