High SHBG / Weakness

marsaday

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Mar 8, 2015
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I have just had some blood tests done in January.

I am experiencing some strange physical symptoms which are quite new. I have been having pains in my arms last year and went to the doctor thinking it maybe arthritis. I had some blood tests done and the inflammation marker was low, so no issue with arthritis i was told.

Anyway my pains have gotten stronger and i am significantly weaker in my forearm and hand area. My knees are also feeling pretty weak.

I am fit and healthy generally, but these pains have really started to get to me now. Hence i had some blood tests done privately.

They show i am low in androgens (at the bottom of the androgen scale), even though testosterone is ok, but it is the high SHBG which is the killer. These are the results:

FOLLICLE STIM. HORMONE 11.8 IU/L 1.50 - 12.40

LUTEINISING HORMONE 7.01 IU/L 1.70 - 8.60

TESTOSTERONE 18.4 nmol/L 8.64 - 29.00

FREE-TESTOSTERONE(CALCULATED) 0.278 nmol/L 0.20 - 0.62

SEX HORMONE BINDING GLOB 54.3 nmol/L 18.30 - 54.10

FREE ANDROGEN INDEX 33.89 Ratio 24.00 - 104.00

17-BETA OESTRADIOL 93.4 pmol/L 41.00 - 159.00

PROLACTIN 263 mIU/L 86.00 - 324.00

I take T4 for hypothyroidism and it is common for thyroid patients to get achy joints, but i never have (until this last year). But my thyroid results are fine. I would say my FT4 would be a little better lower, but generally all good and pretty typical.

THYROID STIMULATING HORMONE 1.39 mIU/L 0.27 - 4.20

FREE THYROXINE 21.700 pmol/L 12.00 - 22.00

FREE T3 4.9 pmol/L 3.10 - 6.80

I am not sure where to go for some help because in the UK we don't really have a system which looks at male hormone health, unless everything is really low. I doubt i will get much help with these results.

What do people think could be the problem ?

I eat a pretty clean diet, don't drink much alcohol and don't smoke. I am always steady with my weight at 80kg and don't carry much fat on the stomach. I don't work out in a gym, but i play football and am pretty active and have a manual job doing construction. I am mid 40's.

Final bit of info which may be relevant; i am sure i have only one working testicle as had one undescended at birth and so had an operation pre puberty. I know i have damaged sperm production as we have undergone fertility help 5 years ago. Hence my always high FSH level (please make more sperm mr testicle).

Thanks for reading any comments appreciated.
 

Hans

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Your cortisol might be high, which is causing muscle weakness and which could also explain the elevated estrogen and prolactin due to elevated aromatase.
Muscle weakness can also be due to low DHT, DHEA, ATP, etc, which is a result of non-optimal mitochondria, nutrient deficiency (calcium, magnesium, vit K, etc.), low calories, stress, etc.
What does your diet look like? Do you bloat after a meal, have indigestion, trouble bowel movements?
How is your overall stress levels?
Do you sleep enough?
 
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marsaday

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Hi Hans

I have done some cortisol profiles over the years but nothing in the last few years as my health has been very good.

My profile is good. Higher in the morning and declining during the day. It was not excessively high.

As to sleeping, i sleep really well and have a normal routine of lights out by 11pm and up at 7-8am. I am married and have kids so we have a pretty set routine.

I take vitamin D in the winter and use magnesium spray, and take a good multi vitamin and mineral supplement 3 times per week. I don't go over the top with supplements. I am sure this is not down to Vitamin K deficiency but i am not using vitamin K.

When i eat don't have indigestion or bowel troubles. I may have a little bloating and i think this is more common recently. I am aware in the past that stomach bloating has been a sign i am not well (thyroid related) but i haven't been having this issue so much in the last few years, but it may be coming back a little. It is subtle and not as bad as before.

This is a typical day for eating:

Breakfast: museli or porridge + cup of tea. This never changes all year. I am pretty set on this pattern. I don't feel i need a big breakfast.

Mid morning: coffee and toast

Lunch: Soup (vegetable and a meat such as chicken or bacon), bread, pastry

afternoon: coffee, pastry or toast maybe some fruit.

Evening meal: Home made by my wife. always varies, but a proper hot meal with vegetables. could be a pasta or rich dish, or meat and potatoes with vegetables, we have fish once per week usually.

always have a cake or something sweet after main meal plus cup of tea.

I have been trying to drink a glass of milk when i go to sleep and have noticed i feel more alert when i wake up.

I am sure i need more fruit in my diet.

I was working yesterday and had to cut a tree down. My arms were really weak moving a ladder about and for the first time in my life i think i know what it feels like to be an older person going about their day.

PS. I have some androsterone and pansterone, but i don't use them. I cant say the androsterone does anything. I only used 2 drops per day at bedtime. The pansterone made be feel very tight in my stomach with only one drop so i don't use it.

