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Zero Libido for 10 Years. Just Got Bloodwork

I’m a 32 year old male and I have suffered with low libido and erectile dysfunction for over 10 years. I almost never experience morning wood. I feel pretty fine besides this. I don’t think I’m depressed or anything like that. My mood is OK and I have a good life.

I just got the following lab results back:

Total Testosterone: 14.60 nmol/L - normal range: 7.6 - 31.4 nmol/L
SHBG: 42.00 nmol/L - normal range: 16-55 nmol/L
Free Androgen Index: 34.80 - normal range: 24-104
Prolactin: 213.00 mlU/L - normal range: 86-324 mlU/L
Oestradiol: 69.00 pmol/L - normal range: 0-192 pool/L
TSH: 2.3 - normal range: 0.30-4.0

The blood test was done at 8.30 AM.

As far as I understand my total T is rather low, and my SHBG is rather high. Thus the pretty low Free Androgen Index. Can these numbers explain my problem? Unfortunately the lab I could find can not test free T directly, but uses this index instead. I live in Scandinavia and don’t have the same labs available like in the US.

I’m currently at around 16% body fat, live healthy, is pretty active with mounting biking, walking and yoga. I sleep around 7 hours at night. This problem have been going on for so long that I don’t think it’s a lifestyle issue. I’ve tried everything. I’ve tried lifting weights a lot for many years and have been under 10% body fat, but all the heavy lifting only seemed to make the problem worse. I’ve also tried sleeping 10 hours every night, all kinds of different macros and supplements etc. Not much change. The only thing that DO seem to make a difference is if I overeat. If I stuff myself with burgers and ice cream and get A LOT of calories in I do see a positive change for some time. But it’s not sustainable as I don’t want to get fat. My testicles are sometimes aching and my nipples sometimes as well. My nipples look completely normal though so it’s not like I have gyno or anything. I currently eat a good multivitamin from Thorne + Zink and Magnesium. No meds besides some Cialis that my doctor just prescribed. I have a kid and my girlfriend is pregnant so my sperm is fine - just had to use Viagra in order to make them pregnant.

TRT is not a big thing here, so I’m considering getting some testosterone on my own. Any advice on how to proceed? I’m lost and the general doctors like most other countries are clueless.

Testosterone is low for your age, no doubt about it. Total T might appear decent, but the usable portion of testosterone is unacceptable. Most of the direct Free T testing is inaccurate anyway, it can be off by as much as 40%.

This hints to why SHBG is elevated, starvation increases SHBG and may be why testosterone is low. Overtraining can also lead to low testosterone. Burgers, ice cream and a lot of calories isn’t exactly healthy.

Managed healthcare doctors tend to not know anything about sex hormones and most determine normal status by reference ranges, only with testosterone in range doesn’t mean normal if you do not take into account age. Old men are at the bottom, middle aged men in the middle and young men at the top.

Unless you can find a sympathetic doctor, your only option is self treat. I’m not sure what type of esters you have excess to, but two 50-60mg injections of T-enanathe should work well. Nebido isn’t recommended, Sustanon should be your second choice.

Thanks a lot for your answer.

Usually I eat a super healthy diet and I don’t undereat. I have read everything I can about eating for high testosterone so I eat according to that and eat as much as I can without gaining weight. A lot of eggs, grass fed beef, vegetables and healthy carbs in 3-4 good meals a day + healthy snacks. My diet is A+. The experience with a lot of calories from unhealthy choices have been random experiences at holidays etc. where I have let my diet slip a few times a year. Usually the wildest it gets for Fridays snacks is blueberries and olives.

I assume I have access to everything I want. I’m good with darknet + I have a strong network within competitive bodybuilders from old friends (I’ve never taking anything myself).

Are you doing Keto diet, or Intermittent fasting?

No not at all. I tried this many years ago to see if it helped, but it made it much worse. So now I eat 300-400 g carbs per day, and eat as frequently as possible.

Because Keto increases SHBG. and decreases free test.

I’m much more interested in the psychology of someone who has a serious problem for an entire decade and doesn’t think it warrants looking in to. How…how does one go through life this way?

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I’m much more interested in the psychology of someone who has a serious problem for an entire decade and doesn’t think it warrants looking in to. How…how does one go through life this way?

It have been a big struggle for me. Definitely. I went to the doctor for the first time when I was much younger, but she just smiled and said she would advice for couple therapy. At that time it had been a huge issue for me for several years, and it felt like being spit in the face from the healthcare system I’m paying big bucks for through taxes here. As a young man that was supposed to be masculine and virile I was also a bit embarrassed of not functioning properly in this area and I think that’s why I didn’t push harder for them to look more into it. I pretty much gave up. I have been trying on my own all along though to figure this out with nutrition, supplements, lifestyle changes etc., and have tried everything I could besides taking drugs/medicine. Nothing have seemed to work so I’ve somewhat come to terms with having to take Viagra in order to have sex. I wrote 10 years but it’s probably even longer. It have been going on ever since I started (trying) having sex, so it’s almost something I “grew up” with and I think it have made it easier to convince myself that “this is just how I am” as I’ve never really tried anything else except for very short amount of time every now and then. But it have definitely been a big mental thing for me throughout the years, so please don’t think I’ve not tried anything.

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Don’t beat yourself up over this. Sometimes, it’s tough to know what normal is like if you have no sense of what normal is. Get on TRT. It may take some time to realize the full benefits but it will be worth it. This could be life changing for you.

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Regarding my initial observation about overeating making things a lot better I just found this very old article: https://www.t-nation.com/diet-fat-loss/testosterone-unleashed

Blockquote
• Over-eating, conversely, lowers SHBG.
In support of this, an over-eating study in identical twins, involving 1000 kcal excess (and plenty of insulin secretion) per day over 100 days did, in fact result in lower SHBG

As overeating has been the only thing that made a big difference to me I think my pretty high SHBG is the problem. Knowing this I will try to dig more into lowering SHBG, although it seems that the consensus on these boards is that it’s not that easy to do unfortunately. Just wrote the only local TRT-clinic as well and hope they can help me out.

Shitty comment.

I dealt w the same and didn’t really realize something was wrong as I was just used to being me.

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It wasn’t meant as an insult. I’m genuinely curious how individuals go through life with these situations. Because I cannot fathom how one does that I decided to ask. I’m wired differently, which means if I ever want to learn about other people’s wiring I need to ask.

Because that’s just the way one feels. And that is the assumed normal by that person.

Sometimes depressed ppl don’t even know they’re depressed until they get medication. Same thing.

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After a lot of research I just started taking 1,5 grams of Calcium D-Glucarate daily. After 2 weeks I will do a new blood test to see if it has lowered my SHBG. After that I will add DIM for 2 weeks and do another blood test. Will be interesting to see if this is effective before turning to TRT.

So, the obvious thing is that SHBG naturally goes up with low androgen levels. It just does, in the absence of complicating factors. Your T levels suck, and I’m sure that your other androgens are equally low, so your SHBG is elevated in response to that. No magic or mystery. Increase your androgen levels and your SHBG will drop over time.

This was basically my life until 45. Not depressed but my life was not ever fulfilling, didn’t make gym gains, couldlt lose weight, etc, etc etc. My whole life. Just thought I was weak willed, not pushing hard enough, being a pussy, etc. The “depression” comes from all this because no matter how hard you work you don’t get anywhere. It was my normal. Not until I advocated for myself and pushed for bloodwork to see what was up did I discover my issue. @iron_yuppie when its your norm you just think it is how it is and everyone is different so I guess I got the short end of the stick. Looking back I know now but if shitty is all you ever know it is just your normal.

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