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<blockquote data-quote="Rand McClain DO" data-source="post: 91038" data-attributes="member: 90"><p>Hi 1Draw,</p><p>A few ways that I know of to reduce SHBG are to lower your E2 (I prefer to use the "sensitive" assay) to a tipping point that I see around just over 20pg/ml. In addition, maintenance of a high (or at least adequate) protein diet, supplementing with nettle, and/or supplementing with a relatively small dose of an anabolic steroid tends to reduce SHBG. The relatively small anabolic steroid dose would be, eg, oxandrolone 5mg - a dose that typically would not, by itself, infer any anabolic benefit to an adult male.</p><p>Red blood cell increases, along with hemoglobin and hematocrit increases, are most often a result of sleep apnea. This condition frequently goes undiagnosed until patients begin using testosterone, at which time the elevations become apparent because the LEVERAGE of testosterone applied to the nightly oxygen debt results in these assay elevations. I call it "training in your sleep". But, before you get any ideas about skipping your cardio workouts, this kind of nightly hypoxic training is not beneficial to your health. Sleep apnea is associated with pulmonary hypertension, daytime fatigue, and getting fat (not only affecting your food choices, but the metabolism of them). Perhaps as or more important is that if you are training in your sleep you are certainly not getting the rest and recuperation, regeneration and rejuvenation you need. (And, no, even if you slept all day, the hypoxic "training" you get at night is not the same as climbing hills on your bike for 7-8 hours).</p><p>Rarely, individuals have what is known as a JAK2 gene mutation which drives the production of RBC's, hemoglobin and hematocrit upward.</p><p>In either case, therapeutic phlebotomies are useful to keep blood from getting too viscous and avoiding SE's therefrom. However, if sleep apnea is the cause of the assay elevations, in my opinion, much more important is to fix the underlying cause so that one can get the requisite rest and all that comes with it nightly. I have seen so many guys who come to my office with their water and food, exercising well, and taking all the right supplements but complain they cannot get to their fitness goals. I ask them how much sleep they are getting and I hear, "well, I'm working 2 jobs right now, so I'm getting about 5-6 hours every night". No way to grow muscle, lose fat, and achieve optimum health this way. If you are bagging 9-10 hours of rack time, BUT, you aren't getting enough oxygen during this time, you are not getting requisite rest required to achieve optimum health and fitness as described above. One with sleep apnea is actually better off spending say 4 hours (one typical first sleep cycle) "asleep" and then the next 4 hours in a position in which he or she can at least breath well enough to get sufficient oxygen perfusion, possibly "awake" but still resting. Better option for sleep apnea of course is to see an ENT specialist who has experience treating sleep apnea and address treatment and resolution of the sleep apnea.</p><p>For those with the JAK2 gene mutation, the only treatments of which I am aware use "cancer" drugs (eg, hydroxyurea), but I have had some success with a combination of therapeutic phlebotomies while limiting consumption of iron in attempts to deplete iron store to the point at which hemoglobin can no longer be made in excess (no iron, no hemoglobin - sort of a self-induced iron deficiency "anemia" state).</p><p>Re exemestane v anastrozole, I find a loose correlation between 1mg of anastrozole with 25mg of exemestane. The MOA's are different, but exemestane can be used effectively to reduce conversion from T to E.</p><p>And, yes, by dosing your T more frequently (and keeping your T titer more narrow), often you can avoid as much conversion from T to E and thereby reduce the need for an anti-estrogen therapy.</p></blockquote><p></p>
[QUOTE="Rand McClain DO, post: 91038, member: 90"] Hi 1Draw, A few ways that I know of to reduce SHBG are to lower your E2 (I prefer to use the "sensitive" assay) to a tipping point that I see around just over 20pg/ml. In addition, maintenance of a high (or at least adequate) protein diet, supplementing with nettle, and/or supplementing with a relatively small dose of an anabolic steroid tends to reduce SHBG. The relatively small anabolic steroid dose would be, eg, oxandrolone 5mg - a dose that typically would not, by itself, infer any anabolic benefit to an adult male. Red blood cell increases, along with hemoglobin and hematocrit increases, are most often a result of sleep apnea. This condition frequently goes undiagnosed until patients begin using testosterone, at which time the elevations become apparent because the LEVERAGE of testosterone applied to the nightly oxygen debt results in these assay elevations. I call it "training in your sleep". But, before you get any ideas about skipping your cardio workouts, this kind of nightly hypoxic training is not beneficial to your health. Sleep apnea is associated with pulmonary hypertension, daytime fatigue, and getting fat (not only affecting your food choices, but the metabolism of them). Perhaps as or more important is that if you are training in your sleep you are certainly not getting the rest and recuperation, regeneration and rejuvenation you need. (And, no, even if you slept all day, the hypoxic "training" you get at night is not the same as climbing hills on your bike for 7-8 hours). Rarely, individuals have what is known as a JAK2 gene mutation which drives the production of RBC's, hemoglobin and hematocrit upward. In either case, therapeutic phlebotomies are useful to keep blood from getting too viscous and avoiding SE's therefrom. However, if sleep apnea is the cause of the assay elevations, in my opinion, much more important is to fix the underlying cause so that one can get the requisite rest and all that comes with it nightly. I have seen so many guys who come to my office with their water and food, exercising well, and taking all the right supplements but complain they cannot get to their fitness goals. I ask them how much sleep they are getting and I hear, "well, I'm working 2 jobs right now, so I'm getting about 5-6 hours every night". No way to grow muscle, lose fat, and achieve optimum health this way. If you are bagging 9-10 hours of rack time, BUT, you aren't getting enough oxygen during this time, you are not getting requisite rest required to achieve optimum health and fitness as described above. One with sleep apnea is actually better off spending say 4 hours (one typical first sleep cycle) "asleep" and then the next 4 hours in a position in which he or she can at least breath well enough to get sufficient oxygen perfusion, possibly "awake" but still resting. Better option for sleep apnea of course is to see an ENT specialist who has experience treating sleep apnea and address treatment and resolution of the sleep apnea. For those with the JAK2 gene mutation, the only treatments of which I am aware use "cancer" drugs (eg, hydroxyurea), but I have had some success with a combination of therapeutic phlebotomies while limiting consumption of iron in attempts to deplete iron store to the point at which hemoglobin can no longer be made in excess (no iron, no hemoglobin - sort of a self-induced iron deficiency "anemia" state). Re exemestane v anastrozole, I find a loose correlation between 1mg of anastrozole with 25mg of exemestane. The MOA's are different, but exemestane can be used effectively to reduce conversion from T to E. And, yes, by dosing your T more frequently (and keeping your T titer more narrow), often you can avoid as much conversion from T to E and thereby reduce the need for an anti-estrogen therapy. [/QUOTE]
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