LOW SHBG increasing

[eli]

My SHBG was at 4 last year, I got lots of blood work done except for Cholesterol. My liver numbers were in range, kind of higher side but never expected anything to be wrong. I was frustrated because everything was perfect. my A1C and thyroid numbers were perfect. That's when I did some more research and found out cholesterol and a damaged liver also contribute to low SHBG. The thing was, I knew I was not a low SHBG guy by genetics, never done blood work before things went south but I just knew. My sex drive was fine for years when I abused steroids, my penis was working fine, but it was towards the end where my sex drive and penis got hit.

A few months ago I got ultrasound done on my liver, I had developed a very mild non alcoholic fatty liver... It was mild, but that affected my SHBG I'd say. My cholesterol numbers were also whack. My triglycerides were high.

There is a doctor on youtube that says 3grams of Choline and Inositol destroy a fatty liver in 4 weeks. So I started doing that.

So this is how I used these supplements. For the FIRST 4 WEEKS:

Choline and Inositol: 3grams (each)
Tudca: 1.5g
NAC: 1.8g
COQ10: 600mg
ubiniquil: 200mg
Citrus Bergamot: 1.5g

After first 4 weeks til now
Choline and Inositol: 1g (each)
Tudca: 500mg
Ubiniqui: 200mg
Citrus Bergamot: 750mg

recently added Cod liver oil and 2grams of Niacin because LDL is a bit high and HDL is low but Triglycerides are fine now


SHBG is now at 13.2. SO it is increasing and OH MAN, I can feel it. My sex drive is coming back and my penis has started to work again on its own without Viagra, but I still take viagra because I'm addicted now lol. I think low SHBG is a liver problem more than anything else

On 90mgs of Test, Total T was 600 something and Free T was 23 (7 - 26)

 

[Sean Mosher]

Is there an option for determining a fatty liver apart from an ultrasound that you know of??
Glad you posted this.
Interesting.

 

[new_man]

Good to know about how to fix a fatty liver.

The thing was, I knew I was not a low SHBG guy by genetics, never done blood work before things went south but I just knew.

How did you just know?

 

[eli]

Good to know about how to fix a fatty liver.
How did you just know?

I used to inject test once a week without any problems... but this last year once a week didn't work, I was aromitizing more and body crashed after 2 days. Weird symptoms that never had before, but as you can see SHBG is going up. I believe it'll go up to 20 25

 

[eli]

Is there an option for determining a fatty liver apart from an ultrasound that you know of??
Glad you posted this.
Interesting.

Not really. Sometimes even ultrasound isn't enough and liver biopsy is needed

 

[Gene Devine]

My SHBG was at 4 last year, I got lots of blood work done except for Cholesterol. My liver numbers were in range, kind of higher side but never expected anything to be wrong. I was frustrated because everything was perfect. my A1C and thyroid numbers were perfect. That's when I did some more research and found out cholesterol and a damaged liver also contribute to low SHBG. The thing was, I knew I was not a low SHBG guy by genetics, never done blood work before things went south but I just knew. My sex drive was fine for years when I abused steroids, my penis was working fine, but it was towards the end where my sex drive and penis got hit.

A few months ago I got ultrasound done on my liver, I had developed a very mild non alcoholic fatty liver... It was mild, but that affected my SHBG I'd say. My cholesterol numbers were also whack. My triglycerides were high.

There is a doctor on youtube that says 3grams of Choline and Inositol destroy a fatty liver in 4 weeks. So I started doing that.

So this is how I used these supplements. For the FIRST 4 WEEKS:

Choline and Inositol: 3grams (each)
Tudca: 1.5g
NAC: 1.8g
COQ10: 600mg
ubiniquil: 200mg
Citrus Bergamot: 1.5g

After first 4 weeks til now
Choline and Inositol: 1g (each)
Tudca: 500mg
Ubiniqui: 200mg
Citrus Bergamot: 750mg

recently added Cod liver oil and 2grams of Niacin because LDL is a bit high and HDL is low but Triglycerides are fine now


SHBG is now at 13.2. SO it is increasing and OH MAN, I can feel it. My sex drive is coming back and my penis has started to work again on its own without Viagra, but I still take viagra because I'm addicted now lol. I think low SHBG is a liver problem more than anything else

On 90mgs of Test, Total T was 600 something and Free T was 23 (7 - 26)

Yes, it is true about Choline and Inositol helping with fatty liver; in fact both are very powerful liver protectors.

You got a good protocol but add in Milk Thistle as well and drink lot of coffee as it also helps with fatty liver and is very good for your liver overall.

