I'm with Defy and have been on TRT and HCG for about 2.5 months. I have my follow up with Nurse Jill in about a month, but wanted to get some more opinions on my bloodwork as the low SHBG is very concerning. I also live in one of the few states without LabCorp and will be traveling in a couple weeks and will be able to use DiscountedLabs.....so I kind of want to take that opportunity to get a few more labs on the cheap and make the picture clearer.
January 12.5mg EOD Clomid and Cabergoline labs. Prolactin had been high in the past but has been fine as of the last several labs so no more caber. Pituitary MRI came back normal last summer.
http://imgur.com/a/qKHHX
Didn't feel any better after several months despite lab values so switched to 80mg twice a week subq cypionate and 40iu twice a week hcg + some anastrozole. Labs were 3 days after injection in the morning recently.
http://imgur.com/a/ixd54
Follow up with Defy isn't for another month so I want to get other's opinions though I know I'm in great hands. A few points:
6'1" 215 and 26 years old. I lift and have started running more. My main concern is libido. Lack thereof. I do notice nocturnal erections when I wake in the middle of the night, but morning wood is only a few days a week, and absolutely zero spontaneous erections. Same prior to taking anything, on clomid, and now. I remember what it was like being 17, that is what I'm chasing and I'm not even close. I have packed on about 5lbs and have put on quite a bit of strength in the 2.5 months on TRT, that is about the only difference. Might've had a libido spike around week 4-5, but that is relative to having none.
Testosterone is fairly high on trough. I was at 320ng/dl before any meds, but my body kicks it into high gear when LH rises. I question whether I need test and should maybe go back to serms or try hcg mono.
Iron really improved after I started supplementation (notice the differences). I take iron, iodine, selenium, vitamin d, and fish oil daily.
Thyroid is a problem. TSH has always been > 2. I did iodine replenishment for a while and that spiked it, but even after all of that and daily iodine + selenium supplementation, it is the same. I have never had hypothyroid symptoms and my body temperatures are good at 97.7F waking and 98.6 mid afternoon. All of my labs look good except for rT3. rT3 to fT3 ratio is not good (14.2, should be > 20). This is a problem. Oh and I had TPO Antibodies tested previously and they came back negative.
I did have one cortisol test ever and it was at the tip top of the range shortly after waking; right where it should have been.
E2 is not the proper assay. I'm going to get the Quest LC/MS/MS. Could have E2 issues, but SHBG seems like a much bigger issue.
LOW SHBG. This is the main point of my post. I know high test will lower it a bit, but if you go back to my clomid labs, the TT/FT ratio was still way off so I suspect this has been a problem for a long time, and potentially is the reason I had low T in the first place. A few points on this
a. I know glucose isn't the same as an insulin test. I have zero family history of type 2 diabetes. Insulin is the most potent hormone to SHBG so I'm going to a low carb paleo diet to be safe. Should probably get this tested.
b. Thyroid could be a reason for low SHBG too. I might ask about temporary T3 supplementation to improve rT3.
c. I ordered Dr Wilson's adrenal fatigue book. Would correspond to the rT3 issue. Do you think I need more adrenal bloodwork ie a 4x day cortisol saliva test?
d. I want to cut down to 190lbs or so. I know this hurts thyroid and other hormones in the short term, but is beneficial in the long term. I will not go too drastic and will follow Leigh Peele's refeeding advice. Still will hurt hormones, I don't see a way around this. T3 supplementation during the cut could help.
e. I think my liver function is good, but am not 100% sure on how to interpret those results. I've stopped drinking as of late and will continue to not drink much if at all. I ordered berberine, slo niacin, and milk thistle to help with liver/insulin as suggested in the peaktestosterone post on curing low shbg.
f. I've been told I'm not a snorer so I don't suspect sleep apnea. I do wake up for a minute once or twice a night on average though. Maybe a sleep study? I usually have 2 nights a week where I have trouble falling asleep. I'm working on improving this drastically. Not stressed in life otherwise. No chronic illnesses or anything like that. Good sleep and I wake up fine. Only real sleep issue is falling asleep sometimes as previously stated.
g. I've read ED or EOD injections can be beneficial for people with low SHBG. But I don't think I'm going to change up the injection protocol until my appointment.
h. While I do have the family genes for it. I started balding really quickly and noticeably by 22. Never took meds or anything, I just shave it and look good. I suspect things started going downhill for my testosterone in my early 20s, but don't recall for sure, but it coincides. Wouldn't low SHBG lead to higher DHT (I haven't read a lot on DHT, nor have had it tested)? I'm just curious to see if this adds anything to the picture.
