Starting TRT due to low free T/ high shbg/ high estradiol. A few questions

[Bill0716]

30 y/o male - good health/ diet/ sleep etc. New here and no former TRT/ AAS use. Key results from two different blood tests (5 weeks apart) are below. Today I went and saw a private hormone specialist (leger clinic - Dr Savage) who advised that I may benefit from TRT due to relatively low Free T. He advised a 3-6 month trial of 125mg enanthate weekly and HCG 500iu 3 times a week.
Test Results - Pre TRT
Online blood test - FSH 2.1 IU/L (range 1.5 - 12.4)
LH 5.8 IU/L (range 1.7 - 8.6)
Oestradiol 185 pmol/L (range 41 - 159) HIGH!!!
Total testosterone 26 nmol/L (range 8.64 - 29)
Free test (calculated) 0.36 nmol/L (range 0.2 - 0.62)
SHBG 65 nmol/L (range 18.3 - 54.1)
NHS blood test - Total T: 20.6 nmol/l (6.0 - 27.0) (lower than before)
17 B Oestradiol 141 pmol/l (55.1-115.6)
SHBG 56 nmol/L (13-71)
Questions
I have been prescribed 125mg enanthate weekly privately and HCG 500iu 3 times a week

1. My main concern is fertility, how effective is HCG at preserving fertility? Doc says not guaranteed, does anyone know the percentage likelihood of this treatment being effective? This is important as me and my partner want to start trying for our first baby in the next couple of years
2. Doc has not yes prescribed an AI - obviously my Estradiol is raised already, if I replace natural production with injection, does my natural production of estrogen also shut down? and therefore the estrogen will be relative to the amount of test I inject? Or am I going to add to the already high levels I have got, without having an AI to supress?
3. Will injecting actually benefit me in people's opinion? My free T is obviously low, and he calculated the NHS results at 0.3 also, he said for my age this hould be higher and that could caue my symptoms.
4. Finally, any known videos sites on how to inject? New to all of this.

Appreciate your help.
Bill

 

[Vince]

If you want to remain fertile, don't go use testosterone. Too many men struggle was trying to get their mate pregnant. I really don't think you would benefit and it will cause too many issues. Hang around this form for a while and read as much as you can. Then if you really want to go on trt, you'll be making an informed decision.

 

[Vince]

Article: Semen analysis results after adding FSH to TRT and hCG

 

[Bill0716]

Thanks for the reply, Vince. I have read a couple of books and hung around other forums (just not this one), I consider myself fairly well informed on the topic but by no means an expert. Unfortunately the link in your post “could not be found”? I’m not adverse to giving TRT a miss, however I have a lot of symptoms (except low libido or ed). I think this may be due to raised estradiol. Doctor was reluctant to prescribe an AI on its own, and therefore I see this as the only option as it stands, in order to address my issues. I wouldn’t however take the chance if it led to infertility, hence my desire to reassure myself that HCG is as good as a guarantee that Spermatogenesis won’t be affected. If you could try and send the link again, it would be much appreciated. Thanks, Bill

 

[Vvs1]

Did the doc mention anything aboug the high estradiol? That's one of the few reasons our terrible health system says is a cause of high shbg.

I have high shbg but my estradiol is below the feel good range. That's why I have been debating HCG with no added T.

A lot of guys on Test will complain about low seminal fluid which makes me believe that FSH is likely involved with making seminal fluid.

I would be greatful if you stuck around to share your experience.

 

[Systemlord]

You can always add HCG and FSH injections for fertility while on TRT. TRT is no death sentence to fertility, there are a couple of ways to go about it..

 

[Vince]

Thanks for the reply, Vince. I have read a couple of books and hung around other forums (just not this one), I consider myself fairly well informed on the topic but by no means an expert. Unfortunately the link in your post “could not be found”? I’m not adverse to giving TRT a miss, however I have a lot of symptoms (except low libido or ed). I think this may be due to raised estradiol. Doctor was reluctant to prescribe an AI on its own, and therefore I see this as the only option as it stands, in order to address my issues. I wouldn’t however take the chance if it led to infertility, hence my desire to reassure myself that HCG is as good as a guarantee that Spermatogenesis won’t be affected. If you could try and send the link again, it would be much appreciated. Thanks, Bill

I see that link isn't working? Here's another one that may help.

