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Type 1 Diabetic. Low T, High SHBG. Opinions on My Labs?

Everyone,

I’ve been lurking around here for a while and wanted to post my most recent labs and get some thoughts/opinions on my numbers and course of action moving forward.

About me:

I’m a type one diabetic. Formerly obese ma n. I weighted close to 300 pounds five years ago. Currently at 195 pounds and 6 foot tall. Probably around 20% body fat, not much muscle mass. I lift 4-5 days a week and try to stay active. For the past year or more, I’ve been feeling run down. Little motivation to start/finish stuff. Libido has declined significantly. Late last year I started having ED problems. Went to my endo who just ran a total testosterone test only. It came back on the low end of normal. He dismissed it. So I went to a T-mill and got the full tests and brought them to him. Those tests showed low T and a high SHBG. After seeing that, my endo ran a bunch of tests (below) and has diagnosed me with hypogonadism. He is starting me out on Androgel for 10-12 weeks and then run the tests again.

I’m not against the gel, but would prefer injections. I give myself multiple insulin shot daily just to stay alive, so one more isn’t going to kill me. But he said he wanted to see how I responds to the gel. Fortunately, insurance is picking up the tab and the gel will only cost me $75 for the three months’ supply. I’m willing to give the gel a try just because I want to start feeling better and to get Captain Winkie working again.

HA1C: 5.1% (4.8-5.6)

Glucose: 79 (65-99 mg/dL)

TSH: 1.9 (0.40-4.50 mIU/L)

ALT: 77 (0-44 IU/L)

AST: 53 (0-40 IU/L)

Vitamin B12: 1366 (232-1245 pg/mL)

Total Testosterone: 127 (250-827 ng/dL)

Prolactin: 3.2 (2.0-18.0 ng/mL)

Sex Hormone Binding Globulin: 59 (10-50 nmol/L)

Estradiol: 21 (<=39 pg/mL)

LH: 2.2 (1.7-8.6 mIU/mL)

FSH: 2.9 (1.5-12.4 mIU/mL)

Free T4: 1.68 (.82-1.7 ng/dL)

T3: 73 (71-180 ng/dL)

Any doctor prescribing androgel is inexperienced and doesn’t prescribe TRT often enough to know androgel is a useless for most men! You’ve been quacked a second time and you will get quacked again is you so choose to seek out another endocrinologist, there are typically the worse at TRT.

Well your testosterone is very low and SHBG high which would see Free T in the gutter is just about any case, most endo’s don’t specialize in TRT and is why the big blunder of not checking SHBG or Free T which is what your body requires, Total T is bound to SHBG and is not bioavailable ~ useless to the bodies tissues.

Usually high SHBG men require levels above the reference ranges to increase Free T to the optimal ranges, something a managed healthcare doctor cannot allow since doctors taking insurance must follow the narrow guidelines put in place by insurance companies which cannot allow your levels >800 ng/dL.

A private doctor in anti-aging or sports medicine play by a different set of rules.

While TSH looks good, T3 is low, TRT will not work unless the free thyroid hormones are sufficiently elevate to at least midrange or higher. Testosterone is metabolized in the liver and the driver behind that process is optimal thyroid hormones ~ Free T3 which is at the bottomed out along with testosterone.

T gels are one of the more expensive versions of TRT, it’s a money maker and why it was chosen and is the least effective version of TRT, injectable testosterone is the lowest cost, least profitable version of TRT and why it wasn’t chosen in the beginning.

You can also transfer androgel to children and other people through physical contact. I use 29G insulin syringes to inject my Test in the shoulders and quads.

No reason not to give the Androgel a try. Some people respond very well to it, but most do not. It’s a starting point. See what happens. It could easily lead to what you actually want, and it could even work for you. If you seek a different doc, look for one that specifically deals with TRT. There are plenty of endo’s that do that these days, and some are quite open and reasonable.

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With insurance covering it, I’d give it a try too. You can always switch over to injections later on.

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