T Nation

High T, FSH, SHBG, Low E2 No Libido. My Lab Results (pellets)


#21

Online consult #1 with a Internal Medicine/Endoc specialist in India:

After going thru ur labs and description of ur condition of body and mind
I think
U are born with some kind resistance in ur SHBG which should be low in view of high testosterone ( cannot help it as ur probably born with such resistance )
High testosterone and FSH are also probably related to ur low sperm count and less libido and both these hormones increase libido and sperm count but maybe ur testicles ( where spermgenesis happen ) are beyond increasing further sperm count so that despite high testosterone and FSH u still has low sperms and libido
I can suggest u to understand this particular situation of u and try to adjust to this as it is inborn probably so no one can actually increase ur sperm count so that ur hormone will stabilise but for less libido u can try
Tab sildenafil 50mg at sleep time ( when u can use ur penis ) provided u donot have any angina and ur Blood pressure is normal
U can come back with further questions and no need of any further labs
28/12/2017 3:15PM

I understand that he is saying:
“You are born with something wrong with to cause high SHBG. Your testicles aren’t going to work any harder, so there is nothing you can do to balance your hormones. The best you can do is take 50mg Viagra at bedtime for sex”.

Well, that was disappointing. Another doctor that says nothing can help me. :frowning:


#22

I asked him about TRT and danazol:

Danazol will not help u
But testosterone supplement therapy can help u to certain level and u can try that with ur local endo Dr
Estrogens also has critical role in libido and erection but giving external estorgen can make matters worse so testosterone supplementation can be tried in your case


#23

There are some doctors who might diagnose hypogonadism off your free testosterone levels. I’ve seen 8 ng/dL used as a cutoff, and you’re just above this. (Click through where it say "I am a health professional.)

https://www.nebido.com/en/hcp/diagnosis/diagnosis-and-treatment-algorithm/

Alternatively, your FSH and LH are really high. This could indicate compensated or subclinical hypogonadism, where your hormone levels are normal, but your body is calling for more. (Again, click through when it asks if you’re a health professional.)

https://www.nebido.com/en/hcp/research/testosterone-research/health-consequences-of-subclinical-hypogonadism.php

My total testosterone and SHBG were higher than yours, but my free testosterone was a bit lower. However, I was diagnosed based on having subclinical hypogonadism.

I don’t know if this will help, but it might suggest another avenue to look into.


#24

I never really considered the difference between “libido” and “arousal”. It is an interesting distinction and I’m trying to determine how this affects my “symptoms”. Because using these definitions, my “libido” has never changed – I think about sex the same now as I did years before.

Sexual desire (also known as ‘sex drive’ or ‘libido’) is controlled by the brain. It is the biological, driving force that makes us think about sex and behave sexually.

Sexual arousal (being ‘turned on’) involves a number of changes in the body. These include increased blood flow to the penis.

Well, this sums up a lot … thanks Graemsay.
Symptoms of post pubescent hypogonadism include sexual dysfunction (erectile dysfunction, …, diminished penile sensation, difficulty attaining orgasm, and reduced ejaculate), …


Distinctions: What is "Libido" vs "Sex Drive"
Difficulties in Achieving Orgasm
Difficulties in Achieving Orgasm
#25

Doctor Consult #2 was completed last night with a well-known hormone/steroid specialist in the US.

He also believed I was “predisposed” to high-SHBG; and that my “system” was working in overload trying to produce enough testosterone to satisfy the “hungry SHBG-monster” (my words). Other hormones out of balance were due to the stress on my system, he opined.

He suggested I do the ultra-sensitive E2 test just to lay-to-rest where my true E2 levels were, and felt I should boost my vitamin D supplements even higher than I am at now.

In the end, his solution was TRT at a high enough dose to overcome the SHBG.

Since I have been back on all supplements, I took another SHBG test today and will post the results when I receive them.


#26

I’ve never felt that I talk to myself as much as this thread. :slight_smile:

The blood tests I ran on 11-9-17 were with me taking only my main vitamin; no supplements at all. Immediately after the blood tests, I began taking all the supplements (boron, stinging nettle, zinc+, d+, etc) again.

On 1-4-18, I ran a new set of labs primarily because I wanted to see if the supplements were doing anything productive.

Results:

Testosterone 778 ng/dl (Ref: 193-740 ng/dL for males over 50)
Free Testosterone 8.43 ng/dL (Ref: 4.70 - 13.63 ng/dL for males over 50)
Free testosterone percent: 1.1% (REF: 1.23 - 2.59)
Bioavailable Testosterone 219 ng/dL (Ref: 103.46 - 317 dn/dL for males over 50)
Biovailable T percent: 28.2%
Albumin 4.79 g/dL (Ref: 3.40-4.80)
SHBG 86.21 nmol/L HIGH (Ref: 20.6-76.7 nmol/L for males over 50)

Two interesting points:

  1. Starting the boron and stinging nettle again reduced SHBG. It is still high, but it is a considerable drop from 11-9-17.
  2. My testosterone dropped to the lowest number in 10 years; confirming what the doctors have said … that my system is overloaded trying to produce enough T for the SHBG; and that as I am getting older, my system is having problems creating enough T.

