T Nation

Very High Total T, Low Free. Can't Figure This Out

Hi Guys,

I would very much appreciate some thoughts on my labs/situation. I’ve been working with a Dr for a few years that specializes in this type of medicine. He’s had me on Anastrazole 1MG a day for the last year. For 2-3 years before that is was every other day. He’s also had me taking Stinging Nettle for the past year. The first couple years things were in a more optimal range but in my labs from the last year things have been going in the wrong direction. This is despite increasing the dosage of Anastrazole and adding in the Stinging Nettle. Here are a few of my questions:

  1. How is it I can have such high Total T but my Free T is still relatively low and my Estradiol somewhat high despite taking Anastrazole? He tells me optimal for Free T is in the 20/30s and Estradiol in the 20-25 range.

  2. I really can’t sort out the impacts of the finasteride in all of this. It stopped my hair loss and I really don’t want to stop taking it unless there is a compelling reason not to. I haven’t noticed really any side effects. I would say I have a below average sex drive but that was true even before taking Finasteride.

  3. I have noticed a lack of morning erections the past year or so but I have no issues getting and keeping erections so not sure how to interpret that.

Here’s a bit on me and my most recent set of labs:

Age: 33
Weight: 184
Body Fat: 18%
Strength Train: 3-4x per week
Currently taking: 1mg finasteride daily, 1 mg anastrazole daily

Labcorp Results:
Total T: 1406 ng/dl
Free T (Direct): 15.5 pg/ml
DHT: 28 ng/dl
T4 Free/Direct: 1.42 ng/dl
DHEA (Sulfate): 239.7 ug/dl
DHEA (Serum): 262 ng/dl
IGF-1: 139 ng/ml
Estradiol: 33.7 pg/ml

Thanks Guys!

You will have to do your own research regarding Finasteride, but you might as well be talking about cyanide around here. Finasteride can be hormonal suicide, sometimes taking years to reverse. It can mess with causing excess estrogen and or SHBG in guys.

Which brings us to the next issue. Your doctor is trying to figure out why your free test is low, but hasn’t checked your Sex Hormone Binding Globulin? This is vital to knowing what your free test situation is, and I would question anyone who didn’t know this but stated they were a professional.

Could be related to your liver, not clearing the e2, and in return, your SHBG has skyrocketed (SHBG is created in the liver from meds,stress on liver) and your free test gets bound by this SHBG. Have you ever gotten this lab. Crucial. Do you have other liver values?

Always post ranges with your labs also.

I don’t see SHBG on may labs but am running them again soon so can add that. Would it be under a different name? I’m also 38 not 33 - wishful thinking :slight_smile:

Good feedback on the Finasteride. I’ll have to think about that. Tough choice to make…

Here are some screenshots of the relevant labs. Let me know what you think.

Your bilirubin is high also. And DHT low, but you have high Total test. It will be interesting to see what your SHBG is. You might have luck with doing a liver cleanse with either Sam-E, CDG, TMG, Milk Thistle, but its up to each individual what will work.

Will be interested to get those further numbers.