Shbg

[recurve6]

Okay Guys, I see that there is a lot of knowledge and expertize here. My question is, I have low SHBG and would like to know how and what affect this potentially has on my TRT?

Thanks,

Recurve6

 

[Vince]

With low SHBG one generally does not feel much if any benefit from TRT. The main reason for low SHBG is high insulin. High insulin may be indicative of insulin resistance.

 

[ERO]

I have low SHBG and yes, I don't feel much of anything from TRT - it mostly feels the same as when I had untreated low T. In my case anyway I do not now, nor ever had high insulin or elevated glucose. It is a good idea to check yours though if you have not already done that.

 

[Vettester Chris]

With low SHBG one generally does not feel much if any benefit from TRT.

Hmmm ... I might have to disagree on this one Vince. I am usually a single digit SHBG guy, and my Free Testosterone is normally in the 3.3% range +/-. If I crash or get too low on my test, it's Darkville with the blues in a bad way.

My main thing that I promote to guys with this scenario is to focus on keeping their total serum in a lower range, maybe an area like 650-750 ng/dl, where free test will maybe fall in the 15 to 21ng/dl range. For me, 650 ng/dl puts me around 20ng/dl on free testosterone, which suits me just right, no E2 issues, no problems. This is obviously different for everyone, but I do believe all patients should dial-in the free & bio available variable equally if not more than just total serum.

The other thing I suggest is the Low SHBG crowd look a little further into making sure they do some good liver cleanse routines, keep an eye out for unusual conditions/issues that are also liver related, as in my case the hemochromatosis carrier gene (HFE genetic mutation), causing excess iron & ferritin to build-up in my body. In short, the mutation can cause some of the regulation features of the liver not to function properly.

Just a note beyond the above ... There's been noted correlations with hypothyroidism and low SHBG. I think one thought on the TRT subject possible not working in patients with low SHBG is that in some cases hypothyroidism is a factor, but not identified or treated, and lingering symptoms of low thyroid hormone activity in the cells of the body can decrease the patient's overall well being in general. I think that could be one possibility out of many ...

 

[CoastWatcher]

Hmmm ... I might have to disagree on this one Vince. I am usually a single digit SHBG guy, and my Free Testosterone is normally in the 3.3% range +/-. If I crash or get too low on my test, it's Darkville with the blues in a bad way.

My main thing that I promote to guys with this scenario is to focus on keeping their total serum in a lower range, maybe an area like 650-750 ng/dl, where free test will maybe fall in the 15 to 21ng/dl range. For me, 650 ng/dl puts me around 20ng/dl on free testosterone, which suits me just right, no E2 issues, no problems. This is obviously different for everyone, but I do believe all patients should dial-in the free & bio available variable equally if not more than just total serum.

The other thing I suggest is the Low SHBG crowd look a little further into making sure they do some good liver cleanse routines, keep an eye out for unusual conditions/issues that are also liver related, as in my case the hemochromatosis carrier gene (HFE genetic mutation), causing excess iron & ferritin to build-up in my body. In short, the mutation can cause some of the regulation features of the liver not to function properly.

Just a note beyond the above ... There's been noted correlations with hypothyroidism and low SHBG. I think one thought on the TRT subject possible not working in patients with low SHBG is that in some cases hypothyroidism is a factor, but not identified or treated, and lingering symptoms of low thyroid hormone activity in the cells of the body can decrease the patient's overall well being in general. I think that could be one possibility out of many ...

I agree with the points Chris makes. I'm a low, double-digit SHBG guy, but I have found a protocol (in my case daily, small injections of testosterone and twice-weekly HCG shots) that have put me in a great place. Low SHBG is certainly a challenge, and some dealing with a lower value do struggle to find a subjective response to TRT, but it can be done. I look at it as just another variable that has to be factored into the equation a patient and his doctor are working to solve.

 

[Vince Carter]

I have it and I disagree, entirely, that low SHBG is a problem. You have to work with it, it dictates a different dosing and injection schedule and takes more care to manage E...high Free T is an absolute PLUS, but with it comes Free E. Smaller more frequent injections leads to high(er) TT and high Free T and likely no use of an AI.
I think that most that complain about it simply don't know that the standard E3.5D is not compatible for them and/or lack the ability to MAKE it work FOR THEM. Absent the discussion is Thyroid, Adrenals, and so forth that have to be investigated and treated if necessary but as a singular topic, SHBG is not bad.

I'm 10X better than I was as a Low T patient, but I test (often) got with Dr Saya, and I'm doing things to make it work, and doing things to get better still.

 

[Vince Carter]

With low SHBG one generally does not feel much if any benefit from TRT. The main reason for low SHBG is high insulin. High insulin may be indicative of insulin resistance.

Scaring someone with Insulin (and Diabetes) isn't the most responsible thing to do here. Advocating a full screening and physical seems to me a softer pathway to follow than tossing around the very scary Insulin/Diabetes words.

