Can anybody tell me if im on the right track ... High shbg years of trying to figure out root cause.
SYMPTOM OVERVIEW
My primary symptoms are:
• complete absence of morning erections and ED
• Very low libido and motivation
• Severely disrupted sleep — repeated entry into REM then bouncing back out , constant waking 2-5am unable to return to sleep
• Chronic fatigue and afternoon energy crashes
• Brain fog, poor concentration, difficulty with executive function and task initiation
• Low mood and motivation — markedly worse than my baseline before age 25
I want to be clear that before approximately age 25 I had none of these symptoms. I was functioning normally across all domains — and then one night I started feeling terrible and never came back.
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TIMELINE
2019-2020 — Age 24-25
First onset of symptoms. Noticed declining libido, loss of sleep and morning erections, and reduced motivation and needing for caffeine . Also noted SHBG was elevated at approximately 70 nmol/L on first testing. This was the first abnormal laboratory finding.
2020-2022 — Age 25-27
Symptoms progressively worsened. Multiple doctor visits. Standard hormonal workup performed — testosterone was high-normal to elevated throughout, SHBG persistently elevated 70-90 nmol/L, standard inflammatory markers largely normal on conventional testing. Sleep disruption worsening. Cognitive symptoms becoming more noticeable.
Interventions tried during this period:
• Danazol — similar temporary SHBG suppression with immediate rebound. No sustained benefit.
• High carbohydrate dietary intervention 400g daily — minimal SHBG response, SHBG climbed further over time.
• Multiple specialist consultations including urology, endocrinology, and primary care — no clear diagnosis established.
2022-2023 — Age 27-28
Further workup. Penile Doppler ultrasound performed — normal. Sleep study performed — no sleep apnea identified but notable finding of repeatedly entering REM sleep and boucing back out. Hormone levels continued to show high total testosterone with persistently elevated SHBG. Standard inflammatory markers continued to appear largely normal on conventional panels.
NO STD, NO hepatitis.
Mercury identified as elevated on comprehensive nutritional testing. Dental amalgam removal performed using SMART protocol with charcoal binders. Followed by 4-5 rounds of IV DMPS chelation plus oral DMPS plus sauna and binders for mercury detoxification.
2023-2024 — Age 28-29
Continued decline despite interventions. Vitamin D crashed from 68 ng/mL in April 2024 to 31 ng/mL by October 2025 despite presumed intake — suggesting ongoing consumption or absorption failure. IGF-1 declining from 214 ng/mL in 2022 toward 169 ng/mL. Free T3 declining from 4.1 pg/mL in 2023 toward 3.0 pg/mL. SHBG climbed to 88.8 nmol/L then 108 nmol/L.
2024-2025 — Age 29-30
Extensive functional medicine workup completed.
Key findings:
Labcorp October 2025:
• Total Testosterone: 1,739 ng/dL — significantly above range 264-916 (would fluctuate between 700-800-1000-1500 for no reason)
• SHBG: 108 nmol/L — severely elevated, range 16.5-55.9( has always climied up and came down and then back up but has never gone under 75)
• Free Testosterone: 191.1 pg/mL — above range despite high SHBG (but felt no different despite having more free T)
• LDL: 147 mg/dL — elevated
• Free T3: 3.0 pg/mL — declining trend
• IGF-1: 169 ng/mL — declining from 214 in 2022
• Vitamin D: 31.3 ng/mL — significantly reduced from 68 ng/mL prior year
• HbA1c: 4.8% — excellent
• Fasting insulin: 6.3 uIU/mL — excellent
• Liver enzymes: ALT 24, AST 21, GGT 11 — all normal
Genova ION Panel March 2025:
• Whole blood mercury: 7.71 ug/L — HIGH above reference 4.35
• Omega-3 Index: 3.4% — critically low
• HVA (homovanillic acid — dopamine metabolite): 0.7 mmol/mol creatinine — LOW, range 1.2-5.3, confirming severely reduced dopamine turnover
• Mitochondrial impairment pattern across multiple markers
• Tryptophan lower range with elevated quinolinate — confirming tryptophan shunting toward inflammatory kynurenine pathway away from serotonin and melatonin
• Essential fatty acid insufficiency
• Alpha-hydroxybutyrate elevated — oxidative stress marker
Mitome Mitochondrial Function Test May 2025:
• Complex I: 34% of normal — severely impaired
• Complex II: 80% of normal — relatively preserved
• Complex II+III: 32% of normal — severely impaired
• Complex IV: 29% of normal — severely impaired
• Citrate Synthase: 279% — massively elevated compensatory mitochondrial mass expansion
• Pattern consistent with mycotoxin poisoning of electron transport chain
Vibrant Total Tox Burden Panel:
• Chaetoglosin A: 35.72 ng/g — above 95th percentile, confirming Chaetomium mycotoxin body burden
• Mercury: 4.08 ug/g — above reference 1.61 even after chelation
• Phthalates MEHHP: 45.53 and MEOHP: 48.00 — both above 95th percentile
Mold Inflammatory Markers March 2026 (same panel and reference ranges for both measurements):
• TGF-beta1: 8,563 pg/mL — range 344-2,380. Nearly 4x upper limit.
• MMP-9: 562 ng/mL — range 0-332. Significantly elevated.
• MSH: less than 8 pg/mL — range 35-81. Essentially undetectable.
Visual Contrast Sensitivity Test February 2026:
• POSITIVE. Biotoxin score 42%. 11 of 13 CIRS symptom clusters positive.
• Greater than 95% probability CIRS diagnosis.
• Mold-related illness and post-COVID syndrome flagged as causes.
2025-2026 — Age 30-31
Treatment initiated based on confirmed CIRS diagnosis.
Cholestyramine binder protocol initiated April 2026 — 4 times daily with fat-containing meals as primary CIRS mycotoxin clearance treatment.
Mold Inflammatory Markers June 2026 — updated on same panel:
• TGF-beta1: 6,209 pg/mL — down from 8,563, 27.5% reduction confirming cholestyramine working
• MMP-9: 752 ng/mL — up from 562, rising despite TGF-beta1 falling. Primary current concern.
• MSH: less than 8 pg/mL — unchanged. Still essentially undetectable after 6 months of treatment.
MyMycoLab Mycotoxin IgG and IgE Antibody Panel June 2026: will include.
Now I've been on treatment for this and have been doing binders since May and if it was causing my symptoms I should have felt some relief at this point ? But I haven't felt much at all so I am not sure if I'm chasing the right thing that contributes to my symptoms at this point.
CURRENT TREATMENT PROTOCOL
Binders:
• Cholestyramine 4g four times daily with meals — primary CIRS binder
Antifungal and Anti-inflammatory:
• Itraconazole 100mg twice daily with fat-containing meals
Nasal - Beg spray
Probiotics:
• MegaSpore Biotic once daily
Sleep:
• Low Dose Naltrexone — currently 1mg nightly, titrating toward 4.5mg
• Quviviq (daridorexant) 25mg nightly
• Magnesium Glycinate 400mg at bedtime
• Liquid melatonin 0.5-1mg sublingual at bedtime
Mitochondrial Support:
• CoQ10 Ubiquinol 400mg daily
Nutrient Repletion:
• Vitamin D3 10,000 IU with K2 200mcg daily
• Omega-3 Fish Oil 4g EPA/DHA daily
• NAC 600mg twice daily
• Phosphatidylcholine 900mg twice daily
Lifestyle:
• sauna 2 sessions weekly
• Resistance training 3 times weekly moderate intensity
Home HERTSMI-2 test -9