Never felt good on injections — had a 2 month window of complete resolution, then crashed. Low SHBG

[TheDemz]

30 years old, been on TRT for a year. Looking for similar experiences.

Before starting TRT, my free T levels were around 0.150 nmol/L, I was clearly deficient.

Labs:

• Total T: 20.78 nmol/L
• Free T: ~0.641 nmol/L
• SHBG: 10 nmol/L (below range)
• Estradiol: 63 pmol/L
• DHT: never tested
• LH/FSH suppressed

Current protocol: Testosterone cypionate 180mg 3x/week, HCG 500IU 2x/week, Anastrozole 1mg

The window: On original 80mg once weekly protocol. I had a major positive response lasting approximately 2 months that made me feel better every single week (energy, brain fog lifting, ED resolved, felt calmer, more assertive etc...) Even my IBS-D which was a lifelong issue at that point, resolved itself for the first time in 13 years. At approximately the two month mark, I totally crashed and never recovered since. I'm guessing this is due to the natural production shutting down.

Current problem: I feel exactly the same as I was before TRT. I lost all the effects that I gained progressively over two months. Higher doses haven't helped. HCG has had no effect. I've tried multiple dosing methods at different concentrations and never could ever reproduce the initial windows where I truly felt good.

I'm wondering if this could be DHT related since the ED came back, the IBS-D came back, everything negative came back despite adequate free T levels. I'm considering using a cream to boost DHT if it comes back low from the blood test.

Has anyone experienced this pattern?

 

[WhiteMale]

1mg of anastrozole at one-time? Or split up? PLease indicate the lab ranges and if in trough before your injection.

 

[Vince]

30 years old, been on TRT for a year. Looking for similar experiences.

Before starting TRT, my free T levels were around 0.150 nmol/L, I was clearly deficient.

Labs:

• Total T: 20.78 nmol/L
• Free T: ~0.641 nmol/L
• SHBG: 10 nmol/L (below range)
• Estradiol: 63 pmol/L
• DHT: never tested
• LH/FSH suppressed

Current protocol: Testosterone cypionate 180mg 3x/week, HCG 500IU 2x/week, Anastrozole 1mg

The window: On original 80mg once weekly protocol. I had a major positive response lasting approximately 2 months that made me feel better every single week (energy, brain fog lifting, ED resolved, felt calmer, more assertive etc...) Even my IBS-D which was a lifelong issue at that point, resolved itself for the first time in 13 years. At approximately the two month mark, I totally crashed and never recovered since. I'm guessing this is due to the natural production shutting down.

Current problem: I feel exactly the same as I was before TRT. I lost all the effects that I gained progressively over two months. Higher doses haven't helped. HCG has had no effect. I've tried multiple dosing methods at different concentrations and never could ever reproduce the initial windows where I truly felt good.

I'm wondering if this could be DHT related since the ED came back, the IBS-D came back, everything negative came back despite adequate free T levels. I'm considering using a cream to boost DHT if it comes back low from the blood test.

Has anyone experienced this pattern?

I would think your low shpg is causing the issues. Because you have low shpg, you should probably go on low dose along with daily injections. You may want to inject 10 mg daily, skip the HCG and AI. Members with anxiety issues and/or low shbg, seems like they always have a hard time getting dialed in.

R

Thread 'Low SHBG Guys'

Aug 10, 2019

Guys that have low SHBG, what protocols have you used and what is your SHBG?

I’m a low SHBG guy myself (11) prior to starting TRT and have tried ED @20mg and it still put my free over the top and E2 out of control. Just thought we could all share in one post what all we’ve tried and the results.

• Ref4ua
• shbg
• Replies: 50
• Forum: Testosterone Basics & Questions

 

[Cataceous]

You had a nice honeymoon period on the initial weekly 80 mg TC dose and then crashed about the time that HPTA suppression took full hold. You've proved that more testosterone is not the answer, and you may be making things worse with the excess, crashing SHBG, feeling the need to manipulate estradiol, etc. Maybe it's time to look elsewhere. It may seem counterintuitive, but sometime less testosterone is the key. See examples. If that doesn't do it then you need to consider other possible factors. One is that TRT's suppression of GnRH and/or kissptpin is a problem. This issue is not well characterized, but in my experience the loss of these hormones does matter. Alternatively, sometimes it helps to go back to basics, establishing a realistic daily rhythm in testosterone levels. This means having a nice midrange morning peak level that subsequently falls off by about 40% to the trough. Daily morning injections of a cypionate/propionate blend can accomplish this. In theory, both problems might be addressed with a trial of short-acting testosterone, such as testosterone nasal gel. The serum level pattern seen with nasal gel is not very natural, but the key is that there are short-lived physiological peaks and pretty long-lived troughs. The added benefit is that this reduces HPTA suppression, restoring some level of GnRH and kisspeptin. The main drawback in your case is that it will take some months to see results when coming off of such high dosing.

