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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Advice on whether or not to start TRT or look for other causes
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<blockquote data-quote="VA-Hiker" data-source="post: 272310" data-attributes="member: 46287"><p>Thanks Vince. My concern with metformin is that the research I can find indicates that it raises SHBG and lowers Free and total testosterone. Much of the research seems to revolve around women with PCOS (polycystic ovarian disease). However there is an older study with a smaller sample size of 12 healthy men which had similar findings of raising SHBG and lower testosterone, even though a small size the findings appear to be statistically significant. </p><p></p><p>[URL unfurl="true"]https://smj.org.sa/content/smj/23/8/934.full.pdf[/URL]</p><p></p><p>In another study of obese diabetic and obese non-diabetic males they found an impact to testosterone levels in both groups, and an increase in SHBG in the non-diabetic group. This patient population also doesn't exactly apply to me as I am anything but obese at this point and have successfully kept off any extra weight for quite a number of months. </p><p></p><p>Also, of interest, typically it seems those with diabetes or obese tend to have a lower SHBG, I'm the opposite. There also seems to be some thought that higher levels of SHBG offer a protective effect from T2DM. </p><p></p><p>[URL unfurl="true"]https://onlinelibrary.wiley.com/doi/10.1038/oby.2001.90[/URL]</p><p></p><p>This next study had a slightly different focus looking at men with hyperprolactenemia and new onset T2DM, finding an association between endogenous testosterone and metformin benefits. They also noted an increase in SHBG during treatment. This was a smaller sample size also with about 28 patients. </p><p></p><p>[URL unfurl="true"]https://onlinelibrary.wiley.com/doi/full/10.1111/bcpt.13307[/URL]</p><p></p><p>I'm really trying to learn and understand these relationships and I do appreciate the help.</p><p></p><p>An increase in lean muscle mass seems to also lead to improved insulin sensitivity and also allows from more efficient utilization of glucose and conversion to glycogen stores within the muscle from what I understand. </p><p></p><p>The doctor at the clinic after recommending I start testosterone (I know these can be biased), had a rationale of hoping to see an increase in muscle mass and improvement in my A1c. If this failed he did mention starting metformin. A repeat A1c is part of the 3 month follow up lab work he wants.</p></blockquote><p></p>
[QUOTE="VA-Hiker, post: 272310, member: 46287"] Thanks Vince. My concern with metformin is that the research I can find indicates that it raises SHBG and lowers Free and total testosterone. Much of the research seems to revolve around women with PCOS (polycystic ovarian disease). However there is an older study with a smaller sample size of 12 healthy men which had similar findings of raising SHBG and lower testosterone, even though a small size the findings appear to be statistically significant. [URL unfurl="true"]https://smj.org.sa/content/smj/23/8/934.full.pdf[/URL] In another study of obese diabetic and obese non-diabetic males they found an impact to testosterone levels in both groups, and an increase in SHBG in the non-diabetic group. This patient population also doesn't exactly apply to me as I am anything but obese at this point and have successfully kept off any extra weight for quite a number of months. Also, of interest, typically it seems those with diabetes or obese tend to have a lower SHBG, I'm the opposite. There also seems to be some thought that higher levels of SHBG offer a protective effect from T2DM. [URL unfurl="true"]https://onlinelibrary.wiley.com/doi/10.1038/oby.2001.90[/URL] This next study had a slightly different focus looking at men with hyperprolactenemia and new onset T2DM, finding an association between endogenous testosterone and metformin benefits. They also noted an increase in SHBG during treatment. This was a smaller sample size also with about 28 patients. [URL unfurl="true"]https://onlinelibrary.wiley.com/doi/full/10.1111/bcpt.13307[/URL] I'm really trying to learn and understand these relationships and I do appreciate the help. An increase in lean muscle mass seems to also lead to improved insulin sensitivity and also allows from more efficient utilization of glucose and conversion to glycogen stores within the muscle from what I understand. The doctor at the clinic after recommending I start testosterone (I know these can be biased), had a rationale of hoping to see an increase in muscle mass and improvement in my A1c. If this failed he did mention starting metformin. A repeat A1c is part of the 3 month follow up lab work he wants. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Advice on whether or not to start TRT or look for other causes
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