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Weird Blood Results

I recently had blood work done the other week due to symptoms of feeling lousy, tired, etc.

29 years old, male, white
165 lbs
~18-20% Bodyfat

I workout 3-4 times a week lifting weights. I take no drugs, meds, etc and drink maybe 1-2 times a month.

Below are the blood results and some of the findings were weird to me: low E2, high SHBG, low FT.

Just wondering if anyone has any input or pointers on where to go from here.

Thanks for all the help!

High SHBG is usually indicative of liver strain. I know you said no meds or drugs, think hard, because usually SHBG is high because of one of those two. It can be genetically high or high because of a low carb, or starvation diet as well.

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.

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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.

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Thank you both for your replies.

alphagunner, i feel like an idiot, but forgot to mention that I was in the ER for a kidney stone 5 days prior to my labs being pulled. They gave me 2 shots of 1 mg Dilaudid (hydromorphone), 2 x shots of unknown amount of Toradol (ketorolac, an NSAID), 1 x Percocet, 1 x 600mg Ibuprofen, 1 x Flomax (tamsulosin), and some anti-nausea med but forget the name – all taken that day, 5 days prior and nothing more after 3pm that day.

So perhaps they still had an affect on my system, even 5 days later?

KSman: Thank you for your reply, very helpful. I started taking my temperature today. AM: 97.5 and PM: 98.6 (forgot to bring thermometer to work), but I’ll keep recording them over the next few days.

I will get the labs pulled again – which need to be re-run do you suppose to get an accurate picture – and how long to wait?

Thank you both for the time and help, much appreciated.

I think its plausible to assume that it could have increased it, at least slightly. SHBG half life is around 7 days.