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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Shbg/free t?
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<blockquote data-quote="Cataceous" data-source="post: 211994" data-attributes="member: 38109"><p>AIs tend to be rather blunt instruments. It doesn't surprise me that low-SHBG guys in particular seem to have a hard time finding the right testosterone and AI doses to achieve a good balance. I suspect it would be even worse with hCG use because then the AI has reduced effect on the intratesticular aromatization.</p><p></p><p>I think <a href="https://www.excelmale.com/forum/threads/what-is-the-reason-low-shbg-needs-ed-injections.22079/post-189857" target="_blank">this post</a> on E2/T ratios is worth repeating:</p><p></p><p style="margin-left: 20px"><span style="font-size: 15px">One of the problems with low SHBG may be the ratio of free estradiol (fE2) to free testosterone (fT). Without TRT, the normal HPTA uses free estradiol as its primary regulator. With a fixed free estradiol, the lower the SHBG the lower the free testosterone. This means low SHBG provides a built-in propensity towards hypogonadism.</span></p> <p style="margin-left: 20px"></p> <p style="margin-left: 20px"><span style="font-size: 15px">So the symptomatic low-SHBG guy goes on TRT. What happens? Now the exogenous testosterone is directly controlling free testosterone. With a fixed free testosterone, the lower the SHBG the higher the free estradiol. What this means in practice is that the low-SHBG guy starts with a higher fE2/FT ratio than in normal guys, and increasing testosterone via large, infrequent injections pushes the ratio even higher.</span></p> <p style="margin-left: 20px"></p> <p style="margin-left: 20px"><span style="font-size: 15px">If we posit that there is a tolerable normal range for the fE2/fT ratio then it's clearly safer for the low-SHBG guy to avoid large peaks in his serum testosterone and estradiol. This is accomplished with smaller and more frequent injections.</span></p> <p style="margin-left: 20px"></p> <p style="margin-left: 20px"><span style="font-size: 15px">Here are some numbers calculated using the multi-ligand model:</span></p> <p style="margin-left: 20px"><img src="https://www.excelmale.com/forum/attachments/1603987233357-png.11341/" class="bbImage" alt="" data-url="https://www.excelmale.com/forum/attachments/1603987233357-png.11341/" style="" /></p> <p style="margin-left: 20px"></p> <p style="margin-left: 20px"><span style="font-size: 15px">In this thought experiment there are two guys on TRT who are identical except for SHBG. They are on the same E5D doses of testosterone cypionate. In the last line of the table the peak fE2/fT ratio of the guy with normal SHBG is chosen as the reference point. The normal guy is operating in a range of 93-100%. The low-SHBG guy starts out at 106% and then climbs to 111%. Suppose symptoms occur at over 109%. In this case daily injections would probably help. But if symptoms occur at a lower figure, such as 107%, then a dose reduction would also be necessary, and this would risk sending free testosterone too low, which might cause other symptoms. It's easy to see why TRT can be a struggle for guys with low SHBG.</span></p></blockquote><p></p>
[QUOTE="Cataceous, post: 211994, member: 38109"] AIs tend to be rather blunt instruments. It doesn't surprise me that low-SHBG guys in particular seem to have a hard time finding the right testosterone and AI doses to achieve a good balance. I suspect it would be even worse with hCG use because then the AI has reduced effect on the intratesticular aromatization. I think [URL='https://www.excelmale.com/forum/threads/what-is-the-reason-low-shbg-needs-ed-injections.22079/post-189857']this post[/URL] on E2/T ratios is worth repeating: [INDENT][SIZE=15px]One of the problems with low SHBG may be the ratio of free estradiol (fE2) to free testosterone (fT). Without TRT, the normal HPTA uses free estradiol as its primary regulator. With a fixed free estradiol, the lower the SHBG the lower the free testosterone. This means low SHBG provides a built-in propensity towards hypogonadism.[/SIZE][/INDENT] [INDENT][/INDENT] [INDENT][SIZE=15px]So the symptomatic low-SHBG guy goes on TRT. What happens? Now the exogenous testosterone is directly controlling free testosterone. With a fixed free testosterone, the lower the SHBG the higher the free estradiol. What this means in practice is that the low-SHBG guy starts with a higher fE2/FT ratio than in normal guys, and increasing testosterone via large, infrequent injections pushes the ratio even higher.[/SIZE][/INDENT] [INDENT][/INDENT] [INDENT][SIZE=15px]If we posit that there is a tolerable normal range for the fE2/fT ratio then it's clearly safer for the low-SHBG guy to avoid large peaks in his serum testosterone and estradiol. This is accomplished with smaller and more frequent injections.[/SIZE][/INDENT] [INDENT][/INDENT] [INDENT][SIZE=15px]Here are some numbers calculated using the multi-ligand model:[/SIZE][/INDENT] [INDENT][IMG]https://www.excelmale.com/forum/attachments/1603987233357-png.11341/[/IMG][/INDENT] [INDENT][/INDENT] [INDENT][SIZE=15px]In this thought experiment there are two guys on TRT who are identical except for SHBG. They are on the same E5D doses of testosterone cypionate. In the last line of the table the peak fE2/fT ratio of the guy with normal SHBG is chosen as the reference point. The normal guy is operating in a range of 93-100%. The low-SHBG guy starts out at 106% and then climbs to 111%. Suppose symptoms occur at over 109%. In this case daily injections would probably help. But if symptoms occur at a lower figure, such as 107%, then a dose reduction would also be necessary, and this would risk sending free testosterone too low, which might cause other symptoms. It's easy to see why TRT can be a struggle for guys with low SHBG.[/SIZE][/INDENT] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Shbg/free t?
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