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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Anyone combine injections and cream? How do you feel?
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<blockquote data-quote="Cataceous" data-source="post: 195183" data-attributes="member: 38109"><p>The variation in testosterone is natural, as long as it's daily and in a physiological range. Under these conditions it's not likely to push up hematocrit. A problem with low SHBG is that guys may be using "normal" total testosterone as a target, when they need to be using free testosterone instead. Low SHBG means that total testosterone is lower for the same free testosterone. The HPTA naturally regulates by free testosterone and free estradiol, not total testosterone.</p><p></p><p>Here's an example using the Vermeulen free T calculator: A normal healthy young guy has SHBG of 30 nMol/L and total testosterone of 650 ng/dL. The calculated free testosterone is 15 ng/dL. So the question is, what happens with his low-SHBG twin, who is physiologically identical except that his SHBG is 10 nMol/L? The twin's HPTA is regulating to achieve the same free T, 15 ng/dL. This means that his total testosterone must be different, and indeed it is 450 ng/dL, much lower.</p><p></p><p>Now suppose the low-SHBG twin goes on TRT. If he makes the mistake of assuming he should match his total testosterone to that of his normal-SHBG twin, 650 ng/dL, then what happens is that his free testosterone jumps to over 22 ng/dL, which is almost 50% higher than his natural set point. It's no surprise then that he gets high hematocrit and symptoms of high estradiol, even though his total serum hormone levels appear to be midrange.</p><p></p><p>Bottom line: If you have low SHBG then you need to target lower total testosterone than is typical. Tracking free testosterone can be helpful, but I don't view any of the methods as foolproof—including a test with the potential for high accuracy, such as equilibrium dialysis.</p></blockquote><p></p>
[QUOTE="Cataceous, post: 195183, member: 38109"] The variation in testosterone is natural, as long as it's daily and in a physiological range. Under these conditions it's not likely to push up hematocrit. A problem with low SHBG is that guys may be using "normal" total testosterone as a target, when they need to be using free testosterone instead. Low SHBG means that total testosterone is lower for the same free testosterone. The HPTA naturally regulates by free testosterone and free estradiol, not total testosterone. Here's an example using the Vermeulen free T calculator: A normal healthy young guy has SHBG of 30 nMol/L and total testosterone of 650 ng/dL. The calculated free testosterone is 15 ng/dL. So the question is, what happens with his low-SHBG twin, who is physiologically identical except that his SHBG is 10 nMol/L? The twin's HPTA is regulating to achieve the same free T, 15 ng/dL. This means that his total testosterone must be different, and indeed it is 450 ng/dL, much lower. Now suppose the low-SHBG twin goes on TRT. If he makes the mistake of assuming he should match his total testosterone to that of his normal-SHBG twin, 650 ng/dL, then what happens is that his free testosterone jumps to over 22 ng/dL, which is almost 50% higher than his natural set point. It's no surprise then that he gets high hematocrit and symptoms of high estradiol, even though his total serum hormone levels appear to be midrange. Bottom line: If you have low SHBG then you need to target lower total testosterone than is typical. Tracking free testosterone can be helpful, but I don't view any of the methods as foolproof—including a test with the potential for high accuracy, such as equilibrium dialysis. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Anyone combine injections and cream? How do you feel?
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