T Nation

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


#1

I feel kind of dumb posting this HUGE data dump, but I’ve been building this file now for a long time trying to find out what is

happening and what I can do. I wll tag @KSman to see my post.

age: 56
height: 5’7"
waist: 31"
weight: 130, 15# body fat?
weight changes: lost 15# in the last 7 months intentionally by improving food choices.
body & facial hair: heavy chest & stomach hair, not as much on back; legs moderately hairy. Face - must shave every day, but couldn’t grow a beard if necessary. Outer eyebrows NOT sparse. <-- update: my wife just told me upon being asked that she does feel my outer eyebrows are “thinning”.
describe where you carry fat: Stomach/love handles

health conditions/sympoms:
-libido decreasing drastically over past two years
-very dry skin; dry lips always; constantly licking lips
-very emotional during tv shows (!); can be easily brought to tears by emotional stories (embarrassing)
-hesitation before urination; lots of stops and starts during urination; urination at least once per night
-night sweats once per night; must uncover, cool off and return to sleep.
-excellent solid 5am erections almost every day; but lose 40% tumescense within five minutes. Use it or lose it.
-No afternoon erections; No erection when actual time for sex. Have always suffered more ED problems at night than morning.
-limited penile sensitivity (translated: VERY difficult to orgasm)
-eye fatique;
-TIRED! I’ve caught myself constantly exclaiming “I’m tired” over the past 9 months more than ever. It is a full body exhaustion
-Sleepiness fatique; regardless of how many hours of sleep I do get, I’m sleepy. In the afternoon, between 3-4, I can barely keep my eyes open at times.
-Difficulty sleeping: sparadic but I have suffered insomnia all my life so I discount this symptom.
-difficulty retaining water / excessive urination
-cold hands and feet; must wear a jacket in restaurants, especially after eating noon meal, even though everyone else is in shorts.
-coldness can overtake my body without warning, making me find and wear a small jacket for an hour or two in the middle of the day.
-severe but sporadic bottom of feet cramps (like charlie horses) usually occurring shortly after getting in bed.
-Sperm count tested in 2008 and was quite low. I have no children. (Added: 12/3/17: I never remember having much ejaculate, but I do notice that it is lower now. It was interesting to find this statement on another page: “testosterone, hypogonadism, sperm production, and SHBG are linked”)
-No head trauma
-Brittle and easy-to-break nails

updated:
Unrelated to all of this, I asked my wife if she felt my voice was changing and she said yes. I read where “hoarseness” can be a symptom of thyroid issues which I have never considered until today.
Blurry eye sight

RX, OTC drugs: prescriptions for acyclovir (prophylactic for cold sores); prescription for Ambien (insomnia all my life).

Other: Men’s vitamins, boron, zinc, vit D,
Daily Vitamin includes Iodine as Potassium Iodide 150mcg; and Selenium as Sodium Selenate 200mcg. (Puritans Pride, Ultra Man 50 Plus).
Vit D: 2000IU (as D3 Cholecaiciferol) plus I supplement with Vitamin D3 2000iu

I am not on steroids; I am not on TRT; No alcohol; No Recreational drugs; No smoking;

describe diet: I am on a reduced carb diet. Protein bar for breakfast; normal lunch including vegetables, beef, salmon, etc.; usually protein bar in mid afternoon when sleepiness hits; and a salad for night meal. I snack throughout the day on almonds & pecans. Coffee 1-2x per week, always decaf. Softdrinks regularly, diet only.

Illness: I suffer from mild Lactose Intolerance and Irritable Bowel. I do not take medicine for either.

describe training: I use a treadmill with a HIIT program 2-3 per week; basic weight training 1-2 per week. Exercise - not training.

do testes ache? No, never.

Medical Diagnostics:

  1. MRI to check for pituitary tumor; negative result.
  2. Ultrasound prostate; all normal.
  3. Digital rectal exam. all normal, not enlarged. Multiple testicle examinations. That sounds better than it was.
  4. Penile doppler. Normal blood flow in and out of the penis.
  5. Four or more urination strength tests; including volume monitoring and pressure of flow; ultrasound bladder to see how empty it was after full urination;
  6. Multiple visits to Urologist and Endocrinologist, who informed me on my last visit that I would probably need to transfer my file to a diagnostic/teaching hospital for more help because she was at a loss. (Think “Dr House”).

Blood Testing:
I have tested often, not all tests at the same time however from 2009-2017. Results from the latest panel will follow this background. I have tested for STD & HIV; all tested negative. Results from other panels included to show additional tests taken previously.