Sex drive is still good and erections not an issue.

I missed my DHEA result off: D.H.E.A. SULPHATE 6.570 umol/L 1.20 - 8.98
 
Last edited:

Soundios

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Hi Hans

I have done some cortisol profiles over the years but nothing in the last few years as my health has been very good.

My profile is good. Higher in the morning and declining during the day. It was not excessively high.

As to sleeping, i sleep really well and have a normal routine of lights out by 11pm and up at 7-8am. I am married and have kids so we have a pretty set routine.

I take vitamin D in the winter and use magnesium spray, and take a good multi vitamin and mineral supplement 3 times per week. I don't go over the top with supplements. I am sure this is not down to Vitamin K deficiency but i am not using vitamin K.

When i eat don't have indigestion or bowel troubles. I may have a little bloating and i think this is more common recently. I am aware in the past that stomach bloating has been a sign i am not well (thyroid related) but i haven't been having this issue so much in the last few years, but it may be coming back a little. It is subtle and not as bad as before.

This is a typical day for eating:

Breakfast: museli or porridge + cup of tea. This never changes all year. I am pretty set on this pattern. I don't feel i need a big breakfast.

Mid morning: coffee and toast

Lunch: Soup (vegetable and a meat such as chicken or bacon), bread, pastry

afternoon: coffee, pastry or toast maybe some fruit.

Evening meal: Home made by my wife. always varies, but a proper hot meal with vegetables. could be a pasta or rich dish, or meat and potatoes with vegetables, we have fish once per week usually.

always have a cake or something sweet after main meal plus cup of tea.

I have been trying to drink a glass of milk when i go to sleep and have noticed i feel more alert when i wake up.

I am sure i need more fruit in my diet.

I was working yesterday and had to cut a tree down. My arms were really weak moving a ladder about and for the first time in my life i think i know what it feels like to be an older person going about their day.

PS. I have some androsterone and pansterone, but i don't use them. I cant say the androsterone does anything. I only used 2 drops per day at bedtime. The pansterone made be feel very tight in my stomach with only one drop so i don't use it.

Sex drive is still good and erections not an issue.

I missed my DHEA result off: D.H.E.A. SULPHATE 6.570 umol/L 1.20 - 8.98
Hi Marsaday. Fructose consumption has been linked to lower SHBG.
 

haidut

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I have just had some blood tests done in January.

I am experiencing some strange physical symptoms which are quite new. I have been having pains in my arms last year and went to the doctor thinking it maybe arthritis. I had some blood tests done and the inflammation marker was low, so no issue with arthritis i was told.

Anyway my pains have gotten stronger and i am significantly weaker in my forearm and hand area. My knees are also feeling pretty weak.

I am fit and healthy generally, but these pains have really started to get to me now. Hence i had some blood tests done privately.

They show i am low in androgens (at the bottom of the androgen scale), even though testosterone is ok, but it is the high SHBG which is the killer. These are the results:

FOLLICLE STIM. HORMONE 11.8 IU/L 1.50 - 12.40

LUTEINISING HORMONE 7.01 IU/L 1.70 - 8.60

TESTOSTERONE 18.4 nmol/L 8.64 - 29.00

FREE-TESTOSTERONE(CALCULATED) 0.278 nmol/L 0.20 - 0.62

SEX HORMONE BINDING GLOB 54.3 nmol/L 18.30 - 54.10

FREE ANDROGEN INDEX 33.89 Ratio 24.00 - 104.00

17-BETA OESTRADIOL 93.4 pmol/L 41.00 - 159.00

PROLACTIN 263 mIU/L 86.00 - 324.00

I take T4 for hypothyroidism and it is common for thyroid patients to get achy joints, but i never have (until this last year). But my thyroid results are fine. I would say my FT4 would be a little better lower, but generally all good and pretty typical.

THYROID STIMULATING HORMONE 1.39 mIU/L 0.27 - 4.20

FREE THYROXINE 21.700 pmol/L 12.00 - 22.00

FREE T3 4.9 pmol/L 3.10 - 6.80

I am not sure where to go for some help because in the UK we don't really have a system which looks at male hormone health, unless everything is really low. I doubt i will get much help with these results.

What do people think could be the problem ?

I eat a pretty clean diet, don't drink much alcohol and don't smoke. I am always steady with my weight at 80kg and don't carry much fat on the stomach. I don't work out in a gym, but i play football and am pretty active and have a manual job doing construction. I am mid 40's.

Final bit of info which may be relevant; i am sure i have only one working testicle as had one undescended at birth and so had an operation pre puberty. I know i have damaged sperm production as we have undergone fertility help 5 years ago. Hence my always high FSH level (please make more sperm mr testicle).

Thanks for reading any comments appreciated.

