That may be too high for a low SHBG guy, low SHBG men have a lot of Free E2 much like they have a lot of Free T. When my E2 was 29 I was jittery, low SHBG men sometimes need estrogen closer to their SHBG levels or slightly above it do to the higher Free E2.
How you feel is more important than any number.
I’m taking levothyroxine due to hypothyroid. My TSH levels are stable at 2.1 but understand that low SHBG is often seen in hypothyroidism (as per @KSman above). Endo has tested for Cushings and Acromegaly and already ruled out. No issues with diabetes or insulin resistance (bloods confirmed). Body fat is high, which will lower it I know but is it a chicken/egg type scenario…
If E2 is high and then I throw exogenous T to the mix, I could end up shooting E2 up further?
My main issue is despite good diet and training, I am still hugely overweight and carry my body fat like a woman…so more E is not going to help that. Libido could be better and still have brain fog and generally feel poor but if I push my body fat up further, that’s the worst for me.
You are underdosed on levothyroxine, a TSH of 2.1 isn’t optimal.
I’m meeting the endo next week. He’d initially said to get TSH <2.0 but even that seems high. Should I be aiming for ~1.5 (or lower ~1.0)?
I’m currently on a very low dose of levo @ 75mcg.
Thinking that maybe worth getting TSH lower before I start TRT and hope that increasing levo will increase SHBG.
Is that a good approach?
A lot of people on thyroid medicine do well with TSH well under 1.0. Free T3 will be your guide to dosing levo, because that’s where the rubber meets the road.
I disagree with alot of people need to be well under 1.
Skip down to the section " Monitoring thyroid function during levothyroxine replacement"
Thanks @systemlord and @charlie12. I guess the first thing that jumps out is that my GP has been using TSH alone as a guide. When I speak to the endo, I will discuss monitoring both T3/T4 and whether I need to adjust does or add in T3 replacement as well.
To be honest, I’m worried about TRT (if you couldn’t guess) and from what I’ve read low SHBG makes it more difficult / less tolerable. In my mind, getting my thyroid right seems more important at this point and if I throw testosterone in to the mix before I do, it’s just going to add to my problems.
Amazing, it means your GP doesn’t really have a clue what he’s doing!
Get another doctor who takes thyroid a bit more seriously and has higher standards.
Another red flag is the GP is struggling to do the job reserved for an endocrinologists.
Plan of attack…I meet the endo who finally got to bottom of thyroid issue in first place (after 2 years and 4 others) next Tuesday.
Appreciate any opinions here. It has been a while since I last posted.
Living in the UK, it is almost impossible to get anyone to take this seriously. I’ve struggled with weight despite lifestyle / diet modifications. Now at all time heaviest of 123.9kg.
I’ve tracked my bloods since 2015, started on T4 mono in 2017 and TRT (2 pumps Testogel) in 2018. Have felt okay for the most part but starting to feel completely terrible since having COVID in Dec 2020. Now seeing a gastroenterologist due to stomach issue (query liver).
From what I can see:
Testosterone
Thyroid
Liver
Also, HbA1c always normal and around 35-38 mmol/mol and FBC are typically unremarkable.
