High SHBG

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I have been on TRT for 6 years starting with compounded cremes, then Axiron and always struggled to get levels up and for the past 6 months switched to IM injection. My current protocol is as follows: 100 mg Testosterone cypionate weekly; 250 IU 3x/week.

I just had labs drawn at trough (Quest Diagnostics) and they are as follows:

Total T 826 NG/dL (250-1100)
Free T 80.9 pg/mL (35-155)
Estradiol ultrasensitive 29 pg/mL (<=29)
SHBG 62nmol (10-50)
Hct 47.7%
Hmg 15.7 (13.2-17.1)
Prolactin 5 NG/mL (2-18)
PSA 1.9

Questions:
1) I have been doing all sorts of things to lower SHBG (stinging nettle, Vit D3, boron, magnesium) but it seems not to be doing anything
2) Would increasing my testosterone dose be a better strategy for pushing free T higher?
3) If I did the conversion correctly my free T is .98% of the total and should be closer to 2%. If I should increase my done, by what amount. Should I go to 125 mg/week?
30 Estradiol seems to be at the top of the range, but I am not having symptoms. My nipples have itched in the past when I have gone too high but not the case now
3) I asked to have prolactin pulled because I have been having difficulty achieving orgasm. The result seems to be fine. Is there another explanation?

Let me know what you think.

Eric
 
Defy Medical TRT clinic doctor
High shbg calls for Less frequent injections and higher dose. So increasing to once weekly 125mg should help.
 
Increasing your dose to get Free T to move is your only option, SHBG requires you play it where it lies...you can't do anything about it contrary to the BroScience that is out there.
Your E @ 29 may very well be too low, for you, given so much is bound up (SHBG binds E, and T).
 
Should SHBG be looked at as a ratio?

Meaning the OP has 62/826 ratio, about 0.75 ratio.

I have a 348 TT and a SHBG of 35, a 0.10 ratio.

So while my shbg is lower, as a ratio it is higher, or impacts me more than the OP.

Is that a good way to look at this?
 
My doc is open to increasing my dose. The question is how much. If I have done my calculations correctly, my current free T is about .98% or about half of what it should be. My current dose is 100 mg/week. Should I go to 125 mg? 150 mg? Anyone with experience with high SHBG? I am repeating my values below for your convenience:

Total T 826 NG/dL (250-1100)
Free T 80.9 pg/mL (35-155)
Estradiol ultrasensitive 29 pg/mL (<=29)
SHBG 62nmol (10-50)
Hct 47.7%
Hmg 15.7 (13.2-17.1)
Prolactin 5 NG/mL (2-18)
PSA 1.9
 
You're going to need your testosterone levels above the normal ranges to affect your SHBG, you will probably need to donate blood as a result. Your current dosage is pretty weak for a high SHBG guy, once weekly injections is ideal for you. I suggest 140mg weekly.
 
I have been on TRT for 6 years starting with compounded cremes, then Axiron and always struggled to get levels up and for the past 6 months switched to IM injection. My current protocol is as follows: 100 mg Testosterone cypionate weekly; 250 IU 3x/week.

I just had labs drawn at trough (Quest Diagnostics) and they are as follows:

Total T 826 NG/dL (250-1100)
Free T 80.9 pg/mL (35-155)
Estradiol ultrasensitive 29 pg/mL (<=29)
SHBG 62nmol (10-50)
Hct 47.7%
Hmg 15.7 (13.2-17.1)
Prolactin 5 NG/mL (2-18)
PSA 1.9

Questions:
1) I have been doing all sorts of things to lower SHBG (stinging nettle, Vit D3, boron, magnesium) but it seems not to be doing anything
2) Would increasing my testosterone dose be a better strategy for pushing free T higher?
3) If I did the conversion correctly my free T is .98% of the total and should be closer to 2%. If I should increase my done, by what amount. Should I go to 125 mg/week?
30 Estradiol seems to be at the top of the range, but I am not having symptoms. My nipples have itched in the past when I have gone too high but not the case now
3) I asked to have prolactin pulled because I have been having difficulty achieving orgasm. The result seems to be fine. Is there another explanation?

Let me know what you think.

Eric


140-150 mg/week would more than likely make a difference................big jump though and would be better to try 125 mg/week for 6 weeks and gauge how you feel along the way, have labs at 6 weeks and go from there.

Either 125 mg/week may be all you need or might have to increase to 140-150 mg/week.
 
I agree with my friends here...once per week @ 125, or 140 with labs in 6 weeks. I think here you really want to target your Free T for dose purposes and know you'll have to run a pretty high TT to get there.
 
Danazol lowers SHBG, I was in the same boat and was told to increase T injection only to have E raise, SHBG raise and free T to stay at same level. Smaller sub Q injections twice a week and Danazol have helped me and I am taking only .125 mg or AI now.
 
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Insulin is another factor. I am type 1 diabetic and learned that insulin helps regulate other hormones and SHBG. Call Defy medical. Just pay the money. I went to every endocrinologist under the sun for over 4 years and am finally having sex and morning wood again. I would pay the cost ten times over. The medical advice from standard doctors is terrible, especially endos who should know wtf their talking about
 
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