low SHBG guy, free T high, too much medication or SHBG creates imbalances?

I have been wondering, since last conversation with Doc. if I actually I'm using too much Testosterone medication, the low SHBG confuses me a bit, before talking to doc I had always thought that to feel well TT would be the number to look at, I was wrong, Free T would be the testosterone ready in the system to do all the good things for our mind and body, this is true except for low SHBG guys.

for most of my TRT I have been on 0,5ml twice a week and lately on 0,35ml x 3 weekly and pretty much my TT is always about 700/800 ng/dl and FT about 30 pg/ml sometime a bit more, as you can see my TT never gets to upper end but my FT goes over the upper limit,

does this happen to all low SHBG guys? in other words do all SHBG guys have a higher then normal FT level in order to feel their best?

I had been experiencing shortness of breath and fatigue while exercising for long time, last BW at the end of January showed my HCT at 51.1 so I decided to donate, I felt great afterwords and tried to lower to 0,3ml 3 x week, better with the symptoms but just didn't do the rest, back on 0,35ml feel much better but I'm afraid I'm developing again this shortness of breath and fatigue when exercising

I have to say also that I was diagnosed with mild sleep apnea probably due to my sinuses which I just had a procedure two weeks a go for, so that could be the cause of my problems

Guys with low SHBG pretty much always have very high Free T. Your shortness of breath issue is most likely due to your sinus issues and/or sleep apnea. I have very low SHBG and while I don't feel anything from TRT I do not experience shortness of breath.

Just an fyi, free testosterone is not the only bioavailable testosterone. Testosterone bound to shbg is unavailable, but testosterone bound to albumin is "lightly bound" and still usable. This constitutes approximately 30-40% of your total in most men, which is why total testosterone matters. There are some tests that will show you your total, bioavailable, and free testosterone, but the reason many doctors don't test bioavailable is because free alone is a pretty good indicator of your overall bioavailable testosterone.

Interestingly, I have very low shbg, so when I took clomid (notorious for raising shbg), my shbg stayed quite low. The result was that my bioavailable testosterone was 601 ng/dL, a whopping 60% of my total of 1012 ng/dL. Nonetheless, I still felt like garbage. Those tests were done via Quest

hopefully the procedure I did will help with sleep apnea, if I can ask what are your numbers and protocol?

ERO said:

Guys with low SHBG pretty much always have very high Free T. Your shortness of breath issue is most likely due to your sinus issues and/or sleep apnea. I have very low SHBG and while I don't feel anything from TRT I do not experience shortness of breath.

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Those kinds of numbers are hallmarks for low shbg...low(ish) totals but FreeT is over range, which is no problem at all as far as I'm concerned. Does everyone feel their best that way...maybe, maybe not, but you won't see good trough numbers until you increase to EOD from this M/W/F routine you're on now. That's what I would do. Have you had your SHBG tested recently if ever? If you went on EOD shots, you would still use the same amount Cyp mg, but cumulatively over the week, at least to start with.

last BW SHBG was 12.5, Doc suggested me already to go for everyday injection, but I can't think of injecting every day IM, I tried subQ before and I couldn't take it for more then two weeks, I just felt crashing everything

Vince Carter said:

Those kinds of numbers are hallmarks for low shbg...low(ish) totals but FreeT is over range, which is no problem at all as far as I'm concerned. Does everyone feel their best that way...maybe, maybe not, but you won't see good trough numbers until you increase to EOD from this M/W/F routine you're on now. That's what I would do. Have you had your SHBG tested recently if ever? If you went on EOD shots, you would still use the same amount Cyp mg, but cumulatively over the week, at least to start with.

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Instead of SubQ, try shallow IM in the shoulders. That is what a great many of us are doing. In my case daily injections with my low SHBG have not helped, but it has helped others so I would definitely give it a try if I were you.

ERO said:

Instead of SubQ, try shallow IM in the shoulders. That is what a great many of us are doing. In my case daily injections with my low SHBG have not helped, but it has helped others so I would definitely give it a try if I were you.

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ERO is on target. I inject daily and well over 90% of those injections are shallow-IM (thigh, shoulders). Good, stable results despite my low SHBG.

