I am 37 years old and have all the symptoms of low T. Extreme fatigue, low libido, no strength, brain fog, no morning erections. Minor gynecomastia confirmed by ultrasound.
I have high Total T, but low free T and High SHBG
Am I a candidate for TRT? Endiconologists and Urologists are stumped. I had an ultrasound done on my testicles everything is normal. Urologist suggesting MRI of Pituitary but Endocrinologist didn’t think it was necessary. No one is addressing my Low Free T and symptoms though.
I suggest you find a new Endo or pursue a TRT clinic to find someone that actually knows what they’re talking about because…
This all makes sense. High SHBG usually results in high TT; this also usually results in relatively low Free T (depending on SHBG and TT). Keep in mind that Free T measurements are usually bunk (like 60-70% accuracy in most cases).
Not really, search “High SHBG” in this forum and you’ll find dozens of threads that read just like yours.
Do you sleep well (7-9 hours a night)?
Are you under a significant amount of stress regularly (or when this bloodwork was taken)?
If you sleep well and aren’t under a lot of stress, then I would say you are a candidate based on your symptoms alone. If your sleep is poor and/or you are under a lot of stress, fix these for a good 6-8 weeks and see if you still have any Low T symptoms.
Ultrasound was unnecessary, MRI is even MORE unnecessary, and expect most doctors to ignore fT values (which typically affect Low T symptoms), unfortunately.
Thanks for the reply, I appreciate the comments and review.
I get 7 hours of sleep a night. My stress level is higher than I would like it to be, but I had the same lab results 2 years ago when my stress levels were very good. I have 2 appointments next week with TRT doctors to see what they recommend.
I take finasteride 1mg, would removing this lower SHBG or be the source of my low free T?
The fatigue is the worst part of this. Hoping for some relief in this department.
I don’t believe finasteride affects SHBG but I have heard it either reduces fT, or artificially raises it (because it ‘blocks’ the androgen receptors). In either case, I wouldn’t assume it changes your bloodwork much - but it can certainly affect your symptoms of Low T. No promises this is your primary cause, but it is a contributing factor.
You may be better suited using the topical version of Finas where you want it so the androgen receptor ‘blocking’ only occurs at that location, rather than a systemic response. For best Low T symptom relief though, you would be best to drop finasteride as a whole… depends on your priorities.
This is not at all unusual in the TRT world, actually very common. That’s LabCorp and not the best way to measure free testosterone, however, with your SHBG you know it is low, plus you feel like crap.
You’ll need to run the total testosterone up in order to get your free testosterone to a decent level. As mentioned, find a TRT practice. Good luck.
Finasteride is an endocrine disruptor, it can cause a whole cascade of issues down multiple hormonal pathways.
The worst cases of post finasteride syndrome can see a doubling or tripling of total testosterone.
You can still get PFS after stopping finasteride. Dr. Rob Kominiarek has a protocol specifically for coming off DHT blockers to prevent disruption and damage.
The way I see it you need to get off this drug asap because the long term studies show harm to just about all tissues in the body, including the liver.
If it were me I’d see what I could do to lower this before to committing to TRT. If you just can’t get that down naturally, replacement isn’t a bad idea.
Private labs and my shbg was over range and free t close to bottom.
175mg per week has my life complete again. I’m not superman but am a 40 year old guy functioning like a 40 year old guy again enjoying life and able to function at work and home and not fall asleep after dinner.
I also recover from exercise like a 24 year old so bonus
No I’ve had no hair loss but had none before TRT- Im not prone to it genetically.
I had some problems with gyno and had a lot of folk on here shouting “dont use an a.i.”, i listened and had some growth.
I now use an a.i. and it works for me in my protocol.
I’m telling you this as SHBG has a higher affinity for androgens than estrogens - so if you’re high SHBG your free-t to free-estrogen ratio can be skewed compared to people with lower SHBG.
I’m not saying you’ll need one, just be aware a lot of people will tell you you don’t - for me it just works using a tiny amount.
Best of luck, i haven’t looked back, the cost is the worst part for me. Pinning e3d is bo bother. Literally as easy as brushing your teeth or putting contact lenses in.
I just got off the call with the medical director of a trt clinic. They sent me to him instead of the standard consultation guy because of my somewhat atypical bloodwork. He is prescribing test with hcg and an ai. I can’t wait to start feeling better. My fatigue is unreal.
Big thanks to everyone in this thread that helped me navigate towards getting help.
