Why Nsima Inyang has low free testosterone (2023 bloodwork analysis)

On a recent Power Project podcast, Mark Bell et al discussed Nsima’s latest blood tests (2023).

His free testosterone came back low, and I’m going to explain the likely reason.

SHBG and free testosterone

SHBG and albumin are the two proteins that bind up most of the testosterone produced, with only 1-4% being free. Albumin binds loosely to testosterone whereas SHBG binds more potently to it.

Although SHBG can be transported into a cell and still activate the androgen receptor, most people experience low libido, motivation, drive and life enjoyment when free testosterone is low.

Very often, low free testosterone is the reason for high testosterone, since free testosterone signals the hypothalamus to reduce GnRH release, thus LH also goes down. It’s very common to see men with low free testosterone have high total testosterone.

Things that lower SHBG

Common things that can help to lower SHBG are:

• Insulin
• Protein
• Zinc
• Low fiber diet
• Exercise
• IGF-1
• Vitamin D
• Thyroid
• Magnesium
• Copper

Things that increase it:

• Long-term calorie restriction
• Fasting
• Low carb diets
• Estrogen
• Nutritional deficiencies

Nsima’s diet and lifestyle

According to the podcasts I’ve listened to, Nsima isn’t very clear about his diet, but does follow various guidelines.

Mostly he eats:

• A moderate to high-protein diet (probably around 1g/lbs of BW to maximize muscle growth)
• Low to moderate carb intake – it varies based on how he feels.
• At maintenance or a slight deficit to stay lean – it varies based on how he feels and his activity level.

He often fasts for long periods of time and does a fair amount of aerobic exercise (Juijitsu and walking). He mentioned that his HRV is often low despite feeling good and rested.

Nsima’s blood test

Total and free testosterone and SHBG

In 2021, his free testosterone was higher with total testosterone and SHBG a little lower. Interestingly, his LH was also higher in 2021 despite total T being lower. He said that he was using Fadogia, which was responsible for the high LH.

High LH usually indicates testicular insensitivity and men with his testosterone level that I usually work with have an LH of 4-5, never over 7. The only thing I’ve seen that boosts LH that high is Clomid and enclomiphene.

As you can see, his SHBG isn’t very high, but it’s definitely getting up there. It took a 10-point jump since late 2021.

He also said that he used Tongkat Ali with Fadogia, which was supposedly responsible for the lower SHBG.

Insulin

Insulin is one of the most potent inhibitors of SHBG production. And Nsima’s insulin is very low. Insulin dropped a little from 2021, coinciding with the rise in SHBG.

This is likely due to doing intermittent fasting combined with low-carb days and perhaps doing even more low-intensity training than before.

It would be good if he can do a C-peptide test, which is a 24-hour marker of insulin release. This shows you how much insulin someone released over a 24-hour period, instead of just what fasting insulin is at a specific time.

IGF-1

IGF-1 helps to suppress SHBG production and insulin is one of the drivers of the production of IGF-1. His IGF-1 dropped quite a bit, which led to higher SHBG.

Low insulin will frequently lead to low IGF-1.

Iron and Copper

Iron saturation is also called transferrin saturation. Stored iron (ferritin) is released from the liver and loaded onto carrier proteins (transferrin). Low transferrin saturation means that there isn’t a lot of iron carried by transferrin. His ferritin is a little high, showing he has enough stored iron. It just isn’t being released.

Copper helps to mobilize iron and increases transferrin saturation as well as iron uptake into tissue. Low copper can lead to low heme synthesis, low hemoglobin and low hematocrit (R). His were on the low side.

Also, low neutrophils (below 60%) can be an early sign of low copper (R). His was at 47%, not terrible, but can be better.

Changes are that Nsima doesn’t consume enough dietary copper and he might benefit from eating more beef/lamb liver.

But why is copper important?

Copper, by increasing ceruloplasmin, lowers SHBG (R).

The sweet spot for ceruloplasmin seems to be around 35mg/dl, then SHBG is at its lowest.

GGT correlates positively with copper. Also, serum ferritin and GGT are markers for iron toxicity (R).

His GGT was on the low side even though ferritin was close to 300. This indicates that his iron is not being mobilized enough and is likely not causing problems.

Estrogen and SHBG

Estrogen is a potent stimulator of SHBG production, however, his estradiol is normal, which is likely not stimulating SHBG production excessively.

Related article:

• How to inhibit aromatase

Thyroid and SHBG

T3 stimulates the production of SHBG. Men with hyperthyroidism (too much T3) tend to have high SHBG and low free testosterone.

This would mean that people with low T3 will have low SHBG. However, in people with low T3 (hypothyroidism), SHBG is often at the same level as people with normal T3. This is because the structure of SHBG changes. Low T3 changes the structure of SHBG to prolong the half-life (R).

In hypothyroidism, despite making less SHBG, it stays longer in the body. Increasing total T3 to a euthyroid range between 150-220ng/dl and free T to around 4pg/mL or more, SHBG will likely remain the same while total and free testosterone increases.

Insulin, cholesterol and triglycerides are usually elevated during hypothyroidism, yet his were low.

It could be that because he drew his labs around 2pm (still in a fasted state). A 16-20 hour fast will definitely lead to low fasting insulin, triglycerides, T3, and IGF-1.

Summary

In summary, his fasting habits, likely low carb intake and nutritional deficiencies (e.g. copper) are what’s keeping his free testosterone low.

If I were him, I’d:

• Increase total and free T3 (by avoiding long-term caloric deficits and fasting and eating more nutrient-dense foods, which contain selenium for the conversion of T4 into T3).
• Eat more beef/lamb liver for copper.
• Stop intermittent fasting or at least limit it to no more than 12 hours.
• Consume more carbs to get insulin up a bit (low selenium intake can also cause low insulin release).

An LH of 8.9 is quite high and can be a sign of Clomid or enclomiphene use, which is not impossible. When someone is fasted, LH usually drops and would be low similar to high cholesterol, triglycerides and insulin.

Regardless, I hope this article gave you some ideas on how to lower SHBG and increase your free testosterone.

More content for my Alpha Energy Male readers

• How to increase testosterone
• How to lower SHBG and increase free testosterone
• Maximize your testosterone higher than puberty levels
• 20 best testosterone-boosting diet plan foods
• Testosterone-boosting breakfast: top 5 recipes