Saliva Testing:
Also in 2017, I tested Testosterone, Estradiol, dheas, progesterone and a four-part Cortisol test. Estradiol test (shown as “high”) was in direct contradiction to every blood test I have had.

11-9-17 Test Sequence:
(These results are similar to proceeding 24 months of tests. However, E2 has dropped and FSH was at its highest.)
Testosterone 908 ng/dl (Ref: 193-740 ng/dL for males over 50)
Free Testosterone 8.74 ng/dL (Ref: 4.70 - 13.63 ng/dL for males over 50)
Free testosterone percent: 1.0% (REF: 1.23 - 2.59)
Bioavailable Testosterone 215 ng/dL (Ref: 103.46 - 317 dn/dL for males over 50)
Biovailable T percent: 23.7%
Albumin 4.53 g/dL (Ref: 3.40-4.80)
SHBG 104 nmol/L HIGH (Ref: 20.6-76.7 nmol/L for males over 50)
GH 0.53 ng/mL (Ref: <3.00)
Cortisol 7.820 ug/dL (Ref: 6.02-18.4)
Estradiol <5.0 pg/mL LOW (Ref: 25.8-60.7)
FSH 27.01 mIU/mL HIGH (Ref: 1.5-12.4)
LH 8.39 mIU/mL (Ref: 1.7-8.8)
PSA 0.720 ng/mL (Ref 0.0-4.0)

4-7-17 Test Sequence:
TSH 1.760 uIU/mL (Ref: 0.270-4.20)
E2 7.8 pg/mL (Ref: 25.8-60.7)

12-29-16 Test Sequence:
E2 25.0 pg/mL (Ref: 25.8-60.7)
FSH 16.68 mIU/mL (Ref: 1.5-12.4)
Prolactin 10.0 ng/mL (Ref: 4.0-15.2)
Ferritin 109.7 ng/ml (Ref: 30.0-400.0)
HbAIC 5.0 (Ref: <5.7)
IGF1 202.0 ng/mL (Ref: 87-238)

12-1-16 Test Sequence:
DHEA-Suphate 106.7 ug/dL (Ref: 48.6-361.8)
E2 10.4 pg/mL (Ref: 25.8-60.7)
FSH 19.34 mIU/mL (Ref: 1.5-12.4)

10-10-16 Test Sequence:
Calcium 9.9 mg/dL (Ref: 8.8-10.2)
Cortisol 3.220 ug/dL (Ref: 6.02-18.4) LOW
Progesterone 0.27 ng/ml (Ref: 0.20-1.40)
Free T3 3.29 pg/mL (Ref: 2.00-4.40)
Free T4 1.29 ng/dL (Ref: .93-1.70)

05-28-16 Test Sequence:
GH 4.56 ng/mL (HIGH) (Ref: <3.00)

04-21-16 Test Sequence:
GH 8.63 nl/mL (HIGH) (Ref: <3.00)
E2 23.8 pg/ml (Ref: 25.8-60.7)

Have not started temperature testing. Will do tomorrow.
Did not post standard panel (cbc, etc) but can if you request.

I’m open to any comments and suggestions. This has been an ongoing problem that does not appear to be heading to a fix. Even the Urologist gave up “you are just getting older”. I refuse to accept that.


High SHBG, Low (?) T, Low Libido
Need High SHBG Advice
Leaky Gut Urine Test - aka Intestinal Permeability Test
#2

Ambien is the cause of all your symptoms, you mention charlie horses shortly after getting in bed, I’m assuming after taking Ambien. This is what medications do that target the central nervous system. These medications will screw with your hormones over time, the longer you take them the more damage will occur. It’s likely the reason for sky high SHBG as they suppress the central nervous system and increase liver enzymes, this in turn will cause night sweating, fatigue and all your symptoms. Get off these frankenstein drugs, the body didn’t evolve to process these man made chemicals which is why there are so many side effects.

Your TT is excellent and this medication is going to permanently screw it up over the long term, how do I know that, I was on Klonopin for 30 years which is also a central nervous system stimulant. Damage is already done. I fail to understand how your doctors failed to make the connection, after all the battery of tests they missed that little detail. Doctors always ask what medications you’re taking. I had foot cramps the whole time I was on Klonopin. You’re taking a medication that suppress the central nervous system, where do you think libido/sex drive comes from? Answer, central nervous system. If you continue with taking Ambien, you will soon find out what’s it like to have zero libido.

