My testosterone level is normal, but I don’t feel normal

Dr. Conner,

I’ve attached a copy of my blood test with my testosterone level.  It’s in the normal range but I just don’t feel right.  I just don’t have the energy that I used to have, no morning erections and not much of a sex drive.  It’s frustrating because my doctor won’t prescribe any testosterone because he says my level is fine.  Any suggestions?  Or can you help me?
Sam

Hey Sam,

Sure I can help you.  You took a blood test that gave you a total testosterone level.  In my opinion, this is pretty much useless in determining your true level.  A high percentage of testosterone is bound to Sex Hormone Binding Globulin (SHBG).  When it is bound, your body cannot use it.  The small percentage that is not bound is active and is used by your body. Basically, the higher your SHBG, the lower your active testosterone.  The lower your SHBG, the higher your active testosterone.

Looking at your test results, your doctor checked your total blood testosterone.  This gives you the amount of both bound and unbound (inactive and active).  The test did not indicate how much of your testosterone is inactive.

The best and easiest way to determine your true level is to take a simple home saliva test.

So, your level is “normal,” but you still have symptoms.  Two things could be going on here…

Your SHBG could be high.  A few different things could be causing this…

1. Liver damage or liver disease with cause your liver to produce more SHBG
2. Excessive alcohol consumption damages the liver, causing increased SHBG
3. High estrogen levels increase SHBG because your body wants it bound and useless
4. Hyperthyroid or excessive thyroid medication
5. Malnutrition – not eating enough calories will raise SHBG

You can lower SHBG by…

1. Increasing your protein intake
2. Supplementing with Omega-3 fish oil, at least 4 grams per day
3. Supplementing with Vitamin D, 5,000IU per day
4. Supplementing with testosterone and/or nandrolone
5. Supplementing with DHEA, 25mg per day
6. Correcting thyroid levels if needed

As you can see, taking the proper supplements can certainly help you here.  All of these supplements are the ones I take daily and recommend to everyone.  You can find them HERE.

You may also have a high estrogen level.  This happens when your body makes estrogen from your testosterone at a higher than normal rate.  It could also mean you are extra sensitive to environmental xenoestrogens.

Here’s a couple articles regarding xenoestrogens…
26 year old male with odd symptoms
Ladies, don’t let your husbands grow-down to be girly-men

There are only two significant ways to lower your estrogen level…

1. Supplementing with DIM (diindolylmethane), helps body remove excess estrogen
2. Taking prescription anastrazole or letrozole

Of course, your diet can certainly play a role in you having too much estrogen.  Your diet should consist of as many naturally occurring foods as possible.  In other words, if it isn’t the way God made it, avoid it.  You also want to avoid eating soy and soy products.

My recommendation for you right now would be the following…

1. a saliva test to get your free testosterone and free estradiol levels
2. a blood test to check you SHBG and thyroid (TSH) levels

These tests will give us an idea of where your true testosterone level is and where your “counter-testosterone” levels are.  Also, a basic TSH test will give a broad view of your thyroid in case excess thyroid hormones are causing your increased SHBG.

Remember, just because your testosterone level is in the “normal range,” doesn’t mean you are not suffering symptoms.  If you are not balanced, regardless of your level, you won’t feel right.  The levels of your other hormones are also very important when it comes to feeling your best.