Mid-Range Total T, Low Free T, High SHBG - Options?

24 years-old, healthy weight, lean/muscular, good diet and regularly exercise/lift. Have been experiencing low libido and a degree of ED for about 2-3 years now. Only recently had my first hormonal test done (doc refused before, given my age…).

Total T - 637 [264-916]

Free T - 10.3 [9.6 - 26.5] VERY LOW END

SHBG - 61 (high)

E2 7.8 [7.6 - 42] VERY LOW END

Prolactin lowish 6.1 [4 - 15]

LH - 4.3 [1.7 - 8.6]
FSH - 2.3 [1.5 - 12.4]

Thyroid and liver tests - normal.

The doctor wants to work on lowering SHBG, as this appears to be the cause of my low free T (but otherwise normal total T). I’ve tried boron, mangesium, zinc, etc. to no avail. I don’t believe this is the problem, as it seems that people who have lowered SHBG have also lowered their total T as well. However, no doc in their right mind is going to put me on TRT at my age with my current total T levels.

Why I think I need to boost T, as opposed to lower SHBG: High-dose Naltrexone (which boosts LH and T by antagonizing mu-opioid receptors) gave me good erections, morning wood, and libido temporarily (until the MOR up-regulated). This is the ONLY supplement/drug I’ve taken thus far that has helped.

What are my options? Should I ask for HcG or Clomid? Should I fake low T by not sleeping and drinking pots of coffee before my tests? I don’t know what else to do. I feel like shit and am wasting away my life.

From my reading online, it sounds like SHBG itself may not even be the problem, and that by lowering it I would also lower my total T? There are many differing opinions, which makes this hormonal stuff all the more confusing.

I’m currently trialing DHEA, which should theoretically increase my T, DHT, and E2. I’ve been on it for about 2 weeks thus far and have yet to see any improvement in sexual function.

Suggestions? I’ve considered proviron to lower SHBG (though I would have to buy it illegally - live in US) and have considered Clomid/Nolvadax to “reset” my HPTA (like something of a PCT, even though I never took AAS). It seems premature to jump on TRT but I would consider it at some point. My life is passing me by and I feel like shit.

Any thoughts would be truly appreciated. Thanks!

Your SHBG is grabbing ahold of too much T, nothing you can do about it except throw androgens at it to increase FT. Your E2 is low because FT is low, you seem to be a low converter of T->E2 allowing you to get away with one-twice weekly dosing.

Sorry, normal doesn’t cut it, not when the reference ranges include people with hypothyroidism.

TSH 2.5> is a problem, 95% of the population is <1.5. TSH is a poor biomarker for thyroid status, free thyroid hormone need testing, fT3 should be midrange or higher, rT3 <15 ng/dL or it will block fT3 at the receptors deactivating a portion of fT3 then causing symptoms, unable to lose fat or symptoms similar to low testosterone like erections at half mast.

Seems like it could cause more problems than it solves, drugs are not natural to the body and have side effects, some not reversible. A YouTuber permanently crashed his testosterone on this medication.

I crashed my testosterone using klonopin for 30 years, we are all of us guinea pigs never knowing what might happen. The only thing I am certain is that TRT will change your life and improve your health and your doctors want to give you harmful drugs.

Thanks for the reply.

By “throw androgens,” do you mean TRT or something like Proviron/ other anabolics?

Specific thyroid numbers:

TSH - 1.69 [ 0.45 - 4.5]
rT3 - 16.6 [ 9.2 - 24.1]
T4 - 1.2 [0.82 - 1.77]

How bad are these?

What are my options?

What is normal thyroid? Technically your T is normal even though it’s shitty.

Specific thyroid numbers:

TSH - 1.69 [ 0.45 - 4.5]
rT3 - 16.6 [ 9.2 - 24.1]
T4 - 1.2 [0.82 - 1.77]

Thyroid looks fine although you don’t have FT3.

It was normal on the most recent test. On my last test, my total T was in the 500s and free T was below range (but this was measured in the afternoon…).

Sorry, T3 is 3.3 [ 2.0 - 4.4]

If you look into telemedicine clinics you can likely get prescribed. It may be a tad bit harder because you’re 24 but it shouldn’t take longer than 24 hrs to find one willing to help you. Mine prescribed me at 600 total T but I’m 30’s.

