TRT did not affect E2 and SHBG levels

tman98 · Feb 18, 2019

Hello guys. I’m 20 years old, been on TRT for 2 months now, protocol is 20mg of test U daily.

This was my pre TRT bloodwork

TT: 341 ng/dL (118 - 948)
FT: 8 pg/mL (4 - 30)
LH: 4.58 mUI/mL (1 - 7.1)
FSH: 2.46 mUI/mL (0.480 - 4.170)
E2 (non sensitive): 32.40 pg/mL (11.8 - 36.6)
Prolactin: 6.65 ng/mL (2.1 - 17.7)
SHBG: 17.4 nmol/L (10 - 57)
TSH: 1.247 uU/mL (0.480 - 4.170)
fT4: 1.40 ng/dL (0.83 - 1.43)

Two months on TRT
TT: 682 ng/dL
E2 (non sensitive): 32.9 pg/mL
SHBG: 17.7 nmol/L

I was expecting E2 and SHBG to increase yet they barely changed, why is that?

Also I increased my dose to 25mg daily and noticed that my pennis when flaccid shrunk and my erections lost strength, I then took 0.1mg of anastrozole and now I can’t get hard, does this mean that my shrunken flaccid was due to low E2 and not high E2.

Thank you

Sean Mosher · Feb 18, 2019

I wouldn't mess with the AI, just return back to your daily dose if that was working for you originally.
Where did your freeT end up with the new labwork?
E2 looks fine.

tman98 · Feb 18, 2019

Unfortunately my doctor did not order free T. I forgot to mention that the E2 test is non sensitive.

CoastWatcher · Feb 18, 2019

tman98 said:
Unfortunately my doctor did not order free T. I forgot to mention that the E2 test is non sensitive.

If that's the case, you'd be foolish to make any decision to add/eliminate anastrozole.

tman98 · Feb 18, 2019

CoastWatcher said:
If that's the case, you'd be foolish to make any decision to add/eliminate anastrozole.

Alright, I will get a free T test and evaluate based on it.

Also, why do you think my SHBG did not change much after starting TRT?

Cataceous · Feb 18, 2019

Calculated free T on TRT is about 20 ng/dL, which is a good number. I wouldn't bother measuring it. Are you sure about the AI dose? 10 micrograms is pretty small to have much effect; I'm pretty sensitive yet still take ~35 micrograms a day.

tman98 · Feb 18, 2019

My bad, it was 0.1mg. Yes it is a very small dose but this is the first time since starting TRT that I’ve had a hard time getting an erection and all points out to being because if the AI since I had never taken any before.

Vince · Feb 18, 2019

tman98 said:
My bad, it was 0.1mg. Yes it is a very small dose but this is the first time since starting TRT that I’ve had a hard time getting an erection and all points out to being because if the AI since I had never taken any before.

As others have said. I wouldn't increase your dose of testosterone and I definitely wouldn't an AI

Systemlord · Feb 18, 2019

Your levels are perfect, leave them along. Just measure Free T at your next blood draw, no way Free T isn't optimal when your Total T and SHBG levels are factored in.

SHBG doesn't usually increase on TRT, it decreases. There have been a few case where SHBG increase for those on TRT that had more to do with being insulin resistant and obese which can suppress SHBG.

Whenever you change your T dosage, you are no longer stable and will lose erections temporarily until levels are stable again.