Trt not working, low SHBG

[brunoreus]

Hello, this is my first post in the forum. I hope i can get some help.
I was diagnosed with hypogonadism because I had the symptoms (erectile disfunction, low libido, low energy, fatigue, brain fog, anxiety) and also my Free T was 10pg/ml which is very low, especially for my age. Total T around 400. SHBG: 15 pre TRT
So about seven months ago I was prescribed testosterone enhantate and the doctor told me to take a 250mg injection every month, obviously didnt work, after 3 months and after I insisted he changed it to the same shot every 2 weeks. After like 2 months with that protocol still felt nothing and my free T numbers were the same (lower: from 10.8 to 10.2pg/ml), so I decided to take the matter in my own hands (he wouldnt prescribe more).
Bought some reliable testosterone (bodybuilder gave me the contact) and started injecting 200mg/week, still didnt feel much change, only like better erections (from 10% to 30% lets say) and more rigid arms, not even bigger but like if I was contracting them all the time and some more acne. But not the complete effects for sure and tested free T: the same.
So after doing research and finding about this low SHBG issue, hyper-excreter, etc, I started daily 15mg E Injections 12 days ago, still feel absolutely nothing.
How long should I wait to feel the effects of daily injections? What advise would you guys give me? Is there someone with low shbg who didnt respond to Trt and found a solution?
Im starting to get a little desperate cause after all the suffering of hypogonadism symptoms when I was prescribed finally testosterone thought it was over, and 7 months after, im feeling exactly the same.
Ps: I have also tried clomid, raised my LH and FSH like a 200% but didnt change testosterone or at least symptoms (didnt test T at that time)
Thank you

 

[jronly11]

I'm on daily subq 20 mg per day test-c after like 3 protocol fails. My shbg was 19 pre-trt and it dropped to about 10. I feel great besides anxiety i get from time to time. You just switched to dailys 12 days ago. Thats not even 2 weeks so you need to be patient and wait 6-8 weeks before making a judgment call. For me personally it took about 7 weeks before I started to feel good. Hang in there and see how you feel then.

 

[Cataceous]

Estradiol management can be tricky for guys with low SHBG. The problem is that free estradiol in particular can easily become relatively large compared to free testosterone. I don't know if this is your problem, but you should be measuring estradiol along with total testosterone and SHBG. Then you can at least estimate the free hormone levels with various calculators.

Did you ever have more comprehensive testing, including thyroid hormones (free T3, free T4, reverse T3) and vitamin D status? There are some overlapping symptoms between hypogonadism and hypothyroidism.

 

[brunoreus]

I'm on daily subq 20 mg per day test-c after like 3 protocol fails. My shbg was 19 pre-trt and it dropped to about 10. I feel great besides anxiety i get from time to time. You just switched to dailys 12 days ago. Thats not even 2 weeks so you need to be patient and wait 6-8 weeks before making a judgment call. For me personally it took about 7 weeks before I started to feel good. Hang in there and see how you feel then.

Couple questions, before getting your right protocol what did you feel from TRT? Absolutely nothing? What protocols did you fail with? What were your symptoms pre TRT? Do you recommend me subq, im doing IM now? Do you recommend me 20 instead of 15mg? Sorry for all the questions and thank you!

 

[brunoreus]

Estradiol management can be tricky for guys with low SHBG. The problem is that free estradiol in particular can easily become relatively large compared to free testosterone. I don't know if this is your problem, but you should be measuring estradiol along with total testosterone and SHBG. Then you can at least estimate the free hormone levels with various calculators.

Did you ever have more comprehensive testing, including thyroid hormones (free T3, free T4, reverse T3) and vitamin D status? There are some overlapping symptoms between hypogonadism and hypothyroidism.

I have E2 in 33.8 pg/ml but is Roche testing. Free T is 10 pg/ml so I agree the ratio is bad. What do you suggest me for managing estradiol? Or only raising free T would be enough?
On the other hand, thyroid panel was tested and values were in range.
Thank you

 

[Cataceous]

The immunoassay estradiol test is actually more reliable, but it should be calibrated against the sensitive mass spectrometry test at least once to see if it's giving falsely-elevated results.

Some guys use anastrozole for estradiol management, but this should only be considered if it's pretty clear estradiol is the problem and there are no good alternatives. Raising testosterone will typically not have much effect on the ratio of free testosterone to free estradiol.

