T Nation

High SHBG, Low Free T and E2, Average Total T. What Should I Do?

Ive had bloodwork done 2 times in the past 6 months. here are my results.

October 2018

Total Testosterone: 441 ng/dL (264 - 916)
Free Testosterone: 8.9 pg/mL (9.3 - 26.5)
Estradiol, Sensitive: 10.0 pg/mL (8.0 - 35.0)
SHBG: 59.2 High nmol/L (16.5 - 55.9)

Feb 2019:

Total Testosterone: 511 ng/dl (246-916)
Free Testosterone: 8.2 pg/ml (9.3-26.5)
Estradiol, sensitive: 15.3 pg/ml (8.0-35)
SHBG: 78.2 nmol/L (16.5-55.9)

any ideas what I can do? or what might be causing this?

I thought maybe it could be liver issues for some reason so I got a liver panel done and had no issues:

AST: 24 IU/L 0 - 40 01
ALT: 22 IU/L 0 - 44 01

Looking at your liver panel suggests high SHBG is genetic. There is nothing you can do but go on TRT or continue as you are, the latter can’t be an option.

You’ll need Total T levels near 1000 to have enough Free T.

Could it be cirrhosis?

If it was cirrhosis, liver function tests would look terrible. I have excellent liver function tests, I have SHBG on the lower end because it’s genetic.

You have high SHBG cured by trt?

My SHBG was about midrange (30) pre-TRT, TRT lowered it to 22, usually the higher the SHBG, the larger reduction you’ll see.

Almost always TRT lowers SHBG, unless obesity and insulin resistance is suppressing SHBG, then you will see an increase. I started out with SHBG at 16 4 weeks after starting TRT, later I found it hovering at 22, I’m insulin resistant and overweight.

In case you would like some additional reading material to kill time …

ttt. any other suggestions?

What other suggestions do you want?

You have high SHBG and low E2. That is uncommon. I know, because I had the same. I was below 10 on the E2 scale. I went over 100 on shbg.

Systemlord told you to go on TRT.
I suggested you look at danazol and then TRT.

Just my opinion - but I think you have all the suggestions you are going to get. I don’t mean this to sound rude …