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Q. I am having low testosterone with high SHBG. Why?

Answered by
Dr. Shaikh Sadaf
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 22, 2019

Hello doctor,

I got bloodwork done for possible low T.

My SHBG is higher, out of the normal range, even though the rest of my blood work is very good to excellent. My doctor told me that this is uncommon. I am curious as to how concerned I should be about this?

Dr. Shaikh Sadaf

Diabetology Endocrinology
#

Hello,

Welcome to icliniq.com.

I read your query and seen your lab reports. (attachment removed to protect patient identiy).

Your report does suggest some concerning things such as high creatinine and low GFR (glomerular filtration rate), which suggest kidney dysfunction and a high SHBG (sex hormone binding globulin).

Increased SHBG levels may be seen in liver disease. I did not find any problem in your reports, but only with the knowledge about your health issues and with a proper medical history, I can find out if there is any underlying cause prevailing.

Overactive thyroid: your thyroid test results are good and suggest a normal thyroid function.

Eating disorders: I need more history from you to rule it out.

Decreased sex hormone production in men: that aspect is good in the test results.

So clearly it narrows down to your kidney function test which might be a possible reason here. Do you have any family history of kidney problems? Any Diabetes? Any excessive alcohol consumption or any over the counter medication intake?

Answers to these questions could shed some light on the reason for high SHBG.

I hope this helps.


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Thank you doctor,

1. No family history of kidney problems.

2. No diabetes.

3. Alcohol consumption has increased in the last few months. I have also been taking Tylenol Cold and Flu medicine (approximately 1.5 boxes past month). Approximately 20-25 drinks in a week. Mostly on weekends. Two to three drinks on a weekday. At times, I would take Tylenol Cold and Flu, sometimes in conjunction with alcohol, sometimes not in conjunction.

4. No eating disorders. I take approximately 180 gm of protein a day, and it varies by the day. This is an average. I do an intermittent fast. Do workout early in the morning (5 am) with a protein shake and a black coffee, both before and after the workout. Then for lunch and dinner, I have lean protein, a lot of veggies, and some fruits.

My blood pressure is 112/71 mmHg. I am muscular, lean, and very active. Supplements that I take are vitamin pack, high dose fish oil, creatine (5g a day), protein.

Dr. Shaikh Sadaf

Diabetology Endocrinology
#

Hello,

Welcome back to icliniq.com.

Then your creatinine and low GFR are due to a high protein diet. I would strictly advise you to avoid such a high protein diet. Just avoid protein extras and eat what is available in a normal routine diet.

Your drink must be less than 14 units a week.

Increase the intake of water.

Repeat your tests in a month and see if your results improve.

A visit to a nephrologist might be beneficial.

I hope this helps.


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