If you're interesting in something simpler but purely speculative then you could try cutting your TC dose back to 40 mg twice a week while adding enclomiphene and cistanche extract:

C

Thread 'A treatment candidate to reduce HPTA suppression under TRT. Possible hCG alternative?'

Jan 3, 2024

TL;DR: Some research suggests that echinacoside may complement a SERM in reducing TRT-induced negative HPT-axis feedback at the hypothalamus.

Background: In testosterone replacement therapy, elevated levels of testosterone and estradiol apply negative feedback to the hypothalamus. This suppresses the release of kisspeptin, which in turn suppresses the production of gonadotropin releasing hormone (GnRH). The lack of GnRH in turn suppresses production of LH and FSH at the pituitary,† which can then lead to a loss of endogenous testosterone production, testicular atrophy and...

• Cataceous
• cistanche echinacoside hcg hpta
• Replies: 9
• Forum: When TRT Is Not Enough (ED, Libido, & More)

• 

If all else fails then you can try directly adding in some GnRH (gonadorelin) and kisspeptin(-10) to your TRT. I have had success with this approach, but it is complicated.

 

[TheDemz]

I would think your low shpg is causing the issues. Because you have low shpg, you should probably go on low dose along with daily injections. You may want to inject 10 mg daily, skip the HCG and AI. Members with anxiety issues and/or low shbg, seems like they always have a hard time getting dialed in.

Hi, the anastrozole is 1mg split into twice a week (0.5 mg each).

All the lab ranges provided are from my through before injection on the Monday. The ranges are provided below.

• Total T: 20.78 nmol/L (range 2.8-21.6 nmol/L)
• Free T: ~0.641 nmol/L (derived from SHBG and total T)
• SHBG: 10 nmol/L (below range, range 13.3-88.5 nmol/L)
• Estradiol: 63 pmol/L (range 55-116 pmol/L)

The anastrozole was only added after my E2 spiked to about 243 pmol/L (normal range 55-165 pmol/L) following dosage change going from 80mg to about 160mg. It hasn't made any difference however going back in range with the anastrozole (AI). I haven't felt any different.

For the SHBG, it's always been low at 10-15 nmol/L before and during TRT.

Thank you for the replies, I'll review my protocol with the urologist.

 

[Vince]

Hi, the anastrozole is 1mg split into twice a week (0.5 mg each).

All the lab ranges provided are from my through before injection on the Monday. The ranges are provided below.

• Total T: 20.78 nmol/L (range 2.8-21.6 nmol/L)
• Free T: ~0.641 nmol/L (derived from SHBG and total T)
• SHBG: 10 nmol/L (below range, range 13.3-88.5 nmol/L)
• Estradiol: 63 pmol/L (range 55-116 pmol/L)

The anastrozole was only added after my E2 spiked to about 243 pmol/L (normal range 55-165 pmol/L) following dosage change going from 80mg to about 160mg. It hasn't made any difference however going back in range with the anastrozole (AI). I haven't felt any different.

For the SHBG, it's always been low at 10-15 nmol/L before and during TRT.

Thank you for the replies, I'll review my protocol with the urologist.

Vince Carter used to be here. He had low shbg. To feel good he needed low estrogen.

Thread 'Suicide Inhibitor like Aromasin/Exemestane'

Apr 20, 2018

https://www.excelmale.com/forum/showthread.php?7885-Inexplicably-high-Estrogens/page3

Is any one using a suicide inhibitor like this? Considering If I perhaps need something other than Anastrozole or would work better in my situation since I'm converting so much.

• Vince Carter
• Replies: 29
• Forum: Testosterone Side Effect Management

 

[FunkOdyssey]

I've tried multiple dosing methods at different concentrations and never could ever reproduce the initial windows where I truly felt good.

Can you elaborate more on exactly what other protocols you've tried? 1 mg anastrozole weekly alone can eliminate most subjective benefits of TRT.

I would try dropping back to a much lower dose, drop the AI, and if the hCG isn't clearly helping then drop that too. Then, experiment with a bit of DHT (don't go crazy) from cream or directly with a DHT topical. Future experiments I would also try: a full cream protocol, and separately, try daily test propionate. Between all of these, you should find something works for you.