Low SHBG but normal SHBG Pre TRT

Hi all, I know there are countless low SHBG posts but I felt the need to start another. Are most of us normal SHBG before TRT? Does that matter in any way?

I am thinking of drastically cutting back my dosage as my free T is consistently high. I have had Total T almost to 1000 with a similar protocol as well with a very high Free and Bioavailable T. Obviously my SHBG is drastically lowered by TRT. Since that is the cause, can't I reduce my dosage to increase SHBG?

I started TRT at 140mg weekly and have titrated up while trying to balance E2 as I am a hyper converter to estrogen and high metabolizer of hormones. I am now wondering if I never hit my sweet spot which could be around 100mg weekly split into daily injections and maybe my SHBG would tick up? Even if it didn't, maybe my free E2 would be a more normal value as it seems total T doesn't matter to low SHBG guys.

Libido and bad ED directly related to a lack of libido continue to be my primary issues. I have waves of feeling good but they don't last long (few days).

Please let me know what you think.

Natural levels in 6/2016:

SHBG = 33 (11 - 57)
Total T = 193 (241 - 827)
Free T = 3.5 (3.7 - 23.28)


My recent labs (5/2017):

SHBG = 16 (10-57)
Total T = 745 (240-950)
Free T = 31.3 (4.65 - 18.1)
E2 = 19 (10-40)

Current protocol:
26 mg Test-C Every Day
220IU HCG eod
.25 mg Anastrazole Every Day
6000 IU vitamin D ED
25mg DHEA ED

I would focus right around that obviously wrong E2 test, the correct test is the LC/MS/MS and has a lab range of <30, a lab range of (10-40), is not the correct test, and your E2 is likely LOWER than 19, which would be my area of interest if it were me. We're on a very very similar protocol, you and me. SHBG typically falls with TRT, not always into the teens or by any kind of set number but it is typical for SHBG to lower with Exo-T use. The only way to raise SHBG is to get off TRT. You're doing what you need to in order to work with the hand you've been dealt, but I suspect it's an E problem/overuse of AI. I would retest with the proper test and report back.

I should've clarified that this was an ultra sensitive LC/MS test from Mayo. I've never not drawn a sensitive test (I've used 2 top well known docs in this arena). I'm not sure why the range is 10-40 but it is sensitive.

OK tho some would still say 19 is on the low side.

I would suggest trying some T gel applied to the scrotum daily. Its the only thing that has given me any libido while on TRT. Now I know everybody is different and it likely won't do that for everybody, but I would say its worth a try. Perhaps drop your daily injection amount a bit at the same time and you may do better with a higher E2 level. I know you are a hyper converter but if you went to, say .15 Anastrozol a day from the .25.

That is a lot to do all at once, though - best bet would be to change one variable at a time so you know if it is helping or not.

Thanks - I have actually tried that. One click of 50mg/ml daily drove my DHT through the roof and I had minimal results along with noticeable hair loss and acne. I tried a lower dose cream of 20mg/ml and felt no effects.

I am mainly wondering if free T is the true feeling of TRT and total T doesn't seem to matter as much for us low SHBG guys, could simply operating at a lower total T and normal range free t possibly be better? I am thinking if androgens obviously drove my SHBG down substantially from 33 to 16 after TRT. It seems that SHBG should raise a bit if I didn't introduce as much testosterone??

My libido definitely has come and gone since starting TRT which makes me hopeful to find the sweet spot. My E2 has run the spectrum of 100 to a low of 10 on a .5mg AI ED protocol. I do not react strongly to AI like many others do. .25mg AI EOD placed me in a 26-32 range on E2. When I switched AI to .25 ED I had a good 4 day stretch of high libido which was a huge achievement.

You may well feel better on a lower T dose and subsequent lower Total T level. It is definitely worth experimenting to find out. Not everybody feels best at the top of the physiological range, some guys feel far better at, say 700 than they do at anything higher.

"E2 = 19 (10-40)" if my estradiol that low, I definitely would think it would hurt the good way I feel. There are so many benefits to good healthy levels of estrogen why suppress it so much?

I wouldn't say you're a hyper converter to estrogen, unless I missed the part where you're on AI.

E2 is low, and most likely is the cause of your issues.

Don't obsess over free test being too high, especially if you're still symptomatic.

johndoesmith said:

I wouldn't say you're a hyper converter to estrogen, unless I missed the part where you're on AI.

E2 is low, and most likely is the cause of your issues.

Don't obsess over free test being too high, especially if you're still symptomatic.

Click to expand...

I am on a somewhat aggressive dose of .25 mg AI ED. I know the 19 E2 sticks out but that result was shortly after stopping an experimental protocol of .5mg ED which brought my E2 down to 10. I will draw labs again next week but would guess I am back to my normal 26-32 range before when I was taking .5mg AI EOD. I have had E2 as high as 100 and low as 10 and have had similar symptoms. Though I have had definite spurts of libido which give me hope of the infamous "sweet spot".

I just don't understand why Total T matters at all for low SHBG if Free T is way above range. Even if it is just a waste of testosterone product, why do we need it if we don't have the transport mechanism? My simplistic mind says just to monitor Free To going forward and reducing the dose and hope for the best. I doubt it could be worse..