T Nation

High SHBG/Low Free Test. Opinions?

Hello all!

After discovering this forum and read a lot, i would appreciate it if you wanne have a look to my situation and feedback with some opinions.

First some info:

I’m 43 years old and from the Netherlands ( so my Englisch writing is not that good ).
Training for 7 years. Last 2 years i changed thinks up. bodyweight was 106 kilo. Cut down to 75 ( realy low bodyfat ) en last half year "lean bulked " back to 82 kilos.
The last two years my lifestyle is realy healthy. Food is on point, training on point, no smoking and very little alchol.
From my puberty till now i suffer from depression and anxiety. Allways had medication for it ( all sorts of SSRI’s ). Now i’m 4 years on escitalopram and pregabaline.
I have always sufferd from periods with low energy and bad sleeping. Also no sexdrive at all. But always blamed it to my depression and anxiaty.
Because my liver values are always a little bit high i check them ones a year.
My coach said that i had to check my testosteron, to see where i was standing.
So i did ( in the Netherlands lokal doctors dont do that often because they can not do anything about it ).

Here are the results:

Ureum and ALAT are little bit high. Dokter said that it was no big problem.
Totel test is very low but within the values.
Free test is very low and outside the values.
SHBG is high but inside the values.
FSH and LH are also low but within the values.

The big question for my is what to do about it.
Is trt the answer or is there something else going on. And what is the influence of the medication to this story.

Problem is that in the Netherland TRT is something housedokters ignore. They dont wanne do anything with it.
My doctor is willing to send my to a internist. But i know that they also don’t do anything about it. My total t is whitin values and that is the only thing they look at.

But how do you people interpret my bloodtest?

Would appreciate your thoughts.


Within range doesn’t mean you don’t have low testosterone, it means there are others in the lower ranges who don’t have symptoms as everyone has their own range where symptoms start to develop. I’m on TRT and recently felt like I had returned to a low T state and checked my levels and labs showed a Total T of 14 nmol/L and I had symptoms of low energy, weak erection and very low libido.

Do to DNA, receptor sensitivity and being biochemically different from everyone else, your body requires a particular range to function optimally, instead doctors like to overly focus on the whole population and apply everyone else’s levels to you, only your DNA is unique to you.

These reference ranges is a very poor way to diagnose a testosterone deficiency considering everyone is different. The symptoms usually are more telling.

thanks for the answer!
I completely agree. Thing is that in the Netherlands there is no way that i will get trt with this values.
But if you look too my values, is there anything you can say about that? What are your thoughts?

While your Total T is good, your Free T is below range and very low. Free T is everything, it’s the portion of testosterone that is circulating in the blood, Total T is not bioavailable and is bound to SHBG and is very high binding up all your testosterone like a great big sponge.

SHBG is produced in the liver and may be genetic and or environmental. Extreme dieting can increase SHBG as well as certain medications. LH is a good indicator of low testosterone, should be midrange or higher.

Middle aged men with lower Free T seem to be the ones getting the most cases of aggressive prostate cancer when compared to those in the high normal range. You need to find a doctor that understand what I just explained or you stand no chance at convincing any doctor you need TRT.