I second what @Hans is saying - muscle weakness may be due to elevated cortisol or at least elevated cortisol/DHEA ratio even if cortisol is in range. So, I would ask your doctor to do tests for cortisol (both AM and PM), DHEA, DHEA-S, CK, LDH, and kidney/liver panel.
Paradoxically, low cortisol can also cause muscle weakness and especially joint pain but this situation is usually seen in adrenal failure (Addison disease), which is pretty rare.
 
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marsaday

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481
So to get more fructose into the body would this be a case of eating more fruit ?

I think i do eat quite a carby diet.

Has anyone used nettle tea before ? I have got some and have started to use it.
 

Kelj

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Messages
299
I think the connection Hans makes to low calories is the correct answer. It is commonly misunderstood how a consistent and inconsistent low calorie intake affects our health. The eating disorder information website edinstitute.com explains that a healthy man within the normal height range over age 25 needs EVERY DAY a MINIMUM of 3000 calories to keep their bodies operating well. If that man has a physically demanding job, he must eat EVERY DAY, MORE than that. If a man eats consistently under that calorie amount, his metabolism will be lowered so as not to run through his daily calories too quickly. He will gradually experience loss of energy and function because he doesn't consistently eat enough for his body to remodel itself. If he sometimes eats more calories in a day than his lowered metabolism uses, they will be stored as fat to protect the body for an uncertain future. Inconsistently eating enough, is the cause of obesity. In your case, it looks like consistently under eating, as you say your stomach is flat. I once made a very large pot of soup with vegetables, pasta and sausage, trying to put as many calories into it as possible and the whole pot was under 2000 calories. You typically eat soup for lunch. That can never be many calories. I know from experience that we can never really know how many calories we eat unless we add them up. Everyone says they eat too much, but I have yet to find anyone who eats their minimum calories consistently, every day. This is so common these days because everyone in American culture and through American culture via American media out to the rest of the world has been brainwashed into eating less and exercising more, creating energy deficits which are at the bottom of every disease, symptoms like high blood sugar and low thyroid, and all obesity. The calorie touchstone of 2000 calories is not enough to keep anyone's body functioning properly. This is what I would do if I were you, have done, and have seen others I advise do to regain strength and body function: 1. Ray Peat says people are usually better when they get off all their supplements. I agree. You take a lot. Probably, you progressively took more and more to solve some of your problems. The Minnesota Starvation Experiment clearly showed that no amount of supplementation helped its subjects recover strength and vitality until they were eating an abundance of calories. 2. Start adding up the calories of what you eat. Realize that if you Don't consistently eat 3500-4000 calories doing your job, and especially because you need to recover, you will continue to degenerate your energy. Your job is to eat. Don't guess about the calories. If you have been undereating you may put some fat on, AT FIRST. This will go away on its own if you consistently eat ABOVE your body's minimum requirement of 3000 calories FOREVER. Do not work until you have eaten a substantial breakfast. You may experience some pain and swelling as some parts of your body begin to heal. Be patient, and work around it as best you can. 3. Rest as much as possible to conserve calories for healing. Exercise does not create energy, it uses it. If you exercise, you must eat even more.
You can recover your strength. You Don't need to feel like an old man at any age. Food is energy. Eat. Eat. Eat.
 
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marsaday

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I can try i suppose, but i have a natural limit on what i can eat.

I don't take a lot of supplements as well. Just Bit D and a multi vitamin and i don't take them religiously.

I am getting some new blood tests from the doctors next week. I have also got some heart scan results back and it looks like i have some blockages in my heart. So now i have to take a low dose aspirin a day, plus they want me on statins. I am doing a lot of research at the moment. I will make another post about the heart results to see what people think.
 

sweetpeat

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I don't know if this has any bearing on your situation, but it seems to me your thyroid hormones may be a bit out of balance even though they are technically in range. What I mean by that is T4 is at the top of the range but t3 is at mid-range. It suggests under-utilization of t4, like poor conversion or something. I mention it because you mentioned digestive issues above and for me that's one of the first signs I get when I need to raise t3 in the fall after lowering it in the summer. Maybe you need to add in a little t3 since it's winter?
 
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marsaday

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Yes it's a good point and something which worries me. My FT4 should be a little lower and the Ft3 a little higher (based on past bloods over the years).

TSH has come up as i would expect. My T4 intake has dropped by 12.5mcg per day to 112.5mcg and this has been since december, so this may explain the lower FT3 and higher TSH, but the Ft4 is still high in range.

Anyway i am trying an increase to 125mcg T4 per day and will see how this works out. I am having new bloods done next week as i have been to the doctor about this issue.

This dose drop may also explain why i am getting these pains. I suppose i will find out the answer eventually.
 

Kelj

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Yes it's a good point and something which worries me. My FT4 should be a little lower and the Ft3 a little higher (based on past bloods over the years).