 

[Nelson Vergel]

Some good discussions here:

Low SHBG ! Good or bad?

www.excelmale.com/showthread.php?3085-Low-SHBG-!-Good...

low SHBG is often a sign of many of the worst chronic diseases that we face in modern, civlized societies. 1.

[TD="class: gsc-table-cell-thumbnail gsc-thumbnail"]

[/TD] [TD="class: gsc-table-cell-snippet-close"] Found this article which says .. ''

[/TD]

How can one increase SHBG when it is too low?

www.excelmale.com/showthread.php?3624-How...SHBG...low

low output of SHBG. Instead of increasing and decreasing the level like it is supposed ...

[TD="class: gsc-table-cell-snippet-close"] I've been having some serious problems with my liver's

[/TD]

Injection Protocol for people with Low SHBG !!

www.excelmale.com/showthread.php?3145...for...Low-SHBG-!!

low SHBG or just high converters to estrogen tend to do better with 3X weekly subQ ...

[TD="class: gsc-table-cell-thumbnail gsc-thumbnail"]

[/TD] [TD="class: gsc-table-cell-snippet-close"] '' However, what I hear "on the streets" is that men who are

[/TD]

Managing Low SHBG and E2, High Free T

www.excelmale.com/showthread.php?5471...Low-SHBG-and-E2...

low on the e2 but keep it in line with my low SHBG. I want to get to the good weeks and days ...

[TD="class: gsc-table-cell-snippet-close"] So I guess my question is how do I avoid going too

[/TD]

TRT has been underwhelming for 4+ years - Low SHBG

www.excelmale.com/showthread.php?4247-TRT...Low-SHBG

[TD="class: gsc-table-cell-thumbnail gsc-thumbnail"]

[/TD] [TD="class: gsc-table-cell-snippet-close"] TRT for me has always been underwhelming even though my blood work is fine, I eat well and exercise 5 to 6 days a week. Libido was far ... [/TD]

 

[ERO]

I have it and I disagree, entirely, that low SHBG is a problem. You have to work with it, it dictates a different dosing and injection schedule and takes more care to manage E...high Free T is an absolute PLUS, but with it comes Free E. Smaller more frequent injections leads to high(er) TT and high Free T and likely no use of an AI.
I think that most that complain about it simply don't know that the standard E3.5D is not compatible for them and/or lack the ability to MAKE it work FOR THEM. Absent the discussion is Thyroid, Adrenals, and so forth that have to be investigated and treated if necessary but as a singular topic, SHBG is not bad.

I'm 10X better than I was as a Low T patient, but I test (often) got with Dr Saya, and I'm doing things to make it work, and doing things to get better still.

I am always amazed at how we all respond so differently. I am basically following your exact protocol:

* Daily injections
* No AI
* Daily HCG 200IU
* Frequent testing, including Thyroid
* Plus, I too work with Dr. Saya @ Defy Medical

I also sleep well, follow a solid weight training & cardio plan, and I eat well overall. And yet, I feel basically the same as when I had Low T. I have very low to no libido, cannot make any progress in the gym, cannot loose weight, (I have been eating low carb for years) and if it were not for work, I could take a nap every afternoon for an hour or so.

 

[CoastWatcher]

I am always amazed at how we all respond so differently. I am basically following your exact protocol:

* Daily injections
* No AI
* Daily HCG 200IU
* Frequent testing, including Thyroid
* Plus, I too work with Dr. Saya @ Defy Medical

I also sleep well, follow a solid weight training & cardio plan, and I eat well overall. And yet, I feel basically the same as when I had Low T. I have very low to no libido, cannot make any progress in the gym, cannot loose weight, (I have been eating low carb for years) and if it were not for work, I could take a nap every afternoon for an hour or so.

It really frustrates me when I read that, ERO, as I follow a protocol so similar to your own and that of Vince Carter, and it works for me. My own doctor has told me that she sees results similar to what you experience in about eight to twelve percent of her patients. When all other variables are controlled for, she said it's a mystery. I admire your ongoing efforts and hope you see results.

 

[Vince Carter]

I have come to often question the thoroughness to which our Dr's actually screen and now what to look for and the questions to ask. For instance I've had clinically low Prolactin (appx 5ng/dL) on three tests, along with DHT in the 40% range on two tests, both weren't given a word by two Dr's. It's taken my direct involvement on those two specific things in order to treat one, my DHT, effectively. Prolactin is my new area of interest. But my point being that low SHBG in and of itself isn't something that is bad. It's when combined with one or more related issues, which most of us have, that SHBG can be an easy target for criticism.
Im now enjoying a little better quality of life through L-Lysine withsome dopamine/norepinephrine response as well as Seratonin through 5-HTP. It's a continuing journey, for sure.

 

[recurve6]

Thanks for all your responses. I definitely have some researching to do.

 

[CoastWatcher]

Thanks for all your responses. I definitely have some researching to do.

All the best.

 

[Vettester Chris]

Some really good talking points on this thread!! Keep us posted with your progress..Thanks!!