New member from Texas

[Eagles21]

Hello everybody,

New member here from Texas.
Just a little background about myself.

I was into bodybuilding in my younger years and started using testosterone at a young age without proper post cycle therapy protocols. Which could be why I now have low T. I really wish I knew what I know now when I was younger lol.

I joined the forum here because I am eager to learn more about trt and maximizing the benefits and dialing in the perfect protocol for myself.

Doctor started me on 100mg per week test cyp Once a week intramuscular injections. No hcg.
I am about a week into my therapy.

My initial lab results:
Total T : 326 ng/dl
Free T : 74.6 pg/ml
SHBG : 25.5 Nmol/l

Estrogen test used was not the sensitive test so the test they used didn’t pick up any measurable amount of estrogen. So im assuming it’s pretty low. I will request the ultra sensitive test next labs.

Thryoid TSH was borderline high but T3 and T4 still in range.

Cortisol was slightly elevated.

CMP and CBC all came back great.

The labs did not include dhea, dht, progesterone, pregnenolone, prolactin. Not sure if I need any of those done or not?

Next labs I will be adding a lipid panel but was wondering if I should add in a test for dhea and pregnenalone or should I not worry about that so early on?

 

[Eagles21]

Bump

Should I add in pregnenalone or wait awhile and see how I feel on the 100mg test cyp?

Also hcg is hard to get where I’m at and the pharmacies that do have it it’s pretty expensive so I don’t know if I’ll be using hcg or not.

 

[Systemlord]

SHBG : 25.5 Nmol/l

This will go down on TRT for men without metabolic syndrome/ type 2 diabetes.

 

[FunkOdyssey]

Should I add in pregnenalone or wait awhile and see how I feel on the 100mg test cyp?

Wait. Don't change anything for at least 8 weeks.

 

[Eagles21]

This will go down on TRT for men without metabolic syndrome/ type 2 diabetes.

I don’t have have any of those health issues.
So lower SHBG would just make free testosterone go up more, which is good. Correct?

 

[Eagles21]

Wait. Don't change anything for at least 8 weeks.

That’s kind of what I was thinking. Don’t want to add or change too many variables too soon makes sense.

I will have more labs done at the 6 week mark to see where the 100mg dose puts me.

I’m hoping I do well on the once a week dose.
As it’s just easier for me to only inject once a week. Using a 25 gauge 1 inch pin and it’s painless for me. But I’ve been reading a lot about sub q and more frequent injections but will see how I feel from the once a week IM injections.

 

[FunkOdyssey]

I don’t have have any of those health issues.
So lower SHBG would just make free testosterone go up more, which is good. Correct?

It actually works more like the reverse of that. Lower SHBG makes total testosterone go down. Free T is unaffected. You don't need to worry about your SHBG or your total T. Pay attention to your free T, which is going to increase proportionate to your TRT dose.

These true statements are controversial outside of this forum so be careful.

 

[Systemlord]

So lower SHBG would just make free testosterone go up more, which is good. Correct?

Androgens lower SHBG.

 

[Eagles21]

It actually works more like the reverse of that. Lower SHBG makes total testosterone go down. Free T is unaffected. You don't need to worry about your SHBG or your total T. Pay attention to your free T, which is going to increase proportionate to your TRT dose.

These true statements are controversial outside of this forum so be careful.

That’s very interesting. Cause I know testosterone bound to SHBG is considered not bioavailable. So you’d think less SHBG would make more un-bound, or free, testosterone. But I’m sure there is more to it than that. I definitely trust your word on it.

Also on my labs for free testosterone it says it uses calculated free testosterone, is that an accurate measurement for free t?

 

[FunkOdyssey]

That’s very interesting. Cause I know testosterone bound to SHBG is considered not bioavailable. So you’d think less SHBG would make more un-bound, or free, testosterone. But I’m sure there is more to it than that. I definitely trust your word on it.

