Latest blood test: TT, free T, SHBG don't seem to add up

[Mprtz]

Just got my latest bloodwork result and am a bit puzzled by the results.
Last time around, I had a very high free T and high percentage (6%), from which I concluded that my SHBG must be very low - but the test results showed otherwise:

Testosterone, Serum 1419 HIGH 348-1197 ng/dL
Testosterone,Free 64.42 HIGH 5.00-21.00 ng/dL
% Free Testosterone 4.54 HIGH 1.50-4.20 %
Sex Horm Binding Glob, Serum 37.0 19.3-76.4 nmol/L
Albumin, Serum 4.2 3.5-5.5 g/dL

I ran the Free & Bio T calculator and the result doesn't fit the data at all, calculating a 2.56% free and 58.8% free and bioavailable percentage from the above values.

Any ideas of what could cause this discrepancy?

 

[Mprtz]

Bump - no ideas? Should I post my whole bloodwork? I'm pretty happy with it.

I was particularly happy to see my HDL back over 50... In the first year of TRT my HDL went from 58 to 55 to 45... a trend I was kind of worried about. Last test had HDL at 52, breaking the pattern.

 

[Megatron28]

What is your estradiol at? Don't forget that estradiol binds to SHBG too.

 

[Mprtz]

What is your estradiol at? Don't forget that estradiol binds to SHBG too.

Estradiol, Sensitive 14 3-70 pg/mL ( a little lower than where I'd like it to be ).

Because my free T ratio was so high, I was concerned my SHBG must be really low and that my free estradiol could be similarly high. I upped my adex dose slightly in the two weeks leading up to this test. Looks like I should drop back down to 0.5mg / week.

I was really surprised to see SHBG come back midrange, and it has eased my fears a little.

I've been feeling that there's something slightly different about how my nipples feel. I don't think there is any visual difference and it might be pure hypochondria.

Maybe I should have added prolactin to the test? I almost did but frugality won out. I've never taken a 19-nor, what are the odds that prolactin is high for some reason?

 

[Megatron28]

I think thyroid levels can affect your SHBG if I remember right. Wouldn't suppose you also have TSH numbers to see if they have changed over time?

 

[Megatron28]

So since you have low E2, that means more of your SHBG is left available to bind to your T. Thus less of your T is free.

 

[Mprtz]

I think thyroid levels can affect your SHBG if I remember right. Wouldn't suppose you also have TSH numbers to see if they have changed over time?

Thyroid is something I've never paid much attention to... always assumed I was pretty normal in that respect. Thanks for taking a look.

8-3-2013:
TSH 2.850 0.450-4.500 uIU/mL SE
Thyroxine (T4) 6.3 4.5-12.0 ug/dL SE
T3 Uptake 34 24-39 % SE
Free Thyroxine Index 2.1 1.2-4.9 SE

12-19-2013:
TSH 2.200 0.450-4.500 uIU/mL SE
Thyroxine (T4) 6.3 4.5-12.0 ug/dL SE
T3 Uptake 36 24-39 % SE
Free Thyroxine Index 2.3 1.2-4.9 SE

3-26-2014:
TSH 1.980 0.450-4.500 uIU/mL SE
Thyroxine (T4) 7.6 4.5-12.0 ug/dL SE
T3 Uptake 33 24-39 % SE
Free Thyroxine Index 2.5 1.2-4.9 SE

7-14-2014:
TSH 2.320 0.450-4.500 uIU/mL 01
Thyroxine (T4) 7.6 4.5-12.0 ug/dL 01
T3 Uptake 35 24-39 % 01
Free Thyroxine Index 2.7 1.2-4.9 01

 

[Mprtz]

So since you have low E2, that means more of your SHBG is left available to bind to your T. Thus less of your T is free.

Yes I suppose, but given the 50 to 1 ratio or so of T to E2 I wouldn't think the effect would be huge. I remain puzzled by the large discrepancy between my test results and the calculated relationship of T/Free T/SHBG/Albumin

EDIT: actually 100 to 1 in my last test, clearly not ideal.

 

[Megatron28]

Thyroid is something I've never paid much attention to... always assumed I was pretty normal in that respect. Thanks for taking a look.

8-3-2013:
TSH 2.850 0.450-4.500 uIU/mL SE
Thyroxine (T4) 6.3 4.5-12.0 ug/dL SE
T3 Uptake 34 24-39 % SE
Free Thyroxine Index 2.1 1.2-4.9 SE

12-19-2013:
TSH 2.200 0.450-4.500 uIU/mL SE
Thyroxine (T4) 6.3 4.5-12.0 ug/dL SE
T3 Uptake 36 24-39 % SE
Free Thyroxine Index 2.3 1.2-4.9 SE

3-26-2014:
TSH 1.980 0.450-4.500 uIU/mL SE
Thyroxine (T4) 7.6 4.5-12.0 ug/dL SE
T3 Uptake 33 24-39 % SE
Free Thyroxine Index 2.5 1.2-4.9 SE

7-14-2014:
TSH 2.320 0.450-4.500 uIU/mL 01
Thyroxine (T4) 7.6 4.5-12.0 ug/dL 01
T3 Uptake 35 24-39 % 01
Free Thyroxine Index 2.7 1.2-4.9 01

Looks fine now, but your first result was putting you pretty close to hypothyroidism back then. TSH over 3.0 is often considered hypothyroid.