Low Shgb

[katfishbilly]

32 low T level was 206 when started TRT, first gels (that was a waist) month later started IM shots at 100mg ever 2 weeks
(felt horrible) doc bumped it up to 200mg ever 2 weeks. Blood test had my T levels at 69 on trough day. Last 6 weeks I’ve been on 200mg every week now. Feel much better but blood tests show very low shgb and free T is to high as well as estro. These results are from 6 weeks of 200mg every week. Doc wants to put me on Clomid instead. Any suggestions?

Here’s my questions
I’m thinking of doing daily IM injections am I on the right track? Will 25g 1/2” needles work? I can only get 200mg in 1ML bottles is it ok to keep using the one bottle all week? If I go daily do I keep to 200mg a week so .14 a day?

 

[BigBamBoo]

With your low SHBG, you have already discovered that one big dose does not work.

Going to ED injections should help from what I have read.

25g needles are fine if not a bit big. I use 29g 1/2” for my T.

Does your 1 ml bottles have the multi use rubber stoppers on them? If yes, then you should have no problem using them throughout the week.

Others will chime in with advice I am sure.

 

[Systemlord]

Your doctor put you on a protocol without regard for your SHBG, it's very likely he doesn't prescribe TRT often and clearly has zero knowledge as it relates to TRT. This regurgitated 200mg every 2 weeks is simply written down for doctors to follow, the person or organization writing these guidelines really have no clue.

Your SHBG is the biggest key to your injection frequency, higher and you will need large weekly doses perhaps twice weekly, mid range moderate doses twice weekly, lower SHBG and smaller more frequent dosing EOD or everyday. The lower a man's SHBG, the more free testosterone he has and the more free estrogen even with what appears to be normal estrogen.

A low SHBG man with an estrogen of 20 nmol/L might look good on the surface, but free estrogen can be much higher. The only way for a low SHBG man to keep free hormones from getting out of control is small injections everyday, this lowers estrogen peaks and keeps estrogen lower in most cases.

Smaller more frequent dosing can also minimize side effects one might experience on TRT, such as high hematocrit, red blood cell count where the blood gets thicker.

I'm about to start every day injections myself.

 

[MarkM]

Hi Katfish, welcome to the forum.

The original protocol of injecting 100 mg every two weeks was all wrong, the protocol of injecting 200 mg every two weeks was all wrong, and the current protocol of injecting 200 mg per week was all wrong, and the new protocol of injecting 200 mg (in one injection I assume) is all wrong.

With low SHBG of 8 you really to be injecting daily or possibly every other day but as low as yours is I would go every day. Injecting daily you will not need 200 mg a week or you'll end up right where you are with high Free T, and high Free E2. You should probably start off with 140 mg a week to start and, if needed, titrate up from there.

Your "Estrogen" test doesn't mean anything and a test for a woman. Men need the Estradiol Sensitive LC/MS/MS assay to properly measure a man's Estradiol level. You really need to have that test.

Your WBC was really high. Have you been sick or have an infection?

Again, welcome to ExcelMale!

 

[katfishbilly]

Thanks for clearing a lot up for me. My WBC I’m thinking was high because I got a tattoo the day before maybe? And have had a little cough but other than that nothing major.. I will definitely try and get the E sensitive results on next blood test. Will a 25g 1/2” needle be ok for everyday IM? Also if I try 140mg to start what mark would that be on a insulin syringe? Thanks!

 

[Systemlord]

Thanks for clearing a lot up for me. My WBC I’m thinking was high because I got a tattoo the day before maybe? And have had a little cough but other than that nothing major.. I will definitely try and get the E sensitive results on next blood test. Will a 25g 1/2” needle be ok for everyday IM? Also if I try 140mg to start what mark would that be on a insulin syringe? Thanks!

Honestly a 25 gauge syringe pinning everyday might get painful after a while, 29 gauges minimize muscle damage over decades. If you were to inject Sub Q into belly fat you could sidestep muscle damage altogether.