Fertility help!!

 

[mlc2010]

30 y/o male - good health/ diet/ sleep etc. New here and no former TRT/ AAS use. Key results from two different blood tests (5 weeks apart) are below. Today I went and saw a private hormone specialist (leger clinic - Dr Savage) who advised that I may benefit from TRT due to relatively low Free T. He advised a 3-6 month trial of 125mg enanthate weekly and HCG 500iu 3 times a week.
Test Results - Pre TRT
Online blood test - FSH 2.1 IU/L (range 1.5 - 12.4)
LH 5.8 IU/L (range 1.7 - 8.6)
Oestradiol 185 pmol/L (range 41 - 159) HIGH!!!
Total testosterone 26 nmol/L (range 8.64 - 29)
Free test (calculated) 0.36 nmol/L (range 0.2 - 0.62)
SHBG 65 nmol/L (range 18.3 - 54.1)
NHS blood test - Total T: 20.6 nmol/l (6.0 - 27.0) (lower than before)
17 B Oestradiol 141 pmol/l (55.1-115.6)
SHBG 56 nmol/L (13-71)
Questions
I have been prescribed 125mg enanthate weekly privately and HCG 500iu 3 times a week

1. My main concern is fertility, how effective is HCG at preserving fertility? Doc says not guaranteed, does anyone know the percentage likelihood of this treatment being effective? This is important as me and my partner want to start trying for our first baby in the next couple of years
2. Doc has not yes prescribed an AI - obviously my Estradiol is raised already, if I replace natural production with injection, does my natural production of estrogen also shut down? and therefore the estrogen will be relative to the amount of test I inject? Or am I going to add to the already high levels I have got, without having an AI to supress?
3. Will injecting actually benefit me in people's opinion? My free T is obviously low, and he calculated the NHS results at 0.3 also, he said for my age this hould be higher and that could caue my symptoms.
4. Finally, any known videos sites on how to inject? New to all of this.

Appreciate your help.
Bill

Hi Bill, I'm also from UK have similiar bloods and similiar age. what symptoms do you have? I have spent 3-4 years trying to lower my SHBG naturally, and the UK doctors have no idea what SHBG is! I'm also tempted to trial test e for a few months to see if it lowers my shbg and improves my symptoms

 

[Gman86]

Hi Bill, I'm also from UK have similiar bloods and similiar age. what symptoms do you have? I have spent 3-4 years trying to lower my SHBG naturally, and the UK doctors have no idea what SHBG is! I'm also tempted to trial test e for a few months to see if it lowers my shbg and improves my symptoms

According to all the experts lately, trying to lower SHBG is apparently the dumbest thing ever. Think we complicate things a little too much sometimes. If you have high SHBG, just increase your dose. Boom, problem solved. The only problems I can see with this is if you have a doctor that doesn’t know what he’s doing, and is scared of you having a high total T. HGB and HCT aren’t an issue, as they are dictated by free T I’m pretty sure. And E2 isn’t an issue. You’ll have a higher E2, but more of it will be bound due to the high SHBG. The only thing that matters is your free E2, which should be fine, even with an elevated total E2.

I’m a high SHBG guy btw. Any guy that thinks lowering SHBG is the answer, is unfortunately wasting time barking up the wrong tree.

 

[mlc2010]

According to all the experts lately, trying to lower SHBG is apparently the dumbest thing ever. Think we complicate things a little too much sometimes. If you have high SHBG, just increase your dose. Boom, problem solved. The only problems I can see with this is if you have a doctor that doesn’t know what he’s doing, and is scared of you having a high total T. HGB and HCT aren’t an issue, as they are dictated by free T I’m pretty sure. And E2 isn’t an issue. You’ll have a higher E2, but more of it will be bound due to the high SHBG. The only thing that matters is your free E2, which should be fine, even with an elevated total E2.

I’m a high SHBG guy btw. Any guy that thinks lowering SHBG is the answer, is unfortunately wasting time barking up the wrong tree.

