My endo says high SHBG is good. Thoughts?

[raginghormone]

What my endo is saying contradicts a lot of knowledge on this forums. I recently had labs:

- Testosterone, serum -- 860 ng/dL (348 - 1197)
- Testosterone, % free -- 1.0% (1.5-3.2)
- Testosterone, free -- 86 pg/dL (52 - 280)
- SHBG -- 64.7 nmol/L (16.5 - 55.9)
- T3, free -- 3.2 pg/mL (2.0 - 4.4)
- T3, reverse -- 16.6 ng/dL (9.2 - 24.1)
- T4, free -- 1.66 ng/dL (0.82 - 1.77)
- DHEA-Sulfate, serum -- 105 ug/dL (33 - 416)
- ACTH-ICMA -- 67 pg/mL (6 - 48)

Testosterone (% free) is below range, SHBG is above range, ACTHA-ICMA is above range. I'm currently on 2 grains of natural dessicated thyroid for my Hashimoto's. I still suffer from lots of symptoms. Low libido, hair loss, dry skin, dry mouth, itchiness, puffy face, fatigue, muscle weakness, anxiety. It has gotten better ever since I started NDT about a year ago but I'm definitely not normal yet. I also donated a kidney 4 years ago which likely severed a vein to my left adrenal gland at the same time, thereby putting it out of commission.

Reading my doctor's dictation, he had this to say:

"His testosterone was 860, which is excellent. Free testosterone is also good at 86. SHBG is high at 64.7. It goes up with hyperthyroidism and is good to be high, rather than low."

I definitely don't agree with his stance on SHBG. Furthermore, my percent free testosterone is low so I don't think my testosterone numbers are "excellent" at all. My theory is the high SHBG is driving up my total but binding to it before it can become free. What are your guys' thoughts?

 

[kenpoengineer]

Agree. Your SHBG is binding your testosterone thus the low free T level. DHEA is also low. Optimal level should be above 500. You may want to check out ExcelMale dot com and the Testosterone Replacement Therapy Discussion FB page.

 

[raginghormone]

Thanks for your response and confirming my suspicions. Should I be finding another endo then?

Are you saying DHEA should be above 500? Isn't that out of range?

Thanks for the group recommendations. I'll check them out immediately!

 

[kenpoengineer]

Yes. Optimal levels of DHEA is 500-600. Be aware that, when it comes to optimal blood testing, each individual is different.
https://www.excelmale.com/showthread.php?743-Bringing-dhea-levels-up

 

[The Matrix]

SHBG is a sign something else is wrong specially with in the gut or liver inflammation.
It can also be from low carb as well. I see it a lot in ketogenic diet

 

[ManOfTheNorth]

Your thyroid medication might not be optimal.

"Our results support the following pathogenetic sequence: thyrotoxicosis leads to a rise in serum SHBG concentration which is accompanied by an increase in testosterone concentration, a fall in the concentration of non-SHBG-bound testosterone and little or no change in the concentration of free testosterone."

 

[ManOfTheNorth]

I can't post a link to the study.

 

[ManOfTheNorth]

Animal based thyroid medicine has a bad ratio of t3 and t4. Too much t3.

 

[ManOfTheNorth]

You could try replacing some of the natural thyroid medicine with t4. Your thyroid labs aren't too high though. Maybe it's not the causte

 

[The Matrix]

E2 was totally overlooked...

 

[kisaj]

Regarding your question, it appears your doctor is ignorant or simply doesn't care, but based on his dictation you may not get the treatment you want/need so if you have other options, I would look around. I went to 3 before I found one that actually treated me like a person rather than another co-pay to get in and out with a standard response.

 

[The Matrix]

Simple solution

Fire your doctor and find one that will listen...

 

[trtdoc]

Your free T is low due to the increase in shbg. Now, medium to higher levels of testosterone should Drop your shbg, it's
Just the mechanism of action at play. Are you supplementing with T?

Dr B

 

[The Matrix]

There is a reason for shbg going up.
Giving testosterone will mask the underlying issue. Shbg going up is a red herring for deeper issues needing further evaluations.

 

[trtdoc]

Always best to rule out anything serious before moving forward. If you are already seeing an endo, get a new one!

Dr. B