New to forum, not new to TRT

[ERO]

Hi All-

I am 50 now and I have been on TRT for the last 4 years. I am one of the "lucky" guys with low SHBG so TRT has never lived up to the hype for me, but I do feel a bit better on than off, so I stay on. Over the last 4 years I have tried every protocol and they all feel about the same - kind of a meh feeling. TRT did not improve my libido or erections at all either, and yes, my E2 is controlled, and I typically look great "on paper" with my blood work. Since TRT has never worked that well for me, I have read every book on TRT, been on a great many of the forums, met with many doctors, and have spent hundreds of hours on Google researching it, so while I would not go so far as to say I am an expert, but I do know a lot about it and enjoy learning new things as they come up.

Anyway, love the forum and the vast resource of great info we have here!

 

[CoastWatcher]

May I ask what your SHBG, total and free testosterone is? My SHBG seems to be fluctuating like mad. Puzzling and frustrating.

 

[ERO]

My SHBG ranges between 7 and 13 on a scale where 20-70 is the normal range, so my free T is always on the high side. The sad part is that most doctors think that is great and don't realize that low SHBG is NOT a good thing.

 

[Vince]

ERO, what problems does low SHBG cause, I would also think that high free T is a good thing.

 

[ERO]

Guys with low SHBG feel very little to no benefit from Testosterone. I first got on TRT because my libido had dropped to nothing so I got tested and was low and I started TRT. Well, for me and other guys with low SHBG, a shot of test basically feels exactly the same as a shot of saline. So here I am 4 years later and I still have no libido, cant really build any muscle, still have ED issue, etc...and I am otherwise in good health. Never smoked, rarely drink, and then its a glass of wine when we have dinner out, I exercise 6 days a week and eat well overall. I am not diabetic or pre-diabetic either, which is often a correlation with low SHBG.

SHBG is like any other hormone or body chemical in that a level too high is not good, and a level too low is not good.

Google "low SHBG and TRT" (no quotes) and you will see what I mean.

 

[CoastWatcher]

Though the title of the post references high SHBG, Nelson has included a good section on those of us dealing with low SHBG.


https://www.excelmale.com/forum/showthread.php?3484-How-to-lower-your-sex-hormone-binding-globulin

 

[Vettester Chris]

ERO, glad you joined!! I've read some of your posts and can see you're pretty versed on HRT. We are glad you are part of the community!!

In similar contrast, I also have Low SHBG, high single digits for the most part. My free test usually falls in the 3.3%-3.4% range. In my case, there's some speculation that the hemochromatosis genetic issue I have is a factor with my liver and the production thereof with SHBG.

Also, knowing that you have low SHBG, there could be other underlying issues related with your thyroid. I imagine you have probably reviewed that subject in detail, but if not, it would be good to take a thorough look at it?!?! That might even be one are of observation, based on how you have described your experiences with TRT.

 

[ERO]

Thank you, and your thyroid question is perfectly timed, as I am in the process of transferring to Defy Medical and I am hoping to go over this with them in detail. Up until recently, my thyroid tests always came back with everything in range, but lately its been off. High T3 and low T4 and some hypo symptoms. I know it sounds crazy when I say it out loud, but at this point I hope it is my thyroid as then I have something to treat as opposed to mere anecdotal ideas to try as I have had in the past.

On an unrelated note, today I went and got a Bod Pod scan as well to send to Defy Medical as every time I get a standard physical exam they use the outdated BMI calculation that always shows me as obese. My Bod Pod results showed me at 20% body fat instead of the 30+% that the BMI always shows. Now I know I should be at 15% and that is my goal, but at least I have proof now that I am not walking around at 30+ percent body fat.

This forum is terrific - I have only been a member for like 3 days and everybody has been very supportive and there is a ton of great info here. Thank you everyone!