I'm in the same boat with the low shbg I started with a 2x a week schedule then a three times a week injection schedule and recently started an EOD schedule and so far I do feel better. I also never thought I'd be injecting every other day but taking baby steps I got there and the insulin syringes have been a huge lifesaver much better than the 23 gauge needle I started out with. I'm very thankful to this site and all the members who have helped guide me to optimizing my HRT.

hey funny i just opened a thread about the same thing.. i was kind of freaking out reading things like ERO experience.. so far i started wiht standard 2x a week im protocol for 3 months or so , before i knew i had low SHBG.. which i just found out yesterday..

i think overall i definteily have some positive results with TRT.. i feel a bit "healthier" a bit more energy.. not "Crashed" i notice better memory, and i have periodic spikes for about a week of libido, after which unfortunately it goes totally down the drain again..

based on what ive read about peopels TRT experience though, mine has maybe been about 30-40% results vs 100% like a normal TRT job..

Ive been reading more and more about this subq every other day injections seem to help a lot of people.. and im going to try to switch to that..

im just wondering though.. when i took clomid alone, my SHBG went all the way up to like 35.. and now its like barely above single digits..

i know taking TRT invalidates SERMs like clomid from working to keep the HPTA active, but would taking clomid or novladex lets say bring up your SHBG while on TRT?

Also I was reading this really crazy shit how women take birth control and it makes their SHBG permanently elevated by as much as 100%.. even after stopping meds.. shit.. id be willing to try anything.. anyone have any thoughts?

https://www.ncbi.nlm.nih.gov/pubmed/16409223

ERO - maybe youd want to ginnypig this stuff since you feel liek shit no matter what? ive read a few of your posts because i seem to be in kind of similar straits, but maybe not quite as bad.. i woudl try the birth control pills but im afraid to screw up any benefits i do have..

I also have been doing daily injection for 3 1/2 weeks now. I dropped my amount of weekly T, down from 200mg per week to 140mg per week. I'm injecting shallow IM easy touch 27g 1/2 and feeling great.

Does anyone know if taking Clomid along with TRT would still raise SHBG?

Ardoc said:

Does anyone know if taking Clomid along with TRT would still raise SHBG?

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In theory it could, and in fact some TRT docs have tried that approach. I am going to try it as well, but I don't hold out a lot of hope at this point because Clomid is known to raise SHBG in guys with normal SHBG levels - but low SHBG guys do not have normal SHBG expression so expecting it to work the same seems a bit of a reach. Still, nothing ventured, nothing gained so I am going to try.

Thanks Ero!
In my case it seems that my SHBG, which I know was at the lower end of the range back when I was having good numbers with weekly injections, has declined. I will be confirming that in a couple weeks.
If it is now lower I have to assume it is as a result of TRT and I am doing EOD injections now with lower TT and high FT.
Might be worth trying?

Ero do you know what dosages have been tried for this purpose?

Ardoc said:

Ero do you know what dosages have been tried for this purpose?

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I do not, but I know that for HTPA re-start purposes the dosages are often small in comparison to what one can see on some of the bodybuilding forums. Like 12.5 mg/day to start. I know that Dr. Saya @ Defy Medical has used Clomid for this purpose so perhaps he will see this post and offer more information.

Ardoc said:

Thanks Ero!
In my case it seems that my SHBG, which I know was at the lower end of the range back when I was having good numbers with weekly injections, has declined. I will be confirming that in a couple weeks.
If it is now lower I have to assume it is as a result of TRT and I am doing EOD injections now with lower TT and high FT.
Might be worth trying?

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I would definitely get some insulin syringes and try small daily shallow IM injections of T as well. That has not been helpful for me, but it has helped a lot of low SHBG guys so definitely give it a go and give it a solid 4-5 weeks to see how you feel. Low SHBG and a single weekly T injection is a very bad combination.

did you notice any difference from 2 x week and 3 x week? I switched about 6 months a go from 2 x to 3 x and It didn't really make any difference, on paper neither, what made difference is daily HCG for me, but like everybody says I should give it a try to every day injection

PAUL-E said:

I'm in the same boat with the low shbg I started with a 2x a week schedule then a three times a week injection schedule and recently started an EOD schedule and so far I do feel better. I also never thought I'd be injecting every other day but taking baby steps I got there and the insulin syringes have been a huge lifesaver much better than the 23 gauge needle I started out with. I'm very thankful to this site and all the members who have helped guide me to optimizing my HRT.

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I was on 0,5ml x 2 weekly and switching to 0,35ml x 3 weekly didn't really make any difference to me, I'm speculating more freq injection may not work for me as well, but I should try, what is your protocol now?

ERO said:

I would definitely get some insulin syringes and try small daily shallow IM injections of T as well. That has not been helpful for me, but it has helped a lot of low SHBG guys so definitely give it a go and give it a solid 4-5 weeks to see how you feel. Low SHBG and a single weekly T injection is a very bad combination.

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very interesting the fact about Clomid in increasing SHBG, only way to see if that can work for us would be try it