T Nation

High SHBG, Low FSH, No Libido - TRT?


#1

Hi, new member hear.
I have been dealing with low T symptoms going on about two years now. Low to no sex drive, brain fog, memory issues.
Age: 27
Height: 176 cm
Weight: 86 kg
Waist: 31"
Facial Hair: Reasonably thick, can grow a full beard
Body Hair: Middle
Body Fat: Some around my waist,

Health

I’ve taken 1,5 years ago anabolic steroids - T Prop 100mg e2d for 3 months.

Hormones

Testosterone: 18.95 nmol/L (8,64 - 29)
SHBG: 61.54 nmol/L** HIGH** (18 - 54)
Free Testosterone (calculated): 220 pmol/L (170 - 670)
Estradiol: 27pg/ml ** LOW** (26-60)
LH 3/03 mIU/ml (1.70-8.60)
FSH 1.28 mIU/ml ** LOW** (1.50-12,40)
Prolactin 7.75 ng/ml ( 4.04-15.20)

Thyroid

TSH: 2.480 mIU/L (0.270 - 4.200)
FT3: 2.78 pg/ml (2.00-4.40)
FT4: 1.15 ng/dl (0.93-1.71)

Vitamins
Vitamin D3: 86 ng/ml (30-80)

Other
Bilurbine 0.4 mg/dl (0.2-1.3)
ALAT 57 U/L (21-72)
ASPAT 31 U/L (17-59)
Cholesterol 280 mg/dl (115-190)
HDL 104 mg/dl (0-40)
LDL 166 mg/dl
triglycerides 60 mg/dl (0-150)
Glucose 85 mg/dl (70-99)
Iron 160 ug/dl (49=181)
CRP 8 mg/l (0-10)

Diet

I’m eating about 2700 kcal, and the macros probably come out around 30% carbs, 40% fat, 30% protein.

I’ve been taking a 5000 iu Vitamin D supplement for the past month.

Training

I’m hitting the gym 3 times a week, and not pushing anywhere near hard enough to be over-training - I sleep very well 8h.

Libido, etc.

My libido is basically non-existent, and there’s a bit of ED going on. I’m in a relationship, so it’s reallyproblem for me and my girlfriend.

Questions

The main one is should I worry about my SHBG levels? A couple of people I’ve spoken to have said that since testosterone is in range it’s not something that’s of concern.

Looking at the causes of high SHBG, I think that I can rule out most of them: Liver disease (the associated tests don’t show anything outside of range); HIV (I think it’s routinely checked, and nothing showed up); alcoholism (i’m drinking one time a month)
hyperthyroidism - looks like, because FSH is very LOW!!!

Please some advise.


#2

TSH: 2.480 mIU/L (0.270 - 4.200)
FT3: 2.78 pg/ml (2.00-4.40)
FT4: 1.15 ng/dl (0.93-1.71)

TSH should be closer to 1.0
fT3 and fT3 should be near mid-range or a bit higher.
The published ranges are rather useless and misleading.

Have you always used iodized salt?
Timeline?
Otherwise could be deficient.

Please follow these links in 2nd post of 1st forum topic.

  • advice for new guys
  • things that damage your hormones
  • thyroid basics explained

Please check oral body temperatures as per the last link above.
Check GF’s oral body temps too.

Do you get colder easier now?
Outer eyebrows sparse?
Thyroid aches, enlarged, lumpy, asymmetrical?
Where are you located?

You could try a HPTA restart, there is a link for that.


#3

How I should start ? If I started TRT - t . Cyp + HCG ,
1 / SHBG should be reduced
2 / should increase the level of FT
3 / should increase the level of E2
4 / should be increased pozion LH and FSH
5 / could also improve thyroid hormones?

Well I think?


#4

Have you always used iodized salt?
Timeline?
Otherwise could be deficient.

