Interpreting a high SHBG

Good day fellas,

I have been struggling with the weirdest symptoms for the past 1.5 years and I have posted about them here before. I am not going to go into depth about it here, I am just curious on how to interpret and how to proceed from here.

I am 33 and I have never been on any cycle.

My Total Testosterone: 30 (Ref 8.6-29)
My SHBG: 76 (Ref 18-54)
My Bioavailable Testosterone: 9.0 (Ref 4.4-14)
Estradiol Sensitive: 102 (Ref <150)
Elevated Cortisol 2/4 morning blood tests so far

How would you proceed from here? My endocrinologist is not very progressive so I rather ask for advice here first so that I can push him for other tests if recommended.

Main symptoms:
- Exercise intolerance (crashes my mental and physical energy for a week or more)
- Low sex drive
- Increased night time urination
- Eye pain and sensitivity to glare/fluorescent lights (could be unrelated but 3/3 opthalmologists couldn't find any problems and 3/3 neurologists including MRI scan of brain found nothing)

Thank you for reading and consider helping :)

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High Estrogen Synthoms. What is your %bf? I think as soon as you reduce your estrogen levels, your SHBG level will decrease, your free testosterone will go up and all this will make the symptoms go away. Although I'm not an expert, wait for kelkel or Y55G to respond.

Are you on TRT? Your test levels look good to me. Your higher SHBG may be bringing your free test down a bit but I doubt are causing your issues. A free testosterone blood test would help. Im not a doctor but I don't think elevated morning cortisol is a problem. That's what gets you going in the morning

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Originally Posted by rplante7

Are you on TRT? Your test levels look good to me. Your higher SHBG may be bringing your free test down a bit but I doubt are causing your issues. A free testosterone blood test would help. Im not a doctor but I don't think elevated morning cortisol is a problem. That's what gets you going in the morning

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I totally disagree! High SHBG pushes up Total T while simultaneously lowering Free T. This is why Total T is a worthless lab and guys with high SHBG feel like $#^T.

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Originally Posted by FreeT

Good day fellas,

I have been struggling with the weirdest symptoms for the past 1.5 years and I have posted about them here before. I am not going to go into depth about it here, I am just curious on how to interpret and how to proceed from here.

I am 33 and I have never been on any cycle.

My Total Testosterone: 30 (Ref 8.6-29)
My SHBG: 76 (Ref 18-54)
My Bioavailable Testosterone: 9.0 (Ref 4.4-14)
Estradiol Sensitive: 102 (Ref <150)
Elevated Cortisol 2/4 morning blood tests so far

How would you proceed from here? My endocrinologist is not very progressive so I rather ask for advice here first so that I can push him for other tests if recommended.

Main symptoms:
- Exercise intolerance (crashes my mental and physical energy for a week or more)
- Low sex drive
- Increased night time urination
- Eye pain and sensitivity to glare/fluorescent lights (could be unrelated but 3/3 opthalmologists couldn't find any problems and 3/3 neurologists including MRI scan of brain found nothing)

Thank you for reading and consider helping :)

---

Yes, your SHBG is very high. Not as high as mine (untreated), but your lab's normal ranges are lower, so proportionally to your high range's high end we are similar.

Without getting too deep into the weeds, there are about 5-10% of men who are genetically programmed for high SHBG. In a nutshell, we add an extra sugar molecule to the protein and this more than doubles its half-life.

As I eluded to in the previous post, high SHBG pushes up Total T because it binds it and protects it from metabolism in the liver. On the flip side, it also prevents T from crossing the blood-brain barrier, which is why you feel so bad. Your body is swimming in T but your brain is starved for it.

There are effective treatments, but getting doctors to prescribe them is difficult. Most of them have drank too much of the "SHBG is meaningless" Kool-Aid. I've got to run off to work now, but we can dive deeper into the treatments I have found most effective in another post when I have more time. In the interim, consider searching the forum for some of my past posts on the subject. I seem to remember even starting a thread on it once (on the subject of ANAVAR).