 

[jronly11]

Couple questions, before getting your right protocol what did you feel from TRT? Absolutely nothing? What protocols did you fail with? What were your symptoms pre TRT? Do you recommend me subq, im doing IM now? Do you recommend me 20 instead of 15mg? Sorry for all the questions and thank you!

I've only ever done subq in the belly so I cant say much about IM. Stay at 15mg since you already 2 weeks in and then gauge how you feel at 6-8 weeks with labs.
My first protocol was 50 mg test-cyp 3 times a week (mon, weds, fri) with 500 iu of HCG along with it. After 8 weeks I noticed I didnt feel much of anything mood wise. A little more energy and libido the same. I felt like heat waves in my head. I didn't do labs for this after 8 weeks. Just didn't feel good so I changed it.

Next protocol was 40mgs eod subq. This was alot better. Mood was good and libido went up but still inconsistent due to my e2 being at 60! I was prescribed anastrozole but never took it so instead my doc just lowered my t dose to 34mgs eod. This protocol was better and I stayed with it for 6 months. With this protocol I experienced body composition changes, great libido (almost too much) but inconsistent mood and energy. Some days I felt great other days not so much.

I kept on reading about an ED protocol and bit the bullet. Best protocol by far for me but the anxiety is becoming a problem. I pin 500iu hcg mondays and fridays with this ed protocol. I'm going to take labs soon and go from there. Might need to lower my dose a bit.

 

[jronly11]

Sorry forgot to mention. Pre-trt symptoms were depression, anxiety, and constant fatigue. My sex drive has always been decent. Been on trt now 1 year

 

[brunoreus]

I've only ever done subq in the belly so I cant say much about IM. Stay at 15mg since you already 2 weeks in and then gauge how you feel at 6-8 weeks with labs.
My first protocol was 50 mg test-cyp 3 times a week (mon, weds, fri) with 500 iu of HCG along with it. After 8 weeks I noticed I didnt feel much of anything mood wise. A little more energy and libido the same. I felt like heat waves in my head. I didn't do labs for this after 8 weeks. Just didn't feel good so I changed it.

Next protocol was 40mgs eod subq. This was alot better. Mood was good and libido went up but still inconsistent due to my e2 being at 60! I was prescribed anastrozole but never took it so instead my doc just lowered my t dose to 36mgs eod. This protocol was better and I stayed with it for 6 months. With this protocol I experienced body composition changes, great libido (almost too much) but inconsistent mood and energy. Some days I felt great other days not so much.

I kept on reading about an ED protocol and bit the bullet. Best protocol by far for me but the anxiety is becoming a problem. I pin 500iu hcg mondays and fridays with this ed protocol. I'm going to take labs soon and go from there. Might need to lower my dose a bit.

Ok I understand, the thing is with my failed protocols is not that I felt bad, I felt nothing, like injecting water. Still very bad erections, low libido, anxiety, etc. Im hoping that this new protocol helps.

another couple questions: With the eod day protocol how long did it take to feel the effects? Why do you use the HCG for? Do you think it would be worth it change to subq?
Thank you,

 

[jronly11]

I use HCG for fertility and to keep my balls from shrinking. It took about 7-8 weeks before I felt good on the EOD.

 

[jronly11]

Yes I prefer subq out of convenience and it could work for you. 29g 1/2" right in the belly. Remember you went from a once a week injection straight to everyday. Your body needs time so don't get discouraged. Id say wait 8 weeks

 

[SilverSurfer]

What did your thyroid panel look like?

 

[Systemlord]

So after doing research and finding about this low SHBG issue, hyper-excreter, etc, I started daily 15mg E Injections 12 days ago, still feel absolutely nothing.
How long should I wait to feel the effects of daily injections?

It's going to take 6 weeks for the half-lives to build up in your system after each dosing change. When you change protocols levels will be in flux for several weeks before finally becoming stable and this is when you should start feeling something.

I have low SHBG (13) and inject 7mg daily and respond very quickly, in fact I feel something minutes after each injection. My case isn't typical and some guys just take longer to feel the effects of androgens. It's the same way with all medications, I can't take a normal dose of anything without over-responding.

On the other hand, thyroid panel was tested and values were in range.

If your Free T3 is low but in range, that would be a reason for being a non-TRT responder. If your cortisol is low you can't even get thyroid hormones into cells and TRT will not work either.

