Help Interpreting New Labs -- SHBG Increased?

[Vince Carter]

That is correct. I have no idea how it could drop -- I was curious about that, too. Maybe it is related to the cream.

E2 numbers over time:
July 2018: 61
- Protocol at the time was AI & HCG
Oct. 2018: 51
- Protocol at the time was AI (higher dose), HCG & Ibutamoren
Feb. 2019: 50
- Protocol is HCG, Ibutamoren, and T cream (no AI)

Do you think there's reason for concern?

Concern about what?

 

[madman]

That's good to know. Doesn't SHBG usually decrease, though, with the introduction of exogenous testosterone? Should I be hoping it will go down? I've seen some mixed information about that.

Transdermal method of trt whether standard body application or scrotal application usually have a minor impact on lowering SHBG.

When using injectable many will notice a small drop in SHBG but not always and it is usually large doses of T 200+ mg/week or the use of c-17 alpha alkylated orals which have been shown in studies to have a larger impact on lowering SHBG.

High T doses (excess androgens) and c-17 alpha alkylated orals (due to first pass) can have a strong effect on SHBG levels.

Most on trt are not using high T doses injected once weekly let alone c-17 alpha alkylated orals are only used by bodybuilders seeking to gain muscle/strength.

I believe Dr. Rand had stated in an earlier thread that he prescribes low dose oxandrolone or stanozolol along with trt to patients with really high SHBG.

If anything mesterolone (proviron) which is not c-17 alpha alkylated is more commonly prescribed in European countries to men on trt with high SHBG.

 

[bkb33]

Ya I see no reason for concern as well. If you’re feeling great, that’s usually the best indicator that your body is functioning optimally. When your body is not happy, and not functioning the way it’s supposed to, it has many ways to let you know. So if you feel great, that’s your body’s way of telling you to not change a thing, imo.

So you were on HCG mono with an ai the first two labs, and then testosterone cream during the 3rd set of labs? So ya it can’t be due to the testosterone cream. Your E2 was very similar on HCG mono as well. So you had a total T of 1989 while on HCG mono??

Thanks for the feedback — good to hear! Yep, I was on HCG mono with AI for the first two labs (1989 Total T), then HCG + TRT for the most recent numbers. I did find it interesting how similar E was despite the changes.

 

[Gman86]

Thanks for the feedback — good to hear! Yep, I was on HCG mono with AI for the first two labs (1989 Total T), then HCG + TRT for the most recent numbers. I did find it interesting how similar E was despite the changes.

Wow, that’s crazy that your testicles could produce that much test just from HCG. What brand were you using of HCG?

And ya you must just be lucky in regards to how much of your testosterone aromatizes into estrogen. That’s awesome that you don’t need an ai with such high test levels.

 

[bkb33]

Wow, that’s crazy that your testicles could produce that much test just from HCG. What brand were you using of HCG?

And ya you must just be lucky in regards to how much of your testosterone aromatizes into estrogen. That’s awesome that you don’t need an ai with such high test levels.

I was using the Empower brand HCG, 300 IU 3x/week. Out of curiosity, why does that make me lucky? Up to this point, I've thought my SHBG was a major hindrance.

 

[Gman86]

I was using the Empower brand HCG, 300 IU 3x/week. Out of curiosity, why does that make me lucky? Up to this point, I've thought my SHBG was a major hindrance.

I was just saying that you’re lucky that you don’t aromatize much of your testosterone into estrogen. Most guys with a 2300 testosterone level would have E2 close to 100, or over. You’re lucky that your E2 was only 50.

Your SHBG level is kind of a hindrance, not gonna lie. Most doctors would not be okay with you getting your total testosterone up where it needs to be in order for you to have a healthy free T level. You’re very lucky that you found a progressive doctor that isnt scared of seeing a patient have a total T of 2000+.

And I’m also on Empower’s HCG, but it adds nothing to my total T. So maybe it’s something with me, and not the HCG. Because clearly it was working amazingly for you.

 

[bkb33]

I was just saying that you’re lucky that you don’t aromatize much of your testosterone into estrogen. Most guys with a 2300 testosterone level would have E2 close to 100, or over. You’re lucky that your E2 was only 50.

Your SHBG level is kind of a hindrance, not gonna lie. Most doctors would not be okay with you getting your total testosterone up where it needs to be in order for you to have a healthy free T level. You’re very lucky that you found a progressive doctor that isnt scared of seeing a patient have a total T of 2000+.

And I’m also on Empower’s HCG, but it adds nothing to my total T. So maybe it’s something with me, and not the HCG. Because clearly it was working amazingly for you.

