I am a 31M, around 5’9”. I have been body building since I was 16. Did powerlifting for a while when I was 21-23; it was just a hobby and I did not use gear. I only used supplements (creatine, glutamine, preworkouts, multivitamins, etc.)
I suffered from low T symptoms since mid-20s, and struggled so much with it and been diagnosed with clinical depression/ED/etc., without physical checkup or blood work until I took charge of my health. If you don’t want to read the backstory and other details, those are my recent results:
Everlywell Men's Health Test (5 months ago). I was taking DHEA supplement for two months.
QuestDiagnostics (4 months ago). I was overweight, no exercise, on a bad diet, and smoking.
TRT clinic (today). I was working out and on a strict diet and stopped smoking.
Obviously, my SHBG is high. This is probably the cause of low free T, even though I improved my total T a bit.
Questions (I appreciate all the help and advice):
- Should I do a specific bloodwork, physical exam, MRI (e.g., to eliminate any pituitary tumor suspicion)?
- Is there any marker I need to look for? Maybe thyroid (e.g., TSH, T3, T4)? DHT?
- Any general advice/guidance? Should I hop on TRT if nothing else works?
__________________________________________________________________________________________________
— Symptom history: During puberty, I noticed some weird changes in my body's composition: I had mild symptoms of gyno and more fat in the thighs/buttocks area, an obvious hormonal imbalance problem since my family members are mostly lean there. Those stubborn fats mostly go away if I get lean, but are there if I am normal weight. I learned to live with it, even though it made me insecure for a while. I did not notice any other changes until I reached my early 20s, during which some low T symptoms started appearing, but they were mild. In my mid 20s (around 24-25), I went through a tough year: too much work/studying, horrible breakup, and other personal problems. I started feeling more tired and depressed, and my libido and erection went downhill. My memory and focus were that of a grandpa; sometimes it is hard to recollect a story or make a proper sentence! I went to several doctors. Some told me I was depressed or suffered PTSD, and others told me it was in my head (i.e., performance anxiety/stress), or that my diet and sleep were bad. But how is that the case? All of those symptoms seem to point to low T and hypogonadism. No one bothered to do a bloodwork or do a physical exam. My symptoms fluctuated throughout those years–one week I am too energetic and horny and happy, and one week I will die if I masturbate and I just feel depressed and cannot focus on anything. It was puzzling, but I managed to live with it and thought I was just stressed and depressed as they said, and took anti-depressants (SSRIs, NDRIs, and Xanax/Clonazepam) as suggested by psychiatrists. Big mistake, of course, as the anti-depressants made my symptoms even worse, and I had to stop after two years; could not take the side-effects anymore, and I had to find the root cause of the problem. The moment I stopped the anti-depressants my libido and focus went through the roof, and I started feeling a bit normal. This was the best phase throughout my journey. After this phase, things tapered again and the symptoms fluctuations came back.
— Bloodwork results: At 30, I started reading more about low T and hypogonadism. I went and did a blood test with Everlywell, and it showed the following:
- T (free): 25.9 pg/mL = 2.59 ng/dL
- DHEA-S: 9.75 ng/mL
- Cortisol "Saliva": 3 ng/mL
- Estradiol: 24.2 pg/mL = 2.42 ng/dL
Super low free T, and a bit high DHEA (I was taking DHEA as a supplement at the time, so it is not a major problem). The low free T shocked me and yet made me happy. At least I know something is wrong with my hormones; I was not crazy or mentally ill as they said, something was wrong with me. I needed to know the total T though. I went to QuestDiagnostics through a urologist and those were my results:
- T (total): 505 ng/dl
- FSH: 4.6 mlU/mL
- LH: 2.3 mlU/ml
- Prolactin: 8.5 ng/mL
Relatively low T, and low LH. To me it was fine since I wasn’t healthy nor working out and I was overweight. My main concern was the free T (it was 0.5% of my total T). I wanted to also know my estradiol, SHBG, free T (again), and DHT, but the doctor refused and said this will suffice and I don't need to bother! Nevertheless, I went after that to two other urologists and one family doctor, and they all said I just need to fix my diet, sleep well, relax, and take Cialis. They claim it is all in my head and due to my daily habits. I did what they said and more: started working out again, and went on a strict diet, started sleeping well, and took enough supplements, and yes, I started feeling better overall (energy wise), but my focus, memory, and sexual problems persisted. Nothing really helped cure my problems. My symptoms still fluctuate no matter what I do and despite general improvements in health.
Two weeks ago, I went to do a more comprehensive test to check my liver and kidney functions as well as other metrics:
High AST and ALT due to large alcohol consumption the night before.
