T Nation

Need KSMan's Help. 27 Y/O. Low Total T, Low SHBG, High FSH

6 1” 255 lbs -BMI of 33
FSH 19.0 - range 1.4-18.1
Prolactin 15.5 - range 2.1 - 17.2
LH 6.5 -range 1.5 -9.3
ALT was (4-56) 60 ( doctor wasn’t concerned)
AST was 30 (5-40)

Vitamin D, 25-OH 28 ng/mL 30 - 100 ng/mL

Testosterone, Total 200 ng/dL 240 - 900 ng/dL Testosterone, Free, Calculated 63.2 pg/mL 21.0 - 135.0 pg/mL Testosterone, % Free 3.2 % 1.5 - 3.2 % Testosterone, Bioavailable, Calculated 148 ng/dL 48 - 317 ng/dL Testosterone, % Bioavailable 74.1 % % Sex Hormone Binding Globulin 10 nmol/L 9 - 54 nmol/L

CHROMOSOME STUDY- Negative looked at all chromosomes and Y chromosome.

Testicular Ultrasound was normal , normal adult size , healthy appearance. I do have a small bilateral variocele (could that contribute to my high FSH?)

What could cUse low SHBG?

Shitty sleep only get around 6 hrs at night. Weird work schedule 3:30 am to 2 pm M-F.
No other symptoms besides tiredness ever since I started my new job almost a year ago. I am stressed out alot too from it.

Family history of hypothyroidism, getting referral to endo.

Could my fertility be fucked? Would HCG , Clomid or SERM work?

I’m no expert but this looks like a case of primary hypogonadism. If your not currently on clomid. Your fsh and LH are really high so the pituitary is doing its job it’s just your testicles are not doing their job. As far as the varicocele there is a slight possibility it could be causing some issue but if you do the invasive surgery you only stand to increase your TT by 15% according to studies. That probably won’t put you in an optimal place. If it were me… knowing everything I know now… I wouldn’t waste a second and get on trt. With your low shbg you will need lower dose more frequently.

I don’t see estradiol. Get the sensitive test and report back. I would imagine its low with those numbers but you never know.

My LH is within normal range. I want to preserve my fertility so Im gonna try and not go on TRT. I hear HCG works in combination though. Would clomid work?

Hcg. No clomid.

Okay , Ill ask my doc before my follow up. I bet it is a combination of things I could try even non medication like losing weight etc.

You can use trt and hcg together and maintain fertility. It’s up to you at the end of the day. Yes. Lose weight. Eat clean. Stay hydrated. These are basic fundamental principles. If you do all this and successfully increase your testosterone… let us know. Haven’t seen it happen yet. Would be a great case study for others.

My SHBG is low which is why my total T is low and othr T readings are in range, Im seeing my uro Friday. Ill keep u guys updated. I got referred to an endocrinologist which means either the urologist thinks my low T is from another cause than testies. Or he doesnt know lol.

No, your T is low because your pituitary gland isn’t producing enough LH, testosterone production has nothing to do with SHBG production, that falls on the liver. Low thyroid hormones can lower SHBG because thyroid hormone speeds up every cell in the body.

Please elaborate cause my LH is normal range.

Your testicles are damaged, LH is better than midrange and testosterone is low. Usually when LH is low, testosterone is low. That’s secondary hypogonadism, you’re primary hypogonadism.

Right so how can I go about still being able to have kids…

Test semen is the only way to find out, as it is you already have testicular dysfunction going on with good LH and poor testosterone levels and high FSH.

Yeah I gotta find one near me

By my urologist sending me to an endo he said there is most likely a imbalance of feedback loop

A high FSH level in a male may mean the testicles are not functioning correctly. Causes of this may include damage to the testicles (from radiation, trauma, or alcohol abuse), genetic problems, advancing age, hormonal disorders, certain medications (like pain medications or steroids), diseases such as HIV/AIDS or Type 2 diabetes, or (in rare cases) tumors of the pituitary gland.
Courtesy of Google

Well The genetic , hiv and diabetes factors are ruled out. Damage i used a cup playing sports. Might be a hormone thing which is why Im getting referred to an endo

@KSman need your insight.

I hear ya bro and I know what your going through. I went through it as well. Low T. Normal FT. I tried for a long time fighting it with no progress. Finally did trt and it has made a huge impact on my quality of life. Even with my low shbg and despite others saying I would have trouble seeing benefits. I love it.

Yeah Its good to know Im not the only one. I just wnana have a family some day and I just need to straighten everything out. Im glad I found out now with time to fix it.