Blood work and TRT input

[rafapark]

Hello Guys:

I’ve been in TRT for about 3 months and I am puzzled about my blood work. I am switching to Defy from a local clinic in June. In the meantime, I’d appreciate some input. I am 61 yo.

Baseline results:

BLOOD WORK 1
1/15/2018
Estradiol (non sensitive): 30.8 pg/ml
Testosterone Total: 434.8 ng/ml
Testosterone, Free (Calculated) : 5.0 ng/dl
DHEA-S: 96.9 ug/dl
SHBG : 74 nmol/L

Started TRT on 3/9/2018

BLOOD WORK 2 - 4/26/2018
Labcorp through the local clinic
Estradiol (non sensitive): 31.1 pg/ml
Testosterone Total: 1194 ng/dl
Testosterone,free (direct): 12.4 pg/ml
DHEA- S: not tested
SHBG: not-tested

In preparation to my appointment with Defy, I did another test

BLOOD WORK 3 - 5/21/2018
Labcorp
Estradiol(sensitive) : 24.8 pg/ml (normal 8.0 -35)
Testosterone Total : >1500 ng/dl (normal 296 -916)
Testosterone Free (direct) : 24.8 pg/ml (normal 6.6-18.1)
DHEA-S : 125.7 ug/dl (normal 48.9 - 344.2)
SHBG: 81 nmol/L (normal 19.3 -76.4)

This is what I am taking
Testosterone ( Cypio/pro/etha) blend: 80 mg twice a week - injected IM
Anastrazole: 0.5 mg twice a week
HCG: 300 IU - Twice a week injected subc
Tadalafil 5 mg: every day

I am feeling pretty good with good energy, libido and strong erections. I am however puzzled by the increase of SHBG from 74 to 81 as compared to the baseline and such a quick increase on free and total testosterone from BLOOD WORK 2 TO BLOOD WORK 3 in less than a month. I will run another test for testosterone > 1500 to make sure I know where it is. The only difference from BLOOD WORK 2 TO BLOOD WORK 3 in terms of therapy are: my doc changed me from once a week to twice a week T injections and from a dual blend (cypio/pro) to a three blend as described above. I also added the Tadalafil.

Based on this tests and what I have been able to learn from this forum I assume I can discontinue the Ai and switch to once a week T injections.

Any reason why my SHBG went up so much? Any other input will be greatly appreciated

RAFA

 

[Systemlord]

Usually SHBG decreases are one begins TRT, but sometimes it goes in the opposite direction. It's said that older men see fluctuations in SHBG levels and also SHBG increases within 24 hours of a workout. However I believe the increase in SHBG is from the Tadalafil, drugs/chemicals are known to raise SHBG, drugs have pros and cons because there not natural to the body.

It's also known that there's a variability in the stickiness of SHBG, meaning your SHBG doesn't get greedy and hold hardnose to all your testosterone.

Most guys wouldn't be getting the results you are with similar SHBG levels, you dodged a bullet. Perhaps stay away from diets that raise SHBG, such as veggies and alcohol.

 

[rafapark]

Thanks for the input. Yes it makes sense about Tadalafil. I will research that. I understand about the alcohol. I don't drink anyway... but veggies? How would veggies impact SHBG ? Any veggie in particular? There is no way veggies can be eliminated from a healthy diet.

 

[FeelingLost]

snip...
Based on this tests and what I have been able to learn from this forum I assume I can discontinue the Ai and switch to once a week T injections.

Any reason why my SHBG went up so much? Any other input will be greatly appreciated

RAFA

Hi RAFA, Nice to see another fellow in their 60's here I am 64 been on TRT for two years. I am with Defy as well.

About your question. NO at your thru the roof TT FT lvl your AI is the only think keeping your E2 sens at a dam near perfect lvl.

I would not change a thing until you talk with Defy then you will just move to their protocol as soon as your new drugs arrive.

Why do you want to stop the AI? Except for a handfull of outliers on this forum most can't take more T cyp than 100mg/wk to be able to stop the AI. I need it at 120/wk.

There is one member here floating a theory that continued use of an AI will bring down your SHGB. I have no clue if that is a thing.
My shgb has been falling for the last two years I have no clue why in fact I posted that question to the group.

 

[rafapark]

Hi Feelinglost. Thanks for your reply. Yes, I will continue as is until I talk to Defy. I did not know that a workout would raise SHBG. I did have a hard workout less than 24 hours before the test so maybe that was causing in. I was also fasting that day, not sure if that has anything to do with the increase. I will test in a few weeks again and see how it goes. I am still confused about why eating veggies would increase SHBG as Systemlord states below. Any comments on that or anything else that might raise SHBG? There are so many variables. Still learning. Thank you.

 

[FeelingLost]

Hi Feelinglost. Thanks for your reply. Yes, I will continue as is until I talk to Defy. I did not know that a workout would raise SHBG. I did have a hard workout less than 24 hours before the test so maybe that was causing in. I was also fasting that day, not sure if that has anything to do with the increase. I will test in a few weeks again and see how it goes. I am still confused about why eating veggies would increase SHBG as Systemlord states below. Any comments on that or anything else that might raise SHBG? There are so many variables. Still learning. Thank you.

I have never heard of eating veggies and moving your SHGB. As I understand it you get what you are born with and have to deal with it.

Where your SHGB lies does determine the best protocol. High SHGB do good with 1 big shot a week. Low SHGB many shots thru the week.
My SHGB is 24 and I inject M/W/F On high SHGB guys one big shot has brought their SHGB down so that would be something you should ask Defy about.

I always 12 hour fast before blood draw but I also drink a ton of water. We are talking a gal in 24 hours.

