I think I am getting it all wrong with dose frequency - High SHBG and poor sleep

[Sandz]

So I've been trying to dial it in for 8 months, starting dose from my doc was 120mg 1x IM. I soon switched to 2x a week sub Q because the peaks were literally keeping me up all nigh, felt like I was on speed, I was too much at the especially at the beginning. I'm a little dude, 165lb, not that it matters, but 4 weeks in I got labs, didn't know Id need a sensitive tests, and I was over 1500. That was in Feb, so I have leaned a lot, had many labs and studied how I feel and my sleep/recover/workouts etc.

8 months in and the below numbers are total dose per week split. I know for sure I was switching too often, sometimes only giving it 4 weeks, not 6 or better yet 8, I know.

120mg 2 x a week
100mg 2 x a week
80mg 2 x a week, 826 through Monday AM furthest out from Friday shot. SHBG was 47. Albumin was 4.4, E was like low 20s sensitive. (free T calc 1.84%)

Thought I would get more androgenic benefit and more even stable numbers at 3x a week so
back to 90mg 3x a week though.

Then to 84mg 3x a week - 1134 through Monday AM furthest out from Friday shot. SHBG was 70. Albumin was 4.6, E was mid 30s so probably even lower sensitive but no symptoms, E is under control. (free T calc 1.54%)

Now at 78mg 3x a week, thinking I will get close to the 80mg numbers and sleep well, but I think I am doing it wrong 3x and still not sleeping. I think I am learning that there is more aromatase activity at 3x per week and this whole time I thought it would stabilize. Is it accurate that slightly longer troughs means less aromatase activity overall? Does more frequency mean slightly higher transient SHBG-suppressing effects, but temp peaks help suppress SHBG? I guess the serum level stays more consistent but the SHBG is higher, am I on to something? I don't feel that different at 826 vs 1134, I felt fine...I think

I am going to ride this out for 8 weeks, 3 weeks in, but If I test again and SHBG is still up, keeping my free T lower than it could be, who cares what the total is.....If I can get a better net effect on a lower dose, I think I will try that. If I was at 800+ before, going back to 78mg (close to 80, easy to measure) If I can get around the same and good free T ratios, the overall sleep and androgenetic benefit would be better, ya? Bottom line, and last question is, is it possible I'm just a 2x a week kinda guy?

 

[madman]

So I've been trying to dial it in for 8 months, starting dose from my doc was 120mg 1x IM. I soon switched to 2x a week sub Q because the peaks were literally keeping me up all nigh, felt like I was on speed, I was too much at the especially at the beginning. I'm a little dude, 165lb, not that it matters, but 4 weeks in I got labs, didn't know Id need a sensitive tests, and I was over 1500. That was in Feb, so I have leaned a lot, had many labs and studied how I feel and my sleep/recover/workouts etc.

8 months in and the below numbers are total dose per week split. I know for sure I was switching too often, sometimes only giving it 4 weeks, not 6 or better yet 8, I know.

120mg 2 x a week
100mg 2 x a week
80mg 2 x a week, 826 through Monday AM furthest out from Friday shot. SHBG was 47. Albumin was 4.4, E was like low 20s sensitive. (free T calc 1.84%)

Thought I would get more androgenic benefit and more even stable numbers at 3x a week so
back to 90mg 3x a week though.

Then to 84mg 3x a week - 1134 through Monday AM furthest out from Friday shot. SHBG was 70. Albumin was 4.6, E was mid 30s so probably even lower sensitive but no symptoms, E is under control. (free T calc 1.54%)

Now at 78mg 3x a week, thinking I will get close to the 80mg numbers and sleep well, but I think I am doing it wrong 3x and still not sleeping. I think I am learning that there is more aromatase activity at 3x per week and this whole time I thought it would stabilize. Is it accurate that slightly longer troughs means less aromatase activity overall? Does more frequency mean slightly higher transient SHBG-suppressing effects, but temp peaks help suppress SHBG? I guess the serum level stays more consistent but the SHBG is higher, am I on to something? I don't feel that different at 826 vs 1134, I felt fine...I think

I am going to ride this out for 8 weeks, 3 weeks in, but If I test again and SHBG is still up, keeping my free T lower than it could be, who cares what the total is.....If I can get a better net effect on a lower dose, I think I will try that. If I was at 800+ before, going back to 78mg (close to 80, easy to measure) If I can get around the same and good free T ratios, the overall sleep and androgenetic benefit would be better, ya? Bottom line, and last question is, is it possible I'm just a 2x a week kinda guy?

