Low SHBG - Lower Total T and Feeling Great

ERO · Nov 20, 2017

I too have low SHBG and I have never felt anything like what you are feeling now, so congratulations! You results make sense in context with Free T levels. Guys with low SHBG often have huge free T levels on a "normal" TRT dose, but I have read that free T being either too high or too low is problematic, so your lower T dose is likely putting your Free T in the ideal range, where a guy with normal SHBG would need a larger dose to have his free T in the ideal range.

You results make me want to try lower doses and see if I can feel anything from TRT. If I do, it would be the first time ever.

Kettlebells · Nov 21, 2017

I am a type 2 diabetic. Low SHBG is par for the course with type 2 diabetes and so is hypogonadism. I was building muscle with a total-T of 240, a free-T of 8.2, and an SHBG of 22. I had no low-T symptoms other than lack of libido and non-responsiveness to phosphodiesterase 5 (PDE5) inhibitors. I underwent coronary artery bypass graft surgery last fall, which resulted in the removal of testosterone replacement therapy (TRT). It is now believed that hypergonadal diabetic non-response to PDE5 inhibitors is due to Rho kinase overexpression (the Rho-associated protein kinase 1, or ROCK1 isomer to be exact). Rho kinase works in the opposite direction of nitric oxide synthase (NOS). It keeps corpus carvenosum in its contracted state by increasing Ca2+ (NOS activity results in the reduction of Ca2+); therefore, even though nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) are increased while PDE5 is inhibited with the use of a PDE5 inhibitor, an erection does not occur because of ROCK1 overexpression keeps the corpus cavernosum from relaxing. If my experience is any gauge, addressing hypogonadism does fix non-response to PDE5 inhibitors in diabetics. With 60mg of Axiron, my total T was only 398 and my free T was only 12.6 on my last visit to my endo, but I have the libido I had in my twenties and erection firmness like I had in my teens with a PDE5 inhibitor (I may not look it, but I am in my mid-fifties). I have also put on 10lbs of muscle since my avatar was shot (my total-T was 240 and free-T was 8.2 when that photo was shot). I am prime example of why total-T is not as important as free-T in a lot guys. My endo told me that my problems would go away when I reached a free-T of 12, and she was right.

riverside · Nov 21, 2017

Kettlebells said:
I am a type 2 diabetic. Low SHBG is par for the course with type 2 diabetes and so is hypogonadism. I was building muscle with a total-T of 240, a free-T of 8.2, and an SHBG of 22. I had no low-T symptoms other than lack of libido and non-responsiveness to phosphodiesterase 5 (PDE5) inhibitors. I underwent coronary artery bypass graft surgery last fall, which resulted in the removal of testosterone replacement therapy (TRT). It is now believed that hypergonadal diabetic non-response to PDE5 inhibitors is due to Rho kinase overexpression (the Rho-associated protein kinase 1, or ROCK1 isomer to be exact). Rho kinase works in the opposite direction of nitric oxide synthase (NOS). It keeps corpus carvenosum in its contracted state by increasing Ca2+ (NOS activity results in the reduction of Ca2+); therefore, even though nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) are increased while PDE5 is inhibited with the use of a PDE5 inhibitor, an erection does not occur because of ROCK1 overexpression keeps the corpus cavernosum from relaxing. If my experience is any gauge, addressing hypogonadism does fix non-response to PDE5 inhibitors in diabetics. With 60mg of Axiron, my total T was only 398 and my free T was only 12.6 on my last visit to my endo, but I have the libido I had in my twenties and erection firmness like I had in my teens with a PDE5 inhibitor (I may not look it, but I am in my mid-fifties). I have also put on 10lbs of muscle since my avatar was shot (my total-T was 240 and free-T was 8.2 when that photo was shot). I am prime example of why total-T is not as important as free-T in a lot guys. My endo told me that my problems would go away when I reached a free-T of 12, and she was right.

Thanks for this post, Kettlebells. Success stories are always great to read! For your Free T reading of 12.6, what was the range? My range has a top end of 18.1 ng/dl so that doesn't seem all that low in contrast to your low Total T. I am not a diabetic but have not responded well to PDE5 inhibitors in the past which I attribute to a complete lack of a libido which I would say has occurred in most of my life and definitely during my 1st year of TRT.

