So I was all prepared to go on TRT, having spent the past week researching it and feeling like it was exactly what I had, and then I get these blood results back.
Vegans are more likely to have high SHBG and lower free testosterone. You have caused this high SHBG and it may or may not be reversible. You leave a lot of unanswered questions as to why TSH is so high, normal TSH is between 1-1.5 as it is for 95% of the population, not these sick care reference ranges.
The fT3 (not TSH or fT4) is the active thyroid hormone, rT3 can block fT3 if elevated deactivating of portion of fT3. I would run full thyroid panel checking TSH, T4, fT3 (not T3), rT3 and both antibody testing.
I would also test IGF-1 which will represent your growth hormone levels.
When time of day did you draw these labs?
My IGF-1 is on there, 103 with range 53-331.
Iāll check those thyroid levels.
Is 98 really a lower free T score? And what about my 1405 Total T? In studies it looks like vegans have ~10% higher T and ~20% higher SHBG, and 3% lower free T. Iām nearly 30% above the top of the range for total T and 60% above the top of the range for SHBG. Also, my diet is mostly vegan, not totally. For example, yesterday I had pizza and chicken. In the past few months, Iāve eaten vegan about 70-80% of the time.
Time of day was morning, half hour after waking.
Thanks for the help.
You have something going on, but low T aināt it. Your Iron is on the low side (not unusual for vegans), but your thyroid is fighting pretty hard to keep up and the SHBG is not good.
http://blog.insidetracker.com/sex-hormone-binding-globulin-new-science-questions-old-beliefs
Completely incorrect. 95% of the population have a TSH below ~4.
Anyways, to take a closer look at your thyroid seems justified.
Iād say your Free T is not your issue, though it certainly isnāt optimal. I agree with @hardartery that low T isnāt your problem, and that your iron is on the low side. I would look further into Thyroid if I were you.
You should also look into supplementing DHEA, as it is looking pretty poor. You can do this on your own OTC.
PSA is 0.4 and perfectly normal
His PSA is 4.73!
No thatās his TSH
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Oh shit youāre right. The alignment of the number is almost dead even with the PSA test headerā¦ my mistake and thanks for catching that.
Iāll edit my above post.
Eating disorders can cause high shbg.
You may need to fix your diet before you medicate.
I would not take dhea at least not yet.
You seem hypothyroid but again I would fix diet (donāt know how) @bmbrady77 can help you here.
Then after a couple months retake labs.
Include thyroid antibodies and free t3. Your reverse t3 May be high also due to diet.
I would also include AM cortisol. Cause if dhea s and am cortisol score low you have adrenal stuff going on. Thatās also why I would not take dhea now.
Btw your fasting insulin is awesome. You are certainly not even close to being insulin resistance.
Why you have little to no hair. Idk. But check DHT. Did you go through puberty fine?
Also your lowing iron and hypo can be your diet. Check ferritin too next time.
You may need a nice piece of ribeye 
a couple days a week.
Also , I keep going up to read ur post, vegan since 12 ?? Putting a child in these restrictive diets bad IMO. You needed lots of nutrients when developing.
Think about it 12. When u getting hair on ur d for the first time. When you are getting arm hair, etcā¦ when u are going through growth spurtsā¦
This is just my opinion. Am 42 with 3 teenage kids.
This are the old outdated reference ranges, weāve learn a few new things over the years. In other countries they are still using the older reference ranges which go all the way up to 10.0 for TSH.
Reference ranges for TSH and thyroid hormones
Though TSH remains the most commonly used endocrine test in clinical practice, the issue of an appropriate TSH, and to a lesser extent, free T4 and free T3 reference ranges is still under debate. First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L. On the other hand, upper TSH reference limit is (assay-dependent) usually around 4.2-4.5 mU/L. There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease.
The evidence for a narrower thyrotropin reference range
It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter.
There is little doubt your IGF-1 is low given your age and is even below average for your age group. Iām 48 and my IGF-1 is in the 150ās which is considered average.
Peptides to the rescue, peptides will increase your natural levels if TRT doesnāt.
I think you have confused lab ranges with actual data. 95% of people do not have a level between 1 and 1,5.
You are mixing up the population distribution of TSH and the reference range.
The population distribution hasnt changed. Still the vast majority of people (we talk about 2 to 3 standard deviations) lie within a TSH of 0.6 and 4 with a median TSH of 1.2. This is also what the article says that you cite and this is what the graph above shows.
