I tested my 27 year old son recently due to some health issues that may indicate low T. First he has been tested and his Total T was 1128, Free T was 15.9 (range 9.3 to 26.2). Estradiol 43.4. Is the moderately above normal T an issue even for a young man?
Its perfect to be above norm. But in fact as you can see the free test that matters most is in the middle. If he feels well the numbers don’t matter much.
It’s too bad you probably cant ask him how he feels sexually. Like if those numbers present him with a good sex drve
Your son most likely has elevated SHBG which when elevated increases Total T and decreases Free T, your sons Free T is low given his age and should be closer to 25 pg/mL which is where most young men score. Total T is not bioavailable, Free T interacts with tissues and is where the rubber meets the road and is low given your sons age. He actually has the Free T of someone older in their 50-60’s.
High SHBG is usually not reversible and is produced in the liver, is do to genetics, alcoholism, starvation diets/cutting and medication to treat depression and/or anxiety. If the latter, stopping the medication should see SHBG return to normal.
This is not the first time we have seen men on T-Nation with high SHBG and suboptimal Free T, actually the testing used is likely the direct immunoassay which have been shown to be inaccurate and overestimate Free T.
It was Dr. Abraham Morgentaler, an expert in testosterone/TRT at Harvard has stated men near or at Free T 15 will likely show benefit on TRT. Dr. Abraham Morgentaler has a book worth reading, “Testosterone for life”.
Sex hormones, TRT is excluded in medical school and if anything TRT is demonized in medical school and is a very taboo subject with doctors. The reason is doctors were taught in medical school TRT causes prostate cancer and is do to a belief, not actual fact, so if you think your manage healthcare doctor is going to be of any help, you’re in for rude awakening.
TRT doesn’t cause prostate cancer, newer studies show TRT does not cause prostate cancer. The sick care system is filled to the brim with clueless (scared/prostate cancer belief) doctors who often do not even read the endocrinology guidelines let alone understand how to diagnose a testosterone deficiency.
Thyroid problems can be to blame as Charlie has suggested, hyperthyroidism would cause overproduction of SHBG because excess Free T3 speeds up every organ in the body including the liver production of SHBG
It can also be caused by hyperthyroidism that can be fixed.
If a medication caused it, would stopping it bring down shbg?
@patrick777 Is the estradiol test the sensitive E2 test?
Either way, I find in interesting his natural estradiol is 43.4.
Thanks for sharing.
That is due to his higher total testosterone.
I naturally had an 1100 TT at one point and still had low FT because my shbg was so ridiculous
@highpull - I thought high/over range FT is what was converted to E2, not high TT.
I just found the numbers interesting after watching a group of forum posters argue about E levels and AI and young people have naturally high TT and E2, but they aren’t on an AI… Blah, blah blah blah…
Thought it was cool to see a non hypogonadal, younger man’s test results show higher E2.
His numbers are very close to mine on 140mg a week (40mg EOD) haha.
Being overweight can cause elevated E2 even with suboptimal Free T, men with low Free T will carry around more belly fat which is where aromatase enzymes accumulate. If the OP son goes on TRT and has higher body fat, he will need to manage estrogen either by very frequent injections or a low dose anastrozole (.125mg) until belly fat is lost.
A thyroid panel is recommended checking TSH, Free T4, Free T3, Reverse T3 and antibodies.
Yeah, I was thinking generally, not pertinent to your son’s levels. This is what happens when one quickly glances at a thread and sends a quick response in the middle of work……………
Thanks for sharing. In his case he isn’t feeling well but it’s probably due mostly to other factors. Some of his symptoms could be indicative of low T, so I thought I would have it checked but I was surprised at the very high T but as mentioned the Free T is low for his age so addressing this may help.
No it is not the sensitive E2 test, thank you.
Thanks for sharing all the info, very helpful. Yeah, even though that free T was in range it would seem it should atleast be high normal. I wasn’t aware of the preferred 25 level for his age group. The SHBG makes sense I will have to get it tested. Truth is he does have a serious drinking issue and does take depression/anxiety meds so maybe he can get the SHBG level down.
I was told by my doctor not that T causes prostate cancer, but that it feeds/accelerates certain prostate cancer types. Is that really BS?
You’re most welcome.
The correct reference ranges for men in their 20’s tops out at 26.5 pg/mL per Labcorp, everyone else uses different ranges.
Bingo, this is why SHBG is elevated, double whammy.
These medication changes the way the brain functions and usually cause problems down the road and were meant as a temporary solution to gain control of a situation, deal with our problems and get off.
Your son will never get TRT prescribed by a managed healthcare doctor with his numbers, private care is where you should be looking for hormone therapy “if” he should need it, but I don’t think he will need TRT he stops drinking and gets off the medication causing the high SHBG.
Hi patrick, SSRI’s SNRI’s benzos will really mess with your sons sex hormones.
His testes are making huge amounts T which means his testes are working fine and his hypothalamus or the pituitary gland is working fine.
Your son does not need TRT he need to get thru or figure out why he is depressed and why he might be anxious and the sooner the better.
I have used whiskey to replace benso’s because they are so addicting. In fact wild turkey 101 is how I go off a benzo addiction.
Primary . This type of hypogonadism — also known as primary testicular failure — originates from a problem in the testicles. Secondary. This type of hypogonadism indicates a problem in the hypothalamus or the pituitary gland — parts of the brain that signal the testicles to produce testosterone.
His T and E2 are fine, and not the problem. He needs to stay away from TRT and look for the cause.
His total testosterone is perfect, but he has average and suboptimal free testosterone. I guess the medicines may rise his SHBG. Test it. He can try supplementing 6-9mg boron per day. This lowers SHBG in many people. Even 20 percent decrease of SHBG will affect massively his free testosterone.
Another thing I would suggest - a full thyroid panel. I’ve read some of these medicines can damage the thyroid. And many of the symptoms he experience can come from them. He needs to test for TSH, FT4, FT3, Reverse T3, Anti-TPO. Some of these tests the provider will deem unnecessary and will not want to cover. Please RUN ALL of them and pay what is necessary. The stupid doctors run only TSH and FT4 when they check the thyroid.
E2 comes from the operation of aromatase enzyme in men. It requires free T, but your overall amount isn’t that important other than the more you have, the more can convert. It’s not that there is some switch that activates the enzyme over a certain threshold.