If you could dissociate a bunch of SHBG from testosterone and remove the SHBG from your body, yes, you would have more free testosterone at that precise moment. Your body is regulating testosterone production based on Free T and E2 though, to keep those hormones at the desired level. If a flood of free T came out of nowhere by crushing your SHBG, your production would slow down or stop until the free T was metabolized. Your new lower SHBG self would find homeostasis at the original free T level and the only change is your total T would now be reduced. You wouldn't feel any different, because your signs and symptoms of eugonadism or hypogonadism are driven by free T, which hasn't changed.

Also on my labs for free testosterone it says it uses calculated free testosterone, is that an accurate measurement for free t?

It is pretty accurate actually. Your calculated value used the Vermeulen formula which we know is pretty damn good. It's better than an inaccurate direct assay for free T. It is also allowing you to compare apples to apples with most other men who are also using the same calculation to derive a free T value.

The only thing better than the Vermeulen calculated free T is to measure it with an accurate test like equilibrium dialysis.

 

[Eagles21]

If you could dissociate a bunch of SHBG from testosterone and remove the SHBG from your body, yes, you would have more free testosterone at that precise moment. Your body is regulating testosterone production based on Free T and E2 though, to keep those hormones at the desired level. If a flood of free T came out of nowhere by crushing your SHBG, your production would slow down or stop until the free T was metabolized. Your new lower SHBG self would find homeostasis at the original free T level and the only change is your total T would now be reduced. You wouldn't feel any different, because your signs and symptoms of eugonadism or hypogonadism are driven by free T, which hasn't changed.


It is pretty accurate actually. Your calculated value used the Vermeulen formula which we know is pretty damn good. It's better than an inaccurate direct assay for free T. It is also allowing you to compare apples to apples with most other men who are also using the same calculation to derive a free T value.

The only thing better than the Vermeulen calculated free T is to measure it with an accurate test like equilibrium dialysis.

Okay thank you for that info.
I won’t worry too much about total T and SHBG then and just focus on Free T.

I’ll be having labs done in about 4 1/2 weeks and I’ll post the results then.

 

[Systemlord]

Androgens lower SHBG.

I didn’t mean to imply lower SHBG is necessarily a problem, only I didn’t want you to be surprised and concerned to find it lower.

 

[J2048b]

Hello everybody,

New member here from Texas.
Just a little background about myself.

I was into bodybuilding in my younger years and started using testosterone at a young age without proper post cycle therapy protocols. Which could be why I now have low T. I really wish I knew what I know now when I was younger lol.

I joined the forum here because I am eager to learn more about trt and maximizing the benefits and dialing in the perfect protocol for myself.

Doctor started me on 100mg per week test cyp Once a week intramuscular injections. No hcg.
I am about a week into my therapy.

My initial lab results:
Total T : 326 ng/dl
Free T : 74.6 pg/ml
SHBG : 25.5 Nmol/l

Estrogen test used was not the sensitive test so the test they used didn’t pick up any measurable amount of estrogen. So im assuming it’s pretty low. I will request the ultra sensitive test next labs.

Thryoid TSH was borderline high but T3 and T4 still in range.

Cortisol was slightly elevated.

CMP and CBC all came back great.

The labs did not include dhea, dht, progesterone, pregnenolone, prolactin. Not sure if I need any of those done or not?

Next labs I will be adding a lipid panel but was wondering if I should add in a test for dhea and pregnenalone or should I not worry about that so early on?

U should just go to ways2well there in texas as they would be ur best best and very affordable.. only in texas

 

[Cataceous]

It actually works more like the reverse of that. Lower SHBG makes total testosterone go down. Free T is unaffected. You don't need to worry about your SHBG or your total T. ...

Let me add one caveat: Anecdotally, men seem more likely to have trouble when SHBG is driven much below 20 nMol/L. One hypothesis is that SHBG also aids intracellular androgen signaling, implying that low levels may reduce androgenic activity. A corollary is that low SHBG reduces androgenic activity relative to estrogenic activity, with the resulting imbalance able to cause symptoms. These ideas should be considered speculative, however.