Your emotional during TV shows is classic low E2. Difficulty retaining water / excessive urination is also low E2, high E2 you’d be holding onto water urinating less. Cold hands and feet, cause low E2 and possible thyroid issues. TT is high E2 is low which makes no sense, Ambien is likely preventing the conversion of T–>E2. Prolonged low E2 is dangerous, bad things will happen. Bone loss, joint pain to name a few.

Everyone that comes in here is going to tell you Ambien is your problem, just look at “some” of the listed side effects.

Digestive difficulties
Persistent fatigue
Recurrent headaches
Dry mouth --> Constant licking lips
Muscle pain --> Muscle foot cramps
Lack of muscle control
Dizziness
Drowsiness
Depression and/or suicidal thoughts
Hallucinations
Confusion
Anxiety
Nightmares
Insomnia
Feelings of withdrawal between doses
Family problems
Unemployment
Bankruptcy
Addiction


#3

How often are you taking Ambien?


#4

I guess I painted a picture of being an Ambien junkie. :slight_smile:

I use less than 1/3 of a 10mg pill in order to shift the mind into neutral and allow me to sleep. However, I can go a few weeks without it, then need it five nights in a row.

I began noticing the cramps during the times that I was NOT taking Ambien.

Right, that is part of the problem. The correlations of what “should” be up or down between hormones are off.

SHBG - HIGH
Estradiol - LOW
FSH - HIGH
GH & Albumin HIGH at different times.

My TT maxed out at 1351. My 8 year average is 1051. The High TT is another factor that has baffled the doctors when taken as a whole with the other blood results.

Thanks for the comments.


#5

I don’t understand why all these tests were run when the cause is staring you in the face, and the solution is simple yet you fail to act. You don’t want to stop taking it even though you know that’s what you should do, that sounds like addiction to me. You can lead a horse to water but you can’t make him drink it.

It took me 10 months to taper off Klonopin, it was horrible! It’s the reason I needed TRT because the medicine damaged my pituitary gland, if I had tapered off at a younger age I probably would have been alright.


#6

Wow! Ok. Thank you.


#7

I found the above statement from @ksman on another post. I have always wondered if the high shbg was artificially inflating my T numbers since they were so high. Plus, I could never get the doctors to explain to me why I had such High T numbers and such terrible free T / free T percentages.

I have been taking boron as a supplement for a while, and the Endo suggested I stay on it in an effort to reduce SHBG.

One day Temperatures using an oral thermometer
7:20am 97.3
10:26am 98.3
1:45pm 97.7
4.15pm 97.8


#8

Day 2 Temperature Readings
7:05am 97.4
10:10am 97.9
1:20pm 97.5
4:30pm 97.4


#9

SHBG is off the charts high. I know someone with problems and it’s half what yours is. It will crush your Free T which it has. Your Estrogen is too low which can cause problems. I wouldn’t be surprised at all if all of your problems revolve around what is causing your SHBG to be so high. Figure out what’s causing it, and address it.


#10

Thanks, @monkey_punch1
That is the million dollar question and one that no doctor (so far) has been able to determine. I’m excluding the ones who say (“High SHBG no problems, because it make Testosterone High, so its ok”). :slight_smile:

I’m on a reduced carb meal plan (NOT a low-carb). There is some literature that it can affect SHBG. But my SHBG has been too high for years and I wasn’t watching food intake all that time. I think any benefit I gained from taking Boron has already been negated.

I’ll meet with the Endocrinologist again this week to share some of the new symptoms I had not realized until preparing this post, including the low temperature charts - and will try to run more detailed thyroid panels than before.

Every person involved has said the same thing: the “highs” and the “lows” do not make sense for anything they have ever diagnosed. Did you notice my FSH at 27.01 (Ref <12.4!) – another off the chart result verified by 9 tests.

I noticed also that my progesterone was low .25 (Ref .2-1.4) which supposedly should cause testosterone to drop. However, it causes E2 to drop, which doesn’t help me.


#11

Day 3 Temperatures:
7:50am 97.3
10:40am 97.6
1:18pm 97.5

Day 4 Temperatures:
7:37am 97.0
10:30am 98.4
2:36pm 97.3


#12

I wrote to a hormone therapy specialist in California to inquire whether he would accept me as an internet-only patient - but he replied that he did not accept patients who did not go into his office. However, as a courtesy, he reviewed my post here and told me the following:

Blockquote
Blood is a poor marker for assessment and monitoring of sex hormones.
I use saliva and urine testing.

No one has mentioned that to me before. So it made me review my previous saliva test. I blamed the results to be an error or a fluke, because my Estradiol was listed as HIGH! 2.8 pg/mL (Ref: 0.5-2.2). Because of that I want to run urine-based hormone tests and see if the results compare to or contradict the blood results. Supposedly saliva & urine are better indicators of free Estradiol floating around the body.


