Confirmed low testosterone, recovery time?

Hello everyone,

First let me start out by saying this forum has an excellent wealth of knowledge, especially in the stickys. Back in late 2016 I starting having episodes unexplained fatigue, heart palpitations and my sex drive started disappearing quickly. I truly felt like I was dying, my sleep was shallow and never felt well rested. I had lost all muscle mass and became physically weak all the time, so I decided to see a doctor which after a blood test confirmed my testosterone was 119 ng/dL. My endo prescribed 200 mg every three weeks back in February which I soon learn would never work as by week three I was already at the bottom of the range and my E2 was making me feel horrible.

I decided to change doctors and my new endo prescribed 75 mg weekly which put me at 550 ng/dL (FT 15.5 ng/dL, SHBG 18 nmol/L) in just four weeks, at my lowest point a day before injection I'm at 442 ng/dL. At the end of the fourth, fifth and sixth week I experience what felt like the partial return of my sex drive but only for one day near the end of the week. I'm now on my seventh injection and have already reached five half lives and my doctor says all hormone levels looks great. My sleep has improved a little , mood is better and cognitively feel a little better. My E2 is in the mid 20s and I'm a little confused by this back and forth return of my sex drive, my thyroid blood tests and body temps look fine.

I thought for sure I'd be feeling dramatically better by the time I reached a steady state, but it seems to be taking longer. I'm 45, 6ft, 230 pounds I'm type 2 diabetic and am wondering is this what recovery will look like in the coming months?

When can I realistically expect to see a return of my energy, sex drive and muscle mass increases?

Thanks.

You're only at the seventh week of treatment? Frankly, that's still very early in the game for most patients. Your SHBG is vey low and I'd be surprised if you ever hit the mark you're aiming for by injecting once weekly. A protocol of 50 mg every 3.5 days is likely to be more successful. How much HCG are you injecting, and how frequently?

CoastWatcher said:

You're only at the seventh week of treatment? Frankly, that's still very early in the game for most patients. Your SHBG is vey low and I'd be surprised if you ever hit the mark you're aiming for by injecting once weekly. A protocol of 50 mg every 3.5 days is likely to be more successful. How much HCG are you injecting, and how frequently?

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Week seven started yesterday on this 7 day protocol. No HCG, I'm injecting 75 mg every 7 days. Since switching from every 3 weeks to every 7 days has brought about a big difference in the way that I feel. I don't feel the peaks and valleys much anymore, I thought HCG was for people looking to restore their natural testosterone levels. I'm assuming more SHBG would transport more testosterone to my body's tissues, also I'm type 2 diabetic which would explain low SHBG. Also won't my SHBG, FT go higher in range after being on testosterone for a longer period of time?

Thanks.

Systemlord said:

Week seven started yesterday on this 7 day protocol. No HCG, I'm injecting 75 mg every 7 days. Since switching from every 3 weeks to every 7 days has brought about a big difference in the way that I feel. I don't feel the peaks and valleys much anymore, I thought HCG was for people looking to restore their natural testosterone levels. I'm assuming more SHBG would transport more testosterone to my body's tissues, also I'm type 2 diabetic which would explain low SHBG. Also won't my SHBG, FT go higher in range after being on testosterone for a longer period of time?

Thanks.

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Hcg does many things, all of them valuable. Not only does it preserve testicular vitality and appearance, it also can support libido while backfilling other critical hormonal pathways that have been depleted due to the shutdown of the HPTA axis caused by exogenous testosterone. It's true that some men don't respond subjectively to Hcg, but it ought to be a part of all protocols. I make that statement as a cynic in this matter - I am one of the men who don't feel a thing from Hcg, but use it for all the reasons I should. I'm grateful that my libido was restored without it.

Your SHBG is not likely to rise. There's very little that can be done to raise it. That means it's all the more important for you to consider taking the notion of more frequent, smaller injections of testosterone one step further. Low SHBG means your free testosterone will zip up...and out; you'll clear your testosterone injection very quickly. Those of us with lower SHBG inject twice weekly, every other day, or daily (I inject every morning). It's nothing to be alarmed about, just something to factor in when a protocol is designed.

I asked my endo about injecting at home and she was fine with that but wanted to wait until I start showing really positive improvements and to make sure everything is done right since my inexperience in injecting could sabotage recovery. While I don't feel peaks and valleys anymore like when I was on that E3W protocol, I do feel low on injection days so once I start injecting at home I will definitely try injecting every 3.5 days.

Once I start injecting every 3.5 days will that change my overall levels since they would be maintained at a higher level?

Also does one lose free testosterone at the same rate as total testosterone?

With that SHBG you're going to have to go to E3.5D as stated, minimum, if not further split it up to EOD. Fortunately you're on the best forum to learn about Low SHBG how to manage it.