Requesting advice on problems in lab work

[duramax]

I'm 55 years old and have been on many different methods of delivery since 38 years old. I have low SHGB and most primary care doctors don't have a clue about it. I even traveled many years ago to visit Dr. Crisler and back in those days he didn't have a clue about low SHGB. Looks like things have came along way now. My numbers look fine for T levels but I get absolutely no benefit from it. When I first started Androgel worked great.....six months later and my body wasn't absorbing or something else was out of wack? Since then I have tried about every delivery method available. My libido is low, energy low, etc., etc. This lab shows my TSH is at the bottom of the chart, but Doc says it's fine like that? I currently take 1.8 MG weekly. What would be an ideal protocol for someone with my numbers. I have been trying injections every 3.5 days... not feeling much different? Any advice would be greatly appreciated. thank you

 

[Vince Carter]

I think that you should reduce your dose from 180mg and consider EOD dosing, having your Free T below the lab range in a trough such as you do might be a problem. Maybe 30mg EOD. Your low SHBG, like me, and it just means, basically, that you process out the T very quickly it's why you're on a high dose but your TT/FT look poor.

Your Thyroid looks fine to me. Free T3 is very good, low TSH is not a problem and neither is a low(er) T4 value.

 

[Gman86]

Ya I would also advise to inject more frequently. I would personally inject daily if I were in your situation.

 

[wondering]

I am one that needs his FT4 a little higher. If you are already taking Thyroid hormone, perhaps try 25mcg of Levothyroxine. Though your TSH being that low means your brain may be getting what it needs.

 

[duramax]

I think that you should reduce your dose from 180mg and consider EOD dosing, having your Free T below the lab range in a trough such as you do might be a problem. Maybe 30mg EOD. Your low SHBG, like me, and it just means, basically, that you process out the T very quickly it's why you're on a high dose but your TT/FT look poor.

Your Thyroid looks fine to me. Free T3 is very good, low TSH is not a problem and neither is a low(er) T4 value.

Thanks Vince! Do you use any HCG? Do you think at my age it would be beneficial? I've never been on a good regiment for HCG. Ejaculation is weak and quantity lacking! I will definitely try 30MG....SubQ. Thank you.

 

[Systemlord]

I have low SHBG only felt good on an EOD and daily protocols, twice weekly protocols and I was a non-responders to TRT, nothing happened. I inject 7mg enanthate daily now or 5mg cypionate and get the same effect.

I also am very sensitive to hormonal fluctuations, so the more my hormones fluctuate between injections, the less benefits I get out of TRT. You never made any mention about scrotal cream which doesn't have the same absorption issues as Androgel because the scrotum skin is 6 times thinner than anywhere else on the body.

 

[wondering]

I have low SHBG only felt good on an EOD and daily protocols, twice weekly protocols and I was a non-responders to TRT, nothing happened. I inject 7mg enanthate daily now or 5mg cypionate and get the same effect.

I also am very sensitive to hormonal fluctuations, so the more my hormones fluctuate between injections, the less benefits I get out of TRT.

Did that change in protocol improve libido and ED or did you just feel less swings in energy/mood, etc.

 

[Systemlord]

Did that change in protocol improve libido and ED or did you just feel less swings in energy/mood, etc.

After about a week it almost feels like I'm at a stable state, fluctuations if they occur at all happen about an hour before my injection and are gone as soon as I inject. My libido, erections and energy are always getting better with each injection.

My sleep also improves after the first week, this never happened on an EOD protocol.

 

[duramax]

I have low SHBG only felt good on an EOD and daily protocols, twice weekly protocols and I was a non-responders to TRT, nothing happened. I inject 7mg enanthate daily now or 5mg cypionate and get the same effect.

I also am very sensitive to hormonal fluctuations, so the more my hormones fluctuate between injections, the less benefits I get out of TRT. You never made any mention about scrotal cream which doesn't have the same absorption issues as Androgel because the scrotum skin is 6 times thinner than anywhere else on the body.

I’ve never tried any scrotal cream. Are you doing subQ injections? If so, how do you manage your lab work? I see a primary care doctor and I’m sure he will not understand subQ or why I am doing daily shots. I showed him my labs and asked about low SHBG....he said my numbers were good and all he could do was refer me to an endocrinologist. I went to an Endo years ago and what a joke. I just want to get to feeling better.....I plan to start daily subQ immediately.

