T Nation

Low FT and High SHBG


#1

Hello all, I am a 25 y.o. male 6'0" 180 pounds. Lately I have had all of the tale tale signs of low testosterone (fatigue, decreased libido,etc.) I went to my Physician and he ran a blood test which came back showing low Free testosterone. He referred me to a urologist who did more blood work and it showed high SHBG. My urologist is now referring me to an endo because he was not sure what to do about the SHBG. My question is based on your experience and my blood results; should I pursue TRT or should I be looking into other options? My blood results are as follows:

Total Testosterone Serum 561 (no range provided)
Estradiol 15.0 pg/mL range - 7.6 - 42.6
FSH, Serum FSH 8.1 mIU/mL 1.5 - 12.4
Prolactin 5.8 ng/mL 4.0 - 15.2
Prostate Specific Ag, Serum 0.4 ng/mL 0.0 - 4.0
Sex Horm Binding Glob, Serum 61.1 High nmol/L 16.5 - 55.9

Testosterone, Free, Direct Free Testosterone(Direct) 9.0 Low pg/mL 9.3 -
26.5

CBC With Differential/Platelet
WBC 4.5 x10E3/uL 3.4 - 10.8
RBC 5.10 x10E6/uL 4.14 - 5.80
Hemoglobin 15.9 g/dL 12.6 - 17.7
Hematocrit 46.4 % 37.5 - 51.0
MCV 91 fL 79 - 97
MCH 31.2 pg 26.6 - 33.0
MCHC 34.3 g/dL 31.5 - 35.7
RDW 12.7 % 12.3 - 15.4
Platelets 212 x10E3/uL 155 - 379
Neutrophils 58 % 40 - 74
Lymphs 33 % 14 - 46
Monocytes 5 % 4 - 12
Eos 3 % 0 - 5 01
Basos 1 % 0 - 3
Neutrophils (Absolute) 2.6 x10E3/uL 1.4 - 7.0
Lymphs (Absolute) 1.5 x10E3/uL 0.7 - 3.1
Monocytes(Absolute) 0.2 x10E3/uL 0.1 - 0.9
Eos (Absolute) 0.1 x10E3/uL 0.0 - 0.4
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2
Immature Granulocytes 0 % 0 - 2
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1

Comp. Metabolic Panel (14)
Glucose, Serum 78 mg/dL 65 - 99
BUN 12 mg/dL 6 - 20
Creatinine, Serum 1.00 mg/dL 0.76 - 1.27
eGFR If NonAfricn Am 104 mL/min/1.73 >59
eGFR If Africn Am 120 mL/min/1.73 >59
BUN/Creatinine Ratio 12 8 - 19
Sodium, Serum 142 mmol/L 134 - 144
Potassium, Serum 4.1 mmol/L 3.5 - 5.2

Chloride, Serum 105 mmol/L 97 - 108
Carbon Dioxide, Total 27 mmol/L 19 - 28
Calcium, Serum 10.1 mg/dL 8.7 - 10.2
Protein, Total, Serum 7.0 g/dL 6.0 - 8.5
Albumin, Serum 4.5 g/dL 3.5 - 5.5
Globulin, Total 2.5 g/dL 1.5 - 4.5
A/G Ratio 1.8 1.1 - 2.5
Bilirubin, Total 0.8 mg/dL 0.0 - 1.2
Alkaline Phosphatase, S 44 IU/L 39 - 117
AST (SGOT) 20 IU/L 0 - 40
ALT (SGPT) 23 IU/L 0 - 44

Lipid Panel
Cholesterol, Total 189 mg/dL 100 - 199
Triglycerides 45 mg/dL 0 - 149
HDL Cholesterol 78 mg/dL >39

VLDL Cholesterol Cal 9 mg/dL 5 - 40
LDL Cholesterol Calc 102 High mg/dL 0 - 99

Thyroid Panel With TSH
TSH 1.970 uIU/mL 0.450 â- 4.500
Thyroxine (T4) 9.4 ug/dL 4.5 - 12.0
T3 Uptake 32 % 24 - 39
Free Thyroxine Index 3.0 1.2 - 4.9

Testosterone, Free, Direct
Free Testosterone(Direct) 9.0 Low pg/mL

My doc said my total testosterone is 561 which he considered normal. He did not give me a reference range for that though.
Thanks for the help. I am still going to the endo in the near future, I am just looking for advice.


#2

@cdudeman

Any update?


#3

I sure missed that one!


#4

Sorry for never giving an update. I did go see a different doctor who prescribed me Test Cyp, HCG, and anastrozole. I have been on it since June '14. My numbers are great now, but I have not seen a significant change in the way I feel or Libido, so right now I am weaning off of TRT to try HCG Monotherapy. I am trying to get my wife pregnant, so I think this is the best course of action now.

thanks for your interest.


#5

Please post your current on-TRT lab work with ranges.

Suggested reading, in 2nd post of 1st forum topic:

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

This worries me:
TSH 1.970 uIU/mL 0.450 â- 4.500
Thyroxine (T4) 9.4 ug/dL 4.5 - 12.0
T3 Uptake 32 % 24 - 39
Free Thyroxine Index 3.0 1.2 - 4.9

Do you use iodized salt?
Get cold easily?
Low energy and brain fog?
Outer eyebrows sparse?


#6

Thanks for responding.

To answer your questions:
No.
No.
Yes to both.
No, i do not think so.

These are my last results, granted it was on my trough day.



#7

You are iodine deficient, but perhaps not if you have been using vitamins that list iodine+selenium for a long time. Please check oral body temperatures as per the thyroid basics link.

TSH should be closer to 1.0
T3, T4, fT3, fT4 should be near mid-ranges or a bit higher.

Others in your household are affected by not having iodized salt.

Brain fog while on TRT can be from high or low E2.

Making baby: Stay on T+AI and switch from hCG to 10mg/ED, 20mg EOD Nolvadex. Some have planned this and got pregnant before they got on the SERM. Please avoid Clomid as it has nasty side effects for some guys. Docs do not know this and the medical community is in a rut re using Clomid.


#8

Thanks for the advice KSman, it is much appreciated. I will have to check my vitamins to see if it has iodine in it. Do you recommend anything else for that besides iodine supplements or iodized salt?

thanks again


#9

If thyroid numbers are off or temperatures are low and there is no evidence of ample iodine intake; taking supplemental iodine may resolve the issues. Always good to have TSH, fT4 and fT3 numbers. I keep running into people in real life who are not using iodize salt or not cooking or eating at home enough to use it. Doctors never ask about iodine.


#10

Can you please elaborate on the lack of libido and energy even on TRT?