I am having low testosterone with high SHBG. Why?
Patient's Query
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.
Please advise.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and saw your lab reports. (Attachment removed to protect patient identity). Your report does suggest some concerning things.
1. High creatinine and low GFR (glomerular filtration rate), which suggest kidney dysfunction and a high SHBG (sex hormone binding globulin).
2. Increased SHBG levels may be seen in liver disease. I did not find any problem in your reports, but with the knowledge about your health issues and with a proper medical history, I can find out if there is any underlying cause prevailing.
3. Overactive thyroid: Your thyroid test results are good and suggest a normal thyroid function.
4. Eating disorders: I need more history from you to rule it out.
5. 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.
Thank you.
Patient's Query
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 in the past month). Approximately 20 to 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 6.4 oz of protein a day, and it varies by the day. This is an average. I do an intermittent fast and work out 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.
5. My blood pressure is 112/71 mmHg. I am muscular, lean, and very active. Supplements that I take are a vitamin pack, high-dose fish oil, creatine (0.1 oz a day), and protein.
Please help.
Thank you.
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.
1. Just avoid protein extras and eat what is available in a normal routine diet.
2. Your drink must be less than 14 units a week.
3. Increase the intake of water.
4. Repeat your tests in a month and see if your results improve.
5. A visit to a nephrologist might be beneficial.
I hope this helps.
Thank you.
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