āFirst of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L [1-3].ā
What has changed partly is the upper reference range. Although no discrete upper range is stated in the article you cite, a value of TSH 3 is discussed as a threshold above which patients show a higher probability of autoimmune disease.
Nowhere states the article something that 95% of the population have a TSH between 1 and 1.5 and nowhere in the article an upper reference range of 1.5 is proposed. Simply, because this id just plane wrong.
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When I say mostly vegan this is what I mean. This is a typical vegan day of eating for me:
Meal 1
Shredded wheat, soymilk, banana
Snack
Smoothie with frozen spinach, berries, soymilk, flax seeds, chia seeds
Meal 2
black beans, sweet potato or potato
Snack
Air-popped popcorn or oats
300g Frozen Broccoli
My servings are large so thatās around 2500 calories.
On non vegan days it might look something like:
Meal 1
Shredded wheat, soymilk, banana
Meal 2
1500 calorie pizza or equiv
Meal 3 & 4
300-500g chicken or turkey
Frozen broccoli
The non vegan days are normally every 4 days or so, but I moved last month and havenāt eaten vegan since August.
I average like 100g of protein on vegan days, and 180-250 on non vegan days.
Hereās what I ate yesterday:
5:50:35 AM - 5:56:28 AM - 75g ralphs shredded wheat, 129g ripe banana, 228g Silk Unsweetened Organic Soymilk
6:56:16 AM - 7:53:20 AM - 317g coldbrew sig select green tea
8:56:41 AM - 11:14:03 AM - 419g coldbrew sig select green tea
9:08:12 AM - 10 drops pure therapro 10,000IU d + k2 (1000mcg mk-4, 360mcg mk-7)
9:12:42 AM - 9:14:32 AM - 5000mcg natrol cyano b-12 lozenge
10:58:51 AM - 11:09:45 AM - 459g first street bbq chicken frozen pizza
3:38:16 PM - 3:50:25 PM - 72g popcorn
5:43:56 PM - 5:52:21 PM - 230g frozen broccoli, 37g panda express bejing
8:01:46 PM - 8:05:10 - 177g chicken breast, 20g sweet baby rayās bbq
When I said somewhat vegetarian since 12, what I mean is that I only ate chicken, turkey, fish and dairy. Twice I got sick after eating beef and couldnāt eat it again after that, and Iāve always hated pork. I know people love it, but I find bacon appalling. I also hate chocolate.
I really donāt think my diet has anything to do with this. Maybe if I were 100% vegan, though even then my numbers are so high that Iād be skeptical.
I went through puberty fine, but late. That said, I was always larger than other kids my age and even ones a bit older. I wanted to check DHT, but itās like $125 to add it on. My dad and grandfather also have pretty much no body hair, though both had more facial hair than I do.
My ferritin was 125 when it was tested a few years ago, so at 73 now it has gone down some if theyāre comparable.
The only thing Iām seeing just āoff the cuffā here is that you may want to reconsider the soy based products. Maybe replace with almond milk instead of soy, and supplement the protein difference with 100% whey isolate.
Recent research has shown that soy isnāt what it was originally cracked up to be. Read this article from Harvard Medical for exampleā¦
Edit.
This hyperlink requires a login to read. Iām not sure why this happens with their linksā¦If you google āupdate on soy Harvardā and click that link it will show the full article without requiring a login.
Also, since you have no red meat intake, and your iron does appear to be creeping down a little, you may want to keep an eye on that particular element over time, monitoring ferritin along with it. You arenāt quite in the supplement territory just yet (make sure you have a serious need to supplement iron before doing so), but you are potentially heading there. If you are considering starting TRT, going in with somewhat low iron already is a cause for concern.
Throw a couple handfuls of fresh baby spinach in your smoothie (in lieu of the frozen stuff) and thatāll help out. While the frozen spinach has more density, and subsequently more spinach by volume than fresh, you lose some of the nutrients and minerals through the processing of the frozen variety. If you want the best of both worlds, even though itās more work, you could sautĆ© some fresh spinach in avocado oil, then let that cool in the fridge and use that in your smoothies. Since you arenāt boiling the spinach (Which is how it is cooked for the packaged frozen kind), you arenāt throwing the baby out with the bath water so to speak, and you can have the benefit of more spinach by volume that you get with the tightly packed frozen stuff.
If I knew your full stats (age, weight, height, activity level, current body fat %, and exercise goals) I could scrutinize this a little deeper if youād like.