Last week, I went to a (supposedly) good men’s health clinic. They read my previous total T and free T, and said we need to re-confirm, and see what is my SHBG to be qualified for the treatment. The result came in yesterday:
- T (total): 650 ng/dl
- T (free): 7.06 ng/dL
- SHBG: 60.2 nmol/L
- Estradiol: 30.2 pg/mL = 3.02 ng/dL
It all makes sense now. I do indeed have a high SHBG, and I still don’t know why no doctor bothered to check it! (I think I improved my total T and free T (1% of total T), so that is a good thing at least.)
— Men’s health clinic experience today: When I went to the clinic to discuss the results, the nurse sat me down and immediately pulled two syringes explaining the dosage amount! Really? How about we talk first about the cause of increased SHBG (liver problem, type-2 diabetes, hyperthyroid, genetics, etc.), diet, or other things like vitamin deficiencies? Side effects? History of symptoms? I am not an expert, but I have learned enough in the past years to know not to just follow doctors blindly. I started asking questions and she started getting bothered, unhappy that I am hesitant about starting the treatment today.
She said: “if we start today we are going with a low dose, 150 mg, and put you on low dose of hcg as well, so it is not like an athletic dosage overall and it will not shut down your natural production.”
I asked more questions, and she acted like my whole existence in that moment bothered her. She got even more irritated and asked: “so you don’t want to be on TRT?”
I answered: “I mean, it is a life commitment and we still did not check organs functions before TRT, and un my case it is like a band-aid not a solution since my total T and other hormones are normal, except for SHBG/free T, which are correlated. I think it is wiser to figure out what is causing my SHBG to be that high and whether Proviron for example would help fix it or not, and whether it is genetic or not.”
She got more irritated and opened the door and said: “well I have other patients waiting.” I left and ignored this whole clinic.
All I can say, be careful of those clinics, most of them don’t care about “men’s health.” They just want you on TRT, and that is it. How about advise me to go to an endocrinologist and do screening and seek some solutions before? Are not you gonna check my health before putting two syringes in me? A lot of doctors have agenda, and some are just ignorant or not educated enough. This includes psychologists/psychiatrists/family doctors. They made me think I am clinically depressed for the past 4-5 years even though my depression seems to be due to hormonal imbalance.
I am a 31M, around 5’9”. I have been body building since I was 16. Did powerlifting for a while when I was 21-23; it was just a hobby and I did not use gear. I only used supplements (creatine, glutamine, preworkouts, multivitamins, etc.)I suffered from low T symptoms since mid-20s, and struggled so much with it and been diagnosed with clinical depression/ED/etc., without physical checkup or blood work until I took charge of my health. If you don’t want to read the backstory and other details, those are my recent results:Everlywell Men's Health Test (5 months ago). I was taking DHEA supplement for two months.QuestDiagnostics (4 months ago). I was overweight, no exercise, on a bad diet, and smoking.TRT clinic (today). I was working out and on a strict diet and stopped smoking.Obviously, my SHBG is high. This is probably the cause of low free T, even though I improved my total T a bit.Questions (I appreciate all the help and advice):Should I do a specific bloodwork, physical exam, MRI (e.g., to eliminate any pituitary tumor suspicion)?Is there any marker I need to look for? Maybe thyroid (e.g., TSH, T3, T4)? DHT?Any general advice/guidance? Should I hop on TRT if nothing else works?__________________________________________________________________________________________________— Symptom history: During puberty, I noticed some weird changes in my body's composition: I had mild symptoms of gyno and more fat in the thighs/buttocks area, an obvious hormonal imbalance problem since my family members are mostly lean there. Those stubborn fats mostly go away if I get lean, but are there if I am normal weight. I learned to live with it, even though it made me insecure for a while. I did not notice any other changes until I reached my early 20s, during which some low T symptoms started appearing, but they were mild. In my mid 20s (around 24-25), I went through a tough year: too much work/studying, horrible breakup, and other personal problems. I started feeling more tired and depressed, and my libido and erection went downhill. My memory and focus were that of a grandpa; sometimes it is hard to recollect a story or make a proper sentence! I went to several doctors. Some told me I was depressed or suffered PTSD, and others told me it was in my head (i.e., performance anxiety/stress), or that my diet and sleep were bad. But how is that the case? All of those symptoms seem to point to low T and hypogonadism. No one bothered to do a bloodwork or do a physical exam. My symptoms fluctuated throughout those years–one week I am too energetic and horny and happy, and one week I will die if I masturbate and I just feel depressed and cannot focus on anything. It was puzzling, but I managed to live with it and thought I was just stressed and depressed as they said, and took anti-depressants (SSRIs, NDRIs, and Xanax/Clonazepam) as suggested by psychiatrists. Big mistake, of course, as the anti-depressants made my symptoms even worse, and I had to stop after two years; could not take the side-effects anymore, and I had to find the root cause of the problem. The moment I stopped the anti-depressants my libido and focus went through the roof, and I started feeling a bit normal. This was the best phase throughout my journey. After this phase, things tapered again and the symptoms fluctuations came back.