meaning of low free T and high SHBG?

[kapakahi]

In Feb. 2022 my total T was 318, free T was 0.8% (ref. range 1.8-3.2) and SHBG was 102 (9-68).

In Sept. 2022 the numbers were 391, 1.2% and 72.

Over that timespan my PSA rose from 1.5 to 2.2, and now is bouncing around the 2.0 mark. For me this isn't great since I have only half a prostate following HIFU, and for 5 years afterward PSA hovered in the 0.6- 0.8 range. The PC is still there (according to axumin scan).

I'm wondering if the T and SHBG numbers mean anything or are just normal fluctuations -- I understand that those numbers might be related to aging (I'm 75). The only thing I've changed is to increase my daily vitamin D supplement from 5,000 to 15,000 on my doctor's advice -- she wanted to see my blood level near the top of normal rather than mid, where it had been. I've just read that vitamin D can raise T levels, and might thereby exacerbate PC.

As soon as I read this, I cut my daily D to 1,000 units (plus what I get in food like milk and yogurt). Before I began taking D 15-20 years ago, my blood level was below normal despite living in Hawai`i and getting lots of sun (and melanoma).

I've seen discussion here about D, but don't know how it relates to these specific T/SHBG levels and activity.

[kapakahi]

Thanks for replying and your insight. You're right -- albumin is 4.5, and has been right around that for a year or so. In Feb. 2022 vitamin D was 65 (ref. range 30-100), which was when my doctor said she'd like to see it near the top of the range, so I went from 5,000 a day to 15,000 (which is what she prescribed for my wife, whose count was 40).

I read such conflicting things about vitamin D when it comes to PC. I increased it about 12 or so years ago to 5,000 a day when I was dx with atherosclerosis (heart calcium score 880) and began taking K2 as well -- supposed to help D work and also ensure calcium isn't deposited in arteries.

I've been taking Life Extension K2 since then -- 2600 mcg (1500 K1, 1000 K2 MK4, 100 K2 MK7). Right around then I got the PC dx and read how D is supposed to help with that -- but since then I've read here and elsewhere that you have to be careful with it. It's a hormone so it's potent stuff -- I think TA cautions about its use.

When I talked to my doctor about all this last night (she calls at night to discuss my blood test results! It's like getting a home visit) and told her I cut the D dose down to 1,000, she said one reason the T level might have gone up was because of the time of day -- it was an early morning draw, and T is highest then. I did not know that. The previous one in Feb. was in the afternoon. So I have to be sure to get it tested at the same time of day each time. Now I wonder if I freaked out needlessly. Yet this morning I read that the variance applies only to younger men.

Anyway, my doctor rattled off a long list of benefits of D supplementation that sunlight only can't provide. So I'm confused. Nothing new there

[Monitoring]

Hi kapakahi and smurtaw.

There is some inter-mixing of measurement definitions in your threads.

Here is the key conversion measurement.

1 ng/ml = 2.5 nmol/L

Here is a link to an EXCELLENT 53-minute video on the importance of Vitamin D by Dr. Roger Seheult, who specializes in Critical Care Medicine, Internal Medicine, Pulmonary Critical Care, and Pulmonary Disease in Banning, California.

I have read a lot of papers on D and this is, by far, the best that I have seen.

youtube.com/watch?v=ha2mLz-...(Not working as expected?)

I upped my D intake over the years and reached 9000 IU daily. Since I retired two years ago ( I am 80 next June) I am getting much more direct sun, so I dropped my daily intake this past summer to 6000 IU. I will go back to 9000 in the winter.

Background: DX with PCa in 2003 with Gl 3+3. Was on AS until 2019 when PCa got aggressive. PSA ranged between 2.5 and 5.1 until 2019 and then went to 18.4 in six months. Gl went to 4+5. Immediately put on three-monthly ADT injections for six months to lower T levels to make 25 radiation treatments more effective. Six months after last rad session, T returned to pre-ADT levels. PSA, which dropped to <0.02 with the ADT, is rising, which is to be expected with rising T, but very slowly to only 0.06. No concerns until it reaches 2.0.

I am a big believer in taking Vitamin D, so really enjoyed reading this thread.

Monitoring in Toronto

[Alexandr1]

For an excellent summary of an emerging view by some experts concerning prostate cancer and testosterone, suggest you Google “Dr. Morgentaler and Testosterone”. A tremendous amount of relatively new research is now available on this issue. I am a PC survivor who supplements with Testosterone, following the advice of (now) three urologists at a premier teaching hospital. I am NOT giving medical advice, just recommending a bit of research on a subject which impacted me, and might impact others in this space….

[kapakahi in reply to Alexandr1]

Thanks. I'd give anything (except my life) to be able to supplement with T again. I felt so much better about everything when I could keep my T level at 700 or so -- alive, vital, strong, happy. Now my muscles have just about vanished along with my sex drive, my cholesterol has gone up, arthritis is disabling, and so on, and worst of all is my outlook on life. But T supplementation sends my PSA shooting up quickly and scarily, so I haven't been able to use it since about 2009 when my doctor told me my PC is very reactive to testosterone. Everything has been downhill since, except that the PC has never metastacized -- and that's no small benefit! I'll look up Dr. Morgentaler -- maybe there's a way around this serious impediment for me?