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High Total Test but Low Free Test Lab Results


27 yr old male here. I just got my labs done because I’ve been experiencing what I thought could be high e2/ low test/ high t4 symptoms including ed, pre e, low libido, fatigue, brain fog, anxiety, heart palps. Here are my lab results, but I’m not quite sure how to interpret them and what I should run.

Testosterone serum 1111 Ng/dl (348-1197)
Free testosterone 13.5 pg/ml (9.3 - 26.5)
Estradiol 23.2 pg/ml (7.6 - 42.6)
TSH 1.350 uIU/ml (0.450 - 4.500)
Thyroxine(t4) 9.3 ug/dl (4.5 - 12.0)
T3 uptake 3.1 (24 - 39)
Free thyroxine index 2.9 (1.2 - 4.9)

I just bought copper and lemon balm to address my thyroid issues but what do I do about my low free testosterone? Why would my free test be that low when my total is so high? Sbhg issue? Thinking about going on arimidex and possibly clomid. What do you guys think?


Yes, your SHBG is high. E2 can be the cause but not in your case, E2 looks ideal. SHBG is made in the liver so start looking there.

TSH and TT4 look good. You need fT4, fT3 and rT3 for a complete look at your thyroid.

Your free T is not that terrible actually, but it is disproportionate to your Total.


Thanks for the feedback! I think I will start with supplementing milk thistle to detox my liver and maybe add some stinging nettle/boron to decrease my shgb levels and see if that helps.And if I don’t see any difference after a couple months, I might go ahead and try danazol.

In the meantime, I went ahead and ordered arimidex and clomid before I saw your post. Do you think low dosing these will be counterproductive?


Does seem like a liver problem not clearing E2.

TSH around 1.0 is good.
T3, T4, fT3, fT4 should be mid-range or a bit higher.

Suggested labs:

In the T replacement formum, 1st topic, second link, please follow these links:

  • advice for new guys
  • things that damage your hormones
  • thyroid basics explained <-- check your oral body temperatures as suggested.
  • you may find others there of interest

If you want to follow up, start your thread in the T replacement forum.

Have you always used iodized salt?

It is fT3 that does the heavy lifting. T4 is mostly a reservoir for T4–>T3

Active thyroid hormones are free, not bound. So T4 may not be what it appears to be.

What gear/meds/supplements?