Initial labwork - low free t, high shbg feedback please

[skubes50]

Hey everyone,
I just got my labs complete and it was like I expected = low free t. I did not expect high shbg, and DHEA was on the low end of normal. Is metabolic acidosis something to be worried about? I was concerned about my liver but it looks OK. I have an appt with doc today and will hopefully be well on my way. Any feedback?? Thanks

[kelkel]

Hi Skubes.

First thing I'd address if your thyroid. Your TSH level is elevated. It's in range for your lab but they're using an old scale. Newer range is .3 - 3.0. I'd suggest more thyroid tests such as FT3 and FT4, probably antibodies as well. If you are hypothyroid or sub-clinical hypothyroid it can lower test levels and cause hypogonadism. It will also indirectly effect and can elevate your shbg.

So, if hypothyroidism is determined to be an issue correcting it can restore your t production, hopefully to an acceptable level. Remember it's free T you should worry about, not total T. When your T rises it will suppress your shbg.

Re your metabolid acidosis comment have you been running daily nsaid's?

[skubes50]

Thanks kelkel. I asked the doc about my thyroid and he suggested that it is due to my adrenals and that they are not up to par due to stress, anxiety, etc. I tend to agree with him and will get more tests done at the 3 month mark. I have not been running any nsaid's and have my diet pretty dialed in. Doc prescribed test, hcg , and anastrozole. Here's what my protocol will be"
thurs am test 5omg, hcg 250 IU's
fri am anastrozole 1/4 tab
sun pm test 50 mg, hch 250 IU's
mon pm anastrozole 1/4 tab
thoughts??

[kelkel]

Thoughts are that you guys are jumping the gun a bit. I don't know your age (or does the 50 in your name indicate that?) but I'd want to be going into HRT with a clear conscience. Meaning that you're not just putting a band aid on a problem. That said, I do understand wanting optimal T levels.

Regarding the protocol given, he's obviously way ahead of most of his peers with TRT which is very refreshing to see. Hell, he even did the correct E2 Sensitive Assay! I agree with his protocol with one exception. I see no need to immediately start on adex. I think you should wait for labs at 6 weeks and make a decision then. Your current E2 is not high and if it doubled it would still be just fine. I'd always rather have my E slightly high than low. Your split T injections will help to minimize T to E conversion as well.

Anyway, I wish you the best and I'd love to see you update this thread with your blood work and progress!

[skubes50]

Thanks kelkel I was on trt years ago and my thyroid was always at decent levels. I think it may be age as I'm now 45, but I'm really excited to get started. I actually directed the lab test and suggested the protocol, but have to give props to my doc for being open minded and agreeing. I am fortunate that this guy exists in the small community I live in.
I will hold off on the adex as you suggested until I update blood work . This makes sense and if I'm off the charts on e2 I can always add it in. Thanks for the encouragement and I will be updating as things progress.

[kelkel]

Look forward to seeing positive results!