29 y/o, Low Free T, High SHBG, Low E2, High TSH and Lowish Cortisol

Pharma / TRT Testosterone Replacement
1

Hey, I got my labs back from medichecks last week and would like some advice.

Symptoms: No motivation, no drive, no energy, no libido, moody/irritable, bordering on depression, just want to go to bed all day (except for maybe a few hours in the morning). Eyebrows thinning a little bit. Never had much body hair, can’t grow much of a beard. Testicles do not ache ever. Used to enjoy going to the gym but now it just wears me out and I stopped.

I had no morning wood, I increased carbs a bit more and morning wood has returned slightly although I wake up 45 mins earlier than I want to now.

I take the Life Extension 2 per day multi and have done for a year or so now. (contains 200mg selenium and 150mcg iodine, I now realise that 150mcg is not enough). Also take 1g magnesium glycinate a day. Stopped taking vitamin D since seeing the high test result.

Labs:

03
03880×244 20.3 KB
43
43881×222 19.6 KB
55
55876×444 31.4 KB

The Iron didn’t test due to an error.

Things to note -

Cortisol seems on the low end
Free T is very low
SHBG seems high
E2 seems low
TSH is high
Vitamin D is off the charts

My body temperatures range from 96.44 to 96.98 upon waking. I’ve been taking 50mg of iodine a day for maybe 4 days now yet my temp this morn was the lowest it’s been at 96.44. I guess it just needs time. I’ve been taking boron 10mg a day also to try and lower the SHBG, don’t know if it works. I don’t feel different.

Not sure what to do about the E2. I read that SHBG is made in the liver so maybe I should get a liver test done? Although I wouldn’t know where to go from there.

I’m suspecting adrenal fatigue and iodine deficiency. Although my actual testosterone seems reasonable (not ideal tho), I would have thought that would be lower if adrenal fatigue was the issue. Does my low E2 mean that more of the T gets bound by the SHBG? I also suspect rT3 might be elevated but not entirely sure.

Any input whether I’ve missed something would be great.

Cheers guys

2

E2 comes from FT, if FT is low E2 is also low. While your T levels are borderline acceptable your shrinking FT is the result of your TT level, meaning your somewhat high SHBG is binding up all your FT, FT goes down TT goes up. If your FT wasn’t so low I wouldn’t even consider your SHBG a problem, but everyone is different as is the efficiency of SHBG to grab ahold of androgens. If your SHBG was mid range your FT would higher and TT lower effectively making you low T, it takes a good doctor to properly interpret lab meaning. TRT will drive cortisol even lower which your doctor will need to address.

Most doctors wouldn’t touch your thyroid, they prefer to wait for “disease status” or until things are as bad as they can get before taking action. TSH closer to 1.0 is optimal, doctors do not optimise health. TRT will decrease SHBG, you should inject moderate doses of T twice weekly based on your SHBG value and you might even get away with weekly shots, at this point labs are a little more useless and your levels are more a result of timing than what’s really going on.

You might cut back on plant based diets, these raise SHBG and as you get older SHBG will continue rising. Something to consider.

3

Interesting, thanks for the response. My temp was up to 97.34 this morning which is the highest I’ve seen although I slept in for an extra hour due to it being the weekend. Keeping my fingers crossed it will continue to improve over the next week. I’m not on a plant based diet so that can’t be a factor.