27 Y/O, Help Analyzing Bloodwork & Symptoms

Pharma TRT
1

I know this is a very common ask on here but I guess it’s because you guys do something right, so here it goes.

I have what I guess are some typical symptoms. Low libido, unable to maintain an erection at times, almost no morning wood. I can easily lose weight (calorie deficit, or IF) but struggle to gain significant weight. Went from around 170 to 180 (max weight ever) over the course of four or five months consuming probably >3000 calories daily with a sedentary lifestyle (two to three big fast food meals a day, lots of soda, only gaming some exercise). Lately I have been feeling unmotivated, disinterested, anxious and down. I am motivated to work out and run a lot, with some lifting regiments thrown in, but other things do not have great motivation. Fluctuating.

Stats:
Male
27 years old
White (99.9% European Descent)
6’0"
155-160 lbs
Normal body definition (slender frame, ectomorph, no obvious collections of fat)
Balding and thinning hair
Low chest hair and back hair

Blood Work (7/25/2018):
CBC: All normal
Hemoglobin A1C: All normal
TSH: 0.872 uIU/mL (0.358 - 3.740) Normal
LH: 3.9 mIU/mL (1.5 - 9.3) Normal
Metabolic Panel: (Non-liver) Normal
Total Bilirubin: 0.9 mg/dL (0.3 - 1.2) Normal
Alkaline Phosphatase: 84 U/L (38 -150) Normal
AST(SGOT): 131 U/L (6 - 58) HIGH
ALT(SGPT): 62 U/L (14 - 67) Normal
FSH: 2.3 mIU/mL (1.4 - 18.1) Normal
SHGB: 86 nmol/L (17 - 66) HIGH
Total T: 540 ng/dL (300 - 1080) Normal
Free T: 50.3 pg/mL (47 - 244) Normal
DHEA-S: 139 ug/dL (80 - 560) Normal
5-a-DHT: 522.9 pg/mL (106.0 - 719.0) Normal
Estradiol: 20.1 pg/mL (10.0 - 42.0) Normal

From what I can see it seems like I’m on the low side of normal with testosterone, especially free testosterone. A high SHGB seems like it could be contributing to that, and my abnormal liver function could be contributing to the high SHGB. My research shows SHGB being mainly produced from the liver.

Talking to my PCP today she wants another blood test for liver function in three months, and sent me towards a doctor that specializes in hormone and fitness medicine.

So I guess am I way off base with my thoughts? Missing something? Anything you guys could add would be awesome.

2

You definitely have high SHBG and is choking your free testosterone, I have to ask are you on any medications? You may require total testosterone to be high normal to feel any relief, some high SHBG guys need levels above ranges to have adequate free testosterone and this may be a problem for most endocrinologists to swallow since guidelines are limited.

The very high SHBG is overstating your total testosterone and inflating it do to the lack of free testosterone that would otherwise be free and bioavailable. TSH closer to 1.0 is optimal, yours looks right on the mark. You can evaluate thyroid status by measuring oral body temperatures upon waking and by 2 p.m, Free T3 directly reflects in your body temperatures.

DHEA-S is low and is likely contributing to your symptoms. I wanted to inquire if you are using the sensitive E2 labs otherwise known as LC/MS/MS method designed for males. TRT can make men infertile and there are ways around this, adding HCG and FSH to your TRT protocol can help. Some even stop TRT for awhile and restart their system when planning for more kids.

When, if you start TRT you will likely grow more hair, once I started TRT hair is fuller and longer.

Your tests are comprehensive for not having seen a hormone specialists.

3

Thanks for the answers.

I’m not on any medication, just over the counter supplements and vitamins. The labwork says it is using LC-MS/MS for 5-a-DHT.

I took comprehensive tests because I saw the suggestions on here and asked for them.

My doctor said the same thing about the SHBG, probably sucking up the small amounts of free testosterone I do have.