I’m 70 and recent labs show total T level of 1015 ng/dl, free T level of 75 pg/ml, and a sex hormone binding globulin level of 114 nmol/L (I know… quite high). Historically, my SHBG levels seem to rise and fall with total T levels. I know this because I was on TRT several years ago. I am NOT currently on any TRT. Should the free T level negate any concerns about the high SHBG (since there’s not much I can do about that anyway)?
Damn, it’s not common to see SHBG this high. Free testosterone + SHBG = Total T, so isolated changes in SHBG may not see any changes in free testosterone, even though total testosterone increased or remained stable
The American urology Association has a study in its possession looking at the effects of low free testosterone on prostate cancer noted, total testosterone was stable over decades, SHBG rose and free testosterone decreased 50% between 40-80 years old.
If I’m reading your free testosterone levels correctly, you’re at a 53% increased risk of prostate cancer having free testosterone in the bottom 25 percentile! Only top 25 percentile sees a 53% decreased risk for developing prostate cancer.
Please include reference ranges for all labs, mainly the free testosterone since not all labs share the same normal ranges.
I’d be curious to see your LH values.
TRT or androgens will lower your SHBG, by how much is very individual. If you do decide on TRT, you’ll need to run a higher total testosterone to achieve healthy free testosterone levels, and not many doctors will understand the impact of crazy high SHBG.
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Free T of 75 if range of 35-155 (Quest) or ~30-35 to ~170-190 if it is Labcorp (they adjust slightly for age) is not very good. Most on TRT will see free test at 200+.
I would expect you to feel better if you doubled or tripled your free testosterone. However, that’s up to you based on how feel now. If you are happy at 75, I wouldn’t worry about it.
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These are based on Quest Labs. Here are the reference ranges:
SHBG normal is 22-77 nmol/L (I’m at 114)
Testosterone, Total, MS normal is 250-1100 ng/dL (I’m at 1015)
Testosterone, Free normal is 30-135 pg/ml (I’m at 75)
Here’s more reading material → https://www.myhormonetherapy.com/wp-content/uploads/2012/06/The-Testosterone-Controversy-by-Faloon.pdf
Because of your astronomically high SHBG, it will be more difficult to determine where you fit into this study, but typically when total testosterone is on the higher end, in the absence of elevations in SHBG (30 nmol/L), free testosterone values are on the higher end.
There’s also a big debacle regarding free testosterone lab testing, where Quest Diagnostics ranges for free testosterone tops out, and let’s say you measure right at the top of QD ranges, measure the same sample of blood using LabCorps lab testing, and you come out midrange.
Another example, LabCorps ranges for SHBG top out at 55 nmol/L, and not at 77 nmol/L. So depending on which lab company used for lab testing, things may look more favorable or in your case if using LabCorp, looks worse on two fronts.
Thank you for that compendium of research. Do you happen to know of any docs who really know their stuff in southeast Florida?
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Dr. Justin Saya, Dr. Calkins are excellent at hormones! Defy Medical is a walk-in as well as telemedicine clinic, cash only establishment in Tampa Bay.
The cheapest and highly regarded.
I’ve been using them on and off for years, I’m currently using them now. I see no reason to use anyone else.
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Same. It’s a good group.