There are some medications that can cause high SHBG, certain medications will do it. Pain meds, opioids and Klonopin for example.
SHBG is made in the liver and liver should be on the radar to some extent.
Increasing T and managing near E2=22pg/ml is about all that one can do do coax SHBG lower. But sometimes SHBG is just high or low.
If SHBG, FT would increase and TT decrease IF T production was unchanged. Lower FT can be expected to increase LH/FSH and T to some extent.
We have guys ~age=20 needing TRT, these things happen.
At your age, it is important to find possible causes. When older it is assumed to be age related.
Get prolactin tested.
Thanks for the reply. Should I get prolactin tested before my consultation? What could that potentially show in regards to my T production? At this point, Ive spent around 500 bucks on blood tests and the physical needed for Defy. I will spend the 50 for a prolactin test if its necessary though.
EDIT* IT was only 30 bucks. Just ordered it.
Got my prolactin test : 12.4 ng/Ml range 4.0-15.2
It’s on the higher end of the range, is that because I have high E2? There is correlation between E2 and prolactin right?
@KSman when you have time, please review this thread and provide any additional thoughts you may have. Got the prolactin test you recommended (2posts above). I scheduled my consult with Defy for April 11 and I would assume they would be willing to treat me since othrs with similar symptoms (low Free T, high SBHG)have been treated. I know @systemlord thinks TRT will help and I appreciate everyone that has given their input.
Bump
In case anyone is still interested in my thread, I had my consultation with Defy this morning. It went as expected and honestly I seemed to know most of what he was explaining already when we went through my blood tests. I attribute that to all I’ve learned on this forum and a couple other sites. Thanks to everyone who shared in this thread.
The only thing that came as a surprise is he recommended I go on a thyroid medication to raise free T3 levels. I’m currently at 3.0 pg/mL range 2.0 - 4.4
We agreed to wait until I start Testosterone so I have a baseline of how I feel instead of starting both at once. I also wanted to research on my own since I know thyroid meds are not something to mess around with.
Another thing is he said even though my estradiol is at 36.8 pg/mL, I could still be experiencing symptoms of low estradiol since I have a high SHBG that binds it just as it does testosterone. Regardless, he recommends .125 AI twice a week and if I start experiencing high E2 side effects to take 3 or 4 doses per week.
Overall my starting protocol is 160 mg of Testosterone a week split into 2 injections every 3.5 days + 1000 iu HCG and .125 AI twice a week(more if needed.)
I asked about taking one large dose of Test once a week to drive down SHBG, but he still said to do twice a week.
If anyone has any thoughts or input to about anything please share. I feel nervous and excited at the same time. Hoping this ends up a positive in my life going forward.
Thyroid meds increase SHBG I know that.
Your e2 was 36 on what protocol?
I know, we talked about that as well. That’s why im also waiting to start TRT before adding thyroid. I want to get a baseline of tests and how I feel after I start T.
My E2 is 36 naturally, I haven’t started a protocol yet.
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