TLDR: Got low free testosterone, but I doesn't look like the clinic wants to solve the problem at the root. I don't know if I am just missing something and was offered the correct course of action or if I am supposed to go overseas to check for the possibility that this is solvable without taking injections for life (because no clinic in Japan seems to test for SHBG).
I got a hormone blood test on a men's health clinic the other day and got free testosterone of
9 pg/ml
Was immediately suggested to take testosterone shots for life every 2-3 weeks in said clinic. I did not do any research before hands so I did not have any questions to ask except for "is this really necessary?"
After doing a bit of research it looks like high SHBG can be a cause for this and high SHBG can perhaps be resolved, avoiding the need for testosterone shots in the first place. Now I understand from searching and asking around that SHBG is not something that is tested in Japan, or perhaps it is but only in research. Also, I happen to have an SHBG test result which I took overseas, albeit from 10 years ago, where I have an abnormally high SHBG (84.2 nmol/l where normal range is 10-57, normal testosterone was normal, free testosterone was low).
A high SHBG, depending on the cause, can be treated. For example hyperthyroidism is but one cause for it which one can even solve just by dietary changes in case one's diet is unbalanced. Why would the clinic not suggest a thyroid check? Even if they can't test for SHBG they can test for the causes of high SHBG to try and rule out that possibility no?
Am I missing something here? It's not clear to me whether this clinic really has the best in mind for me or if it prioritizes profits. BTW I did look up Juntendo before going to that clinic but their website says they will ask for an additional 11,000 yen before even talking to me if I don't have an invitation letter in the best case, or flat-out reject me in the worst.
Does this pg/ml really necessitates shots? I do have some symptoms of low free testosterone.
Why the discrepancy with the US? It looks like the normal range is Japan has 2x pg/ml as the upper limit, whereas the US LOWER limit for the normal range starts at 47 pg/ml. Are they measuring different things? I would expect a bigger difference if the definition of free testosterone differed to include or not include albumin-binded testosterone.
Is there any way, besides going overseas, to test my SHBG and to have the problem solved at the root? (assuming there is a solution)
Usually one is advised to not look for medical advice on the internet and to consult with one's doctor but this is after consulting the doctor and I could not find any clinics that do SHBG so I infer that other clinics would tell me the same thing. Hence my suspicion that I am missing something.
Any help is greatly appreciated!
by psychic10