Interesting. Do you think I should look into oxandrolone or proviron or stanozolol, as @madman mentioned, to lower SHBG? I do agree that it's sort of problematic, even if free T is high, just because my TT has to get so high.

Regarding the HCG, I should note that my total T was already around 1200 before starting it. But yes, monotherapy with it did stimulate a big increase in Total T!

 

[CoastWatcher]

Interesting. Do you think I should look into oxandrolone or proviron or stanozolol, as @madman mentioned, to lower SHBG? I do agree that it's sort of problematic, even if free T is high, just because my TT has to get so high.

Regarding the HCG, I should note that my total T was already around 1200 before starting it. But yes, monotherapy with it did stimulate a big increase in Total T!

You know your doctor; what will the reaction be if you raise questions about oxandrolone, stanozolol...and so forth? It's a fair question, but it may be anxiety-inducing in some physicians and - as a result - the patient may suffer.

 

[Gman86]

Ya I wouldn’t even mess with those drugs. As long as your doctor is okay with you having such a high total T, I don’t see anything wrong with it. Just have to make sure HCT doesn’t go above 54. Other than that, as long as your BP is normal, and you feel great, I don’t see any harm in keeping your total T as high as it is.

 

[bkb33]

Thanks for the feedback, @CoastWatcher & @Gman86. My Dr and I had also discussed Danazol previously. Think I should stay away from that for the time being, too? My thought is that I feel great, but my baseline was so low, and I would love to see if I could feel even better.

 

[CoastWatcher]

Thanks for the feedback, @CoastWatcher & @Gman86. My Dr and I had also discussed Danazol previously. Think I should stay away from that for the time being, too? My thought is that I feel great, but my baseline was so low, and I would love to see if I could feel even better.

Beware what my doctor calls the "TRT Fidget" - the ongoing effort to fix what doesn't need fixing.

 

[bkb33]

Beware what my doctor calls the "TRT Fidget" - the ongoing effort to fix what doesn't need fixing.

Totally hear that. I'll remain cognizant of it. It's just so early for me, and I'm so new to TOT, that I wonder if I "don't know what I don't know," and I don't want to be complacent too quickly.

 

[bkb33]

Update I was so encouraged by the changes in my libido and sense of well-being through 4 weeks. It was like the world was entirely new.

Around that point, though, I hit a big wall, and my sex drive and confidence greatly decreased. This may be because, due to MA laws about only having 6 weeks of T onhand at a time, I had to slightly reduce the amount of T I applied for a few days before my new shipment arrived. I did not expect this minor change to affect me, and even if it did, I would expect I would have rebounded by now (2 weeks later).

After reviewing my labs, we increased my dosage from 2 clicks applied trans-scrotally (ED) to 4 clicks (ED), with 1-2 applied trans-scrotally and 2-3 applied to the inside of the leg. We also added 25mg Danazol EOD. It has not yet arrived, but I will let everyone know how it works.

I am hopeful the increased T + Danazol will bring me back to the effects I was feeling before -- or even better! If this doesn't work, next step may be trying injections or some combination of injections + cream.

 

[Cataceous]

Beware what my doctor calls the "TRT Fidget" - the ongoing effort to fix what doesn't need fixing.

I had this quote in mind as I continued with an experiment in switching to daily T propionate in spite of doing pretty well on EOD T enanthate. In this instance it turned out that doing "pretty well" was in some respects very inadequate compared to what was possible. So I think I'll have to be more circumspect when it comes to warning others against unnecessary experimentation; it can be hard to predict what someone else's subjective results will be.

 

[Gman86]

I had this quote in mind as I continued with an experiment in switching to daily T propionate in spite of doing pretty well on EOD T enanthate. In this instance it turned out that doing "pretty well" was in some respects very inadequate compared to what was possible. So I think I'll have to be more circumspect when it comes to warning others against unnecessary experimentation; it can be hard to predict what someone else's subjective results will be.

So you ended up doing better on daily prop than EOD enanthate?

 

[Cataceous]

So you ended up doing better on daily prop than EOD enanthate?

Overall, yes. And I'd say subjectively it's the best approximation I've had of my pre-hypogonadal days. Until this trial I hadn't even realized how much penile sensitivity I'd lost. It was a very pleasant and unexpected surprise to experience this degree of restoration. A contributing factor may be estradiol that's a little lower, as my actual injected testosterone decreased by 18%, while I held the AI use constant.

 

[apsjiml]

Many guys like me have elevated shbg because I have hemochromatosis (iron overload) that is a common cause of this. So, if it were me, I would want a full iron panel with saturation and ferritin. Liver iron overload is associated with elevated SHBG concentration and moderate hypogonadotrophic hypogonadism in dysmetabolic men without genetic ... - PubMed - NCBI