TRT has been underwhelming for 4+ years - Low SHBG

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Defy Medical TRT clinic doctor
Hi Ero. Sad to hear that TRT has not helped you. Reading your story I think I can help you. These are the things I read in your story:

-no libido
-no muscle building ability despite working out regurarly
-fatigue
-stubborn fat

Looking at your labs and the symptoms you described, I think you suffer from too LOW estrogen.
Estrogen and thyroid hormone are very important in increasing SHBG. Low estrogen/thyroid hormones causes stubborn fat.

How can women, who have much lower testosterone levels than men, build muscle? It just shows that high testosterone levels are not needed to build muscle. Sure having higher testosterone levels should make it easier to build muscle. Higher testosterone is usually also high estrogen.

I would stop using T gel on the testicles because that causes too much DHT which opposes/inhibits E2. I also don't think taking testosterone is helping you in any way. I feel it's worsening you by having more testosterone and DHT which both antagonise estradiol somewhat. Perhaps that is why you felt better before you were taking TRT.

Better is a trial of high dose HCG(1000-1500iu) once or twice(500-750iu) weekly for 3 months. This will increase the E2 to test and DHT ratio.

The second thing I would focus on is your thyroid hormone levels. You might be thyroid hormone resistant to a certain degree. Good levels of test, e2 and dht without sufficient thryoid hormone will not work.

Increasing e2 and thyroid hormone should increase your SHBG. I have read the stories of a few people that have high energy and libido while having low SHBG. I think one of them was someone going by the name xks201 on the alltingsmale forum. Yes I just looked and this is what I found:

''My SHBG was 55. It is now 7. Results are much more energy and libido.''

''My SHBG is 7 and all I want to do is have fun practically. At an SHBG of 55 I couldn't even get it up.''

I think the problem is not low SHBG, but what is causing the low SHBG. Low E2 and or low thyroid hormone or receptors not being sensitive enough to these hormones.

Did you ever take the ultrasensitive e2 test? If so, what was the result? Could you post your latest blood results?

Hope this helps you somewhat.


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 better when I had low T than it has even been since. Tri-mix works, but with my low libido I don't really care much about having sex. No appreciable muscle gain or fat loss either after 4 year of solid hard work. No issues with Prolactin, thyroid or E2, no blood pressure meds, no anti-depressants, not diabetic or pre-diabetic, not hugely overweight, no sleep issues - bottom line, TRT really doesn't do much for me even though I keep hoping for some sort of break-through for low SHBG guys.

I have seen posts where the question is asked - "Why do guys on TRT want to get off?" Well, if you are like me and you dont feel much of anything from it, and it costs you a ton of money for blood work, doctors, Test, HCG, etc...I know that at 50 my natural T levels are gonna be low, so I will probably stay on, but it sure is a lot of cost and effort for damn little reward for some of us.
 
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