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Are other options, like SERMs or hCG not worth bothering with?

I’m scared of the permanent repercussions when starting TRT.

Excess testosterone will suppress SHBG is just about everyone, I’ve seen men with those SHBG levels and once TRT comences SHBG is significantly lower and FT is sufficiently elevated to the high normal ranges.

It doesn’t seem your doctor are very knowledgeable, the more experienced TRT doctor (private) would know this ideal of using High-dose Naltrexone is a fool erwin and will most likely increase SHBG. I can’t believe they want to prescribe opiods.

Serms increase SHBG, HCG will not lower SHBG, TRT causes an unnatural spike in T and E2 and this is what lowers SHBG, and rules out T-gel or T-creams. Good luck finding a competent doctor in sick care, most would prefer to prescribe drugs because this is what drives the medical industry, not hormones.

These bioidentical hormones are 100 times safer than any drug on the market, TRT improves every aspect of your health, muscle mass, heart health, mood, cognition, well being, makes you a better father and husband.

Tell me what drug does all that?

That’s low testosterone messing with your head, men should be fearless, confident and appropriately agressive and the repercussion of not starting TRT is clear.

Testosterone and the Heart

Testosterone (T) has a number of important effects on the cardiovascular system. In men, T levels begin to decrease after age 40, and this decrease has been associated with an increase in all-cause mortality and cardiovascular (CV) risk. Low T levels in men may increase their risk of developing coronary artery disease (CAD), metabolic syndrome, and type 2 diabetes. Reduced T levels in men with congestive heart failure (CHF) portends a poor prognosis and is associated with increased mortality.

Studies have reported a reduced CV risk with higher endogenous T concentration, improvement of known CV risk factors with T therapy, and reduced mortality in T-deficient men who underwent T replacement therapy versus untreated men. Testosterone replacement therapy (TRT) has been shown to improve myocardial ischemia in men with CAD, improve exercise capacity in patients with CHF, and improve serum glucose levels, HbA1c, and insulin resistance in men with diabetes and prediabetes. There are no large long-term, placebo-controlled, randomized clinical trials to provide definitive conclusions about TRT and CV risk. However, there currently is no credible evidence that T therapy increases CV risk and substantial evidence that it does not. In fact, existing data suggests that T therapy may offer CV benefits to men.

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Can you link me to the video of the man who permanently crashed his T on Naltrexone?

I wasn’t prescribed this; I bought it online and trialed it myself. It isn’t an opiate; it is an opioid antagonist, so it basically has the exact opposite effect. Opiates lower T; antagonists temporarily raise it.

Well, there are a few concerns:

  • testicular atrophy
  • lack of fertility
  • reduction of neurosteroid synthesis (unless testis are kept active).

You can read 10 minutes on this forum and answer that question yourself. The long term repercussions of TRT are something to consider. Being jacked and always trying to have sex is a hard life to live.

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Bignoknow on YouTube, locate he older videos.

There are ways to deal with these, while on TRT you can use HCG for testicles fullness and leydig cell stimulation which will keep you making some natural T, FSH injections for sperm production.

You can always stop TRT to restart neurosteroid synthesis, I did.

Right. Does hCG work long-term though?

I hate how many differing opinions there are on this topic, both on the internet and amongst doctors. It makes it confusing as hell and makes it difficult to take the initiative to step into this.

Haha the horror stories have made me wary, I suppose, as well as the extreme lack of consensus among doctors regarding TRT.

All of these sexual issues started as a result of an antidepressant (prozac) - exogenous chemical - after all. I have no idea what the hell it did to my body, but the changes are obviously permanent.

Thanks for the information.

Yes it does and don’t believe the myth of leydig cell overstimulation using HCG, no one has ever seen this in practice.

There is a lot of misinformation out there regarding TRT, like high levels of exogenous testosterone causing prostate cancer, which was based off a 1941 study which was seriously flawed and included castrated men who are in a separate risk category from the general population, oh and women who were included in the study.

Last time I checked women don’t have a prostate and the doctor that did this study went onto win the nobel prize. Most doctors are sheep never really picking up a study and reading it, they go by some else’s word without fact checking, the path of least resistance.

You need studies, YouTube videos on prostate cancer by the experts, ask and you shall receive.

Yeah mine started with Paxil. The doctors didn’t seem to mind the long term effects of that.