25 y/o male low T

[bambam92]

Again..... your doctor can rant and rave all he wants about getting you to a TT of 1100-1200 ng/dL but without knowing your SHBG what ones TT needs to be is pointless.

SHBG is critical and will dictate ones injection frequency and have a huge impact on the effectiveness of ones trt protocol.

Seeing as we have no idea where your SHBG sits if it turns out to be low/lowish.....than 200mg/week (100mg every 3.5 days) may very well be too high a dose as it will make your FT skyrocket let alone e2/free estradiol and that dose will have a big impact on elevating your hemoglobin/hematocrit.....sure one can easily donate blood to help control levels but it could turn out to be a balancing act as many end up crashing their ferritin/iron due to donating too frequently to try and control their hemo/hemato!

If it turns out you have high SHBG than 200mg/week may be needed in orde to obtain healthy FT numbers as men with high SHBG sometimes have to run TT levels well into the supra-physiological range to obtain a healthy FT.

As has been stated many times TT is good to know but it is not the end all be all as FT is what truly matters since it is the unbound active fraction of testosterone responsible for the positive effects.

If your doctor was on the ball he would be basing your protocol dose/injection frequency on your SHBG and seeing as it was not even tested you are just flying blind.

I understand you are still young and eager to start trt but is is not as simple as hitting 1000+ TT as there is so much more involved.

Of course treating symptoms is what truly matters as oppose to what ones numbers are but do understand that blood work is critical and used as guidance to see how said dose effects ones TT, FT, e2 and other hormonal makers let alone overall health markers in order to minimize side effects and keep the patient healthy long term.

Ok.. thanks for help. Would free test levels supersede SHBG? Correct me if I’m wrong but if ones total T is moderate/high and there free T is mediocre it can be safely assumed that there SHBG is high? As men get older I read their SHBG can increase which is why they may need to have higher total T as less of it is bioavailable since its irreversibly bound to SHBG.

Just not quite catching on with the obsession of SHBG. If total T is good and free T is good... you feel good... what is point of testing SHBG? You can’t directly alter it anyways. I’m going to get the test done for it cause you guys recommend it and are more knowledgeable than me. Please explain how my injections would be altered from 2x a week based on SHBG. I appreciate your input.

 

[bambam92]

Hey guys labs finally came in from quest. I highlighted maybe some stuff of particular interest. Includes total test, free test, male sensitive assay estradiol, LH, FSH. Unfortately couldn’t add SHBG cause it was too late.

Blood was taken at 9 am not 12 noon like lab indicates. So now have two tests of total test coming back in the 300’s. My LH was at lower range. But not out of value. My estradiol seems low.

I think a lot of my symptoms are from low estradiol actually such as horrible hot flashes, aches, and soreness. I think getting my E higher would make me feel better but can only do that by bumping my low T.

These labs were taken before I started HCG. So my options are continue HCG mono therapy at 3000 units a week (500 units 6x a week). Or doctor said I can do 100mg test cypionate... 50 mg twice a week. And also do 1500 units HCG (500 units 3x a week) to keep testis functioning.

I’m open to input from all. Thanks

 

[bambam92]

edit: Im gonna go in sometime later this week or next week and get my prolactin level tested to rule out a pituitary adenoma i.e. a prolactinoma which is the most common form of pituitary tumor by far. The lower LH I have in the presence of low test is a little odd considering I'm not on TRT and never have been. Apparently these tumors are usually benign but present in 5-10% of the population but usually go unnoticed. Most are simply treated with a dopamine agonist...no surgery required.

A pituitary tumor could cause that low LH in the presence of low test...unsure what the normal FSH means though as both are released from pituitary. Whatever easy test to get prolactin done and see if its way elevated than I got something going on in pituitary. If normal than I just have idiopathic reason...although my level isn't out of range it is way low.

Will try to tack on the SHBG at this lab

 

[fifty]

I read back through your thread and based on the labs you just posted I think all the prior comments are still pretty accurate.

I stand by my clomid comments and MarkM and MadMan's comments are very valuable. I would bet your SHBG is on the low side so please listen to what they're saying.