High SHBG and Low IGF1, Potential Root Causes?

Pharma TRT
1

Hi,

About me: 24 M, 185cm, 85kg, 13% body fat, no medications, rarely drink and no recreational drugs

The biggest symptoms I had (still have some of these symptoms post starting TRT) are daytime sleepiness, zero libido (definitely different to how I was a few years ago), low motivations.

I got my androgen levels checked and they came out at

Total Testosterone**: 23.1 nmol/L (reference range 11.5 - 32)
SHBG: 84 nmol/L (reference range 15 - 50)
Free Testosterone: 257 pmol/L (reference range 260/740)
IGF-1: H 16 nmol/L (reference range 19 - 54)
Growth Hormone: 15.7 mIU/L (reference range 0 - 15)

I also got a sleep study done which didn’t show sleep apnea (1.6 apneas per hour) and sufficient deep sleep. However it did show 11 brain arousals per hours (normal upper limit is 15 apparently)

after seeing those results I went to an endo who said my results are fine even though I still have symptoms, because of that I decided to get TRT prescribed by a clinic. I got prescribed 150mg Test cyp split twice, HCG 1500 IU split three times, and aromasin 12.5mg split twice. On TRT my levels are

46.5 nmol/L H (reference range 11.5 - 32.0)
SHBG 64 H nmol/L (reference range 15-50)
Free T 784 H pmol/L (reference range 260-740)

While I am feeling a lot better on TRT I do want to investigate all root causes to make sure no stone is left unturned. I read that elevated SHBG can be caused by

anorexia - No, I am on a caloric surplus
pregnancy - No
ageing - still relatively young shouldn’t be this high
growth hormone deficiency - (perhaps? due to low IGF-1 levels and increased growth hormone levels?)
androgen deficiency (no as even on TRT SHBG is elevated
hyperthyroidism

  • Got TSH, free t3, free t4 checked and they are all within the normal range
    liver disease
  • ALT/AST consistently range from 40/60 (reference range 5-40). My doctor ordered an ultrasound and everything came out fine apart from a small 7mm hemangioma which is apparently quite small and shouldn’t cause problems? I also workout quite vigorously 5-6 times a week so I am hoping they are raised because of that. Also hepatitis B, C and HIV came back negative. Any other tests that I should do?
    hyperprolactinaemia - Normal prolactin 200 mIU/L (reference range 45 - 375)
    Keto diet - No on quite a high carb diet

Is there anything else that you recommend that can elevate the SHBG and cause low IGF-1? I assume it is to do with the liver since both of these are created in the liver.

Any help would be greatly appreciated.

2

How’s your mental health? Any external stresses added to your life recently?

I’m not even close to an expert, but a 24 year old on TRT (you actually are on TOT/cruising based on free T lab) makes me raise an eyebrow. I’m not judging at all, so don’t take it that way.

3

Estradiol, prolactin, cortisol checked? Don’t see those here.

4

@Meathead56 I don’t have much stress, I’d say my mental health has been a lot better after starting T. I’d say I still have mild depression though

@swoops39 Other hormones
Prolactin 200 mIU/L (reference range 45 - 375)
Progesterone 1.7 nmol/L (reference range < 4.1)
Cortisol: 238 (reference range 110 - 550)
DHEA-S 5.2 (reference 4.8 - 13.9)
Oestradiol (post TRT) 200 pmol/L (reference range < 150). I was already taking aromasin 12.mg twice a week so I bumped it up to 3 times

Sadly don’t have estradiol pre TRT. I’m also thinking about supplementing with DHEA-S and going to see if I can get my hands on CJC 1295 to increase the IGF-1 levels

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