I have used Himalayan salt for a 6 months

Please follow these links in 2nd post of 1st forum topic.
- advice for new guys
- things that damage your hormones
- thyroid basics explained

Please check oral body temperatures as per the last link above.
Check GF’s oral body temps too.

I have just read these posts. I will check temps tomorrow…

Do you get colder easier now?
Yes, especially hands and feet.
Outer eyebrows sparse?
No, looks normal/
Thyroid aches, enlarged, lumpy, asymmetrical?
No, I dont feel any aches.
Where are you located?
I’m from Poland. According to my doctors test results are within the standards, so everything is OK.

You could try a HPTA restart, there is a link for that.
I will read about that.


#5

Have you always used iodized salt?
Timeline?
Otherwise could be deficient.

I used Himalayan salt.for a year.

Please follow these links in 2nd post of 1st forum topic.
- advice for new guys
- things that damage your hormones
- thyroid basics explained
Please check oral body temperatures as per the last link above

Thanks.
I have just read these posts and tomorrow I will post results of oral body temp.

Do you get colder easier now?
Yes, I get colder easier. Especially hands and feet
Outer eyebrows sparse?
No, eyebrows look good
Thyroid aches, enlarged, lumpy, asymmetrical?
No, i dont feel any thyroid aches, Thyroid looks good.
Where are you located?
I’'m from Poland. For my doctors it is all right . Measurements are within the standards, so I do not have to worry…

I forgot to write that I have very big problems with dropping weight. I’m not very obese ( 13 % bf) but later wants to go down 10%


#6

Himalayan salt does not have any iodine. GET IODIZED SALT.
You are iodine deficient.
http://www.ign.org/newsletter/idd_aug15_poland.pdf

You will need to take a strong amount of iodine for a while.

This is wrong: “For my doctors it is all right . Measurements are within the standards, so I do not have to worry…”

TSH should be near 1.0
T3, fT3, T4, fT4 should be near mid range or a bit higher.

Low thyroid function can have many negative effects.


#7

Tkanks KSman very much.

Allright, so i will start with iodine. Do U think that Iodoral (Total Iodine/Iodide 12.5 mg) will be good for me? I will start with 25mg ed and after week 12,5mg ed.


#8

Many have done 50mg/day for two weeks.
But there are arguments that this is more than needed.
Your plan may work.

Monitor your oral body temperatures.
Note any changes to mental clarity and energy.
May not work if rT3 is elevated.


#9

The cut-off point for hypogonadism due to low free testosterone is a bit of a grey area.

The ISA, ISSAM, EAU, EAA and ASA recommend using 65 pg/ml (226 pmol/L) as the lower bound of normal.

The ISMH guidelines say that a man with free testosterone above 72 pg/mL (250 pmol/L) is unlikely to need replacement therapy. I’m guessing that being below means someone would be a candidate.

I’ve seen references to numbers as high as 80 pg/mL (278 pmol/L) as the cut-off.

You’re below all these, so could be considered hypogonadal. For example, in the Nebido Testosterone Management Tool. But that’s one of Bayer’s sites, and so probably trying to sell you therapy. :grinning:


#10

Does anything discussed in “things that damage your hormones” suggest a link to high SHBG?


#11

I checked the temperature of the body orally
Yesterday 18/02
6:30 AM 96.80000ºF
6:30 PM 98.06000ºF

Today 19/02
6:00 AM 96.26000ºF

I have just read about High SHBG.

Have you heard about Lugol 's iodine ? it will be a good source of iodine ?


#12

@elusiv3

Any update? Sailing in the same boat with high SHBG, low Free T but normal TT.


#13

I am also in the same boat as you guys. Normal T, high shbg low free T, o libido. So far I have few ideas as I have tried many things like TRT, lowering E, Progesterone and many more. Nothing helped much. My thyroid tests seem perfect, cort is perfect.

It would be good if we could work together on this and brainstorm.

my facebook is https://www.facebook.com/vinvan82 I think you can add me there.