My SHBG Is Off the Charts!?
#13

I met with the Endo again and had another testicle inspection (lucky me). Because of my low temperatures, I wanted a full Thyroid panel performed. In the past I have only checked T3/T4.

The results so far:
TSH Receptor Antibody <0.30 IU/L (Ref: 0.00-1.75)
Thyroglobulin Antibody 2.39 IU/mL (Ref: 0.00-4.11)
Microsomal / Thyroid peroxidase Antibody (aka Anti TPO) 0.00 IU/mL (Ref: 0.00-5.61)
TSH 1.520 uIU/mL (Ref: 0.270-4.2)
Free T3 2.80 pg/mL (Ref: 2.00-4.40)
Free T4 1.30 ng/dL (Ref: 0.93-1.70)
Vitamin D 31.56 ng/mL (Ref: >29.00)

The hospital here does not offer a hormone test via urine, so I have ordered one from the US (ZRT Labs 49 Panel Urine Advanced Metabolites Home Test Kit). It will be a while before it arrives and I can get to it).

Unless I am missing something, all my Thyroid results look ok, which doesn’t explain the low temperatures.


#14

The endo missed rt3. If rt3 is high, it will result in low body temps even with all other thyroid markers being optimal because it binds & blocks receptors that would normally accept ft3.

How is your diet? Do you attempt to reduce systemic inflammation and leaky gut as much as possible? Inflammation = DNA damage = myriad of issues whose physical expression can vary from person to person.

Are you eating fermented foods, feeding your gut microbiome with prebiotic foods, eating foods rich in sulfurophane like broccoli sprouts, taking curcumin etc?

Start taking 5000 iu’s of vitamin d3 daily. Your vit d3 is lower than it should be and easy to correct.

Also, get off of the Ambien. If the civilized world ended and production of ambien ceased, you would adapt and be healthier without it.


#15

These medications cause more problems than they solve, these type of meds almost always increase SHBG as their stress to the body and organs.


#16

Hi,
Thanks for the reply. I should have clarified – the doctor didn’t miss the Reverse T3 (rt3), however it is not done in this hospital (I’m not in the USA right now). I will need to arrange for the test when I return to the US.

My diet is good. Lots of vegetables (including broccoli, cauliflower, etc.), lots of fruit, almonds, pecans, salad (green leafy), reduced carb; lots of protein (100mg/day+); Consuming 1800-2500 calories daily. Eating salmon weekly or bi-weekly; 1-2 times per week of 80% dark chocolate. No added sugar; no added salt. No sugary drinks.

Still supplementing with boron. I do not see “cucumin” as part of my supplements
I am already supplementing Vit D: 2000IU (as D3 Cholecaiciferol) in my multi-vitamin, plus I supplement with Vitamin D3 2000iu. I can increase that easily enough.

I need to read more about leaky gut. I don’t recall seeing the tests listed on any of the lab sites for this. I used this page as a reference: https://draxe.com/leaky-gut-test/

I haven’t taken ambien in two weeks.


#17

I decided to add some symptoms I experience that I haven’t really given thought to. I mentioned that I am lactose intolerant and have mild irritable Bowel, but do not take medicine for either (except lactaid pills if I will drink milk products).

Every morning, I wake up with a full tank of gas. On an average morning, I release 20-30 seconds of gas non stop. It can be contain odor, or be odor free (which I believe is based on which vegetables I consumed). Once the gas is out, I experience the urge to defecate. I get a lot of fiber, so my feces are soft (but not runny or liquid), with air bubbles. Air bubbles, I understand, can also point to issues with bad bacteria and gut issues (pointing me toward probiotics).

As I write this, I’m thinking that it can’t hurt if I schedule a consult with a GI specialist, but I just can’t see the relevance of GI to my issues. I did see a GI doctor for a colonoscopy a year or two ago, but I don’t recall going through my symptoms.


#18

Interesting how LabCorp reference values are so different from mine. I was reading the thread (31 Y/O. Normal TT, Low Free T, Very High SHBG, Low DHEA)

LABCORP DHEA-Sulfate ug/dL 138.5 - 475.2

My DHEA was 106.7, and was considered in the normal range. Looking at LabCorp’s range, my results would be considered LOW.

LABCORP Albumin, Serum g/dL 3.5 - 5.5

My ALBUMIN has remained in the borderline HIGH to HIGH on my lab ranges, but would be considered “normal” on LabCorp.1


#19

My ZRT urine hormone assessment results are in. Bringing new questions to the table.