— Bloodwork results: At 30, I started reading more about low T and hypogonadism. I went and did a blood test with Everlywell, and it showed the following:T (free): 25.9 pg/mL = 2.59 ng/dLDHEA-S: 9.75 ng/mLCortisol "Saliva": 3 ng/mLEstradiol: 24.2 pg/mL = 2.42 ng/dLSuper low free T, and a bit high DHEA (I was taking DHEA as a supplement at the time, so it is not a major problem). The low free T shocked me and yet made me happy. At least I know something is wrong with my hormones; I was not crazy or mentally ill as they said, something was wrong with me. I needed to know the total T though. I went to QuestDiagnostics through a urologist and those were my results:T (total): 505 ng/dlFSH: 4.6 mlU/mLLH: 2.3 mlU/mlProlactin: 8.5 ng/mLRelatively low T, and low LH. To me it was fine since I wasn’t healthy nor working out and I was overweight. My main concern was the free T (it was 0.5% of my total T). I wanted to also know my estradiol, SHBG, free T (again), and DHT, but the doctor refused and said this will suffice and I don't need to bother! Nevertheless, I went after that to two other urologists and one family doctor, and they all said I just need to fix my diet, sleep well, relax, and take Cialis. They claim it is all in my head and due to my daily habits. I did what they said and more: started working out again, and went on a strict diet, started sleeping well, and took enough supplements, and yes, I started feeling better overall (energy wise), but my focus, memory, and sexual problems persisted. Nothing really helped cure my problems. My symptoms still fluctuate no matter what I do and despite general improvements in health.Two weeks ago, I went to do a more comprehensive test to check my liver and kidney functions as well as other metrics:High AST and ALT due to large alcohol consumption the night before.Last week, I went to a (supposedly) good men’s health clinic. They read my previous total T and free T, and said we need to re-confirm, and see what is my SHBG to be qualified for the treatment. The result came in yesterday:T (total): 650 ng/dlT (free): 7.06 ng/dLSHBG: 60.2 nmol/LEstradiol: 30.2 pg/mL = 3.02 ng/dLIt all makes sense now. I do indeed have a high SHBG, and I still don’t know why no doctor bothered to check it! (I think I improved my total T and free T (1% of total T), so that is a good thing at least.)— Men’s health clinic experience today: When I went to the clinic to discuss the results, the nurse sat me down and immediately pulled two syringes explaining the dosage amount! Really? How about we talk first about the cause of increased SHBG (liver problem, type-2 diabetes, hyperthyroid, genetics, etc.), diet, or other things like vitamin deficiencies? Side effects? History of symptoms? I am not an expert, but I have learned enough in the past years to know not to just follow doctors blindly. I started asking questions and she started getting bothered, unhappy that I am hesitant about starting the treatment today.She said: “if we start today we are going with a low dose, 150 mg, and put you on low dose of hcg as well, so it is not like an athletic dosage overall and it will not shut down your natural production.”I asked more questions, and she acted like my whole existence in that moment bothered her. She got even more irritated and asked: “so you don’t want to be on TRT?”I answered: “I mean, it is a life commitment and we still did not check organs functions before TRT, and un my case it is like a band-aid not a solution since my total T and other hormones are normal, except for SHBG/free T, which are correlated. I think it is wiser to figure out what is causing my SHBG to be that high and whether Proviron for example would help fix it or not, and whether it is genetic or not.”She got more irritated and opened the door and said: “well I have other patients waiting.” I left and ignored this whole clinic.All I can say, be careful of those clinics, most of them don’t care about “men’s health.” They just want you on TRT, and that is it. How about advise me to go to an endocrinologist and do screening and seek some solutions before? Are not you gonna check my health before putting two syringes in me? A lot of doctors have agenda, and some are just ignorant or not educated enough. This includes psychologists/psychiatrists/family doctors. They made me think I am clinically depressed for the past 4-5 years even though my depression seems to be due to hormonal imbalance. https://ift.tt/eA8V8J https://ift.tt/2V6r1II
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