So I've been trying to dial it in for 8 months, starting dose from my doc was 120mg 1x IM. I soon switched to 2x a week sub Q because the peaks were literally keeping me up all nigh, felt like I was on speed, I was too much at the especially at the beginning. I'm a little dude, 165lb, not that it matters, but 4 weeks in I got labs, didn't know Id need a sensitive tests, and I was over 1500. That was in Feb, so I have leaned a lot, had many labs and studied how I feel and my sleep/recover/workouts etc.

8 months in and the below numbers are total dose per week split. I know for sure I was switching too often, sometimes only giving it 4 weeks, not 6 or better yet 8, I know.

120mg 2 x a week
100mg 2 x a week
80mg 2 x a week, 826 through Monday AM furthest out from Friday shot. SHBG was 47. Albumin was 4.4, E was like low 20s sensitive. (free T calc 1.84%)


As I stated in my replies in one of your older threads that your close to (12 hrs shy) true trough FT was high!

I calculated your free T using the go to linear law-of-mass action Vermeulen (cFTV) seeing as you never even tested your FT using an accurate assay which would be the gold standard Equilibrium Dialysis.

You were started on too high a dose of T off the hop.

Standard starting dose is 100 mg T/week or better yet split twice-weekly (50 mg every 3.5 days).

You are never going to get anywhere seeing as you lack the understanding of how exogenous T works.

Setting yourself up for failure here!

* 8 months in and the below numbers are total dose per week split. I know for sure I was switching too often, sometimes only giving it 4 weeks, not 6 or better yet 8, I know.


It takes 4-6 weeks just to reach steady-state when injecting TC/TE due to the PKs.

Switching a protocol 4, 6 let alone 8 weeks in is too soon.

Once you blood levels have stabilized (4-6 weeks) in and you have blood work done to see where your trough TT and more importantly FT sit and throw estradiol in there too on said protocol (dose of T/injection frequency) you still need to give it a few more months to gauge whether the protocol was truly a success or failure.

The next couple of months after blood levels have stabilized is the critical time period when one needs to gauge how they truly feel overall reading relief/improvement of low-T symptoms and overall well-being!

Every protocol whether just starting on T-therapy or tweaking a protocol (increasing or decreasing) dose of T/manipulating injection frequency should be given 12 weeks before claiming whether it was a success or failure!

This is where most will fail as they are switching things up way too early!

The body needs time to adapt to it's new set-point!

Look over my reply here:

Post in thread 'Starting TRT in Japan – 250mg Every 2 Weeks. Experiencing Bloating – Advice?'

May 10, 2025

Since I started TRT 125mg a week testosterone enanthate split into 2 injections monday and thursday subq I've also been having incredible bloating and diharea issue, I'm being persistent with this routine until my 6 weeks bloods are done and then I plan on going 180mg a week split into 3 injections, I'm coming from a lower place than you at 120 and high e2 which I take an AI for.

Hope you understand the first 6 weeks means nothing when looking at the bigger picture!

No one should be increasing their dose 6 weeks in once blood levels have stabilized unless your blood work shows...

• madman

• 

S

Thread 'Should I lower my trt dose starting semorelin?'

May 15, 2025

Starting semorelin, but concerned because I have high e2 and SHBG. Last test was total T over 1500, free T 17, e2 53 (sensitive) 60 regular, and 60 SHBG.

Last week I lowered my subQ TRT dose from .3cc x2 to .25 x2 (100mg). Not sleeping great and not sure I feel optimal with these high numbers.

Should I lower my TRT to 80mg weekly? As a reference when I was on enclomophine 6.25 EOD I was 900+. Not sure if that response is indictive of TRT response but I feel like I'm responding to small doses.

Thoughts?

• Sandz
• semorelin
• Replies: 6
• Forum: Testosterone Side Effect Management

S

Thread 'Still trying to figure this out - 120mg to 100mg to now 80mg - what a rough week'

Jun 26, 2025

What a wile ride, and a terrible week I have had.

I started my journey at 120mg 2x a week sub q. Primary driver for starting TRT at 48 was low free T, always below 5.

120mgs my numbers were -
Total T - over 1500
Estradiol - 60
Free T - 17.3
SHBG - 67
Sensitive estradiol - 53
Hemoglobin - 16.6
Hematocrit - 49

So after 8 weeks I lowered my dose to100mg because I wasn't sleeping well and felt I was retaining a lot of fluid. I tested and my labs where and was surprised to see E going up! At this point I was a week into going down to 80mg.

Total T - 1245
Estradiol -...

