Low SHBG, high free test %, low total test

[saldivar]

I have a low shbg level and high free testostorone with low total test.
my labs are right here. lab results

My question though is that if I have a low shbg level, does that mean that I won't notice anything from the trt and that losing weight would probably have fixed the problem? According to this http://www.ironmanmagazine.com/archi...0&page_count=1 it sounds like that.

I do feel like i've always had low test though, even when I was at a healthy weight of 185lbs and wrestling. I was just wondering if the doctor did the right thing by prescribing trt?

[BigRagu]

Free test is where u get the bang 4 your buck.... it seems like your body off setted the low amounts of test in your body and keeping it's free test high...... i'm not 100% sure about this so some1 else should also comment on this

EDIT!!!!!!! i just looked at the labs which i should of done first.... your total test % is high which means the amount of free test u have vs bound test is high. BUT since your test lvl is so low to begin with that yea teh % might be high but it's still low......... your total test is def low ... very low at that........ a mri might be of use here...... but if your asking if u should be on hrt is your lvl was that low and they couldn't get your body back to normal.... i would say yea u need it

[marianco]

Originally Posted by saldivar

I have a low shbg level and high free testostorone with low total test. my labs are right here. lab results

My question though is that if I have a low shbg level, does that mean that I won't notice anything from the trt and that losing weight would probably have fixed the problem?

I do feel like i've always had low test though, even when I was at a healthy weight of 185lbs and wrestling. I was just wondering if the doctor did the right thing by prescribing trt?

SUMMARY OF LAB FINDINGS
CHOLESTEROL 211 mg/dL
TSH 3.0 uIU/mL
TESTOSTERONE FREE 37.9 35.0 155.0 pg/mL
TESTOSTERONE, TOTAL 133 L 250 1100 ng/dL
ESTRADIOL 30 pg/mL Normal
AST 47 H 10 40 U/L
ALT 129 H <36 U/L
CORTISOL <1.0 ug/dL - AM
GLUCOSE fasting 97mg 60 - 99
Weight 290lbs.
Age 21.
SEX HORMONE BINDING GLOBULIN: LOW

THOUGHTS:
1. Low Testosterone levels can lead to Insulin Resistance through multiple pathways.
2. Insulin Resistance can directly reduce testosterone production (in a biological death spiral with low testosterone levels).
3. Low Testosterone levels lead to unopposed Estrogen effects.
4. Estrogen effects include blocking thyroid hormone receptors, weight gain, increased SHBG (resulting in lower free testosterone), aggressive or anxious behavior.
5. Low SHBG in the face of normal Estrogen is consistent with the presence of insulin resistance.
6. Obesity (particularly visceral/belly fat) contains a lot of aromatase enzyme - leading to increased conversion of Testosterone to estrogens.
7. Visceral/Belly fat may contribute to fatty liver and small elevation in liver enzymes (ALT, AST, e.g.).
8. TSH > 2.0 is suspicious for hypothyroidism. Confirm by measuring both free T3 and Free T4.
9. Hypothyroidism contributes to obesity, low energy level
10. Visceral/Belly fat may lead to increased cholesterol levels.
11. Low testosterone level may lead to increased cholesterol production by the liver in an attempt to increase precursor (cholesterol) for testosterone.
12. Insulin resistance is tested by 3 hour glucose tolerance test.
13. A more practical way to monitor insulin resistance is for the patient to do frequent finger sticks for blood sugar (fasting, and before, 1, 2, and 3 hours after a meal).
14. Obesity contributes to insulin resistance.
15. Low testosterone levels may lead to increased stress levels since testosterone has calming effect on brain, and reduces stress-response from adrenals.
16. Chronic high stress may lead to adrenal fatigue - where adrenals may not be able to make enough Cortisol in response to stress.
17. Low Testosterone levels may lead to insulin resistance from chronically high cortisol levels. Cortisol normaly directly causes insulin resistance to balance the effects of Insulin.
18. Correction of testosterone levels may lead to correction of adrenal fatigue since perception of stress is reduced by testosterone.
19. Testosterone levels generally decrease over time, are difficult to correct with diet alone since the hormone balances with low testosterone levels are against weight loss.
20. Very low testosterone levels at a young age may have a strong genetic component.
21. Low SHBG indicates testosterone replacement therapy may be more effective since more of the additional testosterone will be free and active.