I also ran a few other tests just to update my records

Serum Iron 114 ug/dl (Ref 59-158)
Ferritin 184.70 ng/ml (Ref 30-400)
HbA1C 4.9% (Ref <5.7)
PSA 0.762 ng/mL (Ref <4.00)
FREE PSA: 26.25% (indicating a very low risk of finding prostate cancer)
IGF-1 165ng/ml (Ref: 36-200)

The changes shown are for me to better understand what is going on. They don’t provide any changes in how I feel. There is still a long road ahead. :frowning:

So it is time to find a doctor for TRT.


Boron - All My Patients Use It and So Should You
#27

A footnote … I eat a LOT of Almonds and have for the past six months. As part of posting this thread, I read where various sites theorized that Almonds increase SHBG, and should be avoided, if you are attempting to lower SHBG.

I finally (!) found the study where this information was obtained, and found that it was based on a study of 31 WOMEN with PCOS.

Here is a quote from the study:

Within groups, walnuts increased SHBG by 12.5% … Almonds increased SHBG by 16% … As SHBG binds testosterone avidly, increased SHBG can decrease the free fraction of androgens.

I am posting this only to point out that the survey was done on WOMEN and that I was unable to find any studies on MALES. However, as part of my desire to continue reduction of my HIGH SHBG, I will eliminate Almonds … after I eat the last of my bowl.


#28

That’s a fantastic reduction in SHBG! A ways to go still but wow, that is great. Keep taking the Boron and stinging nettle.

It seems that everyone has a different issue as to why their shbg is high and they have to find what works for them. Boron and stinging nettle didn’t help me much, but its awesome that it does work for you! That’s great news. (may try some boron again in the future to see if I get any benefit from it now that I have found what supplements works for me )

Yes, when I read that almonds increase SHBG, Im not even going to chance it. I use to eat almonds daily. Not at all anymore.

Also, look into Divanyl, if the stinging nettle is working for you. Divanyl is the stuff that binds to SHBG the most. I think a few products have it in them.


#29

I’ve read a lot of the forums that relate carbs to SHBG. I found this study which debunks that theory

We conclude that age and body mass index are major determinants of SHBG concentrations in older men, and fiber and protein intake are also significant contributors to SHBG levels, but total caloric intake and the intake of carbohydrate or fat are not significant. Thus, diets low in protein in elderly men may lead to elevated SHBG levels and decreased testosterone bioactivity.

And I found this study that correlates increased vitamin D to lower SHBG.

Vitamin D supplementation leads to a significant increase of estradiol levels and a significant decrease of sex-steroid-hormone–binding globulin (SHBG) in middle-aged men with normal testosterone levels,

It is interesting for me, because my vit D was low even with supplementation; indicating that I needed to increase the amount I was taken.


#30

That is interesting the D may increase e2


#31

Since I have been talking to myself in this thread a lot :), I decided to add a few more comments of things that I am learning. Of course, I don’t know if this “learning” will help me or just provide more questions, but some of it has been interesting.

The urine test I had from ZRT is “snake oil medicine” according to some doctors as there is “no scientific evidence” to support this type of urine collection for hormone testing. I don’t know about all that, but it was worth trying the test.

I had never heard of “Bisphenol A” before this test. The test showed a “high” concentration.

Supposedly high levels are caused by SOME water bottles, plastic wrap, soup cans, etc. I started re-checking all the plastic bottles I use (water, soft drinks, etc.), and according to the markings (“Furthermore, plastics marked with a #1, 2, 4, or 5 don’t contain BPA and may be better choices)_”, none of them should be a concern. I very rarely ate soup out of a can, but I did use plastic wrap when heating items in the microwave. Bisphenol A is also in thermal receipts, something I touch multiple times per day.

Oh, and I also found that the use of hand sanitizers allow BPA from thermal receipts to enter your blood stream more easily.

Once I figured out what it was, I looked around to find out what it does. That was the weird part.

An increased urine BPA level was associated with increased prolactin (p<0.001), estradiol (p<0.001), sex hormone-binding globulin level (p=0.001), and a reduced androstenedione (p<0.001) and free androgen index level (p=0.021).
Source

After adjustment for potential confounders using linear regression, increasing serum BPA concentration was statistically significantly associated with [1] decreased androstenedione levels, [2] decreased free testosterone levels, [3] decreased free androgen index, and [4] increased sex hormone-binding globulin levels.

Also affects sperm quality. Source

This was both an interesting and confusing find. I get a half-dozen receipts from other businesses each day … and we use thermal receipts in my business. And I live out of plastic bottles, so I couldn’t imagine what change I would make.

Since no one has a good handle on what REALLY causes increased SHBG (and I have HIGH SHBG levels), I keep looking for anything that might shed some light on the underlying source.

The only thing I can do with this information – stop storing food in plastic containers (I will buy glass); never refill a water bottle; never drink from a water bottle that has been in the direct sun (!); no more canned soup; stop covering food with plastic wrap, especially when heating in the microwave; stop keeping receipts in my wallet; and wash my hands after touching receipts.

