Low SHBG. EOD vs daily shots. Is their a big difference?

[tj]

I have a low SHBG (14.4 last lab). Since measuring my SHBG (even before i started trt) it has always been between 14 and 18.

I have used a lot of protocols the past 3 years with sustanon:

• once a week 125 mg, 150 mg 250 mg (no effect, no weightgain, no nothing. Even on 250 mg for 6 weeks what for some would be a small cycle)
• twice a week 62,5mg 70mg 80mg 100mg
• eod 60mg, 65 mg

Since the eod i am seeing a little increase in strenght and energy, but libido stil not good and even worse than before starting trt.

Latest total t on 65 mg sustanon EOD is 778ng/dl.
It seems that even with higher dosages i can't really get a higher test level. Is this because of the low shbg?
Are their people with experiences going from eod to daily and feeling much better?
Is their a large difference in plasme levels and well being/libido and muscle gains?

 

[ERO]

A lot of folks will tell you that daily shots make all the difference if you have low SHBG, but many if not most of us with super low SHBG feel nothing from any dosing schedule. Daily shots makes it easy to get great numbers on paper, but that doesn't matter if you experience none of the expected benefits of TRT.

That said, I would definitely try it if I were you. Nothing to loose and you may be one of the low SHBG guys where this protocol helps.

 

[Vince]

I agree with ERO, low shbg guys should try daily injections. If it doesn't improve your symptoms you could always go back to twice a week injections. You should give it time though it may take at least six or more months to feel an improvement.

 

[Kettlebells]

All I can say is that having low SHBG makes TRT tricky. My SHBG is in the twenties, and I have pretty much given up for the time being. Things are great during the honeymoon phase, but the side effects make managing replacement challenging after one has transistioned through that phase. There were days and even weeks where I felt great, and then there were extended periods where nothing short of discontinuing TRT for a period of time worked. Everyone is different, so your mileage will vary.

With that said, I am even more confused about E2 than I was before watching Nelson's presentation with Jay on YouTube. Nelson pointed to research demonstrating that a several of the symptoms we associate with high E2, such as fat gain, are actually the result of low E2, not high E2. The science of TRT is changing so rapidly.

 

[tj]

Thanks for al the quick reply's!
Agreed that the science is changing very very fast.
So many opinions about E2 and side effects. I believe dr rouzier and dr nickols even state that al the symptoms like fat gain, gyno etc are from insuline resistance.
It makes it all very confusing...

 

[S1W]

For those that have switched to daily, have you noticed your SHBG going up a bit compared to a larger dose/less frequent injection protocol?

 

[Kettlebells]

I believe dr rouzier and dr nickols even state that al the symptoms like fat gain, gyno etc are from insuline resistance.
It makes it all very confusing...

Low SHBG goes hand-in-hand with insulin resistance. I am a type 2 diabetic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680959/pdf/ec-02-18.pdf

 

[tj]

my recent labs for thyroid and bloodsugar:
tsh 2.3
t4 16.5 pmol/l
t3 5.4 pmol/l
hba1c: 5,20%
Fasting glucose 5.1 mmol/l

i think i am not diabetic.

 

[Kettlebells]

A fasting glucose of 5.1 mmol/l is non-diabetic, but it is not ideal. Ideally, you want it to be under 5.0 mmol/l, which translates to 90 mg/dl (our glucometers display mg/dl reading in the U.S.). Most people without insulin resistance have a fasting blood glucose level lower than 90 mg/dl. I had normal fasting blood sugar readings for years before I was marked as being pre-diabetic (which preceded being classified as a full-blown type 2 diabetic by eight years). My endo said that I was insulin resistant long before being given the diagnosis of pre-diabetes and that low SHBG is a predictive marker for insulin resistance. The numbers do not start to increase until the beta cells in one's pancreas become exhausted from pumping out excessive amounts of insulin.

Low levels of sex hormone-binding globulin and hyperproinsulinemia as markers of increased pancreatic ß-cell demand in men

 

[AndyP]

My SHBG has come up a little on ED doses and now sits at 22. Benefits for me of ED shots is the stability. E2 remains basically constant and I don’t feel the need for an AI at this point. Additionally my hematocrit has stabilized back at my pre-trt baseline. This is critical to me as I can’t donate blood (mad cow disease fears by FDA since I lived in UK) so I have to use scripted phylobotomies.

 

[Gman86]

my recent labs for thyroid and bloodsugar:
tsh 2.3
t4 16.5 pmol/l
t3 5.4 pmol/l
hba1c: 5,20%
Fasting glucose 5.1 mmol/l

i think i am not diabetic.

I agree, you’re not even pre-diabetic. Your fasting glucose converts to 92mg/dL. Ideal fasting glucose is 70-100, so you are on the high end, and close to the pre-diabetic range, but you’re fine for now.

