Low SHBG = lower dosed, more frequent injections. Why?

[TestQuest22]

It doesn't make sense to me, but I am sure there's something I'm missing. Note, I know that there is a complex relationship here, but I'm looking at this on the surface level.

Isn't the "low SHBG = more frequent injection at a lower dose" protocol a bit counterintuitive?

For example. Let's assume two individuals have the same Total T. If one has low SHBG, that means they would generally have more free T than the individual with normal or high SHBG, right?

Therefore, wouldn't injecting every few days be better for the low SHBG person, as that means more testosterone is unbound and free or bio-available vs. if they inject less testosterone more frequently?

IOW, if you have low SHBG, why inject low amounts of testosterone, only for it all (or most of it all) to end up bound? It seems like more Test, injected EOD would be better (than lower amounts of test, ED) from a logical perspective, so that the Testosterone that is not bound by SHBG can remain bio-available and have an impact.

At a basic level, one would think that less exogenous T injected more frequently is bound by the (low) SHBG, thereby resulting in less free T.

Help me understand that relationship and recommendation, please.

 

[Cataceous]

There are some good reasons to believe that the dose of testosterone is directly, i.e. proportionally, driving free testosterone, not total. I often refer to a thought experiment involving twins on TRT, identical except for SHBG. When the dose rate of testosterone is identical then the twins have the same free testosterone. However, the twin with lower SHBG has lower total testosterone than the one with higher SHBG.

It's not definitively known why low SHBG is problematic. Possible reasons include the relatively higher free estradiol seen at a given level of free testosterone. It's speculated that a lack of SHBG interferes with intracellular delivery of testosterone. In addition, some SHBG-bound testosterone is delivered directly to cell receptors.

It's possible that smaller and more frequent testosterone injections help to limit the ratio of free estradiol to free testosterone. Larger, less frequent doses could allow excursions into non-physiological ratios, leading to side effects.

Edit: The premise of free estradiol increasing relative to free testosterone at low SHBG is based on an assumption of total estradiol being driven directly by free testosterone. But it seems more likely that free estradiol follows free testosterone, making total estradiol the dependent variable. In other words, neither free estradiol nor free testosterone changes much when SHBG is reduced in isolation. It's still plausible that lower SHBG leads to reduced androgenic activity relative to estrogenic activity—without a dependence on the free hormone levels.

 

[Charliebizz]

It doesn't make sense to me, but I am sure there's something I'm missing. Note, I know that there is a complex relationship here, but I'm looking at this on the surface level.

Isn't the "low SHBG = more frequent injection at a lower dose" protocol a bit counterintuitive?

For example. Let's assume two individuals have the same Total T. If one has low SHBG, that means they would generally have more free T than the individual with normal or high SHBG, right?

Therefore, wouldn't injecting every few days be better for the low SHBG person, as that means more testosterone is unbound and free or bio-available vs. if they inject less testosterone more frequently?

IOW, if you have low SHBG, why inject low amounts of testosterone, only for it all (or most of it all) to end up bound? It seems like more Test, injected EOD would be better (than lower amounts of test, ED) from a logical perspective, so that the Testosterone that is not bound by SHBG can remain bio-available and have an impact.

At a basic level, one would think that less exogenous T injected more frequently is bound by the (low) SHBG, thereby resulting in less free T.

Help me understand that relationship and recommendation, please.

I have seen a few guys on some of the Reddit threads with low shbg actually do better with less frequent injections.

It’s something I’ve been thinking about trying. But I’m so bad at sticking to changes now lol. The minute I have a side effect I want to go right back to my normal routine. But I without a doubt still struggle with trt being low shbg with my current protocol

 

[goolapsh]

I have seen a few guys on some of the Reddit threads with low shbg actually do better with less frequent injections.

It’s something I’ve been thinking about trying. But I’m so bad at sticking to changes now lol. The minute I have a side effect I want to go right back to my normal routine. But I without a doubt still struggle with trt being low shbg with my current protocol

I’ve seen this too where guys do better with less frequent injections, like once a week. I guess because it’s so difficult to nail the correct t to e ratio that by injecting a larger dose once a week estrogen eventually settles into the sweet spot as the week goes on.

 

[Charliebizz]

I’ve seen this too where guys do better with less frequent injections, like once a week. I guess because it’s so difficult to nail the correct t to e ratio that by injecting a larger dose once a week estrogen eventually settles into the sweet spot as the week goes on.

Are you low shbg ? Have you ever tried 1x a week injection?

 

[goolapsh]

Are you low shbg ? Have you ever tried 1x a week injection?

I am. Shbg 16-20 without trt. I have never tried once a week, but dailies and eod on cypionate didn’t work for me (my dht was below reference range). I started out with 100mg weekly and went all the way to 150mg weekly and dht never went within range. My problem was dht conversion with cypionate injections. I wish I could’ve tried a different ester or switch to once a week injections, but I’m currently off trt and probably won’t get back on anytime soon. Scrotal cream worked to a degree, but i didn’t want to lose my hair.