Here it is:

https://forums.steroid.com/hormone-r...ower-shbg.html

Awesome feedback guys, much appreciated.

Checking out the posted thread and searching around as much as I can. The issue with searching around is that my eyes are burning and becomes blurry from using monitors, hehe. I am hoping it has to do with my hormones but it could be unrelated. I recently found out about Irlen Syndrome (irlen.com) and it makes a lot of sense. Check it out if you haven't heard of it.

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Originally Posted by Youthful55guy

I've got to run off to work now, but we can dive deeper into the treatments I have found most effective in another post

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Please do feel free to do so and if you want to recommend a progressive endocrinologist as well. I would fly across the globe to find a reputable TRT doctor because there are none over here in Asia.
Health before money :)

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Originally Posted by assguy22

High Estrogen Synthoms. What is your %bf?

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I'd gusss around 12-18%. I am slim but have not worked out in about 6 months as it fatigues me horribly. I used to work out a lot before without any issues.
What other Estrogen test would you recommend to check it?

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Originally Posted by rplante7

Are you on TRT?

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No, but I would definitely be willing to try if could help.

Quote:

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Originally Posted by rplante7

Im not a doctor but I don't think elevated morning cortisol is a problem. That's what gets you going in the morning

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It should be higher in the mornning so I've heard, but above the morning cortisol level reference?

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Originally Posted by FreeT

I'd gusss around 12-18%. I am slim but have not worked out in about 6 months as it fatigues me horribly. I used to work out a lot before without any issues.
What other Estrogen test would you recommend to check it?

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The ultrasensitive E2 test is sufficient. I think that in your case would be more important low estrogen, although logically using some androgen would be of great help (wins/oxa/proviron ...) to lower the SHBG even at very small doses and raise the free testosterone, I would first address the situation by lowering body fat and making small changes in the diet to encourage the lowering of these estrogen levels. Do you drink alcohol frequently? It would be the first option, to eliminate it or drastically reduce the intake.

Look for "How to lower estrogen levels naturally" to get a general idea of how to proceed with those changes.

Thanks for the input.

I am not sure I can alter my diets any more to the better. But feel free to comment on it:

- I eat omelette for breakfast and chicken, vegetables and white rice/sweet potato for lunch and dinner. I drink lots of water and turmeric/ginger tea.
- The supplements I take are plenty of fish oil, magnesium and zinc.
- I drink alcohol once every 3 months.
- I take long walks and do yoga 2-3 times daily.

I have a very stress-free job and lifestyle. I consider myself very lucky and happy in general despite my conditions.

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Originally Posted by kelkel

Here it is:

https://forums.steroid.com/hormone-r...ower-shbg.html

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If one would like to lower SHBG with minimal suppression of natural T, could a low dose of Mesterolone be a potential alternative?
Firstly I will have a re-check of my thyroid and liver before experimenting, but I am thinking it could actually be very beneficial for me to do a long term low dosage of something like Proviron.

Thoughts on this guys?

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Originally Posted by FreeT

If one would like to lower SHBG with minimal suppression of natural T, could a low dose of Mesterolone be a potential alternative?
Firstly I will have a re-check of my thyroid and liver before experimenting, but I am thinking it could actually be very beneficial for me to do a long term low dosage of something like Proviron.

Thoughts on this guys?

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A couple of thoughts:

1) I have no experience with Proviron (Mesterolone), so I have little advice to give. I have read that low doses will minimally suppress T, but what is a low dose and what is "minimal"? All androgens (synthetic or not) will suppress natural T production to some degree, it's just a matter of degree that varies between androgens. The question is whether or not you can find a dose that suppresses SHBG more than it suppresses T so that the net effect is to increase Free T. I have chosen a completely different approach, which is to adjust SHBG to normal levels and then use supplemental T to bring Free T into the optimal range. I'm still adjusting the T dose, but getting there slowly. Also, cost is a factor. I've looked into a number of SHBG lowering androgens, and Winstrol (stanozolol) is by far the most cost-effective and EXTREMELY effective at very low doses of just 5 mg/day.

