I am 36 years old and I have health issues. A few weeks ago I had my testosterone checked, and my total testosterone is actually high normal. My shgb is very high, which has my free testosterone in normal range. I’m curious if anyone has any insight as far as why my testosterone would be high normal at my age and given my health issues? When I had my testosterone checked about a couple years ago, the total testosterone was actually outside of high normal range. Is there some reason that the body would try to compensate by producing extra testosterone?
A few years ago, I was on trt because at the time my testosterone tested as low. I didn’t realize that I was being exposed to mold and that’s the reason for the low testosterone as well as my subsequent health issues. I did not benefit from trt, so I discontinued it. I don’t think I even did it for an entire year.
The metric you actually should care about is Free Testosterone (fT), and testing for fT is pretty hit or miss. If you’ve got low T symptoms, even with ‘normal’ fT, you should consider TRT.
You should be asking yourself what’s causing your high SHBG, because maybe if you can figure out what it’s high, only then can you form a plan to lower it.
Your diet affects SHBG, vegan diets has been shown to increase SHBG. Also cutting, starvation can increase SHBG substantially.
Usually when a guy has high SHBG, more often than not there’s nothing you can do about it except drown it in excess androgens to suppress it.
However, we have demonstrated that even the calculated fT values derived from the prevailing equations, based on linear law-of-mass action models or empiric equations, differ systematically from free testosterone measured by equilibrium dialysis by as much as 40%.
Perhaps I am misunderstanding this, but it sounds like there is 60% accuracy in most methods, if measurements can differ as much as +/-40%.
You’re the expert here though, so I’ll defer to you.
This is one reason why some doctors fixate on the Total T and ignore the Free T. This is why diagnosing a testosterone deficiency can be challenging and why so many men get blown off.
It almost makes more sense to just use the calculated fT in these situations. At least if we stick to one measuring stick, we could harmonize TRT in a way that actually helps people. (not that I agree with calculated fT, but this is beside the point)
(note that my tested-fT is almost 3x higher than my direct tested-fT)
One is below range, and the other is just under the high-bar of 26.5 ug/dL.
There can’t be one number for everyone, doctors need a little bit of leeway. The normal range is exist for a reason, otherwise everybody would have the same exact numbers.
We should stick to one means of measuring as a standard. We should also revise and harmonize this means of measuring to accurately match what we should be treating to. That doesn’t really mean 1 number for all, moreso 1 range for all - otherwise we have vitrually no objective treatment criteria.