Life Extension has a lot on this...

 

[ERO]

This is great info and I thank you for sharing.

I have low SHBG that nothing has helped (and I am lean, have no glucose issues, my liver values and H1C have always been well within range) so I am going to try the 3 grams a day of Choline and Inositol and keep my fingers crossed. I don't think I have fatty liver, but I have not had a biopsy or ultrasound so its worth a try.

 

[eli]

This is great info and I thank you for sharing.

I have low SHBG that nothing has helped (and I am lean, have no glucose issues, my liver values and H1C have always been well within range) so I am going to try the 3 grams a day of Choline and Inositol and keep my fingers crossed. I don't think I have fatty liver, but I have not had a biopsy or ultrasound so its worth a try.

Yea add Tudca too. And keep us posted. 3grams of Choline and Inositol will send you to the bathroom quiet often but be patient

There's another guy, named SAM from peaktestosterone that brought his low shbg up to 30, he said he took 5grams of Milk Thistle a day

 

[ERO]

Great, thanks again.

My SHBG moves between single digits and low teens and I do not feel my Test at all, so any improvement to the point where I can find out what Test actually feels like, is going to be a huge win.

 

[eli]

Great, thanks again.

My SHBG moves between single digits and low teens and I do not feel my Test at all, so any improvement to the point where I can find out what Test actually feels like, is going to be a huge win.

hmm don't know what to say, mine at 13 although still low, my sex drive has increase a lot ! not like when I was 18 but it's much better

 

[ERO]

I have had low to zero sex drive the entire time I have been on TRT. It used to be high from puberty until late 40s and now its a memory.

 

[eli]

hmm don't know what to say, mine at 13 although still low, my sex drive has increase a lot ! not like when I was 18 but it's much better

Well try those liver supplements and see what happens. Keep us updated please. Tudca and Choline Inositol

 

[hardrlz]

I am 23 and i have SHBG in the single digids as well, TRT doing nothing, tried lots of things, nothing has worked so far. I will try this protocol as well and will update here if there are positive results.

Actually i have tried Lecithin powder before which provides natural Choline and Inositol at around 3 g, but didnt really notice much, is Lecithin a good source ?

 

[Gianluca]

Guys awesome thread, thank you for this, I realized I have been aromatizing more and more leading to use more anastrozole and I have wondering why, I found several months ago liver enzymes on high side but nothing concerning, 600MG of NAC brought them down to about 22, but still even my lipids at some point started to going out of wrack and I'm also a low SHBG guy, will try choline inositol and see if my E2 will chance and other symptoms will disappear, sometike I do feel some tightness and around liver area but never thought it could be non alcoholic fatty liver due to Testosterone cause my liver enzyme were within nornal

 

[AbsoluteZ3R0]

I'm still baffled as to why SHBG has any effect on the efficacy of testosterone therapy. I'm no expert on pharmacokinetics, but a half-life is still a half-life. I've never actually seen any labs by someone with low SHBG in their trough to confirm that they somehow burn through testosterone more quickly. Moreover, increasing injection frequency seems to be only marginally beneficial, if at all. It really doesn't make any sense to me, especially since there are many who argue that the free value is the only one that matters.

 

[madman]

I'm still baffled as to why SHBG has any effect on the efficacy of testosterone therapy. I'm no expert on pharmacokinetics, but a half-life is still a half-life. I've never actually seen any labs by someone with low SHBG in their trough to confirm that they somehow burn through testosterone more quickly. Moreover, increasing injection frequency seems to be only marginally beneficial, if at all. It really doesn't make any sense to me, especially since there are many who argue that the free value is the only one that matters.

Shbg is critical regarding the efficacy of testosterone as it is one of the PRIMARY GATEKEEPERS of steroid action.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064763/#bib38
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064763/table/tbl3/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480437/

 

[CoastWatcher]

I'm still baffled as to why SHBG has any effect on the efficacy of testosterone therapy. I'm no expert on pharmacokinetics, but a half-life is still a half-life. I've never actually seen any labs by someone with low SHBG in their trough to confirm that they somehow burn through testosterone more quickly. Moreover, increasing injection frequency seems to be only marginally beneficial, if at all. It really doesn't make any sense to me, especially since there are many who argue that the free value is the only one that matters.

Increasing injection frequency proves to be only "marginally beneficial" for men with low SHBG? Why do you draw that conclusion? It's a standard clinical adjustment that is recommended by doctors who are the respected leaders in this field of practice.

