Normal Testosterone but Very Low Free Testosterone

Pharma TRT
41

I will try to explain it this way. There is no unified method that measures free t well enough. Different labs use different methods to measure it and show it in different units that are not comparable to each other.
The practice for now shows that because of that mess it is best to calculate free t form albumin, shbg and total testosterone. This looks accurate enough and is unified and comparable measure that you can relate to something.

42

Take proviron to lower shbg. Shbg are the blocker of free test if you have high shbg then you will have low free test. Shbg binds to free test and make it worthless. take 25-50mg daily. Then you Will boost your free test.

44

Pretty much identical labs to mine at the age of 55 when I was diagnosed with Low T due to high Sex Hormone Binding Globulin (SHBG). Same with the irritability issues. My wife says Iā€™m a much nicer person to live with after I got to a stable TRT dose/protocol.

My recommendation is that future labs include a measure of SHBG to understand whether (or not) this is your issue too. The purpose of SHBG is to help maintain steady (total) T levels by binding with T to protect T it from rapid liver metabolism. Unfortunately, it also prevents it from crossing the blood-brain barrier where you need it to feel normal (hence the irritability). Brain fog and inability to focus are other common symptoms.

There re various theories as to why some of us have high SHBG. One theory that I read (though I canā€™t put my finger on the article right now) is that some of us are genetically programmed to add extra sugar molecules to the SHBG protein (glycosylation) which effectively doubles the half-live of the protein. That means, molecule for molecule of SHBG we produce, it has double the effect of sequestering T. I believe the article estimated that this genetic alteration affects about 15-20% of men. Also, as we age, we normally produce more and more SHBG, so the effect increases dramatically as we age.

What can you do?

  1. You can first try an OTC approach, although Iā€™ve not found it to be very helpful. The supplement boron is supposed to help suppress SHBG.

  2. You can use low doses of certain anabolic steroids to lower SHBG. Iā€™ve found through experimentation (and lots of labs) that both Winstrol (Stanozolol) and Anavar (Oxandrolone) were both very effective in lowering my SHBG to the normal range. For me the optimum dose was 2.5 mg 2X per day for Winstrol or 5 mg 2X per day for Anavar. The biggest problem is that I doubt youā€™ll ever get a main stream doctor to prescribe these drugs, particularly at your age. A second problem is that they both suppress endogenous T production, so you need to be on a TRT protocol. Although these anabolic steroids lower the dose of T you need to overcome SHBG suppression.

  3. Where I netted out after over a decade of TRT and LOTS of experimentation is that You simply find an effective dose/protocol of TRT that saturates the SHBG protein so that enough spill over into Free T to feel normal again. For me, that between 90-120 mg T-cyp per week on an E2D or E3D3 injection cycle. However, at your age, youā€™re again going to find it difficult to get a main stream doc to prescribe TRT and you have the added problem of reduced fertility if kids are in your future, although HCG may help to maintain some fertility.

45

A robust pituitary response will still see high normal Free T levels even with high SHBG, youā€™ll see this is men with high Total T and high SHBG, LH will be high and even above the normal range.

If not, then a man with high SHBG and mid normal LH likely has a pituitary that canā€™t keep up with demand, and therefore also has secondary hypogonadism in addition to high SHBG and sometimes the two are linked.

Also SHBG isnā€™t capable of affecting testosterone production, thereā€™s no mechanism for that. Once the SHBG reaches full saturation, meaning SHBG canā€™t absorb anymore T, like a sponge full of water, the excess water (T) flows around, off the sponge, the Free T rebounds reaching an equilibrium.

46

One test, one random test, doesnā€™t tell you much of anything.
The OP was training every day. It could be here was trashing himself with too much training. Pretty common in young guys.

Was it a morning test? Afternoon test? Was he sleeping well? Vitamin D in a good spot?

Too many factors.