Increase what dose? I'm not taking anything. I'm natural with high shbg, and nothing moves it, and yes I have tried everything, proviron etc

 

[Gman86]

Increase what dose? I'm not taking anything. I'm natural with high shbg, and nothing moves it, and yes I have tried everything, proviron etc

Oh, sorry lol, am at work and just glimpsed at the thread. If high SHBG is your issue, just hop on TRT and solve the problem. If fertility is an issue, there’s many things to combat it while on TRT, and it’s a none issue, imo. Sorry again if this is poor advice based off of your situation, again I’m at work and too lazy to look back lol

 

[mlc2010]

Oh, sorry lol, am at work and just glimpsed at the thread. If high SHBG is your issue, just hop on TRT and solve the problem. If fertility is an issue, there’s many things to combat it while on TRT, and it’s a none issue, imo. Sorry again if this is poor advice based off of your situation, again I’m at work and too lazy to look back lol

Im guessing the million dollar question is, is HIGH SHBG really a problem? A lot of people say no, some say yes

 

[Gman86]

Im guessing the million dollar question is, is HIGH SHBG really a problem? A lot of people say no, some say yes

Seems like all the research, and anectodal evidence, and pretty much every current expert’s opinion that I follow, leads to 100% no being the answer. I honestly haven’t heard of there being any negatives to high SHBG. What are some that you can think of? The only negatives that I can think of, are not really associated with having high SHBG, but more so the causes of it. I’m mostly referring to phytoestrogens from chemicals in the food, water, air, skin products, etc. Probably EMF’s lead to an increased SHBG as well. I’ve honestly never heard of there being negatives to having high SHBG, but the causes are what worry me. Lowering SHBG with drugs doesn’t eliminate the underlying cause for the high SHBG, so I don’t see the point. It’s unnecessary to lower it, imo.

I’d stop wasting time worrying about things you shouldn’t be worrying about, like SHBG, and focusing your time and energy in the right places. And this is coming from someone with high SHBG, that has literally almost tried everything to lower it, and successfully lowered it a few times. But it’s made no difference. I’ve gotten it down to mid 30’s, from high 50’s, and noticed no benefits. All that happened is that my body compensated by lowering my total T and my free T ended up being basically identical, and I didn’t feel any benefits from having a lower SHBG. Trust me man, taking my advice right now will save you years worrying about SHBG nonsense. Years that I unfortunately can’t get back. Learn from my mistakes! Lol.

 

[mlc2010]

Seems like all the research, and anectodal evidence, and pretty much every current expert’s opinion that I follow, leads to 100% no being the answer. I honestly haven’t heard of there being any negatives to high SHBG. What are some that you can think of? The only negatives that I can think of, are not really associated with having high SHBG, but more so the causes of it. I’m mostly referring to phytoestrogens from chemicals in the food, water, air, skin products, etc. Probably EMF’s lead to an increased SHBG as well. I’ve honestly never heard of there being negatives to having high SHBG, but the causes are what worry me. Lowering SHBG with drugs doesn’t eliminate the underlying cause for the high SHBG, so I don’t see the point. It’s unnecessary to lower it, imo.

I’d stop wasting time worrying about things you shouldn’t be worrying about, like SHBG, and focusing your time and energy in the right places. And this is coming from someone with high SHBG, that has literally almost tried everything to lower it, and successfully lowered it a few times. But it’s made no difference. I’ve gotten it down to mid 30’s, from high 50’s, and noticed no benefits. All that happened is that my body compensated by lowering my total T and my free T ended up being basically identical, and I didn’t feel any benefits from having a lower SHBG. Trust me man, taking my advice right now will save you years worrying about SHBG nonsense. Years that I unfortunately can’t get back. Learn from my mistakes! Lol.

Doesnt high shbg Mean low free test?

Are you saying taking T to lower shbg and boost free t will do nothing?

 

[Gman86]

Doesnt high shbg Mean low free test?

Are you saying taking T to lower shbg and boost free t will do nothing?

Ya, high SHBG means that if you and a low SHBG guy had a total T of 1000, you’d have a lower free T. But it’s not a big deal. All you have to do is increase total T. Problem solved. Having a high SHBG isn’t really a bad thing. Just means you’re going to need more total T compared to a lower SHBG guy

And that’s definitely not what I’m saying lol. Before I started TRT my SHBG was in the 50’s, and free T was either bottom of the barrel, or below the low end of the range. Getting on HRT and increasing my total T, which then lowered my SHBG, as well as increasing my free T, has absolutely made a huge difference for me. I feel WAY better with healthy levels of free T.