TSH has come up as i would expect. My T4 intake has dropped by 12.5mcg per day to 112.5mcg and this has been since december, so this may explain the lower FT3 and higher TSH, but the Ft4 is still high in range.

Anyway i am trying an increase to 125mcg T4 per day and will see how this works out. I am having new bloods done next week as i have been to the doctor about this issue.

This dose drop may also explain why i am getting these pains. I suppose i will find out the answer eventually.
Hi, Marsaday! I commented earlier about eating more to facilitate the healing your body is initiating. To say "eat more", I know, is opposite world. Here is why I say it. Pain is a sign your body is attempting to heal. Inflammation is part of the healing process. Your body can and will heal everything with enough energy. The people who know all about this are some of the more enlightened people who work in eating disorder recovery. Even if you Don't have a disorder that enables you to harm yourself when you know you're harming yourself, you can accidentally harm yourself by following the "eat less, calories are bad" mentality. Our bodies must have a certain amount of calories to remodel our tissues every day. Damage accumulates if we Don't. When we begin to eat a bit more at any time, deliberately or not, healing will be initiated by our body. You will feel pain. Here is a quote from the edinstitute on why we Don't feel pain when restricting calories, but do when we eat enough:

"why is there so much pain when I felt fine all while I was starving, exercising demonically, cycling through starving and eating cycles, actively purging (and so on)?

Your body is severely damaged. The pain, the aches, the fatigue, the discomfort and the water retention are there to force some immobility so that the body can attend to repairs."
It is my experience that particular pain in a particular spot may relate to something in that exact spot or to the nerve pathway. You can trace it from acupressure points. But, what to do about the Pain? All the guesswork takes time. Even if you have labs done and it shows you are low or high in this or that, what do you do then? Take something? There are many things that become worse when supplementing. Doc Peat says the safest supplement is vitamin e and everything else is experimentation. It makes for great conversation to haggle it all out, but is the biomarker even related to the pain? You know what knows the answers? Your body, connected to the outside world through your central nervous system. Your body knows what is going on and what it needs. Energy, first and foremost. What can be done without energy? And building materials. Your body can tell you the specific things it needs to do the job. We have to get out of its way and respond to it's directives. When to eat, how much to eat, what to eat. We make rules about these things which hamper us. When we try to apply our intellect to what only our body really knows, we mess things up. Our body uses food to pull from the food the specific things we need with no side effects. If you feel a real hankering suddenly for oranges, and you sit down and keep peeling oranges until you have eaten twenty oranges and then you say to yourself, "I couldn't eat another orange", that's what I'm talking about. You may not want another Orange for six months. If you say to yourself, "I want that many oranges, but it's obscene to eat that much", you are applying intellect and rules to what only your body knows. If the body CAN eat that much of something, anything, it's because it needs it. You can hardly swallow when you Don't need something. Here are the things my body and my husband's body spontaneously healed when the only things we changed were eating as much as we desired, and eating what we felt like and when: tmj, painful knees, painful elbow, arthritic fingers (straightened, too), rosacea, testicular atrophy, thinning hair, low temperature, overweight, low energy, muscle wasting, blurry vision, loss of hearing, receding gums. And more. I'm not kidding. Whatever is causing the pain you are experiencing, your body is onto it and wants to finish the job. Enough, with consistency and whatever the body wants needs to be you motto (and everyone elses). My husband is from England. We spend a lot of time there. There is a cultural pressure there to eat only if everyone else with you is eating. You Can't do that if you want to heal. Your body decides.
 
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marsaday

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But i am not someone who diets or ever has. I eat what i want. I just don't eat the amounts you are talking about. At christmas i did and i put on a little weight but i feel uncomfortable with this bloated over fed state. So i naturally eat a bit less after christmas and return to my steady 80kg.

I have tried increasing the T4 and i feel worse, so i am now trying less T4 and am seeing how this goes. It is 5 days now on less T4. From 112.5 average to 75mcg now. I notice a little tiredness is creeping in, but i am generally feeling ok. I am seeing how a little more T3 works out as well. So today taken 2 x 2.5mcg doses.

If things do improve on less T4 then the culprit may well be to much T4 affecting the joints. Whether this is down to RT3 i don't know.

So if anyone has any experience of joint pains and general muscle weakness due to high T4 this would be good to hear.
 
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marsaday

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Update:

It’s definitely the t4. I am experiencing really good health again plus feel much warmer in the day.

I have now reduced down from 112.5 t4 to 50mcg per day.

The aches are going and strength is returning.

I know excess t3 causes muscle weakness. As I mentioned above I wonder if rt3 is involved here. Now I am on less t4 the rt3 will drop down.

My BP has also dropped back as this has been high since the muscle/ joint issues started.

So why do I need less t4 after many years on it st a fairly stable dose. I wonder if better metabolic health has reduced the need for as much external t4.
 

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