 

[Vettester Chris]

ERO, thanks for sharing that info. on your thyroid. As you've recognized, things usually are going best when thyroid hormone levels are fairly close in relation to the percentage of their respective reference range levels, e.g., FT3 might be at 62% of reference range, you would hope to see FT4 fairly close in its reference range; maybe 55% to 65%.

There could be several factors here, but "usually" when you see FT3 elevated, but FT4 i sluggish, that is a strong indicator that your FT3 is pooling, meaning it's building up and not effectively getting into the cells of the body. This is "usually" the result of issues with cortisol, and/or iron, ferritin, electrolytes, Vitamin D ... Cortisol & iron/ferritin usually being the primary areas to look. You would also want to review your antibodies for autoimmune disorders like Hashis.

When this happens, the body recognizes an issue and begins to divert FT4 to convert higher rates of Reverse T3. Since FT3 is elevated you will usually see TSH to be pretty low and/or even at a "normal" level, as the increased FT3 signals the pituitary that there is not a strong demand for TSH.

If you have or can get FT4, FT3, RT3, TSH, antibodies TPO & TgAb, (or if you have them), it will help provide the current picture. Here's the link to the labs page at STTM.com http://www.stopthethyroidmadness.com/recommended-labwork/ , which covers all the bases.

 

[ERO]

Here are the results of my latest thyroid panel - Next time I will get a more thorough panel

THYROID PANEL WITH TSH:


T3 UPTAKE 49 Result HIGH Range 22-35 % 01



T4 (THYROXINE), TOTAL 3.1 Result LOW Range 4.5-12.0 mcg/dL 01




FREE T4 INDEX (T7) RANGE 1.5 1.4-3.8 01


TSH 2.17 Range 0.40-4.50 mIU/L 01

I know my iron is never low, more often a tiny bit high, but not dramatically, and I know that I am good on Vitamin D as I supplement 5000 IU daily. Last time I did a cortisol test I was in-range on all 4 (saliva test: one AM, one at noon, one at dinner and one at like 11:00pm at night)

Strange...

 

[Vettester Chris]

ERO, there's nothing on your T3 at all with these labs. The Total T4 gives me somewhat of an indicator that your free serum is probably in the same direction, but to be absolutely sure, we need a Free T4 serum lab, as it can deviate just like free testosterone would in relation to total test serum. That T3 Uptake has zero to do with your actual T3, it measures proteins from the thyroid. The index is just a continued calculation based on the T4 and T3 Uptake.

I hope I don't come across condescending, it's not my plan, but I'm telling you in sincerity that these are the labs that doctors use when they don't quite know how to really manage a patient's thyroid health. These labs look important, they sound "buzzy" (all that uptake and index stuff ya know), but they're worthless!!! Has zilch to do with your actual T3!!

OK, you know the labs that are needed ... Let me know. Thanks

 

[Vettester Chris]

Also, on Cortisol, it's not about being in range, as that can be a large area. The AM should be in the top section (80%-90%) of reference range, then labs thereafter would start falling towards mid-point of reference range, and in that direction as the circadian profile progresses.

If your future thyroid labs come up having issues, we can revisit this down the road. For now, we don't know really where things sit on your thyroid, so no need to hash too hard on anything else.

 

[ERO]

Cool, this is great info and I am gonna get new labs this week. I am tired of being "sick and tired" of meh results on TRT so now that I am going to switch to Defy Medical, I want to start out with what I need and hopefully get it straightened out.

So I need Free T4 Serum - anything else on the Thyroid? I am looking at Discounted Labs test options.

also, The test I recently had was called the "Complete Thyroid Panel" which would imply a "complete" test, but I guess not?

 

[Vettester Chris]

Here's everything you need on your thyroid ... Free T4 Serum, Free T3 Serum, Reverse T3 Serum, TSH, Antibodies (TPO & TgAb) .. If they throw in TSI, that's the marker for Graves, but I highly doubt that's a problem.

Thanks, I'll be on the lookout ...

 

[ERO]

Just ordered all of these and will go in for a blood draw tomorrow, so I should have results by the end of the week. I appreciate your help on this!