2) You mention thyroid function. It's good to understand your thyroid hormone levels, but also understand that there is strong evidence that supplemental thyroid hormones will increase SHBG in people who are not clinically hypothyroid. Word to the wise is caution. I discuss the evidence at the end of the thread link that kel posted. I strongly recommend you read through that entire thread, but also understand that it represents a point in time for my experimentation on controlling SHBG. I've learned much more since then and have lowered my stanozolol dose to 5 mg and concomitantly lowered my Armour thyroid dose from 90 mg to 60 mg/day. I believe lowering Armour is what allowed me to lower Stanozolol. I now think I'm at the sweet spot for both medications and am in the process of optimizing my T dose around that combination of medication.

3) You mentioned liver function. I strongly support that approach. Whenever you introduce synthetic androgens into your system, you should be monitoring liver labs and act accordingly. Keep in mind though that other common(non-androgen) drugs will also affect liver labs. My doc and I spent a lot of money on labs and test last year to try and figure out why my liver labs went up slightly (just borderline high). Turns out, that it was my use of naproxen and ibuprofen to treat pain from orthopedic surgery I had a little over a year ago. It had nothing to do with my low stanozolol dose.

Very interesting, Youthful55guy.

I have not checked my thyroid since over a year ago, which seemed normal at that time. The reason I will re-check it is because I read in multiple places that a high SHBG could be caused by hyperthyroidism.

Only 5mg wow. Do you think it could work for one, such in my case, with a high total T that is not on any TRT? Or do you think that the suppression of natural T will result in a plus minus scenario, where the lowering of SHBG will make little to no difference?

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Originally Posted by FreeT

Very interesting, Youthful55guy.

I have not checked my thyroid since over a year ago, which seemed normal at that time. The reason I will re-check it is because I read in multiple places that a high SHBG could be caused by hyperthyroidism.

Only 5mg wow. Do you think it could work for one, such in my case, with a high total T that is not on any TRT? Or do you think that the suppression of natural T will result in a plus minus scenario, where the lowering of SHBG will make little to no difference?

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Yes, hyperthyroidism can and does increase SHBG production.

Yes, 5 mg per day (2.5 mg AM and 2.5 mg PM) is extremely effective at lowering my SHBG, which is at least as high as yours. I've never tried stanozolol as a monotherapy. I suspect that it will not work well. They tried somethin similar with Anavar (which is also effective at suppressing SHBG) in a randomized placebo controlled study of HIV patients. At all doses (10, 20, and 40 mg per day), it suppressed T production. I suspect stanozolol will do the same.

My SHBG, with only 20mg of oxandrolone, dropped to 9. it's very very effective.

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Originally Posted by assguy22

My SHBG, with only 20mg of oxandrolone, dropped to 9. it's very very effective.

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No question about that. The study I quoted above with HIV patients also demonstrated very effective SHBG suppression at 20mg per day. Interestingly, there was only a marginal increase in suppression at 40me and 80mg per day. My personal experience is that 10 mg is enough to get my very high levels to mid-range.


I choose stanozolol because it is equally effective at have the dose and about 6X less expensive.

What is your take on these supplements guys?

Boron
Avena Sativa
Stinging Nettle Root

Perhaps it's worth a shot since I am not on TRT.

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Originally Posted by FreeT

What is your take on these supplements guys?

Boron
Avena Sativa
Stinging Nettle Root

Perhaps it's worth a shot since I am not on TRT.

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When you are an individual with genetically high SHBG, their only effectiveness is to lower the level of your pocketbook.

From oral steroids proviron is less likely to cause serious sides. Maybe your doctor can add it. Yes there of course is also a natural alternative to proviron called Divanil. Both of them can lower shbg.