Urinary Estrogens
Estradiol 0.21 0.18-0.49 µg/g Cr
Estrone 0.75 0.57-1.67 µg/g Cr
Estriol 0.37 0.18-0.64 µg/g Cr
2-OH Estradiol 0.09 0.04-0.14 µg/g Cr
2-OH Estrone 0.38 0.16-0.48 µg/g Cr
4-OH Estradiol 0.08 0.03-0.08 µg/g Cr
4-OH Estrone 0.06 0.04-0.10 µg/g Cr
16α-OH Estrone 0.18 0.06-0.21 µg/g Cr
2-MeO Estradiol <dl L 0.01-0.03 µg/g Cr
2-MeO Estrone 0.08 0.05-0.15 µg/g Cr
2-MeO E1/2-OH E1 0.21 0.20-0.38
4-MeO Estradiol 0.02 <0.04 µg/g Cr
4-MeO Estrone <0.00 <0.04 µg/g Cr
4-MeO E1/4-OH E1 N/A 0.05-0.17
4-MeO E2/4-OH E2 0.25 0.06-0.47
Bisphenol A 3.15 H 0.97-2.31 µg/g Cr

Urinary Progestogens
Pregnanediol 128 47-140 µg/g Cr
Allopregnanolone 1.12 0.32-1.20 µg/g Cr
Allopregnanediol 5.06 1.57-6.82 µg/g Cr
3α-Dihydroprogesterone 0.86 H 0.19-0.73 µg/g Cr
20α-Dihydroprogesterone 1.89 0.51-2.97 µg/g Cr
Deoxycorticosterone 1.10 0.28-1.25 µg/g Cr
Corticosterone 4.73 1.95-8.22 µg/g Cr

Urinary Androgens
DHEA 44.32 9.01-93.80 µg/g Cr
Androstenedione 9.55 H 2.12-9.51 µg/g Cr
Androsterone 890 H 302-724 µg/g Cr
Etiocholanolone 913 H 279-775 µg/g Cr
Testosterone 18.11 H 3.81-14.21 µg/g Cr
Epi-Testosterone 30.60 H 3.15-8.85 µg/g Cr
T/Epi-T 0.59 0.5-3.0
5α-DHT 2.22 0.71-2.46 µg/g Cr

Urinary Androgens
5α,3α-Androstanediol 25.47 H 9.48-24.96 µg/g Cr

Urinary Glucocorticoids
Total Cortisol 36.61 H 8.73-28.52 µg/g Cr
Total Cortisone 66.68 H 14.12-42.84 µg/g Cr
Cortisol/Cortisone 0.55 0.5-0.7
Tetrahydrocortisol 270 201-597 µg/g Cr
Tetrahydrocortisone 738 330-1126 µg/g Cr

Urinary Free Diurnal Cortisol
Free Cortisol 29.08 7.8-29.5 µg/g Cr (1st Morning)
Free Cortisol 122.89 H 23.4-68.9 µg/g Cr (2nd Morning)
Free Cortisol 55.54 H 6.0-19.2 µg/g Cr (Evening)
Free Cortisol 12.47 H 2.6-8.4 µg/g Cr (Night)

Urinary Free Diurnal Cortisone
Free Cortisone 80.36 31.6-91.6 µg/g Cr (1st Morning)
Free Cortisone 273.03 H 63.3-175.8 µg/g Cr (2nd Morning)
Free Cortisone 183.12 H 30.6-88.5 µg/g Cr (Evening)
Free Cortisone 62.90 H 15.5-44.7 µg/g Cr (Night)

Urinary Diurnal Melatonin MT6s
Melatonin 8.31 L 10.1-26.0 µg/g Cr (1st Morning)
Melatonin 6.47 6.0-17.0 µg/g Cr (2nd Morning)
Melatonin 1.18 0.5-3.6 µg/g Cr (Evening)
Melatonin 1.20 L 1.3-8.4 µg/g Cr (Night)

Urinary Creatinine
Creatinine (pooled) 0.78 0.3-2.0 mg/mL
Creatinine 1.09 0.3-2.0 mg/mL (1st morning)
Creatinine 0.85 0.3-2.0 mg/mL (2nd morning)
Creatinine 0.38 0.3-2.0 mg/mL (Evening)
Creatinine 0.29 L 0.3-2.0 mg/mL (Night)


24 Hour Hormone Urine Test - The Gold Standard
#20

I’ve never seen a test like this before but I caught the T being high in the urine, strange considering you should see lots of T in urine on a low SHBG guy.

This will require KSman, he’s probably the only one who can comment.