I have had LabCorp blood test that were just flat wrong twice last year alone. When you get some weird out of the norm always question the test before making a big protocol change.

 

[rafapark]

Yes, I was thinking in repeating the SHBG test to make sure. I have tested SHBG throughout the years and never seen it so high. Mine is usually in the low 70s pretty consistently before and after TRT. It should not change so much. Thank you for the comments.

 

[FeelingLost]

Yes, I was thinking in repeating the SHBG test to make sure. I have tested SHBG throughout the years and never seen it so high. Mine is usually in the low 70s pretty consistently before and after TRT. It should not change so much. Thank you for the comments.

If Defy won't sell you just an SHGB test checkout Nelsons DiscountedLabs. 68 bucks sounds reasonable.
A lot of us guys use his service for quick checks between protocol checkups.

https://www.discountedlabs.com/sex-hormone-binding-globulin-shbg

 

[rafapark]

Yes, thank you. I was planning in using discount labs. Pretty reasonable.

 

[madman]

I have never heard of eating veggies and moving your SHGB. As I understand it you get what you are born with and have to deal with it.

Where your SHGB lies does determine the best protocol. High SHGB do good with 1 big shot a week. Low SHGB many shots thru the week.
My SHGB is 24 and I inject M/W/F On high SHGB guys one big shot has brought their SHGB down so that would be something you should ask Defy about.

I always 12 hour fast before blood draw but I also drink a ton of water. We are talking a gal in 24 hours.

I have had LabCorp blood test that were just flat wrong twice last year alone. When you get some weird out of the norm always question the test before making a big protocol change.

There have been some studies showing that high fiber (vegetables/fruits/whole grains/legumes) diets increase shbg and high protein diets lowering shbg in older men.

There is a stronger correlation with protein/shbg than fiber/shbg.

I would say liver fat/inflammation/insulin also has an impact on ones shbg levels as there is a lot of research being done in this area.

 

[madman]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480437/


-ample evidence suggests that inter-individual differences in plasma shbg levels are in PART inherited.

-hepatic production of shbg fluctuates throughout the life cycle and is influenced primarily by metabolic and hormonal factors.

 

[rafapark]

Madman thank you for your response. When you say high fiber, how much is it? more than 30 grams a day? 50? 100?. I track my nutrition using the nutrition app Cronometer which is pretty detailed and I am usually around 30 to 40 grams of fiber (out of around 140 grams of carbs). According to my research a good target for fiber is around 14 grams per 1000 calories. My target is 2460 calories which means a target of 34.5 grams of fiber. Protein is around 160 grams and fats 140 on a 2460 calorie diet. I also fast once or twice per week for 20 hours or more, eating 1300 calories at the end of the fast. I will however watch for my fiber intake and do the research on high fiber impacting SHBG. If you have a link for the studies that you mention, could you forward to me? I'm very interested in reading them. Thanks for the recommendation.

 

[rafapark]

I found this link that talks about fiber/protein intake vs SHBG.

http://blog.insidetracker.com/from-...new-connections-with-muscle-gain-and-fat-loss

Interesting that there are two conflicting studies. However the summary of the study is:

Summary: "An increase in fiber intake may increase levels of SHBG and decrease levels of free testosterone. However, a diet high in fiber combined with high protein and low fat may decrease SHBG levels and ultimately increase levels of free testosterone".

The only problem that I see in this link is that it does not say what a high fiber or high protein diet means. I assume high fiber means higher than 14 grams per 1000 calories ( which is the recommended fiber consumption) and high protein means 1 gram of lean body weight or more. I guess a ketogenic diet will not be good for somebody with high SHBG.

 

[DragonBits]

Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines.

Naghii MR1, Mofid M, Asgari AR, Hedayati M, Daneshpour MS.
Author information



Abstract

Boron possesses widespread properties in biochemistry and nutrition. Acute supplementation with 11.6 mg of boron resulted in a significant increase in plasma boron concentration. Given such a fast bioavailability, the objective was to determine whether acute (hourly or daily), and weekly supplementation could have any significant biological effects on the steroid hormones and further on some inflammatory biomarkers. Eight healthy male volunteers attended the laboratory on three occasions (days 0, 1 and 7). On the first day (day 0), a blood sample collection at 8.00 A.M was followed by ingestion of placebo with the breakfast. On the next day (supplementation-day 1), similar procedure was followed by ingestion of a capsule containing 10mg of boron. On both occasions blood was collected every 2h for the next 6h. Subjects were requested to consume a capsule of 10mg boron every day with their breakfast, and on the day 7, the blood collection was carried out at 8.00 A.M, again. Boron in plasma increased significantly following hours and weekly consumption. Six hours supplementation showed a significant decrease on sex hormone binding globulin (SHBG), high sensitive CRP (hsCRP) and TNF-α level. After one week (in samples taken at 8.00 A.M, only), the mean plasma free testosterone increased and the mean plasma estradiol decreased significantly. Dihydrotestosterone, cortisol and vitamin D was elevated. Also, concentrations of all three inflammatory biomarkers decreased after supplementation. Of note, despite decreased proinflammatory cytokines, based on recent clinical data, this must be the first human study report to show an increase level of free testosterone after boron consumption.

https://www.ncbi.nlm.nih.gov/pubmed/21129941

 

[rafapark]

Yes, thank you. I already take 8 mgs of Boron. Maybe I should increase to 12mgs.

 

[1Draw]

You have to watch your GFR kidney function if taking boron. Been taking 6mg day for about 2 years for high SHBG and my GFR has been declining. Didn’t know that until recently so I’ve stopped.
https://www.webmd.com/vitamins/ai/ingredientmono-894/boron
If your GFR is ok then I would take it.

 

[rafapark]

Yes, thank you. Good point.