[BigRagu]

Originally Posted by marianco

SUMMARY OF LAB FINDINGS
CHOLESTEROL 211 mg/dL
TSH 3.0 uIU/mL
TESTOSTERONE FREE 37.9 35.0 155.0 pg/mL
TESTOSTERONE, TOTAL 133 L 250 1100 ng/dL
ESTRADIOL 30 pg/mL Normal
AST 47 H 10 40 U/L
ALT 129 H <36 U/L
CORTISOL <1.0 ug/dL - AM
GLUCOSE fasting 97mg 60 - 99
Weight 290lbs.
Age 21.
SEX HORMONE BINDING GLOBULIN: LOW

THOUGHTS:
1. Low Testosterone levels can lead to Insulin Resistance through multiple pathways.
2. Insulin Resistance can directly reduce testosterone production (in a biological death spiral with low testosterone levels).
3. Low Testosterone levels lead to unopposed Estrogen effects.
4. Estrogen effects include blocking thyroid hormone receptors, weight gain, increased SHBG (resulting in lower free testosterone), aggressive or anxious behavior.
5. Low SHBG in the face of normal Estrogen is consistent with the presence of insulin resistance.
6. Obesity (particularly visceral/belly fat) contains a lot of aromatase enzyme - leading to increased conversion of Testosterone to estrogens.
7. Visceral/Belly fat may contribute to fatty liver and small elevation in liver enzymes (ALT, AST, e.g.).
8. TSH > 2.0 is suspicious for hypothyroidism. Confirm by measuring both free T3 and Free T4.
9. Hypothyroidism contributes to obesity, low energy level
10. Visceral/Belly fat may lead to increased cholesterol levels.
11. Low testosterone level may lead to increased cholesterol production by the liver in an attempt to increase precursor (cholesterol) for testosterone.
12. Insulin resistance is tested by 3 hour glucose tolerance test.
13. A more practical way to monitor insulin resistance is for the patient to do frequent finger sticks for blood sugar (fasting, and before, 1, 2, and 3 hours after a meal).
14. Obesity contributes to insulin resistance.
15. Low testosterone levels may lead to increased stress levels since testosterone has calming effect on brain, and reduces stress-response from adrenals.
16. Chronic high stress may lead to adrenal fatigue - where adrenals may not be able to make enough Cortisol in response to stress.
17. Low Testosterone levels may lead to insulin resistance from chronically high cortisol levels. Cortisol normaly directly causes insulin resistance to balance the effects of Insulin.
18. Correction of testosterone levels may lead to correction of adrenal fatigue since perception of stress is reduced by testosterone.
19. Testosterone levels generally decrease over time, are difficult to correct with diet alone since the hormone balances with low testosterone levels are against weight loss.
20. Very low testosterone levels at a young age may have a strong genetic component.
21. Low SHBG indicates testosterone replacement therapy may be more effective since more of the additional testosterone will be free and active.

really nice info.... learned alot from just that one post

[cpeil2]

Originally Posted by marianco

12. Insulin resistance is tested by 3 hour glucose tolerance test.
13. A more practical way to monitor insulin resistance is for the patient to do frequent finger sticks for blood sugar (fasting, and before, 1, 2, and 3 hours after a meal).

Blood glucose meters sell for $70 or less at places like Costco and Wal-mart, so the fingerstick testing becomes very easy.

Using your blood glucose meter, it is possible to do your own glucose tolerance test - ingest a 75 g bolus of glucose, and then measure glucose at regular intervals after ingestion. Probably not as accurate as laboratory assays, but good enough.

[marianco]

Originally Posted by cpeil2

Blood glucose meters sell for $70 or less at places like Costco and Wal-mart, so the fingerstick testing becomes very easy.

Using your blood glucose meter, it is possible to do your own glucose tolerance test - ingest a 75 g bolus of glucose, and then measure glucose at regular intervals after ingestion. Probably not as accurate as laboratory assays, but good enough.

I think it is useful test.

I think it is useful to measure blood glucose before, 1 hour after, 2 hours after, and 3 hours after a meal to see how food affects blood sugar and to learn what food to eat and to avoid to help maintain control over blood sugar.

[ASaxon]

This is how I understand it works. When you develop low testosterone your system compensates by reducing SHBG in order to drive up your free testosterone (the important type.) So if you’ve been low in T for a long time your SHBG could have been driven low as well. Low T and low SHBG are pretty common when the cause of the hypogonadism is from low T production. Some people can have low free T from high levels of SHBG but that type of hypogonadism isn’t usually because of low T production it’s because of high SHBG production for whatever reason.

From my research most studies I’ve seen show that people that are obese can have lower levels of testosterone than normal weighted people but usually not lower than normal except in extreme or massive obesity. So from what you’ve posted it doesn’t sound like you’re massively obese so I wouldn’t think your low T, or low SHBG for that matter, is because of obesity.

I also have low T and low SHBG. I’ve gotten my T levels back up in the high normal range now but my SHBG is still borderline low. I don’t know why but perhaps it will take time to correct itself.

[pmgamer18]

My Dr. feels that SHBG is a waste of time for labs the one that is best is Free T.

[BigRagu]

Originally Posted by pmgamer18

My Dr. feels that SHBG is a waste of time for labs the one that is best is Free T.

yea it is kinda a worless test considering if u see your free test u can prob tell where the shbg is anyway