 

[Eagles21]

U should just go to ways2well there in texas as they would be ur best best and very affordable.. only in texas

I appreciate the recommendation, but I’m happy with the doctor I’m seeing now. They offer all of the same services as ways2well.

 

[Eagles21]

Let me add one caveat: Anecdotally, men seem more likely to have trouble when SHBG is driven much below 20 nMol/L. One hypothesis is that SHBG also aids intracellular androgen signaling, implying that low levels may reduce androgenic activity. A corollary is that low SHBG reduces androgenic activity relative to estrogenic activity, with the resulting imbalance able to cause symptoms. These ideas should be considered speculative, however.

Very interesting. I read something on here that mentioned this.

So what would be a good range for SHBG?

 

[FunkOdyssey]

Let me add one caveat: Anecdotally, men seem more likely to have trouble when SHBG is driven much below 20 nMol/L. One hypothesis is that SHBG also aids intracellular androgen signaling, implying that low levels may reduce androgenic activity. A corollary is that low SHBG reduces androgenic activity relative to estrogenic activity, with the resulting imbalance able to cause symptoms. These ideas should be considered speculative, however.

It seems hard to dissociate low SHBG from the consequences of being the type of guy that has low SHBG. For example, low SHBG is associated with insulin resistance and obesity. Obese insulin resistant men do not do as well on TRT and are liable to suffer more estrogenic sides. So is it the low SHBG or is it the obesity and/or insulin resistance?

Do we have examples of lean and metabolically healthy men with low SHBG that are struggling on TRT?

 

[Cataceous]

It seems hard to dissociate low SHBG from the consequences of being the type of guy that has low SHBG. For example, low SHBG is associated with insulin resistance and obesity. Obese insulin resistant men do not do as well on TRT and are liable to suffer more estrogenic sides. So is it the low SHBG or is it the obesity and/or insulin resistance?

Do we have examples of lean and metabolically healthy men with low SHBG that are struggling on TRT?

This is again partly anecdotal: On the old PeakTestosterone forum there were a few guys with low SHBG who did not have the comorbidities, yet were struggling with TRT. A guy with the screen name "James" posted a lot on this topic, and I quoted him in this thread, and others. It's interesting reading.

 

[Cataceous]

...
So what would be a good range for SHBG?

I'd say no worries if it's in the range of 20-40 nMol/L. But it's not as though dropping into the teens is guaranteed to cause problems. However, if it corresponds with TRT then it could be an indication that your dose is on the high side.

I encourage you to seriously consider twice-weekly injections, and better yet would be 40 mg TC each time rather than 50 mg. The problem with once-weekly is that your peak serum testosterone in the day or so after each injection is two to three times higher than the pre-injection trough. There's some evidence that this pattern contributes to side effects, such as elevated hematocrit. With twice-weekly injections the peaks are reduced to more like 50% over troughs.

 

[Eagles21]

I'd say no worries if it's in the range of 20-40 nMol/L. But it's not as though dropping into the teens is guaranteed to cause problems. However, if it corresponds with TRT then it could be an indication that your dose is on the high side.

I encourage you to seriously consider twice-weekly injections, and better yet would be 40 mg TC each time rather than 50 mg. The problem with once-weekly is that your peak serum testosterone in the day or so after each injection is two to three times higher than the pre-injection trough. There's some evidence that this pattern contributes to side effects, such as elevated hematocrit. With twice-weekly injections the peaks are reduced to more like 50% over troughs.

I am definitely considering it. My doctor said we will most likely up my dose at 6 weeks to 150mg depending on labs.

So at 150mg the peaks will be even higher from the once a week injections. If E2 and hematocrit start rising too much I will definitely switch to twice weekly injections to see how that works out. I want to avoid using an aromatase inhibitor and I don’t want to donate blood that often if I don’t have to due to ferritin levels dropping from too much blood donation. So if it gets out of control hopefully smaller more frequent injections will keep everything in the right ranges.