What I was trying to say is stop wasting your time trying to lower SHBG. Without TRT, I’ve never seen, or heard of, a guy successfully do it. And no offense, but not sure you’re going to be the first guy in history to do it lol. By successfully doing it, I mean lowering SHBG, while increasing free T levels, and feeling good and resolving low T symptoms, all at the same time. Only thing I’ve seen do all those things is HRT. And what I was also saying is that even on TRT, don’t spend anytime trying to lower SHBG. Increasing your testosterone should automatically lower it. Other than that, don’t spend time trying to find other ways to manipulate your SHBG levels.

 

[mlc2010]

Ya, high SHBG means that if you and a low SHBG guy had a total T of 1000, you’d have a lower free T. But it’s not a big deal. All you have to do is increase total T. Problem solved. Having a high SHBG isn’t really a bad thing. Just means you’re going to need more total T compared to a lower SHBG guy

And that’s definitely not what I’m saying lol. Before I started TRT my SHBG was in the 50’s, and free T was either bottom of the barrel, or below the low end of the range. Getting on HRT and increasing my total T, which then lowered my SHBG, as well as increasing my free T, has absolutely made a huge difference for me. I feel WAY better with healthy levels of free T.

What I was trying to say is stop wasting your time trying to lower SHBG. Without TRT, I’ve never seen, or heard of, a guy successfully do it. And no offense, but not sure you’re going to be the first guy in history to do it lol. By successfully doing it, I mean lowering SHBG, while increasing free T levels, and feeling good and resolving low T symptoms, all at the same time. Only thing I’ve seen do all those things is HRT. And what I was also saying is that even on TRT, don’t spend anytime trying to lower SHBG. Increasing your testosterone should automatically lower it. Other than that, don’t spend time trying to find other ways to manipulate your SHBG levels.

I have gave up lowering it naturally. I bought the test a year ago ( is it still good?) I'm just scared to take the plunge. I'm a wuss. What's the worst that can happen right ?

 

[Gman86]

I have gave up lowering it naturally. I bought the test a year ago ( is it still good?) I'm just scared to take the plunge. I'm a wuss. What's the worst that can happen right ?

Haha nah you’re not a wuss. I wasn’t scared at all to start HRT, I was the opposite. I was very very excited to feel better. But I can understand why someone would be hesitant. I would imagine that it is still good as long as you didn’t open it already. Once you puncture the top with a needle for the first time, I would be hesitant to use it after a year of sitting. But as long as it’s unopened, I personally would still use it. It’s pharmaceutical grade prescribed testosterone right?

And trust me man, just freeze your sperm, and start HRT asap. You’re just wasting time, and potentially years of your life you’ll never get back. Living with sub optimal hormone levels is not living, it’s just existing. Just get on HRT asap and start living again. I promise you you’ll be thanking us shortly. Don’t be scared. Be excited.

 

[mlc2010]

Haha nah you’re not a wuss. I wasn’t scared at all to start HRT, I was the opposite. I was very very excited to feel better. But I can understand why someone would be hesitant. I would imagine that it is still good as long as you didn’t open it already. Once you puncture the top with a needle for the first time, I would be hesitant to use it after a year of sitting. But as long as it’s unopened, I personally would still use it. It’s pharmaceutical grade prescribed testosterone right?

And trust me man, just freeze your sperm, and start HRT asap. You’re just wasting time, and potentially years of your life you’ll never get back. Living with sub optimal hormone levels is not living, it’s just existing. Just get on HRT asap and start living again. I promise you you’ll be thanking us shortly. Don’t be scared. Be excited.

Thanks for encouragement. Yes the seal is unbroken

If it's not a personal question. What improvements did you notice?

 

[Gman86]

Thanks for encouragement. Yes the seal is unbroken

If it's not a personal question. What improvements did you notice?

There is no personal questions here, at least with me. I’m an open book. Never really had that much depression and/ or anxiety before, but would have times where I would get a little depressed I guess. But while on TRT I have literally zero depression or anxiety. Mood is always great. Confidence is a little higher. Sleep is great, but it wasn’t really that bad when I was low. Libido is about the same as when I was low. Being able to keep off body fat has definitely improved. Maintaining/ gaining muscle is slightly improved. Strength in the gym seems to be improved. Never had a problem with erections when I was low. They’re still good. I would say the biggest improvement is with mood, and being able to keep depression and anxiety away.