You might, however, be closing in on hypothyroidism. I’m not sure if those are total T3 + T4 values, or free T3 + T4 values, and not sure what ranges go along with the values you posted. Posting values on here without ranges makes it difficult to evaluate labs. I follow an amazing doctor that specializes in the thyroid. His name is Dr. Westin Childs. The reason I say that you might be bordering on hypothyroidism is due to Dr. Childs saying that any TSH over 2 is a clear sign of hypothyroidism. This guy knows hypothyroidism better than anyone else I’ve seen, so if he says that, I tend to believe that he knows what he’s talking about. Just something to consider. Thyroid issues are extremely common. T4 medication is the most commonly prescribed medication in the U.S., and that’s just all the people that have been diagnosed. If doctors were all up on the latest thyroid literature, I bet the amount of thyroid diagnoses would sky rocket. That’s not even counting all the people that have good thyroid labs, but may still be resistant on a cellular level.

 

[tj]

@ Systemlord, that is a very low dose eod. What are you're total and free t levels?

 

[Systemlord]

A 20mg EOD protocol sees a Total T of 496, Free T 20.8 pg/mL and estrogen 43 pg/mL. My lower SHBG 22 explains why Free T is high with only 500 Total T, most men with higher SHBG (>30) need more Total T to equal similar Free T levels.

I'm insulin resistant and overweight. I would like to lose significant weight, improve insulin, lower estrogen and maybe increase the dosage a little in the future.

Cypionate has shorter esters than Sustanon, cypionate has a single ester.

 

[tj]

@Gman86, sorry, will post the reference ranges for thyroid labs:

TSH 2.3 mu/l ref: 0.5 -3.5
free t3 5.4 pmol/l ref: 3.1- 6.8
Free t4 16.5 pmol/l ref: 10-25

I really don't think that any doctor in my country will start thyroid medication with these "in range" numbers.

Same accounts for the possible insuline resistance. No doctor will act on it.

 

[tj]

Systemlord, is that a calculated free t? If i would use a free t calculator your free t would be 12.9 ng/dl

 

[Systemlord]

The measurement was direct, calculated would be 12.9 ng/dL = 2.6 %. This is the absolute bare minimum to relieve symptoms of low testosterone.

Directly measured Free T was pg/mL.

 

[Gman86]

@Gman86, sorry, will post the reference ranges for thyroid labs:

TSH 2.3 mu/l ref: 0.5 -3.5
free t3 5.4 pmol/l ref: 3.1- 6.8
Free t4 16.5 pmol/l ref: 10-25

I really don't think that any doctor in my country will start thyroid medication with these "in range" numbers.

Same accounts for the possible insuline resistance. No doctor will act on it.

Agreed, no doctor that bills through insurance is going to prescribe you thyroid medication with those numbers. You would have to go to a progressive doctor that is up on the latest research, and that isn’t constrained by so insurance. But honestly, you might not even need thyroid medication. Your thyroid might not be ideal, but might not be bad enough to warrant medication. Next time you get your thyroid tested, I would just add reverse T3 and total T3.

 

[Charliebizz]

I agree, you’re not even pre-diabetic. Your fasting glucose converts to 92mg/dL. Ideal fasting glucose is 70-100, so you are on the high end, and close to the pre-diabetic range, but you’re fine for now.

You might, however, be closing in on hypothyroidism. I’m not sure if those are total T3 + T4 values, or free T3 + T4 values, and not sure what ranges go along with the values you posted. Posting values on here without ranges makes it difficult to evaluate labs. I follow an amazing doctor that specializes in the thyroid. His name is Dr. Westin Childs. The reason I say that you might be bordering on hypothyroidism is due to Dr. Childs saying that any TSH over 2 is a clear sign of hypothyroidism. This guy knows hypothyroidism better than anyone else I’ve seen, so if he says that, I tend to believe that he knows what he’s talking about. Just something to consider. Thyroid issues are extremely common. T4 medication is the most commonly prescribed medication in the U.S., and that’s just all the people that have been diagnosed. If doctors were all up on the latest thyroid literature, I bet the amount of thyroid diagnoses would sky rocket. That’s not even counting all the people that have good thyroid labs, but may still be resistant on a cellular level.

So what does one do when labs are good. My labs are fine but I still have low body temp. 97.1-97.8. I tried small dose of t3 a while back when I had high rt3 and I immediately went hyperthyroid yet my temp was still low

 

[Gman86]

So what does one do when labs are good. My labs are fine but I still have low body temp. 97.1-97.8. I tried small dose of t3 a while back when I had high rt3 and I immediately went hyperthyroid yet my temp was still low

How do you know you went hyperthyroid?

And what dose of T3 did you start on? How many times each day did you split up the dose?

 

[Charliebizz]

Within 15-30 mins I started having panic attack sweating racing heart. I started at 10mcg a day split in two doses. So just 5mcg sent me into a panic. It would slow down but I was dizzy and just high anxiety the whole two months I was on it. I worked up to I think 30mcg per day at one point I believe