Updated 1/19/18: I realized that I drink out of plastic cups very often at home. I liked some of the plastic cups that some restaurants give you and I found myself using them instead of the glass ones. When I checked the recycling number on the cup, some were questionable as to whether BPA was included. I have stopped drinking out of this type of plastic cup.


#32

Did you ever get your liver functions checked in the blood. AST and ALT ? I looked up in your post the best I could and did not find.


#33

Hi,
Yes, I run a full blood panel each time … but there has been nothing unusual so I didn’t post all the results.

For example, this is my last AST/ALT test from last week. This is pretty much a standard result, although it has been slightly higher at times.

astalt


Low T Issues, High SHBG Trying to Figure It All Out
#34

11-9-17 SHBG 104 nmol/L HIGH (Ref: 20.6-76.7 nmol/L for males over 50)

1-4-18 SHBG 86.21 nmol/L HIGH (Ref: 20.6-76.7 nmol/L for males over 50)

I added tongkat ali to the boron and stinging nettle and eliminated almonds. But it had no effect.

1-19-18 SHBG Sex Horm Binding Glob, Serum 86.0 High nmol/L 19.3 - 76.4

I’m still waiting on the reverse T3 and the ultra-sensitive Estradiol test … but here are the other results received so far:

Glucose, Serum 90 mg/dL 65 - 99 01
Uric Acid, Serum 4.9 mg/dL 3.7 - 8.6 01
BUN 21 mg/dL 6 - 24 01
Creatinine, Serum 0.95 mg/dL 0.76 - 1.27 01
eGFR If NonAfricn Am 89 mL/min/1.73 >59
eGFR If Africn Am 103 mL/min/1.73 >59
BUN/Creatinine Ratio 22 High 9 - 20
Sodium, Serum 146 High mmol/L 134 - 144 01
Potassium, Serum 5.3 High mmol/L 3.5 - 5.2 01
Chloride,Serum 103 mmol/L 96 - 106 01
Calcium, Serum 9.8 mg/dL 8.7 - 10.2 01
Phosphorus, Serum 4.1 mg/dL 2.5 - 4.5 01
Protein, Total, Serum 6.9 g/dL 6.0 - 8.5 01
Albumin, Serum 4.7 g/dL 3.5 - 5.5 01
Globulin, Total 2.2 g/dL 1.5 - 4.5
A/G Ratio 2.1 1.2 - 2.2
Bilirubin, Total 0.7 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase, S 51 IU/L 39 - 117 01
LDH 150 IU/L 121 - 224 01
AST (SGOT) 23 IU/L 0 - 40 01
ALT (SGPT) 28 IU/L 0 - 44 01
GGT 25 IU/L 0 - 65 01
Iron, Serum 122 ug/dL 38 – 169
Cholesterol, Total 180 mg/dL 100 – 199
Triglycerides 44 mg/dL 0-149
HDL Cholesterol 57 mg/dL >39 01
VLDL Cholesterol Cal 9 mg/dL 5 - 40
LDL Cholesterol Calc 114 High mg/dL 0 - 99
T. Chol/HDL Ratio 3.2 ratio units 0.0 - 5.0
Sex Horm Binding Glob, Serum 86.0 High nmol/L 19.3 - 76.4

Reverse T3, Serum Will Follow 02
Estradiol, Sensitive Will Follow 02


#35

Hey TM. I had looked into Tongkat Ali as well, but I found that the supply that is going around recently is bunk! At least everything I could get a hold of. Apparently its not so easy to come by the real stuff (the root). The tree cant be cultivated and the roots have to be 10 years old I think?

Anyway, I gave up on the stuff.

I’m seeing more people who are having results lowering their shbg with using liver supplements.

Same-E was mentioned in the other post you were on.

Have you tried any liver cleanse/methyl supplements?


#36

No, I have never tried any liver cleansing, liver supplements or methyl supplements. I have considered taking the tests for “leaky gut” but have not done that yet.

I also read all the bad press on tongkat ali, but wanted to try it.


#37

Good luck diagnosing this. I have high SHBG as well. Few years ago, I took a ton of Saw Palmetto for months (based on an article I read)… did nothing. The only thing I know that drops SHBG for certain (via blood work), is Tren. Not overly helpful I know!


#39

You should check these forums out. Some people have had success using liver detox methods.

I dropped mine from 54 to 37 in about 2 weeks using calcium D glucarate.


#40

Finally received the results of the final two tests …

Reverse T3, Serum 18.0 ng/dL 9.2 - 24.1
Estradiol, Sensitive 10.9 pg/mL 8.0 - 35.0

And for a depressing moment from reading the forums about an estrogen/estradiol study …

However, the men with the lowest estrogen levels (below 12.90) fared the worst as they experienced 317% more deaths.


#41

Welcome to my world. I’ve had low estrogen for at least a year that I’m aware of. This is my 4th week of trt and I’m feeling much better. It seems like just before shot day my low estrogen symptoms come back. I can’t wait to do bloodwork again to see what’s going on.