 

[duramax]

Ya I would also advise to inject more frequently. I would personally inject daily if I were in your situation.

What would be a recommended daily dosage?

 

[Systemlord]

I’ve never tried any scrotal cream.

Let's compare androgel to creams, Androgel is 1.62% and the creams are 20%. You are getting a higher testosterone percentage concentration and up to 6 times better absorption on the scrotum.

Are you doing subQ injections?

Tried it and hated it. IM works for everyone.

If so, how do you manage your lab work?

I'm not overly concerned about lab work, I increase the dosage until I feel good, I don't care about the numbers, only how I feel.

I showed him my labs and asked about low SHBG....he said my numbers were good

Having low SHBG isn't good, too many diseases associated with low SHBG, should investigate why SHBG is low. Your doctor is simple minded and ignorant, short of an acute medical condition, he's unconcerned.

Low testosterone and low thyroid hormones have a low priority for treatment. You almost have to seek private care for TRT and thyroid treatment because doctors are too caught up in the normal ranges and would rather let you to suffer in silence.

 

[Vince Carter]

too many diseases associated with low SHBG, should investigate why SHBG is low.

That's not true or proven and none of that has ever been resolved that elevated a guys SHBG to whatever 'normal' actually is...??? Note as well most of what people think is associated with low SHBG is made up lazy people diseases; metabolic syndrome/adrenal fatigue/pre-diabetes.
What has been proven with real guys on the forum(s) is that its benign/genetic.
Too, any time someone say's high SHBG no one runs to this nonsense about made up medical conditions.
Im rather surprised that you played that card.

 

[slicktop]

What would be a recommended daily dosage?

What *I* did: take your recommended weekly dose in MG and divide it by 7. So I was originally at 140mg a week, and was initially doing that in two 35iu/70mg shots spaced 3.5 days apart. My NP said I could up my test dosage a bit to get my free test up a little, so I started with the same overall weekly dose but did it at 20mg a day. The daily shots were enough alone that my free test increased and my estradiol went down. YMMV.

Also, I have to agree with Systemlord in that "You almost have to seek private care for TRT and thyroid treatment because doctors are too caught up in the normal ranges and would rather let you to suffer in silence." I pay more or less out of pocket for most of my TRT (I have an HSA account), but it's absolutely worth it to me.

I have a theory regarding health that borders on predestination: barring those blessed with outstanding genetics, you're basically going to spend the same amount of money on your health over the course of your adult life, no matter what. What you pay for out of pocket now to feel great and be truly healthy is probably the same amount you'll get billed for when you go over your insurance benefits later on.

 

[Cataceous]

That's not true or proven and none of that has ever been resolved that elevated a guys SHBG to whatever 'normal' actually is...??? Note as well most of what people think is associated with low SHBG is made up lazy people diseases; metabolic syndrome/adrenal fatigue/pre-diabetes.
What has been proven with real guys on the forum(s) is that its benign/genetic.
Too, any time someone say's high SHBG no one runs to this nonsense about made up medical conditions.
Im rather surprised that you played that card.

The truth is that many studies have demonstrated the association of bad things with lower SHBG. You can put forth this hypothesis that there are isolated cases of genetically-caused low SHBG that lack these associations, but clearly their numbers aren't large enough to influence the overall statistics suggesting that lower SHBG is problematic, even if it's a non-causal indicator.

 

[wondering]

That's not true or proven and none of that has ever been resolved that elevated a guys SHBG to whatever 'normal' actually is...??? Note as well most of what people think is associated with low SHBG is made up lazy people diseases; metabolic syndrome/adrenal fatigue/pre-diabetes.
What has been proven with real guys on the forum(s) is that its benign/genetic.
Too, any time someone say's high SHBG no one runs to this nonsense about made up medical conditions.
Im rather surprised that you played that card.

Dr. Crisler and Dr. Mariano both told me that their patients with low SHBG have increased anxiety compared to the patients that don't.

 

[blinkyvx]

my SHBG was 22, and do daily injections. A DHEA supplement may consider researching/trying as well