Some guys simply have high/low SHBG with no cause identifiable. Your high SHBG leads to more non-bioavailable SHBG+T that inflates TT that then overstates your T status. So while TT is strong, FT is midrange. However FT changes a lot and cannot read too much into it. A calculated FT would be more useful perhaps.
While liver diseases can increase SHBG, AST/ALT look very healthy. SHBG is made in the liver to scavenge sex hormones and is reduced by higher T and increased by higher E2. Those do not make sense as causes. [ thinking out loud: Wild thought… could liver SHBG also respond to high LH/FSH? E2 is a nice number, wild guess maybe other estrogens could be elevated.]
While prolactin can reduce LH/FSH, we have to also note that LH&FSH are high. So while the possibility of a prolactin secreting pituitary adinoma is possible, we have to then consider that something else may be odd. Please note that orgasms and cuddling babies/puppies/kittens can shift prolactin higher - avoid for a while before labs.
Retest prolactin again later and may need to watch longer term. If you had that adinoma it is easily managed with 0.5mg/week Dostinex/cabergoline - so no need to panic.
High LH/FSH also suggests primary hypogonadism which also does not fit your case.
Have testes examined, testicular cancer is a young mans disease that can secrete and increase FSH. Please note any tenderness or aching.
So your labs are puzzling and your T levels are not as good as TT indicates.
TSH is better near 1.0 and maybe there is a thyroid issue which would explain low energy levels. Please self eval overall thyroid function via oral body temperatures - see below.
Also affecting energy: Vit-D3, suggest 5000iu per day.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.