I asked Dr. saya some questions I couldn't find answers to online. I wrote them here.

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I asked Dr. saya permission of course, he said he would probably comment here if anything was lost in translation. I took notes, so it is possible I made a mistake. I asked mostly general questions not really about myself and my case, more about TRT and the endocrine system in general. Let me know if this isn't interesting, or it should be posted somewhere else.



Q. Does vitamin d actually lower SHBG?
A. Usually in high dosages. High dosages it can. Typically if we're talking 10,000 IU per day or more.

Q. When testosterone binds to SHBG, is it permanently bound and then excreted, or does it bind and then unbind?
A. It's been thought that it's bound permanently, but to be honest our understanding of the role, mechanism, and physiology of SHBG is only in it's infancy. We're still learning, in fact there's some theories out now that SHBG might even interact directly with receptors on it's own, even in the absence of testosterone! So it's thought that it binds permanently, but we don't really know at this point.

Q. How does testosterone increase energy levels? Is it just through RBC, or?
A. RBC is one way, by increasing red blood cells you increase your oxygenation. Also, by increasing your testosterone you in turn increase nitric oxide production which gives you better vasodilation, which not only are you getting higher red blood cells to carry more oxygen but you're dilating blood vessels even down to the smallest level such as small capillaries. Even down to the organs, at any given time your vessels are either to some degree constricted or dilated. When they're more dilated, you're getting blood deeper into tissues, and oxygen, which certainly impacts your energy levels. Vasodilation and vasoconstriction exist on a spectrum, and the nitric oxide production from the testosterone tends to keep you more on the vasodilation side.

Q. Do the testicles themselves produce E2 like they produce testosterone, or is it entirely through aromatisation inside of the testicles?
A. It is entirely aromatisation inside of the testicles, and outside. You have aromatase enzyme all throughout the body, but it is a little more active inside of the testes. The testes don't produce estrogen directly like the ovaries do for females, but they do produce testosterone which aromatises within the testes called Intratesticular aromatisation.

Q. Do androgen receptors receptors down regulate similar to dopamine receptors in cases of drug abuse?
A. We've found no evidence of that, infact not even in the bodybuilder realm, for example with guys who using astronomical doses along with other adrogens that bind even stronger to the androgen receptor. There's been no data suggesting that there's down regulation of those receptors. Which is a good thing! There's certainly a saturation point, which we don't know where that is, but theres no data suggesting that there's downregulation even AFTER that point. My theory is that because there's a negative feedback system in the endocrine system, that is the protective mechanism as opposed to downregulating receptors.

Q. How does the body differentiate between endogenous and exogenous testosterone, as in the case of clomid not working to restore LH and FSH?
A. That's a million dollar question! We don't know why, we just don't know.

Q. I know E2 helps with bone density and growth, does it do the same thing with teeth?
A. Good question, I can't answer that conclusively, I wouldn't want to steer you wrong on that one.

Q. If testosterone itself doesn't have immediate effects like other drugs such as amphetamines, where the effect of the drug is almost as soon as it's absorbed, then why does the body release testosterone in response to stressors in a NON-HPTA supressed man?
A. I believe a lot of that is evolutionary, where the way our body was designed to have the stress response is actually the fight or fleight response. So back in hunter gatherer days, the stressor there is not coworkers but rather if a predator is going to eat you. So if a predator is after you, that flight or flight response is activated and there's a benefit at that time to a more rapid increase in testosterone levels because it can have an affect on things like aggressiveness, your nitric oxide production for things like vasodilation instead of those other long term benefits.
 
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Helboi

New Member
Q. Does vitamin d actually lower SHBG?
A. Usually in high dosages. High dosages it can. Typically if we're talking 10,000 IU per day or more.

Very interesting. When I began TRT I had been taking 10k IU daily for a number of years and my initial SHBG before treatment started was 17-18. I dropped the D to 5-6k daily for the past 8-12 months and now my SHBG is testing at 36. I'm sure it's not down to just one factor, since a lot has change due to my treatment and diet/exercise changes, but I wonder just how much is related to lowering the amount of D I take?
 
Very interesting. When I began TRT I had been taking 10k IU daily for a number of years and my initial SHBG before treatment started was 17-18. I dropped the D to 5-6k daily for the past 8-12 months and now my SHBG is testing at 36. I'm sure it's not down to just one factor, since a lot has change due to my treatment and diet/exercise changes, but I wonder just how much is related to lowering the amount of D I take?

That's interesting, usually SHBG goes down with TRT. Mine certainly did, from about 35 to 24 range 16-55. I actually stopped taking vitamin d since starting TRT.

I can't think of a reason your SHBG would go down with trt. Did you have low E2 when starting? I did, and my E2 is now 36 8-35 coming from 8 7-42. So I don't know if E2 going up would increase SHBG. This is weird.
 

MikeXL

Member
THis is excellent stuff !!!!!!!!!!!!!


I would add (but check with Dr Saya) that the increase in energy also has to do with testosterone stimulating the release of dopamine
 
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