Hi, 45 yr male going through a rough patch with depression, severe stress, cognitive and libido issues. GP is firmly in the "you have health anxiety and this is depression" camp, which I am prone to, but I decided to get my androgens checked (again).
My total T in August 2017 was 24.7 n/mol but Jan 2018 labs (Medichecks) show:
DHEA-S 4.360 umol/L (0.44 - 13.40)
FSH 8.82 IU/L (1.50 - 12.40)
LH *9.2 IU/L (1.70 - 8.60)
T 28.9 nmol/L (7.60 - 31.40
SHBG * 60.7 nmol/L (16.00 - 55.00)
FAI 47.61 Ratio (24.00 - 104.00)
My Sex Hormone Binding Globulin is way too high, so my free T will be low - seriously exacerbating or causing my current problems. A raised LH shows my pituitary is in overdrive telling my body to produce more T, possibly to compensate for low free T.
SHBG increases with excess estradiol / E2 - so my weight increase / diet aren't helping. I may be aromatasing T into E2. Low insulin or growth hormone raise SHBG.
This is worrying because following a nasty thai boxing sparring session in 2015 and concussion, I had extensive 9am fasted blood panels including GH at 0.1mcg/l (all doctors have basically ignored/refused to follow this up). I've had symptoms that overlap with low GH since late 2016.
I strongly feel my GP needs to
Rule out GH (via stimulation test or possibly IGF-1)
Check E2 or free T
Assess whether my antidepressant is messing with hepatic function - SHBG
Re-visit low saliva cortisol results from last Autumn
Basically, if my GP is unwilling to look beyond the total T value of 28.9, where do I go from here?