Dr Kyle Gillett MD discusses how to fix high total testosterone, with high SHBG and low free testosterone! He talks about options to treat high sex hormone binding globulin levels in males, with high total T and low free T.
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A lot of men are having in their blood Work meet normal total testosterone Levels but with a high shpg and as a Result of course they have a low-free Testosterone if they are suffering from The typical OT symptoms with this common Blood work results how do you go about Trying to solve that puzzle do you use a Boron if so does it really work enough To lower the shpg or do you start motrt Directly so what’s your advice there Um sometimes uh that is a good case for An individualized regimen so all the Above would be the answer in that case And identifying the root cause is the Important thing so if you have a higher Shpg then it is very likely that you Metabolize your androgens more slowly so It’s kind of a blessing and a curse so The question would be how fast are you Metabolizing how fast are you Synthesizing so how much synthesis is Happening because some individuals with A very high shpg also have very high Total testosterones So when Um a case where there’s say three Individuals in that exact same scenario Perhaps one of them is boron deficient Or four and insufficient in some areas Boron in the soil is more depleted some People will check the blood of the soil Which I think that’s wonderful I’m I’m In the camp that you just try born and
Most of those individuals it usually Wears off after a couple weeks I don’t Think that like two weeks on two weeks Off two weeks on two weeks off is Necessarily like a magical regimen of Boron I think that I mean it just takes A while for the feedback mechanisms to Kind of readjust shpg after starting Boron but it’s certainly not going to Hurt Um Boron is also a very weak Anti-estrogen and technically a Goitregen as well so it does have other Functions within the body other than Just modulating shbg it’s important to Look at insulin signaling for example if Someone’s on a very low carb diet Insulin binding the insulin receptor in The liver itself directly down regulates Gene transcription of shpg so having a Slightly higher fasting insulin from for Example incorporating healthy carbs in The diet can help control shbg And then in addition to that you want to Make sure that the signaling of things Like igf-1 and estrogen is not in excess So if you have a lot of estrogen Estrogen binding the estradiol Alpha Receptor in the liver is going to induce More Gene transcription of shpg So just kind of give you a good look at The whole picture and determining what Camp someone in is in Um we’ll find if we’re able to optimize
That free testosterone after the free Testosterone is optimized it’s also Important to correlate that with Symptoms so again this just kind of goes Back to the importance of incorporating Objective data in medicine with Subjective data so I’ve also seen cases Where individual with a total Testosterone of 650 and a food Testosterone of six they optimized their Free testosterone naturally to 25 and Still feel the same so in cases like That it’s probably dopaminergic activity That’s the root cause rather than the Androgenic activity last thing on this Is free testosterones are often Inaccurate depending on the assay so Calculating one based on the total T and Shpg to kind of check your work is also Important