 

[madman]

32 low T level was 206 when started TRT, first gels (that was a waist) month later started IM shots at 100mg ever 2 weeks
(felt horrible) doc bumped it up to 200mg ever 2 weeks. Blood test had my T levels at 69 on trough day. Last 6 weeks I’ve been on 200mg every week now. Feel much better but blood tests show very low shgb and free T is to high as well as estro. These results are from 6 weeks of 200mg every week. Doc wants to put me on Clomid instead. Any suggestions?

Here’s my questions
I’m thinking of doing daily IM injections am I on the right track? Will 25g 1/2” needles work? I can only get 200mg in 1ML bottles is it ok to keep using the one bottle all week? If I go daily do I keep to 200mg a week so .14 a day?

You need to lower your weekly dose as your FT is way too high and increase your injection frequency (daily or EOD) due to having such low SHBG.

Using your TT 1044 ng/dL and SHBG 8 nmol/L in the Free & Bioavailable Testosterone Calculator: http://www.issam.ch/freetesto.htm

Your FT is really high 3.73% and your BT is also very high 87.5%.

You have lots of room to bring your FT down.....hence lower weekly dose and more frequent injections ( low SHBG).

Most men do well with FT 2-3% of TT.

If those are your labs after 6 weeks @ 200mg/week when were bloods drawn trough?

 

[MarkM]

I'll bet that tattoo is what raised up your WBC. That's like an open wound.

A 25g 1/2" will work but you don't need something that big. Most of us want smaller holes as possible since we are going to be doing this for the balance of our life. Most use 27g up through 31g. I think 30g and 31g are too small typically but if you are injecting daily then they would probably be fine. You should go with nothing larger than 29g if you change to daily.

140 mg on an insulin syringe will be "70" if injecting 140 mg one a week. The syringe probably has marking of 10 through 100 in increments of 10. If you inject 140 mg a week broken down in every day shots then it would be at the "10" mark. Does it look like this?

 

[katfishbilly]

thats kind of what I was thinking with the wbc...yes that’s what the syringe looks like. Ok so 10 on the syringe each day and 29g needle perfect I’m starting this tomorrow morning, and will keep posted with results on this journey.

 

[katfishbilly]

If those are your labs after 6 weeks @ 200mg/week when were bloods drawn trough?[/QUOTE]

Bloods were drawn 2 days after injection.

 

[madman]

If those are your labs after 6 weeks @ 200mg/week when were bloods drawn trough?

Bloods were drawn 2 days after injection.[/QUOTE]

Bloods should always be done at trough before next injection as we want to see where TT, FT and e2 levels sit.

 

[Systemlord]

When you start an everyday protocol your levels will be very stable and virtually static, you would then be able to draw labs at any time of the day. A guy that injects every 7 days would draw labs hours before his next injection, this is your trough.

 

[MarkM]

SHBG value was 8 on his labs. That's going to be extremely low regardless of any range.

 

[Vince]

You can buy Easy Touch syringes at this site.

https://www.otcwholesale.com/diabet...ulin+Syringes&search_return=all&Size=27+gauge

 

[Vince]

I use an easy touch 29g 1/2" syringe for both testosterone and HCG basically painless. If you inject cottonseed oil you may want to use in 27g 1/2" syringe. A half inch syringe makes for a nice shallow IM injection.

 

[katfishbilly]

1st day trying everyday IM. Never used 25g before it was very hard getting it the right amount, the first couple pulls it just pulled air. Next needle felt a little dull? Other than that all good except I noticed a lot left in tip of barrel wtf? The plunger is maxed out and still a good bit left, does this always happen or any suggestions?

 

[MarkM]

That happens when you use a syringe with a removable needle. If you use a syringe with a permanently attached needle, such as an insulin syringe.


https://www.otcwholesale.com/diabet...ulin+Syringes&search_return=all&Size=27+gauge

 

[Systemlord]

Insulin syringes has no wasted product remaining in the tip, it's one reason why we like to use them. Another is less muscle damage and being painless.

You will run out of medicine before your able to refill your prescription injecting everyday with wasted product in the tip.

 

[katfishbilly]

Thanks so all my 23g needles have had removeable needles because I was drawing out with 18g and would just swap needles, so I’m assuming this has been happening and is a normal thing I just happened to notice it now?

 

[katfishbilly]

all these pharmacist around here keep telling my 1/2 isn’t long enough for IM it’s like they have been trained to say 1-1 1/2 only