If you truly want to get good advice, you will post all labs including reference ranges.

 

[brunoreus]

I use HCG for fertility and to keep my balls from shrinking. It took about 7-8 weeks before I felt good on the EOD.

Whats your complete protocol if i can ask? 20mg subq daily and what more?

 

[brunoreus]

Yes I prefer subq out of convenience and it could work for you. 29g 1/2" right in the belly. Remember you went from a once a week injection straight to everyday. Your body needs time so don't get discouraged. Id say wait 8 weeks

Ok I may try subq. Yes the thing is everyone says to feel the effects 2 or 3 weeks into trt, but maybe for these daily inj protocols its different, will keep going?

 

[brunoreus]

It's going to take 6 weeks for the half-lives to build up in your system after each dosing change. When you change protocols levels will be in flux for several weeks before finally becoming stable and this is when you should start feeling something.

I have low SHBG (13) and inject 7mg daily and respond very quickly, in fact I feel something minutes after each injection. My case isn't typical and some guys just take longer to feel the effects of androgens. It's the same way with all medications, I can't take a normal dose of anything without over-responding.


If your Free T3 is low but in range, that would be a reason for being a non-TRT responder. If your cortisol is low you can't even get thyroid hormones into cells and TRT will not work either.

If you truly want to get good advice, you will post all labs including reference ranges.

Would you recommend me switching from E to C? 12 days into daily.
Thyroid panel:
Free T3: 2.68pg/ml (1.88-3.18)
Free T4: 1.08ng/dl (0.70-1.48)
TSH I dont have it here but it was inside lab range.

 

[Systemlord]

Would you recommend me switching from E to C?

I have found the cypionate to create more fluid retention and I even need more diuretic to counter the fluid retention (veins), on enanthate so far I need none. There are some that would balk at my next statement but I feel as I cannot waver because my experience which is repeatable and undeniable, the cypionate has more potency and the enanthate is like tea that is watered down and I believe this is why I don't have fluid retention on enanthate.

I have noticed a massive difference in the way I feel on the two difference compounds. You probably won't notice a difference, but every now and again someone mentions a similar experience to these compounds and we are told it's in our heads.

We are just outliers. I have also noticed I need 3x more T on the enanthate versus cypionate if on anything other than a daily protocol. I recently attempted 20mg cypionate EOD (2 injections) and then 60mg enanthate (on third) and still didn't get the same effect as the 20 cypionate.

I have no idea why.

Those aren't terrible thyroid numbers, what about Reverse T3?

 

[jronly11]

Whats your complete protocol if i can ask? 20mg subq daily and what more?

Test cyp 20mg subq daily
HCG 500iu mondays and fridays

Ok I may try subq. Yes the thing is everyone says to feel the effects 2 or 3 weeks into trt, but maybe for these daily inj protocols its different, will keep going?

Yes I also feel effects 2-3 weeks into any protocol change but they are usually negative. Fatigue, a little depression, and up and down energy. Things start to go positively for me around week 5-6. I hate changing my protocol and the last time I did was the most brutal which was EOD to ED. I was massively depressed around week 3. Felt like a zombie.

 

[jronly11]

Btw if you dont feel anything on enanthate this whole time and if after hitting 7-8 weeks on this protocol and still nothing, then you might have to reconsider whether you have legitimate T enanthate.

 

[brunoreus]

I have found the cypionate to create more fluid retention and I even need more diuretic to counter the fluid retention (veins), on enanthate so far I need none. There are some that would balk at my next statement but I feel as I cannot waver because my experience which is repeatable and undeniable, the cypionate has more potency and the enanthate is like tea that is watered down and I believe this is why I don't have fluid retention on enanthate.

I have noticed a massive difference in the way I feel on the two difference compounds. You probably won't notice a difference, but every now and again someone mentions a similar experience to these compounds and we are told it's in our heads.

We are just outliers. I have also noticed I need 3x more T on the enanthate versus cypionate if on anything other than a daily protocol. I recently attempted 20mg cypionate EOD (2 injections) and then 60mg enanthate (on third) and still didn't get the same effect as the 20 cypionate.

I have no idea why.

Those aren't terrible thyroid numbers, what about Reverse T3?

Ok, now I dont know if I should change from IM to subq, and also from E to C hahaha.
Today was mas 13th day into daily IM 15mg ENantste injections.