Since moving away from competitive cycling about 12 months ago and hitting the gym/general fitness, I’ve felt pretty low on energy, have a lack of motivation and low libido etc. As a result I decided to run a blood test here in the UK and interested to know what people think? The doctor employed by the company suggested that overall there was nothing to worry about and results were pretty normal.
Male 45/ 6ft 3/ 14st 8 and do not take any supplements/PED.
No, your results are NOT normal! The SHBG is high, estrogen low regardless of what the lab ranges are. That estrogen level would be fine for a 10 year old boy pre-puberty.
Your doctor failed to interpret the lab values for estrogen. This doctor doesn’t realize that boys and men have different baseline estrogen levels.
Normal estrogen for a man that has gone through puberty is 73> pmol/l.
The Free androgens is at the bottom 25 percentile. What this means is you’re at 53% greater risk of aggressive prostate cancer and reoccurrence as well as 30% greater risk of heart attack and an increase in all cause mortality.
Experts recommend against a hard cutoff because men have different types of androgen receptors, and sensitivities to androgens as well as the ability for tissue to respond.
There’s no medical literature or study showing men experience low-T at the predefined cutoffs, which are arbitrary chosen out of thin air by doctors.
I would pay more attention to the free androgen index over the calculated Free T in cases of altered SHBG. It’s not uncommon to also see low estrogen alongside low Free T, since estrogen is a metabolite of Free T.
Many experts strongly believe Free T in the bottom 25 percentile to be a sign of hypogonadism. The UK is the hardest place to get a proper diagnosis for hypogonadism due to doctors having a complete lack of knowledge of sex hormones.
The majority of doctors, even the ones you think would be the experts in this field of medicine, are useless in properly diagnosing and treating hypogonadism/low-T.
Balance My Hormones and The Men’s Health Clinic are two private TRT clinics in the UK.
Thank you for the comprehensive reply and to be honest I’d not even considered androgen and was mainly considered with Prolactin and SHBC given my lack of knowledge in this area! The clinic’s mentioned, can I assume they offer a more comprehensive, experienced and knowledgeable service? Not looking for a specific recommendation but given they are named I was wondering if that was based on reputation and knowledge. Thank you.
I don’t think prolactin high enough to cause problems, which is why I didn’t address it.
Absolutely, better testing as well as better treatment options and less strict on the cut offs compared to the NHS, which is notoriously bad at treating testosterone deficiency.
These two clinics are reputable and the best choice in the UK.
Thank you and I’ll definitely look at booking a test with them asap! To be honest I paid little attention to the Androgen’s as I thought higher levels meant you were more at risk of Prostate Cancer etc.
The opposite is true. Here’s how the myth started in 1941, thanks to Charles Huggins, who was the only expert in androgens in the US at the time, so no one could crossexamine his work and refute it.
His ideas spread like cancer and believed for decades and even taught in main medical schools to doctors, shaping treatment guidelines, until Dr. Abraham Morgentaler debunked his work.
We now use bipolar androgen therapy on men with prostate cancer, using very large doses of testosterone.
OP, if your SHBG is quite high, so your ‘okay’ TT levels are definitely subpar. I would not trust the calculated Free Test. I’d venture to say that if you had your Free Test measured with Equilibrium Dialysis, you would be low or below the range. If you wanted to be sure of that, you could get that tested yourself (this is the only truly accurate test, FYI).
But if I were in your shoes, I would be pursuing TRT through other options to correct symptoms. You sound symptomatic, and your levels indicate you’re a likely candidate for benefitting from TRT.
I’m not in UK but from what I’ve hear, Balance My Hormones is a good TRT clinic out there - but it will probably be out of pocket.
Your prolactin is quite high. If you’re cranking it regularly, this can be the result. If you aren’t - then this is something worth discussing and bringing into range with P5P supplementation. No judgement, IDC what you do either way.
Low libido is a symptom of low estrogen, also lack of energy is E2 related. Talk to anyone who’s taken an AI and knocked their E2 low.
The New England Journal of Medicine has stated estrogen is the main driver of benefits on TRT. Estrogen is responsible for fat loss, muscle mass increase and fullness, libido etc.
Carbs is not an essential nutrient, you don’t need it. Our biology evolved to use fats for energy. A hundred years ago, we barely ate carbs and sugar, we ate primarily meat and in the last hundred years, human have restricted red meat more than at any time in the past and disease rates have never been higher.
There are countless reports of people curing disease eating only red meat, cancer, autoimmune disease etc.
Men need balanced hormones to function optimally. If you give a man estrogen directly, you circumvent the aromatase process and also lose out on DHT, another important metabolite.
Not quite sure what your answer means, but I’ll take it you’re happy with the idea of recommending low carb diets (or even zero carb if carnivore right?) to someone with high shbg then?
OP there is some evidence that low carb diets increase shbg, and strategically eating carbs can lower it, it probably won’t fix all of your issues but might be worth increasing carbs before committing to a lifetime of trt - it may help reduce shbg which given your levels of T are actually reasonable I’d think it worth a shot.