• Sandz
• headache high estrogen lowered dose
• Replies: 22
• Forum: Testosterone Side Effect Management

• 

S

Thread 'Wild ride! Went from 120mg > 100mg > 80mg > 90mg. T is higher at 90mg 3x a week than 100mg 2x a week'

Aug 28, 2025

So its been quite a journey.

48 165ish, 5'6". Always had low free T so I decided to start the journey to optimize. I've posted before, this is my update, thanks for all the previous insight. I can provide other markers if anyone things they are valuable

I started at 120mgs 6 months ago, ended up woth total T over 1500 and didnt think that was good or necessary. Now starting to get dialed in after a lot of trial and error.

100mg sub q 2x a week
T - 1245
E - 77/68 sensitive
SHBG - 60
Albumin 4.6
DHEA - 118

80mg sub q 2x a week (terrible ride down but felt ok after a month)
T - 826...

• Sandz
• dose amount dose frequency dose reduction estadiol free t
• Replies: 13
• Forum: Testosterone Side Effect Management

 

[Sandz]

@madman

I think, wait let me rephrase,......I have come to terms with this isn't an overnight thing, and thank you for sticking with me and being the voice of reasoning. When you're new to the game, and the doc knows less them many of you forum members, its a struggle to sit and wait. I have met several docs and honestly, never been overly impressed.

As the journey continues, I am learning more and more every day, the bottom line like you said.....I gotta give it time to settle! I am realizing not all markers equalize at the same time, and not all elevated or low numbers are good and bad, its a balance. I started learning more about free E and realizing that plays a huge roll in sleep and increased SHBG, and this while time I am trying to lower E, I believe that has been my nemesis.

Since my last adjustment big adjustment or timing change, the only thing I did was down to 84mg from 78mg (7% down, and I shouldn't have 5 weeks ago before my post, shoulda left it!). Again I was chasing sleep and recover and free T, not numbers....I was progressively sleeping less and getting more frustrated but it was never the total T.

I have been basically right there (84mg/78mg) for 10 weeks now, and sticking to 3x a week. I had labs drawn, I am feeling off, and the numbers all indicate things have leveled, my T was 1023 (consistent within 10% and my SHBG was still HIGH AF still 70 (up from 60). (waiting for sensitive E)

I know, don't trust AI, but after consulting, I realize I am suppressing E, and my free E is .06, shit, in the tank. I think it needs to be around .5ish to regain my sleep, and T/E balance. I never had symptoms like sensitive nipples or gyno but I was afraid so I was taking DIM and Cal D. I realize I probably only needed that when I was changing doses quickly and things were adjusting. I need to take the T, let my body level, and do what it naturally wants within reason and if I feel good at a higher E number, so be it.

Only change I am making is backing off the DIM and Cal D. I am sticking on the cadence of 3x for now, sub q, not adding back in DHEA or anything, simply trying to get E where it needs to me, unbind SHBG, gain the androgenic benefits, and sleep well.

I hope I am on to something, and thank you for all the advise....which is stop trying to change things every 4-5 weeks, that's the problem!

 

[madman]

@madman

I think, wait let me rephrase,......I have come to terms with this isn't an overnight thing, and thank you for sticking with me and being the voice of reasoning. When you're new to the game, and the doc knows less them many of you forum members, its a struggle to sit and wait. I have met several docs and honestly, never been overly impressed.

As the journey continues, I am learning more and more every day, the bottom line like you said.....I gotta give it time to settle! I am realizing not all markers equalize at the same time, and not all elevated or low numbers are good and bad, its a balance. I started learning more about free E and realizing that plays a huge roll in sleep and increased SHBG, and this while time I am trying to lower E, I believe that has been my nemesis.

Since my last adjustment big adjustment or timing change, the only thing I did was down to 84mg from 78mg (7% down, and I shouldn't have 5 weeks ago before my post, shoulda left it!). Again I was chasing sleep and recover and free T, not numbers....I was progressively sleeping less and getting more frustrated but it was never the total T.

I have been basically right there (84mg/78mg) for 10 weeks now, and sticking to 3x a week. I had labs drawn, I am feeling off, and the numbers all indicate things have leveled, my T was 1023 (consistent within 10% and my SHBG was still HIGH AF still 70 (up from 60). (waiting for sensitive E)

I know, don't trust AI, but after consulting, I realize I am suppressing E, and my free E is .06, shit, in the tank. I think it needs to be around .5ish to regain my sleep, and T/E balance. I never had symptoms like sensitive nipples or gyno but I was afraid so I was taking DIM and Cal D. I realize I probably only needed that when I was changing doses quickly and things were adjusting. I need to take the T, let my body level, and do what it naturally wants within reason and if I feel good at a higher E number, so be it.