Have you guys tested HGH levels? Low HGH can cause high SHBG in some groups.

Thanks hope to hear from you.


#14

How long did you do TRT? Have you come off it cold outside turkey? Do you have your labs from when on TRT with ranges? What was your pinning protocol? The trouble with normal TT and high SHBG is that doctors will only test TT and tell you that there is no problem. TT is a false figure when SHBG is high, does not reflect your T production, SHBG increases the half life of your serum T. Lowering SHBG is not as simple a solution as it sounds. With lowered SHBG, TT will also be lowered to a good extent and e2 will rise.

TRT needs to be administered with the FT rather than TT values monitored. The doc needs to get you up to the high range FT, which may also reduce to an extent SHBG. But regardless of your TT and SHBG, TRT should be focused on your FT to get rid of symptoms.

As far as causes go, I don’t have any explanation for mine, no head trauma, I do not think HGH is the issue although I would like to learn more about how it could affect SHBG. I have tested for liver problems, I am not hyper thyroid, so I don’t understand why SHBG is high at 23. Usually its always rising as we age, in that way I guess it’s some genetic problem that has come on early.


#15

Hello again,

I have done trt 3 times.

All results were good bloods looked very good on TRT - High T. Did not help though. I measure my free t too and it is now below range but taking T simply does not help for long. It may help somewhat in the first week then the benefits are lost.

E2 is fine on and off TRT.

I have tried, creams, pills and injections. Same issues. I have tried very high dose, medium dose and low dose. I get more sides when I increase the dose.

The thing is SHBG is high for a reason. And I think lowering it makes us worse because our body wants it high for a reason.

I have been though so many trt regimes I am finished with them. They are not the solution for me,

When I did quit TRT after 5 monnths I felt like total crap. Like i was in hell.

Did you ever take saw palmetto, accutane or finasteride? I took finasteride.

Are your other tests fine. Blood cortisol progesterine and prolactin? If they are then your issue is something else and there is a study in kids with low GH their SHBG was higher than normal.

I really think you need to look into GH - Does testosterone help you at all?


#16

I am yet to start therapy. Was your FT also high on TRT and E2 around 25? I can’t make sense how you say that benefits are lost after the 1st week.

I have not had any other prescription drugs like you listed that could cause this. I have been having low T symptoms since the past 3 years. Like you said, SHBG is high for a reason, so lowering it is not what in a simple world seems like. The only way is to work around it. One thing you do not take into account is that SHBG can be high with severe androgen deficiency. Like i said in the previous post, TT values with high SHBG is not really your true figure. SHBG elevates significantly serum TT values. I will ask my doc about HGH though.

Hope we work it out man.


#17

@vincentv

Also, how is your thyroid? It could cause similar sides. Have you got your HGH checked yourself? HGH is very difficult and expensive to get hands on though. Not sure any docs will like to prescribe.


#18

Hey again,

I do not get notifications sometimes from here. So maybe add me to facebook just in case so we can keep in contact and work on this.

My free T went up even over range on some doses of TRT and I did not feel better.

How old are you?

For me my problem is not androgen deficiency, cause TRT does not help much at all.

My thyroid looks great TSH ft3 and ft4 are all good.

I checked my gh many ways

IGF-1 In range but lower 1/3 this was years ago
Urine 24hr GH tested 2 times one time on TRT - Right at bottom of range.
Recently I did serum GH after 40 minutes of exercise it went to 8.0 mIU/L which to me seems low when I look at the other studies.

Is your LH and FSH high or low?


#19

Pls check your other’s folder on Facebook messages. Let’s take this there


#20

@KSman as @vincentv is suggesting, he has gone off TRT having felt no changes in his symptoms, he is looking at a possible relationship between hGH deficiency and high SHBG levels. Have you seen a lot of cases like his? I am a similar case so it’s worrying, might want to start looking for other things if it’s common for people with high SHBG and low FT to not get relief from symptoms with TRT.