I have done more research and reading posts in the last 1.5 years than is probably healthy and I haven't found much information/science for feeling good with normal to high end Free T labs BUT having low Total T. If anyone has found this information, please add a link to this thread. I think there is also an impact for us low SHBG guys from Free E2. I would love to see one of our doctors or veterans weigh in on impacts to low SHBG guys for:

Does any level of low Total T matter if Free T is in range or is high range?

How do we determine the optimal level of E2 when we most likely have high free E2 and only test for total E2? I would assume we need a lower total E2 than normal SHBG guys.

Kettlebells · Nov 21, 2017

That was a LabCorp blood test. I do not recall the top-end value, but I do believe that my value was mid-range. Low SHBG is common with type 2 diabetes. My hbA1C was 5.8, which is very good for a type 2 diabetic. I always get better numbers when I am on TRT. I also work out a lot harder when I am TRT, so that may have something to do with it.

a_crossfitter · Jan 19, 2018

jth0524 said:
Riverside, I just started injecting daily and using the one click cream to scrotum. My question is about your injection sites. I’ve read propionate can leave some serious post injection pain. What sites are you using to inject? Thanks

The trick is to use 27g 1/2 or 5/8 syringes

I inject 20mg test prop daily mainly on my right shoulder...I barely get post injection pain (pip).

Kettlebells · Jan 19, 2018

Kettlebells said:
I do believe that my value was mid-range.

I was referring to free T in this sentence.

Vince Carter · Jan 19, 2018

I might theorize with the stuff Ive been working for my own low SHBG and obviously Free T is a better gauge to health than the total, I would prefer to have a good Free T number than any whatever TT number. With that in mind, I've been pulling and watching very carefully...Free Estrogen. With low SHBG = high Free T (should also) = high FREE Estrogens. My Free Estrogen right now is twice the lab range even on .25mg EOD AI, and LC/MS/MS is ~42.

Of course my Free T is astronomical: 439.1 (Range: 35-155)
My last SHBG was 12, is always 12-15

You could be experiencing much lower Free Estrogens along with the lower Free T that is accounting for your wellbeing and success.

Just my Free E theory.

madman · Jan 19, 2018

Vince said:
Interesting thread, I would think that your T levels are too low. Apparently I'm wrong, the main thing is it's working, I hope it continues to work for you. Keep us posted on your journey.

His free t is in the upper end of the range due to his low shbg. His lower total should not matter as he feels great overall. So many are always chasing a high total t when in reality having a healthy free t is all that matters................excess total t/ free t is not always better!

Systemlord · Jan 20, 2018

Add me to the list of guys discovering how horrible I felt towards the high ranges (SHBG is 18-20), who knew I hit my sweet spot on the first attempt. When I first started TRT my protocol was 75mg once weekly and felt pretty damn good except for the last few day of the week, so instead of spitting up my shots I asked my doctor for an dosage increase. Started new protocol of 50mg twice weekly and felt pretty good but got a little teary eyed when watching TV. So to manage my E2 issues I began injecting 25mg EOD, what a mistake as I blew past 850 ng/dL and my E2 became a wild animal.

My new protocol is 17.5mg EOD and feeling better everyday since I reduced my dosage only a week ago, I know it usually takes 4-6 weeks to feel the full benefits, can only imagine what lies in store for me. I'm going to shoot for 550-650 ranges, it's really a guess of where I believe I'll end up. 75mg once weekly put me at 531 ng/dL with a trough of 442 ng/dL, so 17.5mg EOD (70mg total weekly) should net me slightly more than 531 ng/dL. When I was on 200mg E3W I noticed the point at which my body starts holding on to my T better, I would peak at 1200 and 10 days later I'd land 400-600 ng/dL at which point the loss of T slowed down quite a bit.

My thinking is I simply didn't have enough SHBG to grab ahold of all of that T, probably pissed it right out and held onto only the high E2 leftovers. I don't believe any low SHBG guy should ever shoot for high normal, we just don't have enough SHBG to hold onto that much real estate! Leave the high normal ranges to high SHBG guys since they have the real estate to utilise all of that T without all that waste.

Vince Carter · Jan 20, 2018

Systemlord said:
My thinking is I simply didn't have enough SHBG to grab ahold of all of that T, probably pissed it right out and held onto only the high E2 leftovers. I don't believe any low SHBG guy should ever shoot for high normal, we just don't have enough SHBG to hold onto that much real estate! Leave the high normal ranges to high SHBG guys since they have the real estate to utilise all of that T without all that waste.

That's pretty close to what I believe we're working with here.

Low SHBG - Lower Total T and Feeling Great

ERO

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riverside

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a_crossfitter

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madman

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