Only change I am making is backing off the DIM and Cal D. I am sticking on the cadence of 3x for now, sub q, not adding back in DHEA or anything, simply trying to get E where it needs to me, unbind SHBG, gain the androgenic benefits, and sleep well.

I hope I am on to something, and thank you for all the advise....which is stop trying to change things every 4-5 weeks, that's the problem!

I have been basically right there (84mg/78mg) for 10 weeks now, and sticking to 3x a week. I had labs drawn, I am feeling off, and the numbers all indicate things have leveled, my T was 1023 (consistent within 10% and my SHBG was still HIGH AF still 70 (up from 60). (waiting for sensitive E).

I know, don't trust AI, but after consulting, I realize I am suppressing E, and my free E is .06, shit, in the tank. I think it needs to be around .5ish to regain my sleep, and T/E balance. I never had symptoms like sensitive nipples or gyno but I was afraid so I was taking DIM and Cal D. I realize I probably only needed that when I was changing doses quickly and things were adjusting. I need to take the T, let my body level, and do what it naturally wants within reason and if I feel good at a higher E number, so be it.


How many days post-injection were labs done?

We always want to test at true trough (lowest point) before your next injection which would be 72 hrs post-injection on a 3X/week protocol.

You are still missing the most important blood marker FT.

You are hitting a high TT 1023 ng/dL and even though your SHBG is high 70 nmol/L your FT would still be healthy.

Even then you would need to have your FT tested using the most accurate assay the gold standard Equilibrium Dialysis to know where it truly sits especially in cases of altered SHBG.

You can easily calculated it using the linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.

With a high TT 1023 ng/dL, high SHBG 70 nmol/L and Albumin 4.3 g/dL (default) your FT 14.9 ng/dL would be healthy.

Free & Bioavailable Testosterone calculator

Yes there would be room to increase it if need be.

Most healthy young natty males would be hitting a short-lived daily peak cFTV 13-15 ng/dL.

The majority of men on T-therapy would easily do well with a trough FT 15-25 ng/dL.

Again always need to pay attention to your injection frequency as there is a huge difference between one hitting a high-end/high trough FT injecting once weekly vs twice-weekly vs daily!

More importantly, its metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterone-beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, lipids, and body composition).

Last thing you want to do is drive your estradiol into the ground.

Also keep in mind that some men are what we call over/under converters.

The rate at which T gets converted to estradiol (via aromatase) and DHT (via 5α-reductase) varies significantly between individuals due to genetic differences and enzyme activity.

 

[Sandz]

I'm doing 3x per week, my labs were drawn at trough 3 days later on Monday morning. My last injection was Friday afternoon.

Albumin is 4.5. and the lab shows a free T calculated of 141 but I used your calculator and landed at 1.42%, similar to what you suggested. This was the best and only way I knew at the time as to how to calculate. I am not familiar yet with Equilibrium Dialysis or how to get that figure.

When I asked AI about the percentage it gave me this explanation as well as the chart below - "Why the mismatch? Labs/calculators often use simplified formulas that undervalue free T at high SHBG (71.4 nmol/L). Vermeulen is TRT clinic standard — it shows you're at 22 ng/dL, not 14. Still sub-optimal (target 25–35), but better than it looks."

Method	Free T Value	Units	% of Total T	Verdict
Your Lab	141.3	pg/mL	1.38%	Conservative estimate — common for labs using direct analog methods (less accurate for high SHBG like 71.4). Converts to 14.13 ng/dL (pg/mL ÷ 100 = ng/dL).
Online Calculator	141.3 pg/mL or 14.13 ng/dL	pg/mL or ng/dL	1.40%	Matches lab — likely uses similar formula. Good for quick checks, but underestimates with high SHBG.
Vermeulen Equation (gold standard)	~22 ng/dL	ng/dL	2.15%	Most accurate — accounts for SHBG/albumin binding precisely. Your real free T (what muscles/brain feel).

Based on what you're suggesting, im at 14 and that's not horrible, is that what you're saying? I think I am under converting, my free E is too low relative to total T.

Would you agree with the free E analysis, and if I bridge that gap and the ratio is better that's more optimal? Funny the comment it made - "You kept E2 “low” → SHBG spiked → free E2 crashed → sleep gone."

I am not changing dosage or doing anything but dropping the DIM now, and waiting for my sensitive E number this week when it comes. Do you have any other recommendations, or do you not agree that's the right move? Let estrogen do what my body wants it to, and in turn regain/dial down the SHBG in return? Or is that the wrong thinking assuming I don't get any sides?