Long winded post I know, but I want to try to cover every base that I can. I've been reading about everything I've been able to find. I think that it would be a good idea to test h1ac, ferritin, and tibc. Not sure if adrenals need further looking into because I read a post by Vettester Chris stating that adrenal and iron issues would usually have a much lower fT4 and mine was quite high.
Looking forward to the responses!
January 12.5mg EOD Clomid and Cabergoline labs. Prolactin had been high in the past but has been fine as of the last several labs so no more caber. Pituitary MRI came back normal last summer.
http://imgur.com/a/qKHHX
Didn't feel any better after several months despite lab values so switched to 80mg twice a week subq cypionate and 40iu twice a week hcg + some anastrozole. Labs were 3 days after injection in the morning recently.
http://imgur.com/a/ixd54
Follow up with Defy isn't for another month so I want to get other's opinions though I know I'm in great hands. A few points:
6'1" 215 and 26 years old. I lift and have started running more. My main concern is libido. Lack thereof. I do notice nocturnal erections when I wake in the middle of the night, but morning wood is only a few days a week, and absolutely zero spontaneous erections. Same prior to taking anything, on clomid, and now. I remember what it was like being 17, that is what I'm chasing and I'm not even close. I have packed on about 5lbs and have put on quite a bit of strength in the 2.5 months on TRT, that is about the only difference. Might've had a libido spike around week 4-5, but that is relative to having none.
Testosterone is fairly high on trough. I was at 320ng/dl before any meds, but my body kicks it into high gear when LH rises. I question whether I need test and should maybe go back to serms or try hcg mono.
Iron really improved after I started supplementation (notice the differences). I take iron, iodine, selenium, vitamin d, and fish oil daily.
Thyroid is a problem. TSH has always been > 2. I did iodine replenishment for a while and that spiked it, but even after all of that and daily iodine + selenium supplementation, it is the same. I have never had hypothyroid symptoms and my body temperatures are good at 97.7F waking and 98.6 mid afternoon. All of my labs look good except for rT3. rT3 to fT3 ratio is not good (14.2, should be > 20). This is a problem. Oh and I had TPO Antibodies tested previously and they came back negative.
I did have one cortisol test ever and it was at the tip top of the range shortly after waking; right where it should have been.
E2 is not the proper assay. I'm going to get the Quest LC/MS/MS. Could have E2 issues, but SHBG seems like a much bigger issue.
LOW SHBG. This is the main point of my post. I know high test will lower it a bit, but if you go back to my clomid labs, the TT/FT ratio was still way off so I suspect this has been a problem for a long time, and potentially is the reason I had low T in the first place. A few points on this
a. I know glucose isn't the same as an insulin test. I have zero family history of type 2 diabetes. Insulin is the most potent hormone to SHBG so I'm going to a low carb paleo diet to be safe. Should probably get this tested.
b. Thyroid could be a reason for low SHBG too. I might ask about temporary T3 supplementation to improve rT3.
c. I ordered Dr Wilson's adrenal fatigue book. Would correspond to the rT3 issue. Do you think I need more adrenal bloodwork ie a 4x day cortisol saliva test?
d. I want to cut down to 190lbs or so. I know this hurts thyroid and other hormones in the short term, but is beneficial in the long term. I will not go too drastic and will follow Leigh Peele's refeeding advice. Still will hurt hormones, I don't see a way around this. T3 supplementation during the cut could help.
e. I think my liver function is good, but am not 100% sure on how to interpret those results. I've stopped drinking as of late and will continue to not drink much if at all. I ordered berberine, slo niacin, and milk thistle to help with liver/insulin as suggested in the peaktestosterone post on curing low shbg.
f. I've been told I'm not a snorer so I don't suspect sleep apnea. I do wake up for a minute once or twice a night on average though. Maybe a sleep study? I usually have 2 nights a week where I have trouble falling asleep. I'm working on improving this drastically. Not stressed in life otherwise. No chronic illnesses or anything like that. Good sleep and I wake up fine. Only real sleep issue is falling asleep sometimes as previously stated.
g. I've read ED or EOD injections can be beneficial for people with low SHBG. But I don't think I'm going to change up the injection protocol until my appointment.
h. While I do have the family genes for it. I started balding really quickly and noticeably by 22. Never took meds or anything, I just shave it and look good. I suspect things started going downhill for my testosterone in my early 20s, but don't recall for sure, but it coincides. Wouldn't low SHBG lead to higher DHT (I haven't read a lot on DHT, nor have had it tested)? I'm just curious to see if this adds anything to the picture.
Long winded post I know, but I want to try to cover every base that I can. I've been reading about everything I've been able to find. I think that it would be a good idea to test h1ac, ferritin, and tibc. Not sure if adrenals need further looking into because I read a post by Vettester Chris stating that adrenal and iron issues would usually have a much lower fT4 and mine was quite high.
Looking forward to the responses!
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