I have very low SHBG (below normal range) - High T, High Free, very high free androgen index, lowish E2
Can anyone suggest ways to increase this. I’ve had no libido for years and at my wits end. On 140mg / week taken daily
SHBG - 15 (18.3 - 54.1) nmol/L
OESTRADIOL 62 (41 - 159 R) pmol/L
TESTOSTERONE 23.3 (8.64 - 29 R) nmol/L
FREE TESTOSTERONE -0.69 (0.2 - 0.62 R) nmol/L
FREE ANDROGEN INDEX 150.3 (24 - 104 R)
PROLACTIN 253 (86 - 324) mU/L
Androgens lower SHBG. You would have an easier time lowering SHBG if it were high, as for lower SHBG on TRT, you can do little to nothing to raise it.
The low E2 is a problem, given your Total T and Free T are high, the ratios are way off.
You must have an aromatase insufficiency, the conversion of T->E2 which is where the majority of estrogen comes from in men and women.
Estrogen in men is essential for modulating libido and erectile function.
You need to add hCG to your TRT protocol or get used to having no libido!
I already use HCG - Even at high doses my E2 doesn’t move a lot higher.
I have considered lowering my test dose to reduce the androgens and then in turn raise my SHBG however then I am risking my E2 going even lower. A lot of people have said Clomid or another SERM increases HCG and E2
Removing carbs from your diet is a sure way to raise SHBG
It’s simple, you need estrogen therapy.
my shbg which is 11, stays that way, no matter what I do. keto doesn’t touch it or anything else. i don’t see any issues with it though. I need a relatively high dose of T to feel good. my e2 last lab is around 50. you might look into estradiol pills like someone said here?
1/4 tablet Tamox or Clomid 3 x a week alongside TRT. Purely to raise SHBG.
I’ve edited my post to include blood work - It’s been suggested to me that I need to lower my dose and I’m possibly crushing my SHBG and that may have an affect on the aromatise function.
well, or the opposite, maybe raise it and switch the ester to Tprop. i have been recommending this in many threads, by daily Tprop injection at 30mg or so significantly improved my libido/energy. find your max dose with no sides (like anxiety) and see if there is a difference.
How many mg of Clomid would you suggest?
I spoke to someone on another thread that offered a good suggestion / explanation. When free test and free androgens are too high they are suppressive of SHBG, he suggests that as I have been adding a trt dose that is more than my body is naturally used to dealing with to lower my trt dose down to a point where my FreeT and Androgen index are within normal range. He personally feels great on 84mg of test / week and like me, was using a lot more for years and getting libido issues. If supraphysiological doses of test are suppressive of SHBG then it makes sense that although I am running a reasonable trt dose, as far as my body is concerned I’m using more than I am naturally supposed to produce. I’ll let you know how I get on.
You do that and estrogen drops even lower. You can’t ignore the low E2.
Yeh I absolutely get that but I’ve had higher E2 before when running cycles and it didn’t make any difference. If I can get my SHBG up with a lower dose and still have E2 issues then I’ll start taking E2 tablets. I’m trying to isolate the issue as much as possible is it the low E2, Is it the low SHBG, is it both. Who knows
I wouldn’t get my hopes up if I were you, because SHBG is the hardest hormone to manipulate, it goes where it wants and you have little to no control over it.
I have my thyroid work too:
TSH 0.847 (0.27 - 4.2)
mIU/L
FREE T3 5.34 (3.1 - 6.8)
pmol/L
FREE THYROXINE
17.3 (12 - 22) R
pmol/L
My blood pressure is absolutely fine and other than slightly high HDL that’s in check too.
How does my thyroid look to you? I know nothing about thyroid health
Low TSH is an indication that your pituitary gland detects plenty of thyroid hormones.
My TSH is even lower at 0.49.
So do you think there is anything wrong with my numbers or does everything look OK? Sorry, I don’t know anything about thyroid
Whats your take on this? Mine is consistently the same, right on the low edge of the range, maybe 0.05 above or below. Is that slight hyperthyroid or euthyroid?
The low TSH is your pituitary slamming on the brakes so to speak, to keep you out of a hyperthyroid state. TRT at least for me lowered my TSH (0.89->0.49), because TRT increased a lot of other processes in the body, fat burning ability, hunger, more fuel for the body.
Hyperthyroidism would be very high Free T3.
Put 1/4 clomid\tamox tablet x 3 a week to your existing TRT regimen to raise SHBG.