In my own situation, low SHBG, 19, was determined to be a key factor in why my twice weekly protocol failed. An anemic total trough and sky-high free testosterone levels left me feeling better, but not where I wanted to be. Prior to the protocol change my blood was drawn every day for a week. Sixty milligrams of testosterone drove my total testosterone level to 1300 and it fell like a stone within a 3.5 day window. My doctor is an advocate of small, multiple injections and was determined to see if the lab work she could obtain from patients supported her clinical instincts. It did. Many in her clinic are happy daily injectors.

This provides support for the advice we give members with low SHBG every day here EM: discuss small, frequent injections with your doctor. I argue that it explains why so many report success when they make that adjustment.

 

[ERO]

Small daily doses of T definitely help even out a low SHBG guys T levels but that does not guarantee they are going to feel better. Some low SHBG guys definitely do, others, even though their labs may look great, continue to feel little to nothing from TRT.

That said, switching to small, frequent dosing is the state of the art treatment for low SHBG so I definitely recommend giving it a go.

 

[JMP]

So ERO, I just got my labs yesterday from my first 3 months of trt. Surprisingly my SHBG went from 22 to 29.9. The only thing that I changed in that three months was taking an NAC 3x/day. All other vitamins and supps were the same. I wonder if I have a slight liver problem that NAC is helping and thus raising SHBG? With that said I am glad you are finally getting it higher and feeling some positive effects. I hope the trajectory continues for you.

 

[johndoesmith]

I'm still baffled as to why SHBG has any effect on the efficacy of testosterone therapy. I'm no expert on pharmacokinetics, but a half-life is still a half-life. I've never actually seen any labs by someone with low SHBG in their trough to confirm that they somehow burn through testosterone more quickly. Moreover, increasing injection frequency seems to be only marginally beneficial, if at all. It really doesn't make any sense to me, especially since there are many who argue that the free value is the only one that matters.

aMCR-T correlated negatively with age (P = 0.0007), SHBG (P = 0.046), and total testosterone during treatment (P = 0.02) and percent body fat at baseline (P = 0.01) and during treatment (P = 0.004).

https://academic.oup.com/jcem/artic...fferences-in-the-Apparent-Metabolic-Clearance

Clearance of testosterone decreases as SHBG increases.

While measurements of free steroid concentrations remain the most robust indicator of the biological activities of plasma steroids (Vermeulen et al. 1999), adoption of the free hormone hypothesis as a universal explanation for how steroids access their target cells in different tissues and organ systems is overly simplistic (Mendel 1989). This is because steroid-target cells in multicellular organ systems are often compartmentalized and separated from the blood vasculature. Moreover, tissues and organ systems vary enormously in terms of their vascular permeability and the nature of their blood supply, including blood flow and transit time. Extreme examples include the highly fenestrated aspect of the blood vasculature in the liver, where hepatocytes are essentially bathed in blood, vs cells within the brain and testis that are separated by blood barriers. In addition, sex steroid-sensitive epithelial cells in organs such as the prostate, breast, and endometrium are separated from blood capillaries by complex basement membranes, and are compartmentalized together with other cell types (e.g., stroma and adipocytes), in which steroids may either act directly or are metabolically converted into more active hormones in intracrine or paracrine fashions. Thus, the locations of target cells in relation to the blood supply, the endothelial vascular permeability, the composition of the extravascular fluids and extracellular matrix, as well as the juxtaposition of different cell types within a tissue all dictate the ultimate ability of steroids to access their target cells

Free hormone hypothesis vs free hormone transport hypothesis. It's easier to understand the free hormone hypothesis, which is why it's often repeated on forums. Once you start to think about steroidal function a little bit more than just superficially, this hypothesis makes less and less sense.

but a rare missense genetic mutation that produces a secretion defective SHBG variant (SHBG G195R) was recently reported in a young man and his *sister, both of whom were homozygous for the mutant SHBG allele and had no detectable SHBG in their blood As expected, plasma testosterone concentrations in the male proband were well below the normal range, yet his free testosterone levels were normal. Clinical assessments indicated fatigue, overt muscle weakness, and low body weight, and other symptoms of hypoandrogenism, but gonadal development and sperm production and function appeared to be normal. The proband’s affected sibling reported a late menarche and irregular menstrual cycles, but surprisingly had no signs of hirsutism or hyperandrogenism (Vos et al. 2014). Although this report provides an indication that plasma SHBG is not essential for male reproductive development and sperm production, the proband’s clinical phenotype suggests a more direct role for SHBG in supporting the anabolic activities of androgens.

http://joe.endocrinology-journals.org/content/230/1/R13.long

Basically this provides a possible explanation of why low SHBG guys may report little to no improvement with some symptoms, but lack other negative symptoms.