Daily injections is the recommended protocol for low SHBG guys having trouble on TRT, what were your precious protocols and pre-TRT labs?
Creams may not be much different as your ability to bind androgens is compromised do to low SHBG and levels will swing on creams probably more so than with injections. Keeping levels steady is more important for low SHBG guys.
My SHBG is 22 and feel very little unless I'm injecting every 2 days.
SHBG is 14. I’ve been on EOD injections of 40mg and .125 mg Anastrozole. Also take 500IU HCG every 4 days. Been on this for over a year.
Labs have been pretty steady at 750 Test and 25-30 E2.
I’m just not feeling any benefit from the TRT. I’ve heard that cream gives the most stable levels so thought it might help.
I can easily see your problem, you have high testosterone and estrogen is towards the higher end of the range and your SHBG is very low.
The estrogen towards the top of the range may look innocent, but hiding underneath the surface must be insanely high free estrogen, this is most likely why you feel no benefit. There isn't a low SHBG guy on this board that wouldn't have symptoms with very low SHBG and estrogen on the higher end.
One of the reasons a low SHBG guys tend to have anxiety is because of high free testosterone and therefore high for estrogen. You're free hormones are in excess.
Transdermals pose a problem for low SHBG guys. I have SHBG of 16. I started out TRT with T gel applied daily. When I had blood tests 12 hours after applying the gel my Total T level would be around 800. However when I running blood tests 22 hours after applying the gel my Total T would drop to 180.
The later Dr. Crisler said that this was because the T absorbed via the skin goes very quickly to the bloodstream with low SHBG guys like me it's flushed quickly via the urine. He recommended me to switch to bi weekly SUBQ injections, stating the the T is absorbed slower via the SUBQ tissue. I've been doing that for 2 years now and this protocol enabled me to sustain a steady and healthy levels of T.
I was applying 75-100mg T gel daily. I didn't feel good and thought that the problem was psychological until I got tested 22 hours post injection and saw that my levels were constantly fluctuating up and down like a mad seesaw.
Twice a day application is not practical as you don't want the spouse and children touching you and having the T transferred to them.
Why are your kids touching your balls?Twice a day application was not practical for me as I need to ensure the T isn't transferred to my spouse and kids by touch.
I did my best, too date, with my trough Sens E2 in the single digits. Free E on the lower half of the lab range, IIRC .18 on a <0.45 scale. SHBG was 12 recently.
Most all my body acne subsided, I can use regular body wash now and take one shower per day. Penile sensitivity was improved, and orgasm was remarkably improved.
This is my experience also.I went the other way, from gel to injections. I found gels to be an unstable nightmare with monthly measured tt levels wildly swinging over 500 points up and down. ...
16mg/D Cyp (Ive been using Enanthate the last two weeks).
--I base my dose off my trough Free T and nothing else. This puts my trough at the
lab range but not over.
200iu HCG once per week
12.5mg Exemestane EOD ( aromatase A LOT and this is what it takes to control it)
no DHEA
no Preg