Came off TRT 2 years ago: my balls are much smaller than before and decreased fertility, but hormone levels are good. How can I get back to normal?

I’m not convince of this idea that high SHBG lowers FT. I can’t see a mechanism where this would be the case. Androgens lower SHBG, so low levels of androgens would see a rise in SHBG, and may be more than one factor increasing SHBG, like improvements in insulin sensitivity through fasting or starvation.

I should have been more clear with a robust TT 584 ng/dL and high SHBG his cFT would be at the bottom end.

SHBG inflating his TT.
 
I’m not convince of this idea that high SHBG lowers FT. I can’t see a mechanism where this would be the case. Androgens lower SHBG, so low levels of androgens would see a rise in SHBG, and may be more than one factor increasing SHBG, like improvements in insulin sensitivity through fasting or starvation.

It is far from a given that one will drive down SHBG when using exogenous T.

Not everyone will see a significant drop in SHBG.

Higher doses would have a bigger impact and even than the c-17 alpha-alkylated orals would hold the title when it comes to driving down let alone crushing SHBG!

My pre-trt SHBG was 34 nmol/L.

Always hovers around 30-32 nmol/L 7+ years on TTh!
 
The testing method is critical!

Always include the testing method (cFT, direct)/assay used (direct immunoassay, Equilibrium Dialysis, Equilibrium Ultrafiltration) and the reference range.

@Systemlord

This is the first thing you should be telling everyone on the forum that posts labs without all the critical info!

You have been on here long enough yet fail to mention this every time.
 
This is the first thing you should be telling everyone on the forum that posts labs without all the critical info!

You have been on here long enough yet fail to mention this every time.
This is the first thing you should be telling everyone on the forum that posts labs without all the critical info!

You have been on here long enough yet fail to mention this every time.

Fail to mention it every time? I just posted this. I haven’t posted here in forever.

I mean…thanks for the help and everything, seriously, but I don’t lurk here all the time and keep up with the requirements for posting. I’d be happy to adhere to them if I knew them…which is why I posted that info with no protest when it was asked.
 
Fail to mention it every time? I just posted this. I haven’t posted here in forever.

I mean…thanks for the help and everything, seriously, but I don’t lurk here all the time and keep up with the requirements for posting. I’d be happy to adhere to them if I knew them…which is why I posted that info with no protest when it was asked.

This was directed at Systemlord.
 
ok your problem is small balls relative to previous after long term trt. i had similar issue.For me it Took 2 years to get ball volume back. Its a long and slow process and i needed 3xweekly HCG ( i used recombinant HCG high dose )for the full 2 years. The stem cells from which the relevent testicular tissue recovers takes a long long time to regenerate. Longer than the actual Leydig cell function that puts out the T .
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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